Adrian C Sleigh

Australian National University | ANU · National Centre for Epidemiology & Population Health, Research School of Population Health, College of Medicine Biology and Environment

Background The study aims to identify the common patterns of multimorbidity and their distribution by age and gender. Method This cross-sectional study collected self-reported data from 42 785 Thai Cohort Study members through mailed questionnaires. Employing prevalence-based analysis, it identified common multimorbidity (coexistence of two or mor...

Tuberculosis (TB) is the second leading infectious cause of mortality worldwide and arguably the most important neglected topic in bioethics. This chapter: (1) explains the ethical importance of TB, (2) documents its neglect in bioethics discourse, (3) maps the terrain of ethical issues associated with TB, and (4) advocates a moderate pluralistic a...

Objectives: To investigate associations between multimorbidity, socio-demographic and health behaviour factors, and their interactions (multimorbidity and these factors) with all-cause mortality among Thai adults. Methods: Associations between multimorbidity (coexistence of two + chronic diseases) and mortality between 2005 and 2019 were investigat...

Background: The risk of cardiovascular diseases may be reduced by residing in green environments. However, there are relatively few longitudinal cohort studies, especially in Southeast Asia, that focused on the health benefits of long-term greenness exposure in young adults. The present study examined the association between long-term exposure to...

Objective To examine the relationship between baseline union status (ie, including marriage and cohabitation) and mortality, paying attention to gender differentials, through an 11-year follow-up of a large cohort in Thailand. Design Cohort data from Thai Cohort Study (TCS) were linked official death records over an 11-year follow-up period. Sett...

OBJECTIVE: As Thailand modernizes an ensuing health risk transition associates with rising chronic non-communicable diseases, especially hypertension. This is a driving force for emerging vascular disease, especially stroke and hypertension. Studies in other countries have shown hypertension is associated with obesity. Longitudinal information is n...

OBJECTIVE: Kidney disease (KD) is increasing its burden in Thailand but prospective observational KD studies are few. So we analysed 8-year nationwide Thai Cohort Study (TCS) data on KD incidence, distribution and risk association among Thais.DESIGN & METHOD: TCS is a longitudinal study of the Thai health-risk transition among Open University stude...

OBJECTIVE: Rapid economic growth is transforming Thailand into a middle-income country. Also emerging are chronic diseases particularly hypertension, diabetes mellitus and kidney disease. There are few studies of the incidence of hypertension. We analyse the effect on 8-year incidence of hypertension of transitional health-risk factors including de...

2013 TCS survey questionnaire (original in Thai). (PDF)

2013 TCS survey questionnaire (translated in English). (PDF)

In recent decades, a health-risk transition with changes in diet and lifestyle in low and middle-income countries (LMICs) led to an emergence of chronic diseases. These trends in Southeast Asian LMICs are not well studied. Here, we report on transitional dietary patterns and their socio-demographic predictors in Thai adults. Dietary data in 2015 we...

In the last 50 years Thailand has achieved advanced demographic and health transitions. Many infectious diseases are controlled and infant and maternal mortality rates are among the lowest in the region. Within such a low mortality setting, however, substantial variations in health persist, with education being a major driver. This paper assesses t...

Background Body mass index (BMI) cut-off values (>25 and >30) that predict diabetes risk have been well validated in Caucasian populations but less so in Asian populations. We aimed to determine the BMI threshold associated with increased type 2 diabetes (T2DM) risk and to calculate the proportion of T2DM cases attributable to overweight and obesit...

Background The global prevalence of type 2 diabetes mellitus (T2DM) is high and is increasing in countries undergoing rapid socio-economic development, including Thailand. Sugar-sweetened beverage (SSB) intake may contribute to the risk of developing T2DM. However, few studies have assessed this association in Asian populations, and the results hav...

Background: Overweight and obesity have been shown to be risk factors for a range of non-communicable diseases, especially cardio-metabolic conditions, worldwide. But less is known about the effects of weight change on adults' overall health and wellbeing, particularly in transitional low- and middle-income countries. This study aimed to assess th...

Purpose The purpose of this paper is to assess the usefulness of nutrition labels in Thailand during nutrition transition from traditional to modern diets that increase salt, sugar, and calorie intake and to note socio-demographic interactions and associations with consumption of transitional processed foods. Design/methodology/approach The auth...

Little is known about the impact of drug resistance on recurrence in TB. We conducted a cohort study to measure the impact of multi-drug resistance (MDR) on TB recurrence over nine years in Henan Province China. We reviewed medical records and conducted field interviews of 100 MDR and 150 non-MDR TB patients who were treated between 2001 and 2002....

Background Low back pain (LBP) is a major cause of disability throughout the world. However, longitudinal evidence to relate low back pain and functional limitations is mostly confined to Western countries. In this study, we investigate the associations between low back pain and functional limitations in a prospective cohort of Thai adults. Methods...

p> BACKGROUND : Much of South East Asia is experiencing an epidemiological transition. In Thailand, chronic disease has emerged and the prevalence of diabetes has tripled. As part of a large cohort study of the Thai transition to chronic disease, we gathered data on self-reported diabetes. Epidemiological studies commonly ascertain such data by sel...

Background Type 2 diabetes mellitus (T2DM) is increasingly prevalent in countries undergoing rapid development, including Thailand. We assessed T2DM incidence over an 8-year period in a nationwide cohort of Thai adults. Methods Thai Cohort Study participants were surveyed in 2005, 2009 and 2013. The analysed cohort members were aged (15–88), did n...

Introduction Injury and psychological distress are public health priorities because of their high occurrence in the population. This study examines the longitudinal effects of injury characteristics on psychological distress. Methods Study participants were enrolled distance learning Thai adults (N = 42,785 at 2013 follow-up) residing nationwide....

Increase in body size has appeared as an epidemic in Western countries and is now rapidly emerging in low- and middle-income countries, contributing to the rise in non-communicable diseases worldwide. Brazil and Thailand have gone through similar economic and health transitions, and this unique comparative study investigates changes in body size (b...

In contrast to the mortality dynamics of the former socialist economies of Europe during their transition era, few studies have examined mortality changes in China since the start of its socialist economic reforms. This article examines mortality trends of Shanghai permanent residents during the transition from planned socialism to state capitalism...

Thailand has experienced dramatic growth of large national and international modern food retailers, such as supermarkets, hypermarkets and convenience stores in large cities and regional centres in the last two decades. Nevertheless, Thai consumers continue to purchase perishables (fruits, vegetables and animal products) from fresh markets (wet mar...

Background: We analyzed population-based injury trends and the association between injury and alcohol consumption patterns in Thailand, a middle-income country undergoing rapid social change. Methods: A nationwide cohort of 42 785 Thai adult Open University students, who were aged 15 to 87 years at enrolment, participated in cross-sectional asse...

Background As people in middle and lower income countries live longer, more people become sick, disabled, and frail and the demand for family caregiving grows. Thailand faces such challenges. This study investigates the relationship between caregiving and mental health among workers drawn from a large longitudinal cohort of Thai adults. Methods Pa...

Traditionally, Thais have bought their food from fresh markets. However, recently multi‐national supermarket chains have expanded rapidly so that currently, Thais procure food from both modern and traditional retail formats. If Thailand were to follow the Western pattern, supermarkets will become the dominant food retail format. We present a synthe...

Thailand is deeply linked to the world food system, with food exports key to the country's global connections. It has been a world leader in tackling poverty‐related malnutrition and is food secure at a national level. New challenges are emerging with increases in obesity and diet‐related disease as well as the relative poverty of farmers constrain...

Background: Heavy alcohol consumption is an established risk factor for non-communicable diseases (NCDs) but few studies have investigated drinking and disease risk in middle income, non-western countries. We report on the relationship between alcohol consumption and NCDs in Thailand. Methods: A nationwide cross sectional survey was conducted of...

Our research investigates the significance of frequent solo consumption of main meals and the association with a holistic wellbeing measure of happiness using data from 39820 Thai Cohort Study members who completed 8-year follow-up in 2013. This nationwide cohort has been under study since 2005 to analyse the dynamics and determinants of the health...

Background In rich countries, smokers, active or passive, often belong to disadvantaged groups. Less is known of tobacco patterns in the developing world. Hence, we seek out to investigate mental and physical health consequences of smoke exposure as well as tobacco-related inequality in transitional middle-income Thailand. Methods We studied a nat...

Background: Smoking is a strong risk factor for mortality in both the developed and the developing world. However, there is still limited research to examine the impact of smoking cessation and mortality in middle-income Southeast Asian populations. Methods: We use longitudinal data from a large Thai cohort of adult Open University students resi...

Background We conducted a cohort study to compare the characteristics of MDR-TB with non-MDR-TB patients and to measure long term (9-year) mortality rate and determine factors associated with death in China. Methods We reviewed the medical records of 250 TB cases from a 2001 survey to compare 100 MDR-TB patients with 150 non-MDR-TB patients who we...

This paper reviews the evolution of Thai food and nutrition label policies and Thailand’s international role relating to food product safety and standards. The historical record has been interpreted to identify future trends and challenges related to food labelling. These challenges are arising in Thailand and many similar emerging economies. Thai...

Background: Obesity and obesity related conditions, driven by processes such as urbanization and globalization, are contributing to pronounced cardiovascular morbidity and mortality in developing countries. There is limited evidence on the influence of living in an urban environment in early life on obesity and obesity related conditions later in...

Transnational food retailers expanded to middle-income countries over recent decades responding to supply (liberalized foreign investment) and demand (rising incomes, urbanization, female workforce participation, and time poverty). Control in new markets diffuses along three axes: socio-economic (rich to poor), geographic (urban to rural), and prod...

Objective: Tuberculosis (TB) poses a significant public health challenge in the 22 Pacific island countries and territories. Using TB surveillance data and World Health Organization (WHO) estimates from 2000 to 2013, we summarize the epidemiology of TB in the Pacific. Methods: This was a descriptive study of incident TB cases reported annually b...

Background: Systematic reform of nutrition labels in Thailand has not been attempted and there is a little information on Thai consumer understanding of existing labels. To fill this gap, we investigated Thai consumers and real food packages, identifying the difficulties and barriers consumers have with both Nutrition Information Panels (NIP) and G...

Most research on the influence of psychosocial job characteristics on health status has been conducted within affluent Western economies. This research addresses the same topic in a middle-income Southeast Asian country, enabling comparison with a Western benchmark. We analysed and compared the Health Survey for England conducted in 2010 and the Th...

Background: This qualitative study employed the Knowledge-Attitude-Behaviour (KAB) model and Health Belief Model (HBM) to investigate factors influencing Thai consumer decision making about use of nutrition labels. Labels include both Nutrition Information Panels (1998-) and Guideline Daily Amounts labels (2011-). Method: In-depth interviews wer...

Elimination of kala-azar is planned for South Asia requiring good surveillance along with other strategies. We assessed surveillance in Gaffargaon upazila (a subdistrict of 13 unions) of Mymensingh district, Bangladesh highly endemic for kala-azar. In 4703 randomly sampled households, within nine randomly sampled villages, drawn from three randomly...

Objectives: The aim of this study was to investigate the impact of motorcycle to car transitioning and urbanisation on traffic injury rates in Thailand. Design: Analysis of two consecutive surveys of a large national cohort study. Setting: Thailand. Participants: The data derived from 57,154 Thai Cohort Study (TCS) participants who provided...

Thailand is experiencing a development-associated health-risk transition with increasing prominence of chronic diseases. We aim to determine the risk factors for cardiovascular disease (CVD) deaths in Thailand. We conducted longitudinal analyses of deaths in the nationwide Thai Cohort Study from 2005 to 2010 (n=86866)using national vital registrati...

Objectives To determine the association between diabetes and the clinical features and treatment outcomes of TB in Kiribati.Methods We enrolled consecutive TB patients who presented from August 2010 to February 2012 and compared clinical features and TB treatment outcomes for patients with and without diabetes, as measured by hemoglobin A1c assay....

In order to better inform local management of TB-diabetes collaborative activities, we aimed to determine the prevalence of diabetes among persons with and without TB; and to determine the association between TB and diabetes in Kiribati, a Pacific Island nation. We compared consecutively enrolled TB cases to a group of randomly selected community c...

Contrairement aux dynamiques de mortalité des anciennes économies socialistes d’Europe durant leur période de transition, les changements de la mortalité en Chine depuis le début des réformes ont été peu étudiés. Cet article analyse les tendances de la mortalité des résidents permanents de Shanghai au moment où la Chine est passée du socialisme pla...

We investigate variation in body mass index (BMI) reference and 5-year all-cause mortality using data from 87151 adult Open University students nationwide. Analyses focused on BMI reference bands: "normal" (≥18.5 to <23), "lower normal" (≥18.5 to <20.75), "upper normal" (≥20.75 to <23), and "narrow Western normal" (≥23 to <25). We report hazard rat...

Copepod Mesocyclops as biological control agents for dengue was previously proven to be effective and sustainable in the Northern and Central provinces of Vietnam. We aim to study social sustainability of Mesocyclops intervention in south Vietnam. Both quantitative and qualitative approaches were used. An entomological survey was carried out in 100...

Background Few studies have examined the link between self-reported health (SRH) and subsequent mortality in developing countries, and very few considered mortality effects of changes in SRH. We examined the relationship between SRH and subsequent all cause or cause-specific mortality in Thailand. We also noted if mortality varied after people chan...

Background A relationship between happiness and mortality might seem obvious, but outside of affluent settings in developed countries there is almost no actual evidence that this is so. Findings We report our findings on happiness and mortality in Buddhist Southeast Asia. Our data are derived from a prospective nationwide cohort study of 60,569 Th...

Background Urban populations usually have higher levels of cardiovascular risk factors than rural populations in developing countries. However, association between cardiovascular risk factors and duration of urban dwelling, particularly for early stages of urban migrations, has not yet been adequately studied. We examined cardiovascular risks in re...

Purpose – The purpose of this paper is to investigate whether the food retail transition underway in Thailand, a transitional middle-income setting, is associated with increased consumption of processed foods high in fat, salt and energy. Such “problem foods” are important risks for avoidable cardio-vascular disease and diabetes burdens. Design/me...

Objective To present predictors of injury mortality by types of injury and by pre-existing attributes or other individual exposures identified at baseline. Design 5-year prospective longitudinal study. Setting Contemporary Thailand (2005–2010), a country undergoing epidemiological transition. Participants Data derived from a research cohort of 87 0...

Sugar sweetened beverages (SSBs) are implicated in the rising prevalence of obesity and diet-related chronic diseases worldwide. However, little is known about their contribution to weight gain in Asian populations. This study aimed to investigate weight change associated with SSB consumption between 2005 and 2009 in a large national cohort of Thai...

The setting for this study was the Pacific island nation of Vanuatu, an archipelago of 82 islands, located in the South Pacific Ocean. Our objective was to assess the knowledge, attitudes and practices of tuberculosis (TB) patients towards TB. This was a descriptive study using qualitative and quantitative methods. Quantitative analysis was based o...

This study was conducted in the Pacific island nation of Vanuatu. Our objective was to assess knowledge, attitudes and practice of traditional healers who treat lung diseases and tuberculosis (TB), including their willingness to collaborate with the national TB programme. This was a descriptive study using both qualitative and quantitative methods....

Surveys for chronic diseases, and large epidemiological studies of their determinants, often acquire data through self-report since it is feasible and efficient. We examined validity and associations of self-reported hypertension, as verified by physician telephone interview among participants in a large ongoing Thai Cohort Study (TCS). The TCS inv...

Socioeconomic status is a recognised determinant of health status, and the association may be mediated by unhealthy behaviours and psychosocial adversities, which, in developed countries, both aggregate in low socioeconomic sectors of the population. We explored the hypothesis that unhealthy behavioural choices and psychological distress do not bot...

We investigate the links between health and injury in Thailand. This is important because of the high burden of injury in transitional countries and limited information for public health. We analyse 2005 baseline and 2009, 4-year follow-up data from distance learning students of Sukhothai Thammathirat Open University residing nationwide (n = 60569)...

In the modern world a globalized food system has emerged, dominated by transnational food companies. Local food cultures, environments, and diets are being transformed with increased food availability and diversity reducing malnutrition worldwide; however, increased energy availability is driving an epidemic of obesity and diet-related disease. In...

This paper investigates associations between hazardous jobs,mental health and wellbeing among Thai adults. In 2005, 87134 distance-learning students from Sukhothai Thammathirat Open University completed a self-administered questionnaire at the 2009 follow-up 60 569 again participated. Job characteristics were reported in 2005, psychological distres...

There is limited evidence on the association between oral health and general health in middle-income countries. This study analysed data from 60,569 adult students enrolled at Sukhothai Thammathirat Open University and residing throughout Thailand who reported oral health impacts at the 2005 baseline and 2009 health status based on Short Form (SF-8...

This article reviews inequalities in health risks and outcomes based on a large longitudinal cohort study of distance-learning adult students enrolled at Sukhothai Thammathirat Open University (n = 87,134). The study began in 2005 and the first follow-up was completed in 2009. Risks analyzed for health inequalities were divided into demographic, so...

Background We investigated risk factors for fracture among young adults, particularly body mass index (BMI) and physical activity, which although associated with fracture in older populations have rarely been investigated in younger people. Methods In 2009, 4 years after initial recruitment, 58 204 Thais aged 19 to 49 years were asked to self-repo...

Objectives To explore individual determinants of workplace injury among Thai workers. Design Cross-sectional analysis of a large national cohort. Setting Thailand. Participants Thai Cohort Study participants who responded to the 2009 follow-up survey were included if they reported doing paid work or being self-employed (n=51 751). Outcome measures...

Thailand is undergoing a health-risk transition which increases chronic diseases, particularly hypertension, as a result of a rapid transition from a developing to a developed country. This study analyzes the effect of health-risk factors such as demography, socioeconomic status (SES) and body mass index (BMI) on the prevalence of hypertension. Thi...

A more rigorous and nuanced understanding of land-use change (LUC) as a driver of emerging infectious disease (EID) is required. Here we examine post hunter-gatherer LUC as a driver of infectious disease in one biogeographical region with a compressed and documented history-continental Australia. We do this by examining land-use and native vegetati...

Supplementary Information (PDF, 172 KB)

Objective This study evaluates the impact of a number of demographic, biological, behavioural and lifestyle health risk factors on the incidence of hypertension in Thailand over a 4-year period. Design A 4-year prospective study of health risk factors and their effects on the incidence of hypertension in a national Thai Cohort Study from 2005 to 20...

Thailand is promoting a sufficiency economy (SE) emphasizing community solidarity, mixed farming and sustainable agriculture. We analyze to what extent the SE philosophy is part of the daily lives of communities in Isan, NE Thailand. We interviewed rural household representatives and community leaders on education, employment, community dynamics, a...

Global warming will increase heat stress at home and at work. Few studies have addressed the health consequences in tropical low and middle income settings such as Thailand. We report on the association between heat stress and workplace injury among workers enrolled in the large national Thai Cohort Study in 2005 (N=58,495). We used logistic regres...