Surachai Phimha’s research while affiliated with Khon Kaen University and other places

The misuse of antibiotics has become a significant problem in Thailand and was particularly exacerbated after the COVID-19 pandemic. Increased access to antibiotics during the pandemic has led to a heightened risk of irrational antibiotic use. This study aimed to analyze the relationships and identify factors associated with antibiotic usage behavior among the Thai population. To examine the factors influencing antibiotic use behavior in Thailand post-COVID-19 and to provide recommendations for targeted interventions. This study utilized secondary data from the 2021 health and welfare survey conducted by the National Statistical Office of Thailand. A total sample of 25,833 individuals was analyzed using multiple logistic regression, adjusting for covariates including demographic factors, health status, and healthcare utilization patterns. The key factors influencing antibiotic use included experiencing illness (adjusted OR: 6.74, 95% CI: 6.11–7.44), sustaining injuries from accidents (adjusted OR: 2.84, 95% CI: 2.19–3.67), receiving dental care (adjusted OR: 1.44, 95% CI: 1.25–1.66), and illness without hospital admission (adjusted OR: 1.60, 95% CI: 1.23–2.10). Additionally, knowledge of antibiotic use was significantly associated with antibiotic use behavior, with those having low knowledge showing higher odds of antibiotic use compared to those with high knowledge (adjusted OR: 2.75, 95% CI: 2.32–3.27). The findings highlight the need for targeted interventions to address inappropriate antibiotic use. The government and relevant agencies should promote health awareness and literacy, develop effective medication, and implement stricter regulations to minimize the adverse effects of antibiotic misuse. Enhanced public education and ensuring access to accurate information from healthcare professionals are essential for mitigating the threat of antimicrobial resistance in Thailand.

Background Epilepsy has a significant impact on individuals’ lives, as well as on society and the economy, due to its unpredictable nature and the financial burden it places on those affected. Even though Thai citizens hold health benefits or health insurance, excess costs can occur; thus, this study aimed to describe the direct medical costs among hospitalized patients with epilepsy from both social and patient perspectives. Moreover, the factors associated with costs were investigated. Methods This was a prevalence-based cost-of-illness study using data from the Thailand National Health Security Office database. Patients who were diagnosed with epilepsy (ICD-10 code G40) and admitted to the hospital in the fiscal year 2022 were included. Direct medical costs were reported from societal and patient perspectives. A generalized linear model with gamma distribution and log-link function was employed to investigate the factors influencing these costs. Results Among 31,635 epilepsy visits, the mean direct medical costs from a societal and patient perspective were 1,043.45 PPP-USD and 14.02 PPP-USD per visit, respectively. From a societal perspective, patients who underwent procedures experienced a substantial increase of 120.9% in costs compared to those without procedures, while hospital stays exceeding one week showed a significant 750.1% increase in costs compared to shorter stays. Furthermore, female sex, older age, and the presence of comorbidities or complications significantly increase costs. From the patient’s perspective, those with comorbidities or complications during admission had a 56.0% increase compared to those without such conditions. Moreover, elderly patients, those who underwent procedures, and individuals with extended hospital stays were associated with increased costs. Conclusions Factors influencing costs were hospital stay duration, comorbidities or complications, and types of procedures.

The utilization of antibiotics among the geriatric population in Thailand has been markedly influenced by the COVID-19 pandemic. This investigation sought to analyze the correlation between antibiotic utilization and determinants such as pharmacy density, healthcare workforce, household internet accessibility, and income during the period of 2021–2023. A spatial examination employing panel regression was performed on data derived from Thailand’s National Statistical Office Health and Welfare Survey 2023, encompassing all 77 provinces. The research scrutinized antibiotic usage trends among individuals aged 60 and above, associating them with diverse socioeconomic and healthcare access metrics. Notable spatial and temporal variations in antibiotic utilization were detected. The physician ratio demonstrated a negative association with antibiotic usage (Coefficient=− 0. 613, P = 0.035), while household internet accessibility showed a positive relationship (Coefficient = 0.003, P = 0.001). Household income exhibited a slight negative effect (Coefficient=− 0.0002, P = 0.024). No statistically significant associations were found between antibiotic usage and pharmacy density or nurse ratio. The study clarifies complex interrelations between healthcare accessibility, socioeconomic determinants, and antibiotic usage among the elderly in post-COVID-19 Thailand. These results indicate the necessity for targeted interventions to foster judicious antibiotic utilization, including enhancements in healthcare accessibility, the development of dependable digital health infrastructures, and the execution of income-sensitive health education initiatives.

Background Risky sexual behaviors refer to actions or practices that increase the likelihood engaging in sexual intercourse. Such behavior can lead to HIV infection/AIDS, sexually transmitted diseases, and unintended pregnancy. The impact of risky sexual behaviors is a growing public health concern. These issues pose significant challenges to public health, particularly among university students and younger age groups who may be more vulnerable to various factors. Thus, this research aimed to examine the factors and sexual health literacy associated with risky sexual behaviors among undergraduate students in the four major regions of Thailand. Method A cross-sectional study was conducted among 916 undergraduate students in their final semester of the 2023 academic year, from March to May 2024, at public, autonomous, and private universities across four regions: northern, central, southern, and northeastern of Thailand. The study employed multistage random sampling method. A self-administered structured questionnaire was used to assess risky sexual behaviors and the data were analyzed using multiple logistic regression. Results A total of 916 students participated in the study. The prevalence of risky sexual behavior was 46.84% (95% CI:43.56% to 50.12%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with grade point averages (GPA) between 2.00–3.00 could protective risky sexual behaviors was 42% as compared to GPA > 3.00 (AOR = 0.58, 95%CI:0.42 to 0.79), ex-substance use (AOR = 3.48, 95%CI:1.46 to 8.26), Current smoker (AOR = 2.90, 95%CI:1.90 to 4.43), negative attitudes toward risky sexual behaviors (AOR = 2.32, 95%CI:1.32 to 4.06), access to places of ill repute and access to sexual arousal stimuli (sometime) (AOR = 2.23, 95%CI:1.41 to 3.52), social influences (high level) (AOR = 0.29, 95%CI:0.15 to 0.55), and sufficient to excellent level of the application of information about sexual health (AOR = 0.48, 95%CI:0.26 to 0.87) of statistical significance at P < 0.05, which was significantly associated with risky sexual behavior. Conclusion The findings of this study offer important insights for preventing risky sexual behaviors among undergraduate students across four regions. By promoting healthy sexual practices and encouraging behavior modification, negative consequences can be reduced. Public health care providers, policymakers, and stakeholders should implement tailored strategies, such as comprehensive sexual education and accessible health services, to address the specific needs of these students. These targeted interventions can significantly reduce the prevalence of risky sexual behaviors.

Community leaders in Thailand play an important role in preventing and controlling infectious diseases, especially during the COVID-19 pandemic. Hence, risk perception and adequate health literacy among these leaders influence the population. This cross-sectional study aimed to investigate the relationships among health literacy, risk perception factors, and the implementation of COVID-19 prevention and control. A self-administered structured questionnaire was administered to 1,338 community leaders in northeast Thailand to assess the level of implementation of COVID-19 prevention and control measures. Multiple logistic regression was performed to identify the influence of risk perceptions and health literacy on the prevention and control of COVID-19. Approximately 64% of the sample was male, and the participants had an average age of 50.51 ± 8.47 years. The factors associated with moderate and high levels of COVID-19 prevention and control among community leaders were moderate and high levels of perceived susceptibility (adjusted odds ratio [ORadj] = 3.01; 95% CI: 2.13–4.25; p-value < 0.001) and perceived severity (ORadj = 1.73; 95% CI: 1.22–2.45; p-value = 0.023) as well as adequate access (ORadj = 1.56; 95% CI: 1.08–2.25; p-value < 0.001) and adequate understanding (ORadj = 2.29; 95% CI: 1.34–3.93; p-value < 0.001), with a level of statistical significance of 0.05. The incorporation of health literacy and risk perception, especially in dimensions such as access, understanding, perceived susceptibility, and perceived severity, is essential for leaders to possess strong skills in community health development, particularly during crises such as the COVID-19 pandemic.

University students have been faced with challenges, including COVID-19 public stigma, which results in increased stress and depression. Few studies have assessed stress, depression, and public stigma of COVID-19 after the pandemic. This paper investigated stress, depression, and public stigma of COVID-19 among Thai University students. A cross-sectional study was conducted using an online questionnaire to assess stress, depression, and public stigma resulting from COVID-19 among Thai university students between 15 and 30 August 2022. The questionnaire was developed by the Department of Mental Health, Ministry of Public Health, Thailand. Public stigma was measured by the COVID-19 public stigma scale. The effects of public COVID-19 stigma on stress and depression were analyzed using multivariable multi-level logistic regression. A total of 2,422 students completed the questionnaire. After multivariable analysis adjustment, students who experienced COVID-19 public stigma showed increased stress (AOR = 1.53; 95% CI [1.27–1.84]) and depression levels (AOR = 1.34; 95% CI [1.01–1.79]). Those who lived with high-risk COVID-19 individuals showed significant risk factors for stress, depression, and public stigma of COVID-19, while income presented the reverse effect. Those vaccinated with over two doses showed significantly reduced chances of depression. The COVID-19 public stigma plays a vital role in stress and depression levels among Thai university students. To mitigate stress and depression, an evaluation of public stigma is needed even after the pandemic. Further cohort studies are required to verify long-term results.

Background Dengue is a viral infection that spreads from mosquitoes to people. It is especially prevalent in tropical and subtropical regions of the world. To address the challenges posed by dengue in countries such as Thailand, effective prevention and control to strengthen health literacy at the community level is needed. One way of achieving this goal is to work with village health volunteers (VHVs). This article documents the use of VHVs for dengue fever prevention in Mueang district, Khon Kaen province, northeast Thailand. Method A quasi-experimental study was conducted. The experimental group comprised 45 people who received a programme that aimed to enhance health literacy through the provision of knowledge and social support by community-based volunteers accompanied by a short drama programme. A group of 45 people receiving health services without the drama programme comprised the comparison group. The duration of the activity was 12 weeks. Data were collected by means of a pre- and post-test survey and were analysed using descriptive statistics and a comparison of mean health literacy and practice scores before and after the intervention. Results Following programme delivery, the experimental group had a mean health literacy score which was significantly higher than that of the comparison group, while the mean practice score of the experimental group was also higher than that of the comparison group. Conclusion The results suggest that a health literacy programme which includes a short drama programme could be effective in bringing about desired changes with respect to dengue fever prevention. The programme provided in this study was effective and easy to understand. The model developed here could also be useful in other villages in epidemic areas.

Background The misuse of antibiotics has become a significant problem in Thailand and was particularly exacerbated after the COVID-19 pandemic. Increased access to antibiotics during the pandemic has led to a heightened risk of irrational antibiotic use. This study aimed to analyze the relationships and identify factors associated with antibiotic usage behavior among the Thai population. Methods To examine the factors influencing antibiotic use behavior in Thailand post-COVID-19 and to provide recommendations for targeted interventions. This study utilized secondary data from the 2021 health and welfare survey conducted by the National Statistical Office of Thailand. A total sample of 22,173 individuals was analyzed using multilevel logistic regression, controlling for covariates including region, province, and municipal areas. Results The key factors influencing antibiotic use included experiencing illness (adjusted OR: 4.96, 95% CI: 4.40–5.60), sustaining injuries from accidents (adjusted OR: 2.82, 95% CI: 2.19–3.64), hospital admission due to illness (adjusted OR: 1.64, 95% CI: 1.41–1.92), receiving dental care (adjusted OR: 1.31, 95% CI: 1.04–1.65), being ill but not receiving hospital treatment (adjusted OR: 1.84, 95% CI: 1.39–2.44), having problems and being unable to care for oneself (adjusted OR: 1.72, 95% CI: 1.42–2.08), ceasing prescribed medication (adjusted OR: 2.72, 95% CI: 2.40–3.09), and receiving information about antimicrobial resistance (adjusted OR: 5.09, 95% CI: 4.52–5.73). Conclusion The findings highlight the need for targeted interventions to address inappropriate antibiotic use. The government and relevant agencies should promote health awareness and literacy, develop effective medication reimbursement policies, and implement stricter regulations to minimize the adverse effects of antibiotic misuse. Enhanced public education and ensuring access to accurate information from healthcare professionals are essential for mitigating the threat of antimicrobial resistance in Thailand.

Background Erythrosine+potassium iodide-mediated photodynamic therapy has shown an anticandidal effect. Single session, however, has inadequate fungal inhibition. Objectives We aimed to examine the effects of multiple aPDT sessions on Candida albicans inhibition and singlet oxygen formation. Methods 220 μM erythrosine +/-100 mM potassium iodide was applied to C. albicans biofilms for 1 min prior to irradiation at 530±10 nm using a 250 mW/cm² light-emitting diode. Negative and positive controls were phosphate buffer saline and nystatin, respectively. Single, double and triple irradiation sessions with a 5 min resting time between sessions were performed. Post-treatment candidal counts were done at 0, 1 6 and 24 hr while log10 colony forming unit/ml was calculated and compared using a Kruskal-Wallis with Dunn’s post hoc test at a p<0.05 - Singlet oxygen amount was compared using one-way ANOVA with a post hoc test at a p< 0.05. Results Two and three irradiation sessions to erythrosine+potassium iodide could inhibit Candida albicans at 7.92 log10CFU/ml (p < 0.001) . Singlet oxygen from a combination groups was significantly higher than for erythrosine (positive control). Moreover, the correlation coefficient (r) between singlet oxygen production and decreased Candida albicans counts was equal to 1. Conclusion Multiple sessions PDT of 220 μM erythrosine+100 mM potassium iodide effectively inhibited a Candida biofilm.