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The use of ultrasound in obstetrics nowadays is an integral part of prenatal care. As a non-invasive method it has a wide application for the detection of abnormalities. During the course of pregnancy the foetus may be exposed to ultrasound waves often several times. Presently it is not clear whether this has a negative effect on the health and development of children. A systematic review of scientific literature on possible harmful effects on child development of ultrasound investigation during pregnancy. Databases of scientific literature were screened through for publications dealing with the use of ultrasound on the development of children. Studies were included if they had been published since 1990. Sixteen studies were included in this review -- 13 randomised controlled trials, one cohort study, and two case-control studies. This included three for speech development, two for vision and hearing, one for school performance, three for handedness, and seven for birthweight and growth. All studies demonstrated that ultrasound examinations during pregnancy increased the risk of undesirable developmental outcomes. On average, the magnitude of such effects was minimal. However, most of the studies have some methodological defects, in particular, outcome measurements, overlooking possible bias and confounding factors, and statistical insufficiencies. It is concluded that there is no adverse effect of ultrasound examinations during pregnancy on child development outcomes. [ABSTRACT FROM AUTHOR]

Object The purpose of this study was to gain knowledge of tuberculosis infection in HIV/AIDS-infected patients, the purpose of this study was to investigate an association between tuberculosis infection and mortality in HIV/AIDS-infected patients. Methods A prospective, hospital-based cohort study was conducted in HIV/AIDS patients registered in hospitals between January 1993 and April 2010. In total, 52,459 patients with HIV/AIDS infection were routinely observed and followed up, covering 14 provinces in southern region of Thailand. Results The main results found that one-third of the HIV/AIDS patients were infected with Mycobacterium tuberculosis (27.94%) during the follow-up period. However, the risk of Mycobacterium tuberculosis infection was not statistically significant in terms of association with mortality among HIV/AIDS patients (HR: 1.01; 95% CI: 0.96 to 1.05). In contrary, HIV/AIDS patients with pulmonary tuberculosis were more likely to have a longer life by about 19% (HR: 0.81, 95% CI: 0.73 to 0.91). As well, HIV/AIDS patients with extrapulmonary tuberculosis were more likely to have a longer life by about 31% (HR: 0.69; 95% CI: 0.57 to 0.83). Conclusion In conclusion, tuberculosis infection was associated with mortality among HIV/AIDS patients. Early treatment of tuberculosis is needed for HIV/AIDS patients, in order to decrease morbidity and mortality among HIV/AIDS patients with tuberculosis. [ABSTRACT FROM AUTHOR]

Opisthorchis viverrini (OV) infection, which can progress to cholangiocarcinoma (CCA), poses a critical public health challenge. While numerous studies have investigated behavior modification programs aimed at preventing OV and CCA, the effectiveness of these interventions remains inconclusive. This systematic review and meta-analysis sought to synthesize evidence on the efficacy of behavior modification programs, particularly those based on self-efficacy, in preventing OV and CCA. We reviewed experimental and quasi-experimental studies, comprising 2-group comparisons or 1-group pretest-posttest designs, that evaluated health education interventions focused on behavior modification for OV and CCA prevention. Relevant literatures was systematically retrieved from the PubMed, Google Scholar, ThaiJo, and ThaiLis databases. Of 702 identified studies, 13 met the systematic review and meta-analysis inclusion criteria. The analysis assessed the quality of the studies, extracted data, and evaluated the risk of bias. Standardized mean differences were calculated to determine the impact of self-efficacy- based programs on knowledge, self-efficacy, and behavior modification. The results indicated significant post-intervention improvements in all outcomes (P<0.001) despite high heterogeneity in knowledge (I²=76%), self-efficacy (I²=77%), and behavior modification (I²=93%). The experimental group demonstrated significantly more significant improvements in knowledge (mean difference=1.52, 95% confidence interval (CI)=1.36-1.68), self-efficacy (mean difference=1.08, 95% CI=0.90-1.26), and behavior modification (mean difference=1.78, 95% CI=1.63-1.92) compared to the comparison group, with I² values of 74%, 84%, and 92%, respectively. In conclusion, health education programs grounded in self-efficacy principles effectively enhance knowledge, selfefficacy, and behavior modification to prevent OV and CCA. These findings suggest that self-efficacy-based behavior modification programs may also apply to the prevention of other diseases.

Background: Lung cancer is a leading cause of global morbidity and mortality, severely affecting patients' quality of life (QoL). Understanding the factors associated with QoL in these patients is crucial for improving treatment and care. This study aimed to assess QoL among lung cancer patients and identify the factors influencing it., Methods: This cross-sectional analytic study included 130 patients diagnosed with lung cancer at a tertiary facility in Northeastern Thailand. QoL was evaluated using the FACT-L interview, covering subscales such as physical, social/family, emotional, and functional well-being, as well as a lung cancer subscale, and the FACT-L Trial Outcome Index (TOI) and FACT-G. Descriptive statistics and multiple logistic regression were used for data analysis., Results: The majority of subjects had low overall QoL (52.31%; Mean ± SD: 45.24 ± 11.33), low FACT-L TOI (83.08%; 21.05 ± 9.21), and low FACT-G (57.69%; 35.72 ± 8.70). Subscale analysis revealed low levels of physical well-being (85.38%; 6.56 ± 3.54), emotional well-being (85.38%; 6.15 ± 3.67), and functional well-being (96.15%; 4.97 ± 3.82). However, about half of the subjects reported moderate social/family well-being (50.77%; 18.04 ± 4.17) and lung cancer subscale scores (56.15%; 9.51 ± 4.31). Multivariate analysis identified factors significantly associated with higher QoL, including age (AOR = 1.05, 95% CI: 1.01-1.10), absence of comorbidities (AOR = 3.95, 95% CI: 1.60-9.74), and absence of lymph node invasion (AOR = 4.42, 95% CI: 1.26-15.56). Conversely, sleep problems (AOR = 0.26, 95% CI: 0.08-0.81), local metastasis (AOR = 0.25, 95% CI: 0.09-0.72), and undergoing radiotherapy (AOR = 0.25, 95% CI: 0.07-0.98) were associated with lower QoL., Conclusions: These findings suggest that lung cancer patients with sleep problems, local metastasis, or undergoing radiotherapy should receive intensive palliative care to improve their QoL during the end of life stage.

Objective: Opisthorchis viverrini and cholangiocarcinoma have been recognised by the World Health Organisation as critical public health concerns, particularly in northeastern Thailand, where Opisthorchis viverrini is a significant cause of cholangiocarcinoma. This study examines the factors influencing Opisthorchis viverrini and cholangiocarcinoma prevention within the One Health framework in Kanthararom District, Sisaket Province, Thailand., Methods: A cross-sectional study was conducted among 327 residents aged 20 and above, utilising a structured questionnaire to assess knowledge, attitudes, perceived self-efficacy and prevention behaviours. Data were analysed using descriptive statistics, Pearson's product-moment correlation coefficient and multiple regression analysis to identify relationships and predictors within the dataset., Results: The results showed that 53.52% of participants had moderate knowledge and attitudes towards prevention, while perceived self-efficacy was generally high. Positive correlations were found between income, knowledge, attitudes, self-efficacy and prevention behaviours. Key predictors of Opisthorchis viverrini and cholangiocarcinoma prevention behaviours included attitudes towards human health (β = 0.212), perceived self-efficacy in human health (β = 0.211), attitudes towards animal health (β = 0.205) and knowledge about human health (β = 0.138), accounting for 24.40% of the variance in prevention behaviours. These predictors were statistically significant at 0.05 (F = 25.95; p <0.001)., Conclusion: The findings suggest that enhancing knowledge, attitudes and self-efficacy is crucial to improving Opisthorchis viverrini and cholangiocarcinoma prevention. This study underscores the need for integrated public health strategies incorporating human, animal and environmental health to reduce the prevalence of Opisthorchis viverrini and cholangiocarcinoma in high-risk regions., (© 2024 John Wiley & Sons Ltd.)

Objective: This study aimed to determine the proportion of fruit and vegetable (FV) consumption in regions of Thailand with the highest risk for cholangiocarcinoma (CCA)., Methods: A multi-stage sampling method was employed to recruit participants. One sub-district per district was selected using random sampling. Simple random sampling was used to select individuals based on age range and sex, resulting in a final sample size of 744 participants. Data were collected using a structured questionnaire. FV consumption was assessed through a 24-hour recall interview, recording the types and quantities consumed in three meals. Consumption proportions were calculated by comparing the amounts of each FV consumed. Household consumption units were converted to grams. Descriptive statistics, including number, percentage, mean, and standard deviation, were calculated. The total amount of FV consumed across all meals was compared to the recommended daily intake of ≥400 grams. The prevalence rate of FV consumption was also calculated.  Results: The prevalence rate of FV consumption in Ubon Ratchathani, Thailand, was 11.30 per 100,000 people. The highest frequency of FV consumption was 1-3 days/week, reported by 66.93% of participants. Most respondents (61.43%) exhibited excellent knowledge regarding FV consumption. Similarly, the mean score for attitude regarding the health benefits of FV consumption was 3.10±0.18., Conclusion: This study highlights insufficient FV consumption, associated with the high incidence of CCA, in the studied region. To mitigate the risk of CCA, relevant organizations should implement campaigns to raise awareness about the importance of FV consumption through social media communication and other channels.

Background: Health literacy is crucial in managing health outcomes, including overweight, which is a significant issue among late adolescents. Despite the importance of health literacy in weight management, research focusing on this population remains limited., Objective: This study aimed to investigate the factors influencing health literacy in overweight management among late adolescents in Thailand., Methods: A cross-sectional study was conducted with late adolescents from five higher education institutions in Ubon Ratchathani Province, Thailand. A total of 403 participants were selected through multistage random sampling. Self-report questionnaires, validated for reliability and accuracy, were used to collect data from March to May 2023. Multiple regression analysis was employed, with a significance level set at 0.05., Results: The sample consisted predominantly of females (91.10%) with an average age of 20-21 years (54.30%). The prevalence of overweight/obesity among participants was 25.06%. Four factors were significantly associated with health literacy in overweight management: access to health and weight control resources ( r = 0.368, p <0.001), access to online social learning resources ( r = 0.321, p <0.001), access to books, journals, and websites ( r = 0.340, p <0.001), and management of weight control behaviors ( r = 0.145, p <0.001). These factors together accounted for 20% of the variance in health literacy ( R 2 = 0.200)., Conclusion: The study identified key factors that enhance health literacy in overweight management among late adolescents in Thailand. It is recommended that nurses and other healthcare professionals develop targeted interventions focusing on these factors to effectively manage overweight in this population., Competing Interests: The authors declare no potential conflict of interest in this study., (© The Author(s) 2024.)

Background: Due to the dramatic rise in overweight and obesity, adolescent weight management interventions are required. Therefore, this study aimed to study the components and the effect size of weight control programs for adolescents with overweight and obese., Materials and Methods: Following the PRISMA 2020 guidelines, we systematically searched electronic databases (PubMed, Google Scholar, ThaiJo, ThaiLis, and Embase) through December 2021 published in English and Thai, samples aged 15-22 years, and presenting the mean, SD a sample size of both experimental and control groups. However, we excluded articles other than full-text articles. In addition, a risk of bias assessment was performed according to the Cochrane Collaboration's quality assessment tool. Finally, this meta-analysis included six studies that met the criteria. The meta-analysis used a fixed-effects model with a forest plot to compute effect sizes and Cochran's Q and I 2 statistics as measures of heterogeneity., Results: We found six primary studies which included 721 overweight adolescents. The analysis of the effectiveness of weight control programs for overweight adolescents revealed that 360 adolescents with overweight and obese (49.93%) who underwent the weight control programs changed body weight and body mass index values with the effect size of -0.80 (-1.03, -0.56) and I 2 was 56.00%., Conclusions: The results indicate further studies should focus on constructing programs that consider adolescents' changes in technology and lifestyles. Additionally, social and mobile tools should motivate and educate adolescents about body weight control to help them adapt to a healthy lifestyle and maintain weight control over time., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

Cholangiocarcinoma (CCA), caused mainly by Opisthorchis viverrini (OV) infection, is a public health issue. Health literacy can play a significant role in preventing OV and CCA and adopting preventive behaviors. Therefore, this study aimed to evaluate, summarize, and synthesize the current evidence on health literacy programs for preventing OV and CCA.A systematic literature search, with Thai and English languages, was performed using electronic databases through PubMed, Google Scholar, ThaiJo, ThaiLis, and Embase to identify studies examining health literacy programs to prevent OV and CCA. We followed PRISMA 2020 guidelines. In addition, we used the RevMan software to perform a meta-analysis to analyze effect sizes using a fixed-effects model and measures of heterogeneity using Cochran's Q and I 2 . This meta-analysis included seven studies that met the criteria. The results showed that the people who received a program had an increased health literacy overall and in each aspect with a statistically significant (p < 0.001). So, health literacy programs can assist people in understanding their health and gaining access to health information and services. Additionally, the effect of programs (communication abilities, self-management, media and information literacy, and decision-making in practice) can help prevent OV and CCA. As a result, multi-disciplinary healthcare teams are crucial to developing preventive programs to prevent OV and CCA. Further studies need to be done and applied to these programs to modify behavior to avoid other diseases., (© 2023. The Author(s) under exclusive licence to American Association for Cancer Education.)

Background: Globally and in Thailand, the incidence of colorectal cancer (CRC) is third-ranked behind lung and breast cancer, respectively. This hospital-based retrospective cohort study aimed to determine factors associated with mortality among patients with CRC., Methods: This study was performed by using the secondary data of the cancer registry among patients with CRC registered in Phatthalung Hospital. Two hundred twenty-eight patients with CRC were diagnosed and followed up from January 2014 to December 2018. Multiple logistic regression analysis was used to analyze factors associated with mortality among subjects with CRC., Results: The results revealed that the proportion of mortality among subjects with CRC was 50.44% (115 cases) at six months of following up. Subjects who had an increasing age every ten years (adjusted odds ratio [OR adj ] = 1.40, 95 percent confidence interval [95% CI]: 1.09-1.80) were diagnosed with CRC at stage 3 (2.64, 1.19-5.84) and at stage 4 (11.63, 2.69-50.15) more likely to die. Also, subjects who received a combination of chemotherapy and radiotherapy treatment (3.44, 1.20-9.85), combination treatment of surgery, and postoperative care (2.46, 1.22-4.94) were more likely to die. Subjects who had not had surgery treatment were more likely to die (35.00, 7.44-168.27)., Conclusions: In conclusion, factors such as the age of patients, stage of CRC, and treatment were associated with mortality among patients with CRC. Hence, medical and health professionals should consider these factors according to the treatment and optimization in patients with CRC., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 International Journal of Preventive Medicine.)

Background: Dancing is a type of physical activity that has been associated with physical benefits in older adults. Regular dancing can help maintain physical function and improve the quality of life in this population. This review evaluated randomized control trials (RCTs) of the effectiveness of dance programs on the physical function of healthy older adults., Methods: We systematically searched four databases (PubMed, Google Scholar, Embase, and ThaiLis) through December 2021 for primary studies evaluating dance programs in healthy older adults aged 60 years and over. The meta-analysis used a random-effects model to compute the effect sizes using a forest plot and Cochran's Q and I2 statistics as heterogeneity measures., Results: Eight types of dance programs showed significantly improved physical function. Muscle strength was assessed using the five times sit-to-stand test (I2=89%; p=0.003), chair-sit-to-stand-30S test (I2=75%; p=0.006), and 30-s arm curl test (I2=22%; p=0.260). Static balance was evaluated using the Berg-balance scales test (I2=0%; p=0.620) and the one-leg-stand test (I2=32%; p=0.220). Dynamic balance was tested based on the time up-and-go and eight-foot up-and-go tests (I2=51%; p=0.110). Flexibility was assessed based on the back-scratch (I2=56%; p=0.130) and sit-and-reach test (I2=0%; p=0.930)., Conclusion: Dance exercise programs improved muscle strength, balance, and flexibility. Such programs are effective and safe for healthy older adults for use as daily exercise to promote health. Therefore, researchers, healthcare providers, and policymakers should establish properly organized dance interventions to improve physical function in healthy older adults.

Although Opisthorchis viverrini (OV), lifestyle, and diet co-factors have a relatively high prevalence in the Greater Mekong Subregion (GMS) population, cumulative (0-74) incidence rates of cholangiocarcinoma (CCA) do not reach 5% in this region. Other co-factors must influence, but in this study, we only highlighted positive factors for guiding joint planning to address public health problems at the regional level. Therefore, we aimed to study prevalence and factors associated with CCA incidence focusing only on protective factors. A cross-sectional analytic study was carried out from June to October 2017. Participants with informed consent completed the questionnaires. Descriptive statistics were used to analyze general information. Primary variables were classified into high and low levels by mean. Logistic regression was employed to investigate the correlation between interesting variables and the overall risk level of CCA. The overall prevalence of CCA protective factors of the whole region was knowledge (61.39%), health beliefs (42.32%), prevention behavior (31.93%), and community participation (14.53%). When considering the proportions at a high level, they were 49.53%, 53.72%, 35.37%, and 49.67%, respectively. Significant factors associated with CCA prevention were females with secondary or vocational education, a high level of perceived seriousness and benefits, and community participation. These findings are likely to be helpful for both the public and administrators. First, it can be information for people to be aware of CCA risk. Second, policy-driven authorities at the local or regional level should apply the critical issues from this study for joint planning to sustainably solve regional public health problems., Competing Interests: The authors have declared that no competing interests exist.

Introduction/objective: To examine the effects of applying social marketing and Health Belief Model (HBM) in preventing cholangiocarcinoma (CCA) in high-risk areas of Thailand., Methods: About 2 randomized high-risk areas of CCA from multiple-stage sampling were assigned as study areas. The 150 participants were allocated to the experimental group, which received a 12-week health education program that applied social marketing and HBM. The comparison group received the usual services. Data were collected by a questionnaire created by the researchers. We employed descriptive, inferential statistics (paired t -test and independent t -test) for normal distribution, while Analysis of Covariance (ANCOVA) was used for mean scores differing before the experiment., Results: After the experiment, the mean scores of the perceived risk of CCA, perceived severity of CCA, perceived benefits of CCA prevention, perceived barriers to CCA prevention, and correct behaviors of CCA prevention in the experimental group were significantly higher than those before the experiment the .05 level. They were also considerably higher than those of the comparison group at the .05 level., Conclusion: This is the first study to integrate social marketing and HBM for CCA prevention. Therefore, formulating policies or measures to prevent disease through public communication will form a model to avoid CCA and create a channel for distributing useful information to the general public.

Thailand and Laos were classified as risk areas for cholangiocarcinoma (CCA) in a 2017 assessment in the Greater Mekong Subregion. In 2019, the potential of village health volunteers (VHVs) in both risk areas was developed. The VHVs trained in 2014 (VHV-A) were mentors transferring knowledge of CCA prevention to the trainees (known as VHV-B) in a parallel manner. After that, VHV-Bs in each area educated people to change their behavior. Both parties worked in the same direction to reduce risk factors. In 2020, data were collected after the program was organized in the same populations. The people were aged 30-69 years, whose names were in the civil registration, and had lived in that area for at least five years. Afterward, no less than 172 participants from each location were randomly selected. The research tools used were intervention and questionnaires. Descriptive and inferential statistics were employed for data analysis. After the experiment, all the experimental group's risk factors were significantly different from those of the control group. This study's outcome was an effective program for proactive action in reducing risk factors in the risk areas. Therefore, it should be applied to reduce risk factors for CCA in other regions.

Cholangiocarcinoma (CCA) still affects the health of rural people in northeast Thailand. Most people had a high level of overall risk according to CCA risk assessment in 2014. The question is how to make prevention of CCA as cost-effective as possible. The most appropriate answer is that someone should become a health leader to transfer knowledge to the public. This is the reason for developing the training program for village health volunteers (VHVs)-who play the role of change agents-to transfer knowledge to villagers. As for the evaluation of success, it is not evaluated if VHVs have increased knowledge or not, but it is assessed if people have better knowledge/attitudes, which lead to the correct behavior modification or not. After the program had been implemented for 2 years, people were evaluated on knowledge, attitudes, perception, and satisfaction with the operation of VHVs in providing people with the knowledge and ability to prevent CCA. It was found that people had a higher level of knowledge and attitudes in preventing CCA than before implementing the program. Also, they perceived that VHVs transferred knowledge to villagers so that they had the ability to prevent CCA. Nowadays, VHVs in the digital era (VHVs 4.0) is very useful in solving CCA problems in Thailand because they are the main drivers of success. Potential development of VHVs together with use of digital technology is an advantage for high-risk area with limited public health personnel., (© 2020. American Association for Cancer Education.)

Objective: This research aimed to study the effects of the risk communication program through the Cambodian folk song to prevent Opisthorchiasis-linked cholangiocarcinoma (OV-CCA)., Methods: We conducted the quasi-experimental research between August and December 2017 in the Cambodian communities, one-fourth of ethnic minorities residing in multicultural areas of Sisaket Province, Thailand. The samples consisted of 94 equally people divided into experimental group and control group. The experimental group included 47 people at-risk of OV-CCA who received the program for 12 weeks, while the control group received regular services. We collected data by using a questionnaire with a reliability of 0.93. Descriptive and inferential statistics were used for data analysis., Results: The study indicated that the socioeconomic information of both groups was not different. The mean scores of all issues (health beliefs, social support, and prevention behavior in the experimental group were higher than those of the control group with statistical significance. Closer inspection showed that the mean difference of the health beliefs was 55.61 points (95%CI: 52.39-57.42, p<0.001), social support was 9.09 points (95%CI: 8.12-10.05, p<0.001), and prevention behavior was 6.38 points (95%CI: 5.43-7.33, p<0.001)., Conclusion: Through the Cambodian folk song, the risk communication program by applying the health beliefs and social support to prevent OV-CCA is beneficial for behavior modification in areas with similar cultures.

Objective: To study the effectiveness of public health interventions in preventing Opisthorchis viverrini (OV) re-infection in high-prevalence areas of Thailand., Methods: 68 people from Sisaket, the province with the second-highest prevalence in Thailand, who tested positive for OV eggs in faeces and took praziquantel before the start of the study, participated. 34 participants were allocated to the experimental group, which received a 12-week public health intervention based on the self-efficacy theory and group process between July and October 2018. The control group received the usual services. Data were collected using a questionnaire with a reliability of 0.84. Faecal examinations using the formalin-ether concentration technique were conducted before and after the experiment. The re-infection rate was analysed after the experimental 12 weeks and after one year. Descriptive and inferential statistics, including paired t-test and independent t-test, were employed for data analysis., Results: After the experiment, the mean scores of knowledge, perceived self-efficacy, self-efficacy expectation and OV prevention behaviour of the experimental group were significantly higher than before the experiment and also higher than scores of the control group (P < 0.05)., Conclusion: The public health intervention is useful. It educated the experimental group about OV, perceived self-efficacy and self-efficacy expectation in changing behaviour to prevent OV re-infection. As a result, no re-infections were observed after the 12-week intervention nor at the one-year follow-up. Public health benefits will be evident if the results are extended to other high-prevalence areas., (© 2021 John Wiley & Sons Ltd.)

Opisthorchiasis and cholangiocarcinoma (CCA) are major public health problems in Northeast Thailand, especially in Ubon Ratchathani, which are the alluvial plains. Those with poor food habits are mostly at risk of having diseases. This study was a participatory action research (PAR) aimed to define the models/plans for CCA prevention. The samples consisted of 40 community representatives. The data were collected by the PAR method. Qualitative data were analyzed by content analysis. The samples coordinately analyzed and prioritized the problems and presented information to the community. The plans consisted of (1) cultivating the right values and behaviors of eating food safe from CCA in children, (2) supervising the shops not to sell foods that are the main risk factors for CCA, (3) supporting the community leaders to act as good role models to the people, (4) assigning every housewife to cook clean and safe food from CCA, and (5) encouraging the villagers to have knowledge and awareness, which can protect them from CCA. After the community designed these plans, responsible persons were assigned to implement them. Two years later, researchers evaluated the outcome. The average scores on knowledge and attitude toward CCA were significantly higher than before implementation. For the impact of projects, prevalence of opisthorchiasis in 2016 was significantly lower than that in 2014. CCA prevention by community participation employed a combination of quantitative and qualitative studies. This study has been successful and sustainable since the community has human resources, budget, and appropriate management of the project.

Opisthorchiasis-associated cholangiocarcinoma (OV-CCA) is a major public health problem in Greater Mekong Subregion (GMS) Countries, the poorest region in Asia. People in this region have similar traditions or respect the same religion. There is no difference in lifestyle and food culture. Excluding Thailand, publications on risk factors for OV-CCA from the GMS Countries are few, especially data on behavioral risk factors for OV-CCA. Therefore, this study aimed to assess the behavior-related risk factors and to compare the risk of OV-CCA among rural people living along the Mekong River in five GMS countries. It was a cross-sectional analytic study during June and October 2017. All participants with informed consent completed the questionnaires. Descriptive statistics were used to describe the prevalence of risk factors. Odds ratio with 95% confidence intervals were used to compare the risk of OV-CCA. It was found that there were more drinkers than non-drinkers in all areas, except in Vietnam. The highest history of liver fluke infection was found in Cambodia. Praziquantel use and consumption of raw freshwater fish dishes were mostly found in Lao PDR. The highest consumption of nitrosamine-contaminated foodstuffs was found in Ubon Ratchathani, Thailand. The spatial comparison of OV-CCA risk showed that Lao PDR and Ubon Ratchathani were two risk areas when compared to Tachileik, Myanmar (a reference area). This study provided the behavior-related risk factors for OV-CCA among people in five GMS Countries which would be a major jigsaw puzzle leading to proactive surveillance for OV-CCA prevention in the future., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Chronic inflammation and repeated infection with Opisthorchis viverrini (O. viverrini) induces intrahepatic cholangiocarcinoma (ICC). Inflammatory cytokines such as interleukin (IL) and tumor necrosis factor (TNF) are substances in the immune system that promote inflammation and causes disease to progress. Genes that help express proinflammatory cytokines can affect an individual's susceptibility to disease, especially in cancer-related chronic inflammation. This study aimed to investigate risk factors for ICC with a focus on opisthorchiasis and polymorphisms of proinflammatory cytokines (IL-1β and TNF-α)., Methods: This study was a nested case-control study within a cohort study. 219 subjects who developed a primary ICC were identified and matched with two non-cancer controls from the same cohort based on sex and age at recruitment (±3 years). An O. viverrini-IgG antibody was assessed using enzyme linked immunosorbent assay. IL-1β and TNF-α polymorphisms were analyzed using a polymerase chain reaction with high resolution melting analysis. Associations between variables and ICC were assessed using conditional logistic regression., Results: Subjects with a high infection intensity had higher risk of ICC than those who had a low level (OR = 2.1; 95% CI: 1.2-3.9). Subjects with all genotypes of TNF-α (GG, GA, AA) and high infection intensity were significantly related to an increased risk of ICC (p < 0.05)., Conclusions: Polymorphisms of IL-1β and TNF-α are not a risk of ICC, but an individual with O. viverrini infection has an effect on all genotypes of the TNF-α gene that might promote ICC. Primary prevention of ICC in high-risk areas is based on efforts to reduce O. viverrini infection.

Cholangiocarcinoma (CCA) caused by opisthorchiasis is a specific public health problem in the Greater Mekong subregional countries. The Northeast Thailand is considered a world's prime area of CCA. Many epidemiological studies found the association between fruit and vegetables consumption and CCA, but their results were inconclusive. Therefore, this meta-analysis aimed to investigate the relationship between fruit and vegetables consumption and CCA prevention in the Northeast Thailand. The authors conducted a comprehensive search of scholarships on MEDLINE, EMBASE, and SCOPUS published during 1990 and 2015. Selected studies about fruit and vegetables consumption and CCA were analyzed. The fixed-effect model was used to estimate pool odds ratios for the consumption vs. nonconsumption. Based on a meta-analysis, consumption of mixed fruit [odds ratio (OR) = 0.79; 95% confidence interval (CI): 0.65-0.96], mixed vegetables (OR = 0.61; 95% CI: 0.50-0.75), and combined fruit and vegetables (OR = 0.68; 95% CI: 0.57-0.80) was associated with the reduction of CCA risk statistically. These findings support that fruit and vegetables consumption is associated with CCA risk reduction. If implemented in a larger geographical area, the study will shed light on possibilities to future reduction of CCA. Educators can replicate the study to solve CCA or other types of cancer and discover the best practice.

In northeast Thailand, cholangiocarcinoma (CCA) is a major cause of mortality. Patients with CCA have a poor prognosis and short-term survival. The purpose of this study was to investigate the association between health-related quality of life (HRQOL) and survival time, and to explore whether change in HRQOL score is related to survival among CCA patients. The study was performed between February 2011 and January 2012, and included 171 patients with newly diagnosed CCA from 5 tertiary hospitals in four provinces of northeast Thailand. The HRQOL was measured at baseline, 1 month, and 2 months after diagnosis by the FACT-Hep questionnaire (Thai version 4). The outcome was survival time from diagnosis. Cox's proportional hazard model was used to evaluate the association between HRQOL and survival time. A higher overall score on HRQOL was associated with a significantly better survival (HR per 5 units increase in HRQOL was 0.92, 95% CI: 0.88-0.96). Two of the separate domains contributing to the overall HRQOL-functional well-being and hepatobiliary cancer subscale-were found to have independent effects on survival, even after adjustment for potential confounding variables, and the other domains of HRQOL. CCA patient whose HRQOL scores had improved (≥9 units) at the 1st month of follow up had a reduced probability of dying from the disease (HR: 0.56, 0.32-0.95) after adjustment for the same confounding factors. A positive association between HRQOL at diagnosis and survival time was found. An improvement in HRQOL score in the first months after diagnosis further increases survival., Competing Interests: The authors have declared that no competing interests exist.

Wetland geographical areas have a higher incidence of Opisthorchis viverrini-associated cholangiocarcinoma (CCA), confirmed by data from geographic information systems, than other areas. Behavioral data also indicate that people in these areas traditionally eat uncooked freshwater fish dishes, a vehicle for O. viverrini infection. The best approach to reducing CCA incidence is decreasing risk factors together with behavior alteration. Evaluation of CCA risk and its related factors are first needed for planning the prevention and control programs in the future. We therefore aimed to evaluate the CCA risk and explore its related factors among people in wetland communities of Ubon Ratchathani, Thailand. A cross-sectional study was conducted between July and August 2014. In total 906 participants, with informed consent, completed questionnaires. Overall risk of CCA was determined by multiplying odds ratios (ORs) of the risk factors for CCA from literature reviews. A mean score of 5.95 was applied as the cut-off point. Assessment of factors related to overall risk of CCA was accomplished using conditional logistic regression. Of all participants, 60.15% had a high level of the overall risk of CCA. Factors related to the overall risk of CCA were gender (<0.001), marital status (<0.001), perceived susceptibility (p=0.043) and prevention behavior for CCA (<0.001). In conclusion, most participants in this community had a high level of overall risk of CCA. Therefore, integrated prevention and control programs continue to be urgently required.

Background: Cholangiocarcinoma (CCA) remains a major health problem and causes high mortality in Northeastern Thailand. Patients with CCA have a poor prognosis, and little is known about their health-related quality of life (HRQOL) and its determinants., Objective: The objective of this study was to investigate factors affecting HRQOL and its changes over time among CCA patients., Methods: Two hundred thirty-seven patients with CCA were recruited during a 6-month period in 2011 in 5 tertiary hospitals in 4 provinces of northeastern Thailand. Health-related quality of life after diagnosis of CCA was measured by the Functional Assessment of Cancer Therapy-Hepatobiliary questionnaire (Thai version 4). The HRQOL score of CCA patients at different times after diagnosis was compared by repeated-measures analysis of variance. Generalized estimating equation was used to identify factors affecting HRQOL among CCA patients., Results: Of 237 eligible patients registered, 99 confirmed cases completed follow-up at 2 months. Overall HRQOL varied over time, with the score at baseline being significantly lower than 1 and 2 months later. An adjusted analysis showed that patients who were 60 to 69 years old had higher HRQOL scores than did younger patients. Patients using alternative medicine had lower HRQOL scores than did those who did not., Conclusions: Health-related quality-of-life scores among CCA patients changed over time and were related to age at recruitment and use of alternative medicine., Implications for Practice: Healthcare providers should carefully communicate about the diagnosis and its implications. Patients with CCA, especially younger patients and those who have used traditional medicine, may benefit from counseling and help with mobilizing family and social support.

A high prevalence of Opisthorchis viverrini infection is usually found in wetland geographical areas of Thailand where people have traditional behavior of eating uncooked freshwater fish dishes which results in cholangiocarcinoma (CCA) development. There were several approaches for reducing opisthorchiasis-linked CCA, but the prevalence remains high. To develop community participation as a suitable model for CCA prevention is, firstly, to know what factors are related. We therefore aimed to investigate factors associated with the community participation in CCA prevention among rural residents in wetland areas of Ubon Ratchathani, Thailand. This was a cross-sectional analytic study. All participants were 30-69 years of age, and only one member per house was invited to participate. A total of 906 participants were interviewed and asked to complete questionnaires. Independent variables were socio-demographic parameters, knowledge, health belief and behavior to prevent CCA. The dependent variable was community participation for CCA prevention. Descriptive statistics were computed as number, percentage, mean and standard deviation. Associations were assessed using logistic regression analysis with a P-value <0.05 considered statistically significant. Of all the participants, more than 60% had regularly participated in activities to prevent CCA following health officials advice. Age and health behavior to prevent CCA were factors associated with community participation for CCA (p<0.001). Both factors will be taken into consideration for community participation approaches for CCA prevention through participatory action research (PAR) in future studies.

Objective: The present study was to investigate clinical risk factors of survival among HIV-infected children born from HIV-infected mothers in the Southern region of Thailand., Material and Method: Data from routine prospective cohort studies between 1990 and 2010 were analyzed In these studies, 1,549 HIV-infected children born to HIV-infected mothers were enrolled at birth and followed longitudinally. Information on demographic, clinical manifestations, and HIV-infection status factors was collected Survival analysis was used to determine risk factors associated with mortality., Results: Results found that one-fourth of HIV-infected children died (434, 28.02%) during the follow-up period. The follow-up available equals to 135,295 person-months. The incidence rate was 1.03 times per 100 person-months (95% CI: 0.97 to 1.08). The median survival time among HIV-infected children from diagnosis to death was 87.34 months (95% CI: 87.32 to 87.36). HIV-infected children were diagnosed to confirm as AIDS (88. 44%) and symptomatic HIV positive (11.56%). Clinical risk factors on survival among HIV-infected children were found HIV-infected children were more likely to die if they were infected with candidiasis (HR: 1.47, 95% CI: 1.07 to 2.00), Mycobacterium tuberculosis (HR: 1.51, 95% CI: 1.26 to 1.81), and Pneumocystis jiroveci (HR: 1.50, 95% CI: 1.27 to 1.76) as compared to HIV-infected children without clinical manifestation., Conclusion: Mortality among infected children born to HIV-positive mothers is high in the Southern region of Thailand Consequently, health service system related to prevent mother-to-child HIV-transmission is needed to improve child survival.

The purpose of this study was to investigate the mortality rate among HIV/AIDS patients coinfected with Mycobacterium tuberculosis in southern Thailand. A prospective, hospital-based cohort study was conducted among 52,459 HIV/AIDS patients registered at hospitals in 14 provinces of southern Thailand between January 1990 and April 2010. Twenty-seven point nine percent of the subjects were coinfected with Mycobacterium tuberculosis. Coinfection with Mycobacterium tuberculosis was not significantly associated with an increased mortality among subjects (HR 1.01; 95%CI 0.96-1.05). Subjects with pulmonary tuberculosis infection were 19% more likely to have a longer life (HR 0.81, 95%CI 0.73-0.91) and subjects with extrapulmonary tuberculosis were 31% more likely to have a longer life (HR 0.69; 95%CI 0.57-0.83). Early treatment of tuberculosis in HIV/AIDS patients can decrease mortality rates in southern Thailand.

Cholangiocarcinoma (CCA) is a major health problem and cause of death among people in Northeastern Thailand. In this prospective study 171 patients newly diagnosed with CCA by physicians in 5 tertiary hospitals in four provinces of northeastern of Thailand between February and July 2011 were followed up to January 2012. The outcome was survival time from diagnosis to death. A total of 758.4 person-months of follow-up were available. The mortality rate was 16.9 per 100 person-months (95%CI: 14.1-20.1). The median survival time among CCA patients was 4.3 months (95%CI: 3.3-5.1). Cox's proportional hazard model was used to study the independent effects of factors affecting survival time among patients. Statistically significant factors included advanced stage at diagnosis (HR: 2.5, 95%CI: 1.7-3.8), presentation with jaundice (HR: 1.7, 95%CI: 1.1-2.4) or ascites (HR: 2.8, 95%CI: 1.8-4.4), and positive serum carcinoembryonic antigen (HR: 2.3, 95%CI: 1.2-4.3). Patients who had received standard treatment had a better prognosis that those who did not (HR: 0.5, 95%CI: 0.3-0.7).