Boonyarat Warachit

Hatyai hospital, Amphoe Muang Songkhla, Songkhla, Thailand

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Publications (7)16.86 Total impact

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    ABSTRACT: The immunogenicity and safety of a pediatric dose of a virosomal hepatitis A vaccine (Epaxal®) was evaluated in a group of 45 Thai children with human immunodeficiency virus (HIV) infection, age 2-16 years. Vaccines were administered at 0 and 6 months. Anti-HAV antibody titers were measured at baseline (before injection) 1 and 7 months after primary vaccination. The prevalence of HAV protective antibody in 45 Thai HIV-infected children was 13.6%. The seroprotection rate was 71% at 1 month and 100% at 7 months. The booster dose increased geometric mean concentration (GMC) from 106.5 mIU/ml to 3486.1 mIU/ml. Higher CD4 lymphocyte counts at enrollment was a predictive factor for HAV antibody response. Both doses of Epaxal® were well tolerated. These preliminary data suggest that a pediatric dose of Epaxal® is an effective hepatitis A vaccine for HIV-infected children and should be considered for implementation on a larger scale in the pediatric HIV population.
    Vaccine 06/2011; 29(29-30):4735-8. · 3.77 Impact Factor
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    ABSTRACT: Three patients were admitted to Hat Yai Hospital, Songkhla Thailand with hemoptysis. They were previously healthy children aged 6, 13, and 14 years old who had attended schools in which outbreaks of influenza had occurred. They all had a history of fever, rhinorrhea, and severe cough accompanied by hemoptysis. Two developed hemoptysis on Day 3 and the third on Day 6 of illness, with one of them displaying massive hemoptysis. Chest radiographs were compatible with viral pneumonia in two cases and the third case was unremarkable. Coagulation profiles in the severe case were carried out and were normal. All the patients responded very well to treatment with oseltamivir and did not require intubation. Their subsequent nasopharyngeal swabs were positive for human pandemic influenza A H1N1 by real-time reverse transcription-polymerase chain reaction (RT-PCR), and their sputum for acid-fast bacilli and tuberculin skin tests were negative.
    The Southeast Asian journal of tropical medicine and public health 11/2009; 40(6):1259-63. · 0.61 Impact Factor
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    ABSTRACT: Safety and reactogenicity of a new heptavalent DTPw-HBV/Hib-MenAC (diphtheria, tetanus, whole cell pertussis-hepatitis B virus/Haemophilus influenzae type b-Neisseria meningitidis serogroups A and C) vaccine was compared with a widely used pentavalent DTPw-HBV/Hib vaccine. Three phase III randomized studies comparable in design and methodology, in which healthy infants received DTPw-HBV/Hib-MenAC (N=1334) or DTPw-HBV/Hib (N=446) at 2, 4, and 6 months, were pooled for analysis. Solicited symptoms were recorded for 4 days, and unsolicited adverse events for 31 days after each dose. Serious adverse events (SAEs) were recorded throughout the studies. There were no significant differences between the two groups in the proportion of subjects with fever >39.5 degrees C or >40.0 degrees C (p<0.005). Compared to group DTPw-HBV/Hib, a significantly higher percentage of subjects in group DTPw-HBV/Hib-MenAC reported fever >39 degrees C (21.2% vs. 14.8%, p=0.004). Fever subsided quickly, did not lead to differences in attendance to medical services and did not increase from dose to dose. Sixty-seven SAEs were reported, 56/1334 (4.2%) in group DTPw-HBV/Hib-MenAC and 11/446 (2.5%) in the DTPw-HBV/Hib group. Overall, the heptavalent and pentavalent vaccines had similar safety profiles. The difference observed in percentage of subjects with fever >39 degrees C did not lead to differences in medically attended visits for fever.
    International Journal of Infectious Diseases 01/2008; 12(1):88-97. · 2.36 Impact Factor
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    ABSTRACT: A trial to compare the reactogenicity and immunogenicity of a reduced antigen content diphtheria-tetanus-acellular pertussis (dTpa) vaccine with diphtheria-tetanus-whole-cell pertussis (DTPw) vaccine was conducted in Thailand. Three hundred and thirty children aged 4-6 years, primed with four doses of DTPw, received a single injection of either dTpa or DTPw. There was a significantly lower incidence of local and general reactions following dTpa than DTPw (P<0.001). One month after vaccination, 99.4 and 100% of all subjects had protective anti-diphtheria and -tetanus titers, respectively. The vaccine response rate to pertussis antigens was similar in both groups, with 96.9% versus 92.5% for anti-pertussis toxin (PT), 96.9% versus 97.5% for anti-filamentous hemagglutinin (FHA) and 95.1% versus 90.8% for anti-pertactin (PRN) in the dTpa and DTPw groups, respectively. For anti-BPT, the vaccine response in the dTpa group was 29.6% versus 94.4% for DTPw. In conclusion, the dTpa vaccine was as immunogenic and significantly better tolerated than DTPw. The new dTpa vaccine could improve coverage for routine booster vaccination in children and provide a good replacement for DTP vaccines at 4-6 years of age.
    Vaccine 10/2003; 21(27-30):4194-200. · 3.49 Impact Factor
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    ABSTRACT: The primary objective of this study was to estimate the efficacy of a recombinant hepatitis B vaccine (H-B-VAXII) in preventing chronic hepatitis B infection when given alone without concomitant hepatitis B immune globulin (HBIG) to healthy Thai infants born of HBeAg-positive carrier mothers. The infants received a 0.5 ml (5 micro g HBsAg) intramuscular injection of H-B-VAXII either at birth, 1, and 6 months of age (Schedule A) or at birth, 1, 2, and 12 months of age (Schedule B). Blood drawings for the determination of hepatitis B virus (HBV) serologic markers were scheduled 4, 9, and 13 months following the initial dose of vaccine. At 13 months, 5 (10%) of 50 infants vaccinated on Schedule A and 7 (14.9%) of 47 infants vaccinated on Schedule B had experienced chronic HBV infection. Based on an expected infection rate in unimmunized infants of either 70 or 90%, the overall efficacy for both schedules combined was estimated to be 82.3% (95% CI: 70.6, 90.6) or 86.2% (95% CI: 77.1, 92.7), respectively. Corresponding schedule-specific estimates were for Schedule A: 85.7% (95% CI: 68.8, 95.3) or 88.9% (95% CI: 75.8, 96.3) and for Schedule B: 78.7% (95% CI: 59.6, 91.1) or 83.4% (95% CI: 68.6, 93.1). These results suggest that in areas of high endemicity, where mothers may not always be screened for HBV infection, routine vaccination of infants at birth with a course of hepatitis B vaccine alone should be highly protective, even for very high-risk infants of HBeAg-positive mothers.
    Vaccine 12/2002; 20(31-32):3739-43. · 3.49 Impact Factor
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    ABSTRACT: This study was conducted to elucidate the magnitude of problem and the clinical course of invasive meningococcal infection from 13 government hospitals in Thailand between 1994 and 1999. Thirty-six strains of Neisseria meningitidis were isolated from 16 blood and 24 cerebrospinal fluid specimens; 4 patients had positive culture in both blood and CSF. Of the 16 strains, 9 (56.3%) were serogroup B. Seventy-one and eighty-four percent of the isolates were susceptible to penicillin and cefotaxime/ceftriaxone respectively. Five out of six penicillin-nonsusceptible strains were found to be relatively resistant to penicillin with the MIC of 0.125 microg/ml. Of 33 patients whose medical records were available, 21 were males and 12 were females, with a mean age of 11.2 years. Fifteen patients (45.5%) presented with meningococcemia and 18 patients (54.5%) presented with meningococcal meningitis. Hypotension and purpura were found in 24.2% and 33.3% of patients respectively. The overall mortality rate was 9.1%. In conclusion, meningococcal disease is not common in Thailand, meningococcemia is a life-threatening condition whereas meningococcal meningitis is much less severe. The prevalence of meningococci relatively resistant to penicillin seems to be increasing.
    The Southeast Asian journal of tropical medicine and public health 01/2001; 31(4):708-11. · 0.61 Impact Factor
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    ABSTRACT: Blood samples were collected from healthy subjects, aged 9 months-29 years in urban and rural communities from 4 distinct regions in Thailand, to determine the seroprevalence rate of varicella-zoster virus (VZV) antibody and its relationship with demographic, climatic, and socioeconomic factors. The overall seroprevalence rate was 52.8% and increased from 15.5% in the 9-month to 4-year-old group to 75.9% in the 20-29 year-olds. The age-adjusted seroprevalence was significantly higher in the cooler than in the warmer regions. In the warmer regions only, the age-specific seroprevalence was significantly higher in the urban population than in the rural population. In Thailand, climate is the main determinant of VZV seroprevalence. The delayed onset of natural immunity is more marked in warmer climate areas. Population density is a secondary determinant; in the warmer areas, the pattern of adolescent and adult susceptibility was greater in rural than in urban areas.
    The American journal of tropical medicine and hygiene 64(3-4):131-6. · 2.53 Impact Factor