Journal of the office of disease prevention and control 9 Nakhon Ratchasima

Outbreak of Chikungunya Disease in Dongklang Sub-district, Khon San District, Chaiyaphum Province

Vimonluk Jomkumsing — 2025-08-21

On July 9, 2023, the Surveillance and Rapid Response Team (SRRT) of Khon San District in Chaiyaphum Province, received a report from Khon San Hospital of a suspected chikungunya case in Village 8, Dong Klang Sub-district. The SRRT team conducted a field investigation from July 10 to 16, 2023, to determine the cause of the outbreak, identify risk factors. This investigation was a descriptive epidemiological study to confirm the diagnosis, examine the spread of disease, and implement prevention and control measures. The results showed that the outbreak was found in three villages within Dong Klang Sub-district, including Villages 4, 7 and 8. The first case developed symptoms on June 22, 2023, including fever, joint pain, rash, and sought care at the Dong Klang Health Clinic. Investigation revealed that the patient worked at a bottled water factory located in Non Sa-at Sub-district, Chum Phae District, Khon Kaen Province, which was already experiencing an outbreak. The index case was confirmed on July 9, 2023, and lived near the first patient. From June to July 2023, a total of 41 chikungunya cases were identified, including 5 confirmed cases. Most patients were female (63.41%), with the highest proportion aged 51–60 years (21.95%). All patients had fever and rash, while 90.24% reported joint pain. The longest duration of joint symptoms was 173 days. A key environmental factor associated with the outbreak was the water containers that served as breeding sites for Aedes larvae, particularly during the rainy season. The larval indices exceeded the standard threshold (set at <5%), indicating a high risk of disease transmission in the affected areas. Control measures followed national vector-borne disease guidelines. Measures included larval source elimination on days 1, 7, 14, 21 and 28, adult mosquito fogging using the 3-3-1 measure, health education, community mobilization, patient monitoring, surveillance and active case finding. Following the implementation of these measures, no further chikungunya cases were identified in the area.

The Effects of Enhancing Health Literacy Program on Falls Prevention Behaviors among Village Health Volunteer in a Community, Nakhon Ratchasima Province

Pannarat Pensuk — 2025-08-21

This study was a quasi-experimental, one-group pretest-posttest design. The objective of this research was to study the effect of a health literacy program on fall prevention among the elderly, focusing on village health volunteers (VHVs) in a community in Nakhon Ratchasima Province. The sample group included VHVs from the area served by Nongkham Health Promoting Hospital in Nong Rawiang Subdistrict, Phimai District, Nakhon Ratchasima Province. Fifty participants were selected based on inclusion criteria, and the program was implemented over an 11-week period. Data collection was performed before and after the program using questionnaires. The data were analyzed using percentages, mean, standard deviation, and paired sample t-test to compare the pretest and posttest mean scores. The results showed that after joining the program, the VHVs had significantly higher knowledge about fall prevention in the elderly (p < 0.05). Their behavior in helping to prevent falls also improved significantly (p < 0.05). Therefore, this health literacy program for fall prevention in the elderly that was used with VHVs should be applied to caregivers of elderly patients with other conditions. Healthcare workers can also utilize this program for developing, promoting, and preventing physical deterioration in the elderly, addressing fall prevention issues, and other aspects of physical decline.

The Model Development of Health, Occupational Health and Safety Knowledge-Building among Migrant Workers in Health Region 8

Simalak Dithisawatwet — 2025-08-21

This action research aimed to develop a knowledge-building model for health, occupational health, and workplace safety among migrant workers in Health Region 8. The sample consisted of 158 migrant workers selected via simple random sampling from nine establishments across three provinces: Udon Thani, Sakon Nakhon, and Nong Khai. Quota sampling was subsequently applied. The study was conducted over nine months, from January to September 2023, and comprised three phases. First, the Preparation Phase involved reviewing the situation and roles of relevant agencies, publicizing the project, and opening registration for interested business establishments. Second, the Implementation Phase focused on conducting a needs assessment and designing a knowledge-based training program consisting of five modules: 1) COVID-19 and Emerging Infectious Diseases Prevention and Control, 2) Tuberculosis, AIDS, and Sexually Transmitted Diseases Prevention and Control, 3) Control of Tobacco and Alcohol Consumption among Workers, 4) Occupational Risk Assessment, Occupational Health Check, and Safety and Workplace Environment Management, and 5) Workers’ Rights and Relevant Laws. Finally, the Evaluation Phase involved assessing participants’ knowledge before and after the training sessions, collecting feedback from stakeholders, and conducting a lessons-learned review. Quantitative data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation). Inferential statistics were analyzed using paired t-test, while qualitative data were analyzed through content analysis. The findings revealed that the majority of the sample group was male (75.32%) and of Lao nationality (66.46%), with an average age of 36.68 years (SD = 13.52). The most demanded activity among migrant workers was occupational health check (83.33%). Regarding health issues experienced in the past year, the most common were body aches and musculoskeletal disorders (66.67%). Additional support required by workers included health education materials, condoms, face masks, hand sanitizers, hand wash soap, first-aid kits, and sports equipment. Mean knowledge scores before and after training significantly differed (p < 0.001). The results indicated that the knowledge-building model for health, occupational health, and workplace safety among migrant workers facilitated knowledge exchange and practical application among migrant workers. To further enhance knowledge-building among this group, workplaces should employ interpreters and trainers capable of effectively communicating with migrant workers to ensure mutual understanding and consistent implementation of the practices.

Health literacy and Health behaviors 3E-2S among Public Health Students in Kalasin University

Sonthaya Saiyasalee — 2025-08-21

The study of health literacy and health behavior 3E-2S among public health students in Kalasin University was a cross-sectional descriptive study. The objective of the study was to examine the factors associated with health behavior 3E-2S of public health students at Kalasin University. The samples were 387 first- to fourth-year public health students. The data were collected in January 2024 using a questionnaire. Quantitative data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. The chi-square test and Pearson’s correlation coefficient were used to test relationships. Results showed that the samples had a good overall level of health literacy (𝒙̅ = 50.83, SD = 5.86) and a good overall level of 3E-2S health behaviors (𝒙̅ = 21.18, SD = 3.28). When analyzing the relationship between health literacy and 3E-2S health behaviors, it was found that health information and service access, health communication, self-management, media and information literacy, and overall health literacy were significantly positively correlated with 3E-2S health behaviors (p < 0.001). Meanwhile, making appropriate decisions was also significantly positively correlated with 3E-2S health behaviors (p < 0.01). In addition, the samples had an inadequate level of health knowledge and understanding, and a fair level of health communication. Therefore, health literacy should be promoted among public health students in terms of health knowledge and understanding, as well as effective health communication. Integrating these elements into relevant curricula could enhance and develop their health literacy. This would enable them to effectively communicate health information to the public, helping individuals adopt correct and consistent health behaviors based on the 3E-2S framework.

Factors Associated with Adaptation among First-Year Health Sciences Students Sirindhorn College of Public Health, Chonburi

Kansinee Sripattanothai — 2025-08-21

The objective of this cross-sectional quantitative study was to investigate the factors associated with the adaptation of first-year health sciences students at Sirindhorn College of Public Health, Chonburi. The sample consisted of 115 first-year health sciences students selected through systematic random sampling. The study was based on Roy’s Adaptation Model, which classifies stimuli into three types: contextual stimuli, focal stimuli, and residual stimuli. The research instrument was a questionnaire. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation, as well as inferential statistics using the chi-square test. The results revealed that 69.6% of the participants had a good overall level of adaptation. The highest level of good adaptation was found in the peer dimension (80.9%), followed by the instructor dimension (64.3%) and the activity dimension (59.1%). In contrast, the dimensions with the highest levels of poor adaptation were the environmental dimension (61.7%) and the academic dimension (43.5%). Regarding correlations, stress as a focal stimulus and emotional quotient as a residual stimulus were significantly associated with adaptation at the 0.05 level. Therefore, educational institutions should promote activities that support the development of stress management skills and enhance emotional quotient. These efforts may help students foster positive adaptation to learning and living in a new environment with creativity and well-being.

Factors Affecting Mortality during Treatment in Pulmonary Tuberculosis Patients, Surin Province, between 2018–2022

Sattawat Sanmai — 2025-08-21

The study was a retrospective cohort analysis. The objectives of the study were to determine the mortality rate and to identify factors associated with death among pulmonary tuberculosis (TB) patients undergoing treatment in Surin Province, Thailand. Data on pulmonary TB patients were obtained from the National Tuberculosis Information Program (NTIP) database for individuals who were registered and initiated treatment between January 1, 2018, and December 31, 2022. A total of 6,760 pulmonary TB patients were included. Data were analyzed using descriptive statistics, including frequency and percentage, and inferential statistics. The mortality rate among pulmonary TB patients was calculated. Bivariate analysis was conducted to assess associations between individual variables. Multivariate analysis was performed using a generalized linear model (GLM_s) with backward elimination to control for confounding factors. The results revealed that 562 patients died, corresponding to a mortality rate of 8.11 per 100,000 population (95%CI:7.46–8.81). Factors significantly associated with mortality included age 58–69 years (adjusted RR = 2.10, 95%CI: 1.56–2.83), age ≥ 70 years (adjusted RR = 4.08, 95%CI: 3.07–5.42), chronic kidney disease (adjusted RR = 1.80, 95%CI: 1.27–2.55), HIV co-infection (adjusted RR = 4.33, 95%CI: 3.17–5.92), chronic alcohol use (adjusted RR = 2.85, 95%CI: 1.89–5.92), and malnutrition (adjusted RR = 2.82, 95%CI: 1.53–5.19). Therefore, healthcare facilities should strengthen care plans for pulmonary tuberculosis patients, particularly for elderly individuals, those with comorbidities such as chronic kidney disease and HIV co-infection, and patients with immunocompromised conditions. Treatment protocols should be appropriately adjusted, with close monitoring of patient symptoms, to help reduce mortality rates among pulmonary tuberculosis patients.

Association between Low-Density Lipoproteins (LDL) and Cardiovascular Disease in Patients with Chronic Kidney Disease at Kutchum Hospital, Yasothon Province

Pimploy Chaiyarat — 2025-08-21

Cardiovascular disease (CVD) is a major complication that can occur in patients with chronic kidney disease (CKD), from early to end-stage, with a prevalence 2–4 times higher than in the general population. The objectives of this study were to determine the incidence of cardiovascular disease and to examine the association between low-density lipoprotein cholesterol (LDL-C) levels and the occurrence of cardiovascular disease in CKD patients at Kutchum Hospital, Yasothon Province. This was a retrospective analytical study. Data were obtained from the medical records of 257 CKD patients who received treatment at Kutchum Hospital, Kutchum District, Yasothon Province, between October 1, 2012, and September 30, 2023. All patients were followed from the time of chronic kidney disease diagnosis until cardiovascular disease occurrence. The association was analyzed using generalized linear models (GLMs). The results showed that the incidence of cardiovascular disease among chronic kidney disease patients was 31.5%. Patients with LDL-C levels ≥100 mg/dL had a 2.05-fold increased risk of developing cardiovascular disease compared to those with LDL-C levels <100 mg/dL (adjusted RR = 2.05, 95%CI: 1.33–3.18, p = 0.001). This study found that LDL-C levels were significantly associated with the occurrence of cardiovascular disease. The incidence of cardiovascular disease among chronic kidney disease patients with LDL-C levels ≥100 mg/dL showed an increasing trend. Therefore, screening and control of LDL-C levels should be implemented to maintain levels below 100 mg/dL in patients with chronic kidney disease, alongside strengthened individualized care. In addition, educational interventions for cardiovascular disease prevention should be enhanced, particularly for overweight individuals and those with a CKD duration of more than five years. These interventions intend to enhance awareness and promote self-care practices for cardiovascular disease prevention.

Development of Competency Indicators and Competency Assessment for Investigation and Control of Dangerous Communicable Diseases among Communicable Disease Control Unit (CDCU) Officers in Health Region 7

Jamabhorn Jaipakdee — 2025-08-21

The objective of this research and development (R&D) study was to develop competency indicators and assess the competencies related to the investigation and control of dangerous communicable diseases among officers of the Communicable Disease Control Unit (CDCU) in Health Region 7. The study was conducted in two parts. Part 1 focused on developing competency indicators for disease investigation and control that align with current public health conditions and cover core responsibilities. As a result, five core competency domains and fifteen performance indicators were identified. Part 2 assessed the competencies of CDCU officers in Health Region 7. A sample of 236 officers was selected using a simple random sampling method from 23 districts, proportionally representing each province in the region. Data were collected using the developed assessment tool. Quantitative data were analyzed using descriptive statistics, including percentage, mean, and median. Confirmatory factor analysis (CFA) was performed to validate the competency model. The results showed that in Part 1, the developed indicators revealed that the component with the highest factor loading was communicable disease control, accounting for 88.6% of the explanatory variance. The component with the lowest factor loading was academic potential, accounting for 13.8%. In Part 2, the competency assessment regarding outbreak investigation and control revealed that 73.73% of CDCU officers had overall knowledge at the basic level. The assessment of five core competencies yielded the following results: 1) academic potential was at a good level (47.46%), 2) practical skills were at a basic level (36.86%), 3) outbreak investigation was at a basic level (58.05%), 4) communicable disease control was at a basic level (41.95%), and 5) personal attributes were at a good level (38.14%). The competencies most in need of improvement, based on specific indicators, were outbreak investigation report writing and academic development in epidemiology. Therefore, it is essential to strengthen the competencies of officers in outbreak investigation report writing and dissemination of findings through academic publications.