Thai Health Promotion Foundation

This study aimed to develop practical, cost-effective screening guidelines using Robert's Test and J48 decision tree algorithm to optimize microalbuminuria detection in health screening programs. Data were collected from random spot urine samples during daytime from 709 participants who received routine health checks at the Center of Medical Laboratory Service, Medical Technology Program, Nakhonratchasima College. The samples were screened with protein and microalbumin dipsticks, confirmed by Robert's test, and analyzed for the microalbumin-to-creatinine ratio (MA/CR). Kruskal-Wallis and Pearson correlation tests assessed statistical significance at p < 0.05 and 95% confidence intervals. Several significant correlations were found, including the relationship between increasing age and higher blood pressure, fasting plasma glucose, creatinine, and urea nitrogen levels. The reduced estimated glomerular filtration rate (eGFR) was significantly correlated with microalbuminuria (p < 0.01) among participants younger than 83 years. The J48 analysis showed that Robert's test and fasting plasma glucose (FPG) were effective for screening. Participants with a negative Robert's test and FPG < 96 mg/dL had 97.7% normal microalbumin levels. However, participants with trace protein and FPG > 84 mg/dL had a 35% chance of microalbuminuria. This algorithm can develop practical guidelines for detecting microalbuminuria, potentially reducing costs and laboratory burden and identifying high-risk groups in population health.

To assess the impact of an integrated model of care in curing hepatitis C in people who use drugs in Thailand. The C-Free Study enrolled people with current or prior drug use and their partners in a prospective cohort at community drop-in centres providing harm reduction services. Participants were screened for human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and sexually transmitted infections. Eligible participants with HCV infection received a 12-week course of sofosbuvir-velpatasvir. The main impact outcome was sustained virological response, measured 12 weeks after treatment completion. Between June 2019 and April 2023, we enrolled 2871 participants in 10 sites across Thailand: 1601 (55.8%) had HCV antibodies; 1275 (44.4%) had active HCV infection; 846 (29.5%) had HIV; and 221 (7.7%) had HBV. Of 1134 participants with active HCV who started treatment with sofosbuvir-velpatasvir, 939 (82.8%) achieved a sustained virological response. Among 987 participants completing treatment, 95.1% achieved a sustained virological response. In multivariable analysis, age > 40 years (adjusted odds ratio, aOR: 1.63; 95% confidence interval, CI: 1.04-2.54) and poor treatment adherence (aOR: 0.06; 95% CI: 0.02-0.20) were associated with sustained virological response. Of 34 serious adverse events during treatment, six led to treatment discontinuation including five non-treatment-related deaths. Community-based HCV treatment of people who use drugs in Thailand, within harm reduction settings, is safe and effective. Integration of this strategy into national programmes could enhance HCV elimination in people who use drugs.

This study investigated ionospheric Total Electron Content (TEC) anomalies as potential precursors to a moderate earthquake magnitude of 4.5 that occurred in Phai Lom, Bang Krathum District, Phitsanulok Province, Northern Thailand, on June 28, 2023 (Universal Time, UT). High-resolution GPS data from the UTHG GNSS station were analyzed at 1-second intervals over 15 days (June 21–July 5, 2023) using the ±2σ statistical boundary method to detect abnormal variations in TEC. The analysis revealed a pronounced TEC enhancement of approximately 2.61 TECU on June 23, five days before the earthquake, followed by a significant depletion on the day of the event. These variations exceeded the Upper and Lower statistical limits (UB and LB), indicating statistically significant deviations from the expected median trend. A moderate geomagnetic storm (Dst = –57 nT) was recorded on June 25; however, correlation analysis (r = –0.507) indicated only a moderate negative relationship between geomagnetic activity and TEC variations. During the earthquake period, the Dst index remained above –30 nT, signifying geomagnetically quiet conditions. To validate the findings, global TEC data obtained from the GNSS-TEC database displayed consistent temporal trends, confirming that the anomalies were not site-specific. Moreover, analysis of the Rate of TEC Index (ROTI) revealed short-term irregularities on June 23 and June 28 UT, further supporting the presence of ionospheric disturbances related to the seismic event. Overall, these results align with previous studies and emphasize the potential of GNSS-based ionospheric monitoring and correlation analysis as reliable tools for short-term earthquake forecasting, particularly in low-latitude regions such as Thailand.

ABSTRACTObesity represents a significant public health challenge closely associated with dyslipidaemia. The objective of this study was to evaluate the impact of chitosan oligosaccharides (COS) supplementation on lipid profiles and body composition among overweight or obese Thai women. A randomized, double‐blind, placebo‐controlled trial was conducted over a duration of 60 days, involving 60 participants. The participants were assigned to one of three groups: one group received 1.5 g of COS daily (1.5COS, n = 20), another group received 3 g of COS daily (3COS, n = 20), and a control group received a placebo (n = 20). Biochemical and anthropometric data were collected prior to and following the intervention, while dietary intake was monitored throughout the study. The intention‐to‐treat analysis indicated that no statistically significant differences in lipid profiles were noted between the COS and placebo groups. However, the 1.5COS group exhibited a significant increase in mean high‐density lipoprotein (HDL) levels (p = 0.024). Additionally, the waist‐to‐hip ratio reduction was observed as a within‐group change in the 3 COS group, not a statistically significant between‐group difference. The findings of this trial did not indicate a clinically significant reduction in lipid profiles attributable to COS supplementation.Trial Registration: Thai Clinical Trials Registry: TCTR20250625005 on 25 June 2025

Frailty in the elderly population is a known risk factor for common geriatric syndromes, contributing significantly to adverse health outcomes. Therefore, we examined the relationship between prevalence of fear of falling and frailty among older adults. A cross-sectional design was employed, and data were collected through in-person interviews conducted between April and May 2024. Participants were selected through simple random sampling from a total of 409 individuals aged 60 years or older, who were included in the analysis. The fear of falling (FOF) was evaluated using the Short Falls Efficacy Scale International (Short FES-I). Frailty was evaluated using the Thai version of the Simple Frailty Questionnaire (T-FRAIL). The mean age was 69.5 years, and 58.7% were female. The prevalence rates were 47.4% for non-frailty, 39.1% for pre-frailty, and 13.4% for frailty among older adults. Multinomial logistic regression analysis revealed that pre-frail adults had significantly higher odds of high FOF (OR: 5.27; 95% CI: 3.16-8.80, p-value < 0.001), whereas frail adults had significantly higher odds of moderate FOF (OR: 4.37; 95% CI: 1.55-12.32, p-value = 0.005) and high FOF (OR: 17.36; 95% CI: 6.79-44.39, p-value < 0.001) compared to a reference group of non-frail participants. Preventing frailty and pre-frailty among older adults could involve interventions that target various risk factors, such as demographic characteristics, and FOF.

Introduction: Nutrition literacy represents a critical determinant of oral health outcomes. Guided by Social Cognitive Theory and the Nutrition Literacy Skills Framework, this study evaluated the implementation and effectiveness of a nutrition literacy programme for oral health promotion among village health volunteers (VHVs), key implementers in Thailand's healthcare system, during January to December 2024. Methods: A convergent parallel mixed-methods design was employed to address existing methodological gaps in nutrition literacy research. The quantitative component comprised a cross-sectional survey (N=60 VHVs trained in January 2024) and clinical outcome monitoring via electronic health records. The qualitative strand involved a multi-case study approach with purposive sampling (n=20) through in-depth interviews. Data collection occurred at 6-month post-implementation (July 2024), with clinical monitoring through December 2024. Analysis integrated descriptive and inferential statistics with thematic analysis. Results: Post-implementation analysis revealed significantly enhanced nutrition literacy skills (M=4.14, SD=0.414), with notable improvements in communication (M=4.74, SD=0.511) and implementation (M=4.21, SD=0.440). All six nutrition literacy domains showed strong correlations (r=0.712-0.868, p<.01), supporting the framework's interconnected nature. Clinical outcomes improved significantly: oral health check-up rates increased from 1.41% to 2.61% (p<.05), and functional teeth retention rose from 87.36% to 92.72% (p<.01). Qualitative findings revealed adaptive knowledge transfer methods and context-specific implementation strategies influenced by community readiness. Conclusion: Through comprehensive mixed-methods evaluation, the 12-month implementation data demonstrated significant improvements in both VHVs' nutrition literacy skills and clinical oral health outcomes. Success factors included theoretically-grounded implementation strategies and stakeholder engagement in resource-limited settings.

BackgroundThe six-minute walk test (6MWT) is one of the most commonly-used assessments of functional capacity. However, its length and space requirements can limit feasibility in busy clinical settings. There is limited evidence on the validity of shorter or alternative functional tests compared to the 6MWT in individuals with obesity. Therefore, this study aimed to evaluate the concurrent validity of the distance covered during the first two minutes of the 6-minute walk test (2’6MWT), the 2-minute step test (2MST) and the 1-minute sit-to-stand test (1STST) against the full 6MWT in individuals with obesity.MethodsThis was a cross-sectional study. Participants with obesity completed three functional tests—6MWT, 2MST and 1STST—on the same day. Spearman’s rank correlation was used to assess the concurrent validity of the 2’6MWT, 2MST and 1STST in relation to the 6MWT.ResultsA total of 59 individuals with obesity (16 men) participated in the study. Age was 34 (8.5) years (mean (standard deviation)), and body mass index was 40.9 (6.5) kg/m2. The 2’6MWT demonstrated a strong correlation with the 6MWT (Spearman’s rank correlation, rs = 0.87, p < 0.001), while the 2MST and the 1STST showed moderate and weak correlations, respectively (rs = 0.45, p < 0.001; rs = 0.31, p = 0.02).ConclusionThe 2’6MWT may serve as a valid alternative to the 6MWT for assessing functional capacity in individuals with obesity, offering a shorter duration and potentially reducing fatigue. The 2MST may be a more suitable alternative to the 1STST in settings with limited space for walking tests.