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Acceptance and accessibility to the early phase COVID-19 vaccination among the healthcare workers and hill tribe population in Thailand.

ABSTRACT: Coronavirus disease 2019 (COVID-19) is a serious emerging disease and an extreme threat to human life. This study aimed to understand the perceptions of hill tribe people living in the border areas of Thailand-Myanmar and health workers regarding the acceptability and accessibility of the COVID-19 vaccine and health workers' perceptions of the readiness to implement the vaccination program during the early period of national COVID-19 vaccination. A qualitative method was applied to elicit information from key informants who lived in hill tribe villages and the health professionals who served them. The study was conducted in seven hill tribe villages located along the Thailand-Myanmar borders in Mae Fah Luang District, Chiang Rai Province, Thailand. The participants were hill tribe villagers aged 20 years and over; public health care professionals working in village health centers who had primary roles in implementing disease prevention and control measures; and public health care professionals working in districts and provincial public health offices who had primary roles in policy development and implementation. A total of 63 participants (26 men and 37 women) from seven hill tribe villages provided information. Three acceptance choices regarding receiving the COVID-19 vaccine were found among the hill tribes: definite acceptance, likely acceptance, and no preference. Two factors related to obtaining access to the new COVID-19 vaccine were found: Thai citizenship and the level of literacy related to the vaccine. There was no process or protocol in place for implementing the new vaccine among health professionals working at the district, subdistrict, or community levels, but the national expanded immunization program (EPI) system was clearly demonstrated to extend throughout the health service chain in Thailand. During the early period of national COVID-19 vaccine implantation in Thailand, not all members of the hill tribes accepted the vaccine; participant acceptance depended on several factors, including a participant's previous experience with vaccination, whether he or she required more information before making a decision, etc. While acceptance of the vaccine depended on the individual's background, not everyone had an equal opportunity to access the vaccine. The new COVID-19 vaccine should be available at the village level, including in hill tribe villages, to reduce the systemic threat to the country.

SUBMITTER: Wongnuch P

PROVIDER: S-EPMC9244445 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThalassemia is a severe disease that occurs due to abnormalities in hemoglobin genes. Various genetic factors in different populations lead to different clinical manifestations of thalassemia disease, particularly among people who have a long history of migration and who have married among tribes, such as the hill tribe people in Thailand. This genetic epidemiological study aimed to estimate the prevalence of various forms of thalassemia among the six main hill tribe populations in Thailand.MethodsA cross-sectional study was conducted to obtain information and blood specimens from school children belonging to one of the six main hill tribes in Thailand: Akha, Lau, Hmong, Yao, Karen, and Lisu. Hill tribe children who were attending grades 4-6 in 13 selected schools in Chiang Rai Province, Thailand, were invited to participate in the study. A validated questionnaire and 3 mL blood specimens were collected after obtaining information consent forms from both the children and their parents on a voluntary basis. A complete blood count (CBC) was performed, followed by osmotic fragility (OF) and dichlorophenol indophenol precipitation (DCIP) tests to screen for thalassemia. High-performance liquid chromatography (HPLC) and real-time quantitative polymerase chain reaction (qPCR) were used to identify hemoglobin type and α-thalassemia, respectively. A t-test, chi-square and logistic regression were used to detect the associations between variables at the significance level of α = 0.05.ResultsA total of 1,200 participants from 6 different tribes were recruited for the study; 50.0% were males, and 67.3% were aged 11-12 years. The overall prevalence of thalassemia carriers according to the screening tests was 9.8% (117 of 1,200). Among the cases, 83 were A2A (59 cases were α-thalassemia 1 carrier or α-thalassemia 2 carrier or homozygous α-thalassemia 2, and 24 cases were β-thalassemia trait with or without α-thalassemia); 1 case was EE (homozygous Hb E with or without α-thalassemia); 31 cases were EA (30 cases were the Hb E trait, and 1 case was Hb E trait with or without α-thalassemia); 1 case was A2A Bart's H (Hb H disease α-thalassemia 1/α-thalassemia 2); and 1 case was A2A with abnormal Hb. The prevalence of the α-thalassemia 1 trait among the hill tribe population was 2.5%. The greatest prevalence of the α-thalassemia 1 trait was found in the Karen (3.0%) and Hmong (3.0%) tribes.ConclusionsThe prevalence of some forms of thalassemia in the hill tribe population is higher than that in the Thai and other populations. Effective and available thalassemia screening tests, including essential information to protect the next generation through the specific counseling clinic, are crucial, particularly due to increasing marriages within these populations.

Project description:BackgroundPrediabetes is a major silent health problem that leads to the development of diabetes within a few years, particularly among those who have a low socioeconomic status. Hill tribe people are vulnerable to prediabetes due to their unique cultural cooking methods and their hard work on farms, as well as their low economic status and educational levels. This study aimed to estimate the prevalence of prediabetes among hill tribe people in Thailand and identify the related factors.MethodsThis cross-sectional study included participants who belong to one of the six main hill tribes: Akah, Lahu, Hmong, Yao, Karen, and Lisu. The study was conducted in 30 hill tribe villages in Chiang Rai Province, Thailand. A validated questionnaire was administered, and 5-mL blood specimens were collected. Data were collected between November 2019 and March 2020. Logistic regression was used to determine the associations between independent variables and prediabetes.ResultsA total of 1,406 participants were recruited for the study; 67.8% were women, 77.2% were between 40 and 59 years old, and 82.9% were married. The majority worked in the agricultural sector (57.2%), had an annual income ≤ 50,000 baht (67.5%), and had never attended school (69.3%). The prevalence of prediabetes was 11.2%. After controlling for age and sex, five factors were found to be associated with prediabetes. Members of the Akha and Lisu tribes had 2.03 (95% CI = 1.03-3.99) and 2.20 (95% CI = 1.10-4.42) times higher odds of having prediabetes than Karen tribe members, respectively. Those with hypertension (HT) had 1.47 (95% CI = 1.03-2.08) times higher odds of having prediabetes than those with normal blood pressure. Those with a normal total cholesterol level had 2.43 (95% CI = 1.65-3.58) times higher odds of having prediabetes than those with a high total cholesterol level. Those with a high triglyceride level had 1.64 (95% CI = 1.16-2.32) times higher odds of having prediabetes than those with a normal triglyceride level. Those with a high low-density lipoprotein cholesterol (LDL-C) level had 1.96 (95% CI = 1.30-2.96) times higher odds of having prediabetes than those with a normal LDL-C level.ConclusionAppropriate dietary guidelines and exercise should be promoted among hill tribe people between 30 and 59 years old to reduce the probability of developing prediabetes.

Project description:Background: The coronavirus pneumonia is still spreading around the world. Much progress has been made in vaccine development, and vaccination will become an inevitable trend in the fight against this pandemic. However, the public acceptance of COVID-19 vaccination still remains uncertain. Methods: An anonymous questionnaire was used in Wen Juan Xing survey platform. All the respondents were divided into healthcare workers and non-healthcare workers. Multinomial logistic regression analyses were performed to identify the key sociodemographic, cognitive, and attitude associations among the samples of healthcare workers and non-healthcare workers. Results: A total of 2,580 respondents completed the questionnaire, including 1,329 healthcare workers and 1,251 non-healthcare workers. This study showed that 76.98% of healthcare workers accepted the COVID-19 vaccine, 18.28% workers were hesitant, and 4.74% workers were resistant. Among the non-healthcare workers, 56.19% workers received the COVID-19 vaccine, 37.57% workers were hesitant, and 6.24% workers were resistant. Among the healthcare workers, compared with vaccine recipients, vaccine-hesitant individuals were more likely to be female (AOR = 1.52, 95% CI: 1.12-2.07); vaccine-resistant individuals were more likely to live in the suburbs (AOR = 2.81, 95% CI: 1.44-3.99) with an income of 10,000 RMB or greater (AOR = 2.00, 95% CI: 1.03-3.90). Among the non-healthcare workers, vaccine-hesitant individuals were more likely to be female (AOR = 1.66, 95% CI: 1.31-2.11); vaccine-resistant individuals were also more likely to be female (AOR = 1.87, 95% CI: 1.16-3.02) and older than 65 years (AOR = 4.96, 95% CI: 1.40-7.62). There are great differences between healthcare workers and non-healthcare workers in their cognition and attitude toward vaccines. Conclusions: Our study shows that healthcare workers are more willing to be vaccinated than non-healthcare workers. Current vaccine safety issues continue to be a major factor affecting public acceptance, and to expand vaccine coverage in response to the COVID-19 pandemic, appropriate vaccination strategies and immunization programs are essential, especially for non-healthcare workers.

Project description:A retrospective cohort study was conducted to determine the situation, trend, and factors associated with TB infection, and factors related to the life status among the HIV/AIDS Hill-tribe in Northern Thailand. Hill-tribe people have been migrating to and formed settlements along the Thai border areas for many decades. There are now having 1.6 million people of 6 different groups-Akha, Lahu, Lisu, Hmong, Yao and Keren-each with a specific culture, language and lifestyle. The Hill-tribe becomes a new vulnerable of HIV and TB infections in Thailand.A systematic data-reviewing approach was used to identify the information from the rosters of ARV clinics, OPD cards, and laboratory reports from 16 hospitals in Chiang Rai Province, Thailand. The data were collected from the first reported HIV/AIDS case of the Hill-tribe to the end of 2010. A chi-square test and logistic regression models were used to identify associations at the significance level of alpha = 0.05.A total of 3,130 cases were included in the study. The majority of patients were Akha (46.0 %) followed by Lahu (19.7 %), 54.6 % were males, 44.6 % were 26-35 years old. The major risk factor of HIV infection was sexual intercourse (93.1 %); 23.9 % were still alive at the date of data collection, 30.7 % were diagnosed with pulmonary TB. The Akha Hill-tribe HIV/AIDS individuals had a greater chance of TB infection than did Yao individuals with ORadj = 1.50 (95 % CI = 1.01-1.92). Females had a greater chance of TB infection than males with ORadj = 1.33 (95 % CI = 1.11-1.59); being classified as HIV and AIDS groups had a greater chance of TB infection than those asymptomatic group with ORadj = 11.59 (95 % CI = 7.19-18.71), and ORadj = 1.71 (95 % CI = 1.03-2.87); and not having received the ARV group had a greater chance of TB infection than those who having received the ARV group with ORadj = 2.59 (95 % CI = 2.09-3.22). The patients who had been diagnosed with HIV infection during 1990-1995 and 1996-2000 had less chance of TB infection than those who were diagnosed from 2006-2010, with ORadj = 0.04 (95 % CI = 0.01-0.14) and 0.11 (95 % CI = 0.07-0.17), respectively. Regarding life status; females had a better chance of being still alive at the date of data collection than being males with ORadj = 1.41 (95 % CI = 1.19-1.66). Those who had a defined route of transmission in the category of "mother-to-child" and "IDU" had a better chance of being still alive compared to those who contracted HIV from "sexual intercourse," with ORadj = 2.05 (95 % CI = 1.56-2.18), and ORadj = 8.45 (95 % CI = 1.55-46.13), respectively.Thailand needs to create a TB and HIV/AIDS surveillance system for Hill-tribe populations to determine the situation and trend and to develop an appropriate model for providing care at the earlier stage of HIV/AIDS infection to prevent later TB infection.

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Acceptance and accessibility to the early phase COVID-19 vaccination among the healthcare workers and hill tribe population in Thailand.

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