The office of disease prevention and control 9th Nakhon Ratchasima Journal

Mind and Body Medicine Interventions for Stroke Survivor Recovery: A Narrative Synthesis

Thawari Khansamrong — 2025-04-02

Stroke is a common cause of chronic disability. Its burden arises from the resulting impairments and disabilities, which often necessitate ongoing rehabilitation and reliance on caregivers. This has prompted the integration of complementary and alternative medicine (CAM), either alongside or as a substitute for conventional medicine, to restore organ and system functions in stroke patients and enhance their quality of life. This study synthesized research through a narrative review, focusing on the characteristics and effectiveness of alternative rehabilitation methods for stroke patients using meditation, yoga, and qigong interventions from 2012 to 2021. A total of 40 papers were selected, and a record form was used as a research tool. The review process adhered to Cochrane’s guidelines. The results showed that rehabilitation effectiveness can be categorized into two dimensions: 1) the physical dimension includes improvements in mobility, reduced falls, better performance in daily activities, decreased pain, and increased cerebral blood circulation, and 2) the psychosocial dimension includes reduced stress and depression, improved concentration and memory, enhanced cognitive abilities, and greater social well-being. The findings suggest that public health agencies should adopt policies promoting effective physical and psychosocial rehabilitation for stroke patients by incorporating meditation, yoga, and qigong in conjunction with conventional treatments.

The Road Traffic Injuries Investigation on Caused of Dead from a Pickup Truck Crashed a Tree, Nakhon Ratchasima Province on January 17–18, 2023

Prapasri Samjai — 2025-04-02

On January 16, 2023, the Office of Disease Prevention and Control 9 (ODPC 9), Nakhon Ratchasima Province, was notified of a pickup truck that had crashed into a tree on a curve near Sra Takhae Hin Village, Banlang Subdistrict, Non Thai District, Nakhon Ratchasima Province. An investigation was jointly conducted by ODPC 9 and network agencies on January 17–18, 2023, to determine the causes and risk factors associated with the injuries and fatalities and to propose preventive measures for future accidents. A descriptive study employing descriptive statistics and a risk analysis using the Haddon matrix model was performed. The results showed that the accident occurred at approximately 2:40 a.m. on January 16, 2023. The pickup truck veered off the curve, overturned, and crashed into a tree while returning from a karaoke shop. There were nine victims in total: five dead at the scene, one seriously injured individual, and three with minor injuries. All the victims were male, with a median age of 20 years (range 14 years). They all sustained head injuries and multiple wounds, with lacerations being the most common type (66.67%). The five dead included the driver and four passengers who were in the truck bed. The overturned vehicle crushed the occupants. Neither the driver nor the front-seat passengers were wearing seatbelts. The driver’s blood alcohol concentration was 149 mg/dL, exceeding the legal limit of 50 mg/dL. Additionally, the vehicle had been modified to enhance its power. The accident occurred at night. The risk factors contributing to this accident included drunk driving, a modified vehicle, poor road conditions, and environmental factors. The severe injuries and fatalities were also attributed to the absence of seatbelt use and passengers riding in the truck bed. Therefore, strict enforcement of drunk driving laws and prohibitions on passengers riding in the truck bed are essential measures, alongside improvements to unsafe road infrastructure and environmental conditions, to prevent similar accidents in the future.

Anxiety before Receiving Coronavirus 2019 Vaccine among Students Aged 12–18 Years Old Studying at a School in Taphong Sub-district, Mueang Rayong District, Rayong Province

Nalattaporn Keereelang — 2025-04-02

This cross-sectional survey research aimed to investigate the level of anxiety and factors associated with anxiety prior to receiving the coronavirus 2019 vaccine among students aged 12–18 years old enrolled in a school in Taphong Sub-district, Mueang Rayong District, Rayong Province. The target group consisted of 204 students. Data were collected from August to September 2022 using a questionnaire comprising three sections: personal factors, information about the coronavirus 2019 vaccine, and anxiety levels concerning vaccination. The data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. Inferential statistics were also applied, including the chi-square test, odds ratio (OR), and 95% confidence interval (CI). The results showed that most participants were female (58.82%) with an average age of 16.33±9.76 years. Most were studying in lower secondary school (47.06%) and living with their parents (61.76%). A large proportion had no underlying diseases (87.75%) and no history of drug, food or vaccine allergies, repoerted at 96.08%, 94.61%, and 96.08%, respectively. Additionally, 82.84% had no history of illness within the preceding 14 days. Online social media was the primary source of vaccine-related information for most participants (70.21%). A high proportion (79.90%) reported anxiety prior to vaccination. The top three issues contributing to high levels of anxiety among participants were family or parents (22.70%), followed by the impact on daily life (9.20%) and potential side effects or adverse reactions (4.29%). Moreover, a significant association was found between a history of influenza-like illness within 14 days and anxiety prio to vaccination (OR = 4.95, 95% CI = 1.14–21.56, p < 0.05). Therefore, providing accurate and relevant information about the coronavirus 2019 vaccine is crucial for addressing anxiety among students and parents, particularly those with a recent history of influenza-like illness, to ensure they gain accurate knowledge and understanding. Furthermore, the preparedness of healthcare staff and emergency services at vaccination sites is essential to minimizing anxiety about the coronavirus 2019 vaccine.

Resistance Status to Insecticide Temephos in Aedes aegypti larvae from Dengue risk Areas in Thailand

Thanyapak Makruen — 2025-04-02

The insecticide temephos, commonly known as Abate sand, is widely used to control Aedes aegypti larvae in Thailand. However, long-term and continuous use of insecticides for mosquito control can lead to the development of insecticide resistance. This research aimed to determine the resistance status of Ae. aegypti larvae to temephos in dengue-risk areas across Thailand. Ae. aegypti larvae were collected indoors from 21.2% to 64.0% of households, corresponding to 207 to 164 households in each study area. The mosquito larvae were tested for susceptibility to temephos at concentrations ranging from 0.0015 to 0.048 mg/L using WHO protocols. The 50% lethal concentration (LC₅₀) was determined, and resistance ratios (RR) were calculated. The results showed that temephos produced mean mortality rates ranging from 15.00±3.83% to 100% in laboratory-reared Ae. aegypti larvae, with an LC₅₀ value of 0.005 mg/L. Field-collected Ae. aegypti larvae from nine provinces exhibited mean mortality rates of 0–100% and LC₅₀ values ranging from 0.016 to 0.038 mg/L. The mean mortality rates of mosquito larvae demonstrated significant differences among the studied provinces (p < 0.05). The Ae. aegypti larvae from nine studied provinces, including Lamphun, Nakhon Ratchasima, Kanchanaburi, Maha Sarakham, Phitsanulok, Nakhon Pathom, Chanthaburi, Trat, and Chumphon, had temephos resistance ratios ranging from 3.20 to 7.60. Among these, larvae from Nakhon Ratchasima, Kanchanaburi, Nakhon Pathom, and Chumphon had resistance ratios (RR) less than 5, indicating susceptibility, while those from Chanthaburi, Maha Sarakham, Phitsanulok, Trat, and Lamphun had RR values between 5 and 10, indicating moderate resistance. In conclusion, Ae. aegypti larvae from four provinces were susceptible to temephos (RR < 5), while those from five provinces exhibited moderate resistance (RR 5–10). To prevent further development of resistance, the use of temephos for mosquito larval control should be reduced, and insecticide rotation strategies should be implemented. Alternatives such as Bacillus thuringiensis israelensis (Bti) and insect growth regulators (IGRs) are recommended for effective Aedes mosquito control to prevent dengue outbreaks.

Development of Malaria Health Education Model based on Active Learning for Students in the Border Patrol Police Schools, Surin Province, Academic Year 2023

Sunanta Punkunkeeree — 2025-04-02

This action research aimed to develop and evaluate a malaria health education model based on active learning for students in Border Patrol Police schools in Surin Province. The study targeted 1,138 students from seven Border Patrol Police schools during the 2023 academic year. A purposive sampling method was used to select 395 students from grades 4–6. The research was carried out in four phases: 1) assessing the current situation and conducting data analysis, 2) designing and developing the educational model, 3) implementing the model, and 4) evaluating its outcomes. Qualitative data were collected through discussions with administrators, health teachers, and officers from Vector-Borne Disease Control 9.3, Surin. Quantitative data were analyzed using frequency, percentage, mean, standard deviation, and dependent t-tests to compare pre- and post-intervention scores on knowledge, perceptions, and behaviors related to malaria. The research developed a malaria health education model based on active learning consisting of three steps: 1) an introduction to the lesson, 2) learning bases, which included the Anopheles mosquito base, prevention and control base, and symptom and treatment base, and 3) a summary of key lessons learned. The evaluation revealed that after implementing the health education model, the average scores for knowledge, perception, and behaviors regarding malaria were 9.27, 12.91, and 10.79 points, respectively. The mean scores for knowledge and behavior before and after the program were significantly different (p < 0.05), while the perception scores showed no significant difference. Administrators, health teachers, and class teachers expressed the highest level of satisfaction with the malaria health education model ( = 4.60, SD = 0.50). Therefore, activities should be enhanced to improve student perception and awareness of malaria, both in school and at home, by utilizing modern media technology and encouraging parental participation in malaria disease surveillance.

Surveillance of Temephos and Deltamethrin Resistance and the Synergistic Effects of Piperonyl Butoxide in Aedes aegypti from Tourist Areas in Nakhon Ratchasima, Thailand

Parichat Saosoong — 2025-04-02

This study is experimental research. The objective of this research is to investigate the resistance of Aedes aegypti larvae to temephos and the resistance of adult Ae. aegypti to a combination of piperonyl butoxide (PBO) and deltamethrin in three tourist destination districts: Mueang, Pak Chong, and Wang Nam Khiao, in Nakhon Ratchasima province. These findings are important because vector-borne disease outbreaks in these areas could have significant economic and tourism-related impacts. Ae. aegypti larvae samples were collected from these districts and reared to obtain first-generation (F₁) mosquitoes. The larvae were tested against a 0.012 mg/L temephos solution, and the adults were tested against deltamethrin (0.03%) and PBO (4%). Mortality rates were recorded after 24 hours, following World Health Organization (WHO) guidelines. The results showed 100% mortality in larvae in all areas, indicating no resistance to temephos. Adults from Pak Chong district exhibited 98% mortality when exposed to deltamethrin (0.03%), indicating susceptibility. In contrast, adults from Mueang and Wang Nam Khiao districts had mortality rates of 79% and 80%, respectively, indicating resistance to deltamethrin. The knockdown times for 50% (KT₅₀) of mosquitoes from Pak Chong, Mueang, and Wang Nam Khiao districts were 17.84, 22.01, and 49.68 minutes, respectively. Testing the combination of PBO (4%) with deltamethrin (0.03%) resulted in increased mortality rates (84–100%) compared to exposure to deltamethrin alone. The synergistic ratio (SR) was greater than 1, indicating that PBO enhanced the efficacy of deltamethrin in mosquitoes from all districts. However, mosquito resistance to chemical agents is influenced by various factors, emphasizing the need for further research to better understand these relationships and guide future chemical management strategies.

Effectiveness of Telemedical Refilling Program for Controlled Hypertension Patients in Sub-District Primary Care, Muang District, Phetchabun Province, Thailand

Tassana Thammaros — 2025-04-02

This post-implementation study aimed to evaluate the effectiveness and patient satisfaction of a telemedical refill program for patients with controlled hypertension in sub-district primary care settings in Muang District, Phetchabun Province, Thailand. Conducted from May 1 to July 31, 2024, the study involved reviewing development meeting reports, electronic medical records of patients using the telemedical refill program, and patient satisfaction surveys. Data were analyzed descriptively and analytically, with differences in mean blood pressure values tested using repeated measures ANOVA at a significance level of 0.05. A total of 56 eligible patients participated. The mean systolic and diastolic blood pressure values (mean±SD) for the first, second, and third measurements were 127.16±8.19 mmHg, 126.55±9.79 mmHg, and 125.27±10.24 mmHg for systolic pressure, and 72.48±7.72 mmHg, 70.52±9.33 mmHg, and 70.59±10.15 mmHg for diastolic pressure, respectively. No statistically significant differences were observed. Patient satisfaction was highest regarding convenience of travel and staff service. Patients also suggested extending medication refill periods beyond three months and incorporating home medication delivery. In conclusion, the telemedical refill program effectively supported continuous care for patients with controlled hypertension, with high levels of patient satisfaction reported. Recommendations include enhancing program flexibility, such as offering home delivery or allowing family members to collect medications, and conducting long-term follow-up studies to evaluate health outcomes and potential adverse effects in the future.

Model Development for Village Health Volunteers Performance in Na Nang Subdistrict, Phonphisai District, Nongkhai Province

Vutpiwat Khamhongsa — 2025-04-02

The objectives of this research were to: 1) assess the current conditions and needs regarding the development of a performance enhancement model for Village Health Volunteers (VHVs), 2) create and develop a performance enhancement model for VHVs, and 3) evaluate the outcomes of implementing this model in Na Nang Subdistrict, Phonphisai District, Nongkhai Province. A research and development methodology was applied. The study population included 76 VHVs in Na Nang Subdistrict, divided equally into an experimental group (38 participants) and a control group (38 participants). The experimental group participated in activities based on the performance enhancement model. The research findings were as follows: 1) The necessary operational level was higher than the actual performance level in three aspects: knowledge ( = 4.05, SD = 0.43), skills ( = 3.88, SD = 0.59), and attitude ( = 4.06, SD = 0.94). This indicated a significant need for the development of a performance enhancement model for village health volunteers in Na Nang Subdistrict, Phonphisai District, Nongkhai Province, 2) The developed model included two activities and seven key components. Learning activities focused on fostering a volunteer mindset, role acceptance, and commitment. Supportive activities emphasized teamwork, participation, societal motivation, and operational motivation, with attention to appropriateness, utility, feasibility, and comprehensiveness, and 3) The evaluation of the model implementation showed that the median score of the experimental group post-intervention was significantly higher than the pre-intervention score. Additionally, the experimental group had a significantly higher median score compared to the control group post-intervention, with statistical significance at the 0.01 level.

Outcome of Patients: Early Nephrologist Consultation in Cardiorenal Syndrome

Suchart Jenkriangkrai — 2025-04-02

The Cardiac Intensive Care Unit (CCU) at Maharat Nakhon Ratchasima Hospital has implemented a rapid nephrology consultation process for patients with acute kidney injury (AKI) secondary to heart failure. However, it remains unclear whether these measures have significantly impacted patient outcomes. The aims of this study were to investigate mortality rates, clinical characteristics, and factors associated with 28-day mortality among acute kidney injury (AKI) patients. This retrospective descriptive and analytical study used Cox regression analysis to evaluate the survival rate. Data were collected from the medical records of patients diagnosed with AKI in the CCU between November 2020 and August 2021. A total of 52 patients were included, with a mean age of 67.9+ 11.2 years. The majority were male patients (71.2%). At the time of nephrologist consultation, most patients (78.8%) were in stage 2 of kidney injury. The predominant cardiac diagnosis was ST-elevation myocardial infarction (STEMI)in 67.3% of cases. Treatment interventions included vasopressor medications (82.7%) coronary angiography (78.9%), and required an intra-aortic balloon pump (51.9%). The median cumulative fluid balance on day 5 was -1,119.0 mL (interquartile range: -2,859.5 to 1,616.0 mL). During hospitalization, the total follow-up period was 715 patient-days. with 27 deaths recorded, This Corresponds to an in-hospital mortality incidence of 9.4 per 100 patient-days (95%CI: 6.4-13.7). The median patient survival post-hospitalization was 19 days. Survival rates at 7, 14 and 28 days were 69.1% (95% CI: 0.546-0.426), 57.7% (95%CI: 0.426-0.702), and 39.4% (95%CI: 0.22-0.564), respectively. Significant factors associated with 28-day mortality included age ≥ 80 years (Adjusted Hazard Ratio: 4.66; 95%CI: 1.66-13.06; P=0.003) and sepsis (Adjusted Hazard Ratio 2.39;95%CI: 1.06-5.36; P=0.035). Therefore, AKI patients admitted to the CCU experience a high in-hospital mortality rate. Older age and sepsis are critical factors associated with 28-day mortality. These findings underscore the urgent need for targeted interventions to improve outcome in this high-risk patient population.