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Thai in vitro
In Thailand, infertility remains a source of stigma for those couples that combine a range of religious, traditional and high-tech interventions in their quest for a child. This book explores this experience of infertility and the pursuit and use of assisted reproductive technologies by Thai couples. Though using assisted reproductive technologies is becoming more acceptable in Thai society, access to and choices about such technologies are mediated by differences in class position. These stories of women and men in private and public infertility clinics reveal how local social and moral sensitivities influence the practices and meanings of treatment.
eBook
Disparities in Childhood Obesity Prevalence and Spatial Clustering Related to Socioeconomic Factors in Isaan, Thailand
Globally, rapid economic growth has contributed to an overall increase in the incidence of childhood obesity. Although the prevalence of obesity has been well recognized, the disparities related to a region’s socioeconomic environment in terms of the incidence of obesity are still less understood. Therefore, the purpose of this study was to examine the spatial pattern of childhood obesity and identify the potential associations between childhood obesity and socioeconomic environment in the northeastern region of Thailand, Isaan. Using nationally collected obesity data from children aged 0–5 years in 2019, we employed a geographic information system (GIS) to perform obesity cluster analysis at the smaller regional level, investigating a total of 322 districts in study area. Global and local statistical approaches were applied to calculate spatial associations between the socioeconomic status of neighborhoods and childhood obesity. The study revealed that 12.42% of the total area showed significant clusters at the district level, with high values observed in the western and northeastern areas. The results of the spatial statistical model revealed that childhood obesity was significantly positively associated with areas exhibiting high levels of socioeconomic environment factors. Identifying the associated factors and highlighting geographic regions with significant spatial clusters is a powerful approach towards understanding the role of location and expanding the knowledge on the factors contributing to childhood obesity. Our findings, as a first step, offer valuable references that could support policy-makers and local authorities in enhancing policy development with the aim of reducing childhood obesity and improving public health.
Journal Article
Health equity and COVID-19: global perspectives
The COVID-19 is disproportionally affecting the poor, minorities and a broad range of vulnerable populations, due to its inequitable spread in areas of dense population and limited mitigation capacity due to high prevalence of chronic conditions or poor access to high quality public health and medical care. Moreover, the collateral effects of the pandemic due to the global economic downturn, and social isolation and movement restriction measures, are unequally affecting those in the lowest power strata of societies. To address the challenges to health equity and describe some of the approaches taken by governments and local organizations, we have compiled 13 country case studies from various regions around the world: China, Brazil, Thailand, Sub Saharan Africa, Nicaragua, Armenia, India, Guatemala, United States of America (USA), Israel, Australia, Colombia, and Belgium. This compilation is by no-means representative or all inclusive, and we encourage researchers to continue advancing global knowledge on COVID-19 health equity related issues, through rigorous research and generation of a strong evidence base of new empirical studies in this field.
Journal Article
Access to Healthcare Services among Thai Immigrants in Japan: A Study of the Areas Surrounding Tokyo
Numerous undocumented and uninsured foreigners living in Japan have faced barriers when trying to obtain appropriate healthcare services, which have occasionally led to issues with unpaid medical bills to medical institutions. Although information on health and socioeconomic status is essential to tackle such issues, relevant data has been unavailable due to difficulties in contacting this population. This study involved a cross-sectional survey using questionnaires concerning the general demographic characteristics, socioeconomic status, health profiles, information access, and knowledge/attitude/practice of health insurance of Thai nationals living in Japan. The study participants included Thai nationals who lived in Tokyo and the surrounding prefectures. The survey was conducted mainly at public religious events from September 2022 to December 2022. Overall, the questionnaires were obtained from 84 participants, though 67 participants were included in the final analysis after excluding missing variables. There were participants with unspecified visa status (32.8%) and uninsured status (40.3%). Among them, 86.4% expressed positive attitudes towards health insurance. However, multivariate multivariable regression analyses revealed the low insurance practice status among the unspecified visa group (aOR, 0.02; 95% CI, 0.00–0.13). Overall, the results reveal limited access to healthcare services in subgroups of Thai immigrants in Japan.
Journal Article
Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Low- and Middle-Income Countries
Vaccination is fast becoming a key intervention against the ongoing COVID-19 pandemic. We conducted cross-sectional online surveys to investigate COVID-19 vaccine acceptance across nine Low- and Middle-Income Countries (LMICs; N = 10,183), assuming vaccine effectiveness at 90% and 95%. The prevalence of vaccine acceptance increased from 76.4% (90% effectiveness) to 88.8% (95% effectiveness). Considering a 90% effective vaccine, Malaysia, Thailand, Bangladesh, and five African countries (Democratic Republic of Congo, Benin, Uganda, Malawi, and Mali) had lower acceptance odds compared to Brazil. Individuals who perceived taking the vaccine as important to protect themselves had the highest acceptance odds (aOR 2.49) at 95% effectiveness.Vaccine acceptance was also positively associated with COVID-19 knowledge, worry/fear regarding COVID-19, higher income, younger age, and testing negative for COVID-19. However, chronic disease and female gender reduced the odds for vaccine acceptance. The main reasons underpinning vaccine refusal were fear of side effects (41.2%) and lack of confidence in vaccine effectiveness (15.1%). Further research is needed to identify country-specific reasons for vaccine hesitancy in order to develop mitigation strategies that would ensure high and equitable vaccination coverage across LMICs.
Journal Article
Prevalence of Diabetes and Relationship with Socioeconomic Status in the Thai Population: National Health Examination Survey, 2004–2014
Objective. To determine the prevalence and trend of diabetes, related glycemic control, and influential socioeconomic (SES) factors in the Thai population aged ≥20 years during 2004–2014. Methods. Data from the Thai National Health Examination Survey 2004, 2009, and 2014 were used. Age-adjusted prevalence was calculated, and the associations of education levels with prevalence of diabetes and glycemic control were examined using logistic regression. Results. Age-adjusted prevalence of diabetes increased from 7.7% in 2004 to 7.8% in 2009 and 9.9% in 2014 (8.9% among men and 10.8% among women). Proportions of undiagnosed diabetes were slightly decreased but remained high in 2014 (51.2% for men and 41.3% for women). Diabetes prevalence was higher among those with primary education in both sexes; however, undiagnosed diabetes was higher among women with secondary and university educations. The percentages of those treated and controlled slightly improved among men (45.9%) but not among women (36.4%). Unmet glycemic control was also higher among women with secondary education levels and among men with university-level educations. Conclusions. Epidemic diabetes continues to grow in the Thai population, particularly in individuals with lower educational attainment. Measures to detect new cases and strengthen glycemic control should be scaled up.
Journal Article
The Dynamics of Migration, Health and Livelihoods
Using INDEPTH's multi-site network to provide new demographic insights into population variables, this book provides a new perspective on migration, health and livelihood's interaction over time. The book starts with providing a conceptual and methodological framework to inform the epidemiological studies that are clustered into two themes, showing the dynamics of migration with either household livelihoods or individual health outcomes. The findings demonstrate the important cross-national regularities in human migration. The contributed chapters also exemplify the fact that the impacts of migration can be either positive or negative for sending and/or receiving communities, depending on the issues at hand and the type of migration under consideration.
eBook
Maternal undernourishment impairs murine placental development during pregnancy
Background
Maternal undernourishment (MUN) is a public health issue in developed and underdeveloped countries. There is a wide range of causes, from poor access to nutrition to hyperemesis gravidarum. This condition can adversely affect the development of the placenta, the critical interface between mother and fetus, producing adverse outcomes such as anemia, hemorrhage, developmental delays, and low birth weight (LBW) neonates.
Methods
We use a murine undernourishment model to examine the consequences of MUN on the placenta at the whole organ and trophoblast (extraembryonic cells that form the placenta) levels. Pregnant dams of this model consumed a combined reduced protein and caloric diet during gestation, resulting in the generation of LBW offspring. We examined placental vascularization (immunostaining), vascular reactivity (myography), and blood perfusion (laser-Doppler flowmetry). We further examined drivers of placental pathology during MUN in both whole placenta and primary trophoblast cells, such as oxidative stress (including mitochondrial), on trophoblast quantity, apoptosis, proliferation, and differentiation. Therapeutic drugs were also investigated to elucidate the pathways involved and as possible interventions.
Results
Analysis revealed that MUN reduced placental weight, altered the labyrinth/junctional zone ratio, and compromised overall trophoblast integrity and pool size. Increased oxidative stress production and dysregulated endogenous antioxidant mechanisms contribute to the associated impairments in the MUN placenta. Uterine blood flow, umbilical vein vasoreactivity, placental vascularization, and placental efficiency are also hindered, effects modulated by oxidative stress, including that produced by mitochondrial and toll-like receptor 4-sensitive pathways.
Conclusions
MUN upregulates oxidative stress in the placenta, an effect that consequently reduces trophoblast pools while impairing placental development and vascular function. Our study also implicates mitochondrial superoxide production and TLR4 in the detrimental impact of MUN on placental vascular function and development while identifying therapeutic agents as possible add-on interventions.
Journal Article
Personal wellbeing and depression among Thai people living in poverty: evidence from the COVID-19 crisis
Background
Understanding the multifaceted impacts of global crises on vulnerable populations remains critical. This cross-sectional study examines associations between individual and contextual characteristics, personal wellbeing, and depressive symptoms among individuals living below the national poverty line, utilizing secondary data collected in 2021 during the COVID-19 pandemic.
Methods
A structural equation model was applied to examine how socio-demographic characteristics, economic conditions, and health behaviors were associated with mental health outcomes, estimating both direct and indirect pathways between personal wellbeing and depressive symptoms.
Results
Among the 694 participants, 12.8% reported mild to moderate depressive symptoms. Older individuals and those who experienced changes in their work status during the pandemic reported lower levels of wellbeing and higher levels of depressive symptoms. These patterns may reflect heightened socioeconomic and psychosocial challenges faced by people living in poverty during crisis conditions. Additionally, individuals living in municipal areas and those with lower physical activity levels were more likely to report depressive symptoms. Although the study was conducted during the pandemic period, the findings illustrate how structural disadvantages and behavioral factors were associated with mental wellbeing among people living in poverty.
Conclusions
These findings remain relevant for informing mental health and social protection strategies in future public health or economic crises.
Journal Article