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Chronic malnutrition in adolescents may result in significant academic difficulties. The impact of nutritional status and related factors on the academic achievement of adolescents in high schools in Myanmar was determined. A cross-sectional survey using a self-administered questionnaire on food intake and other factors potentially affecting nutritional status was used to gather information from 301 students aged 13-17. Grade-point averages (GPA) in the previous academic year were also recorded. Most respondents showed average body mass index values, followed by underweight, overweight, and obese. Regarding academic achievement, a GPA of A, B, C, and D was seen in 41.5%, 36.2%, 15.3%, and 7.0% of the respondents, respectively. Nutritional status was significantly associated with academic achievement. Underweight students had a 1.96 times higher likelihood of achieving mediocre grades (C, D) than normal-weight students. Among other factors examined, only the number of meals per day was associated with nutritional status. The duration of the walk to school, the duration of watching or playing games, and the parent's socioeconomic status were associated with academic achievement. The study found an association between nutritionrelated factors on levels of academic achievement of adolescent students in the study area. [ABSTRACT FROM AUTHOR]

Wastewater-based epidemiology (WBE) is a beneficial tool for comprehensive health information on communities, especially during the COVID-19 pandemic. In developing countries, including Thailand, the application of WBE is limited. Few SARS-CoV-2 detections and variants have been monitored in wastewater in these countries. This is because of the time-consuming, low recovery of viruses in the concentration techniques and difficulties in finding the proper primers and amplification kits. Therefore, this study aimed to quantify SARS-CoV-2 RNA concentration using a commercial clinical kit. We identified the SARS-CoV-2 variants and estimated the detection costs in the wastewater samples. One hundred and fifty hospital wastewater samples were filtered with commercial ultrafiltration (UF) and then detected for the SARS-CoV-2 concentration using a Sansure Biotech SARS-CoV-2 kit. The recovery of the virus concentration technique in UF was studied using a surrogate (porcine epidemic diarrhea virus). The virus detection in wastewater was quantified by RT-qPCR. In addition, the mutation sites in the partial spike glycoprotein (S) gene of SARS-CoV-2 were verified using short nested RT-PCR. The results showed a high recovery of the commercial UF (80.53%), and 24.6% of hospital wastewater contained SARS-CoV-2. The detection of SARS-CoV-2 in wastewater cost USD 35.43 per sample. The virus variants revealed V70del, H69del, and V144del mutations in the partial S gene of SARS-CoV-2 in B.1.1.7 (SARS-CoV-2 Alpha variant), and T95I and G142D mutations in B.1.617.2 (Delta variant). [ABSTRACT FROM AUTHOR]

Background The prevalence of obesity has increased globally, with childhood and adolescent obesity being more common in developed countries. There has been no study on teenage obesity in Bhutan. In this study, we aimed to assess the prevalence of obesity in Bhutan for the first time in order to provide a baseline for future researchers. Methods The investigation, which included 392 adolescents, aimed to identify the prevalence of overweight and obesity and its contributing factors. Anthropometric measurements, food recall and knowledge, attitude, behaviour and environment questionnaires were administered. The body mass index (BMI) cut-off points for adolescents matched with those of the US Centers for Disease Control and Prevention. Results The prevalence of overweight and obesity among the participants were 7.1% and 1.5%, respectively. The prevalence of obesity was 1.0% in females and 0.5% in males (p < 0.001). There were significant (p < 0.001) correlations between BMI and other variables; however, Pearson's χ2 test uncovered no significant associations. BMI also had no significant associations with attitude, behaviour, environment and distance travelled to school. Food recall results revealed the following findings for average food consumption: total energy intake, 3522.6 kcal; fat, 47.6 g; carbohydrate, 690.2 g; protein, 90.5 g; fibre, 20.3 g; and sodium, 12.5 g. Conclusion The results of this study clarified the prevalence of obesity among adolescents in Bhutan, who require appropriate strategies for combating overweight and obesity. [ABSTRACT FROM AUTHOR]

Chikungunya fever (CHIKF) is an acute febrile illness caused by a mosquito-borne alphavirus, chikungunya virus (CHIKV). This disease re-emerged in Kenya in 2004, and spread to the countries in and around the Indian Ocean. The re-emerging epidemics rapidly spread to regions like India and Southeast Asia, and it was subsequently identified in Europe in 2007, probably as a result of importation of chikungunya cases. On the one hand, chikungunya is one of the neglected diseases and has only attracted strong attention during large outbreaks. In 2008-2009, there was a major outbreak of chikungunya fever in Thailand, resulting in the highest number of infections in any country in the region. However, no update of CHIKV circulating in Thailand has been published since 2009. In this study, we examined the viral growth kinetics and sequences of the structural genes derived from CHIKV clinical isolates obtained from the serum specimens of CHIKF-suspected patients in Central Thailand in 2010. We identified the CHIKV harboring two mutations E1-A226V and E2-I211T, indicating that the East, Central, and South African lineage of CHIKV was continuously circulating as an indigenous population in Thailand. [ABSTRACT FROM AUTHOR]

This systematic review elaborates the concepts and impacts of border malaria, particularly on the emergence and spread of Plasmodium falciparum and Plasmodium vivax multidrug resistance (MDR) malaria on Thailand-Myanmar and Thailand-Cambodia borders. Border malaria encompasses any complex epidemiological settings of forest-related and forest fringe-related malaria, both regularly occurring in certain transmission areas and manifesting a trend of increased incidence in transmission prone areas along these borders, as the result of interconnections of human settlements and movement activities, cross-border population migrations, ecological changes, vector population dynamics, and multidrug resistance. For regional and global perspectives, this review analyzes and synthesizes the rationales pertaining to transmission dynamics and the vulnerabilities of border malaria that constrain surveillance and control of the world's most MDR falciparum and vivax malaria on these chaotic borders. [ABSTRACT FROM AUTHOR]

A prospective field study was conducted to determine transovarial dengue-virus transmission in two forms of Aedes aegypti mosquitoes in an urban district of Bangkok, Thailand. Immature Aedes mosquitoes were collected monthly for one year and reared continuously until adulthood in the laboratory. Mosquitoes assayed for dengue virus were processed in pools and their dengue virus infection status was determined by one-step RT-PCR and nested-PCR methods. Of a total 15,457 newly emerged adult Ae. aegypti, 98.2% were dark and 1.8% of the pale form. The results showed that the minimum infection rate (MIR) by transovarial transmission (TOT) of dengue virus during the one-year study ranged between 0 to 24.4/1,000 mosquitoes. Dengue virus TOT increased gradually during the hot summer months, reaching a peak in April- June, while dengue cases peaked in September, a rainy month near the end of the rainy season. Therefore, mosquito infections due to TOT were prevalent four months before a high incidence of human infections. TOT dengue virus infections occurred in both forms of Ae. aegypti. All four dengue serotypes were detected, with DEN-4 predominant, followed by DEN-3, DEN- 1, and DEN-2, respectively. [ABSTRACT FROM AUTHOR]

This sequential explanatory mixed-method study consisted of analytical, cross-sectional, and qualitative studies. The research was conducted in the Khao Nor and Khao Kaew areas of the Banphot Pisai districts of Nakhon Sawan Province in 2019. Here, we examined the rodent contact characteristics of villagers in these areas and determined the potential characteristics/risk factors associated with rodents using a semi-structured questionnaire, key informant interview (KII), and focus group discussion (FGD). Results of the quantitative study (N1 = 372) characterized participants that contacted rodents per gender, age, occupation, knowledge, attitude, and practice (KAP), including their cultural contexts, and beliefs. Ninety participants (24.2%) reported contact with rodents, and the reasons for their direct physical rodent contact were hunting (35, 9.4%), killing (41, 11.0%), preparing rodents as food (33, 8.9%), consuming cooked meats (12, 3.2%), feeding food (4, 1.1%), cleaning feces (17, 4.6%), and cleaning carcasses (33, 8.9%). Moreover, logistic regression results showed that males encountering rodents were statistically significant (Adjusted OR = 3.137, 95% CI 1.914–5.139, p < 0.001). Low monthly household income (

Hand, foot, and mouth disease (HFMD) is a contagious childhood illness and annually affects millions of children aged less than 5 years across the Asia–Pacific region. HFMD transmission mainly occurs through direct contact (person-to-person) and indirect contact with contaminated surfaces and objects. Therefore, public health measures to reduce the spread of HFMD in kindergartens and daycare centers are essential. Based on the guidelines by the Department of Disease Control, a school closure policy for HFMD outbreaks wherein every school in Thailand must close when several HFMD classrooms (more than two cases in each classroom) are encountered within a week, was implemented, although without strong supporting evidence. We therefore conducted a prospective cohort study of children attending five kindergartens during 2019 and 2020. We used molecular genetic techniques to investigate the characteristics of the spreading patterns of HFMD in a school-based setting in Bangkok, Thailand. These analyses identified 22 index cases of HFMD (symptomatic infections) and 25 cases of enterovirus-positive asymptomatic contacts (24 students and one teacher). Enterovirus (EV) A71 was the most common enterovirus detected, and most of the infected persons (8/12) developed symptoms. Other enteroviruses included coxsackieviruses (CVs) A4, CV-A6, CV-A9, and CV-A10 as well as echovirus. The pattern of the spread of HFMD showed that 45% of the subsequent enteroviruses detected in each outbreak possessed the same serotype as the first index case. Moreover, we found a phylogenetic relationship among enteroviruses detected among contact and index cases in the same kindergarten. These findings confirm the benefit of molecular genetic assays to acquire accurate data to support school closure policies designed to control HFMD infections. [ABSTRACT FROM AUTHOR]

• The people of a community in Thailand's Nakhon Sawan Province had various levels of contact with macaques, based on their occupations, perceptions, beliefs, religion, previous experiences, and local regulations. • Monks and vendors selling food for LTs were considered as the persons who had closed contact with LTMs. • The macaques that made their lives in the temple were thought of as the old abbot's sons. As a result, the majority of the community worships them and refrains from criticizing them. • Villagers believe that offering food to the macaques will bring them good fortune, luck, and good health. Interestingly, the study's participants believed that harming or stealing the macaques from the mountains would curse and harm them. • Villagers lacked understanding of about zoonotic diseases and demonstrated inappropriate knowledge, attitudes, and behaviors toward LTMs and zoonotic infections. A wide range of zoonotic pathogens can be transmitted during human-wildlife interactions. Few qualitative studies have been conducted on human-nonhuman primate interfaces in Thailand, notably direct and indirect contact. Since Long-tailed macaques (LTMs) are prevalent in Thailand's Banphot Phisai district, part of Nakhon Sawan province, this qualitative study was conducted in 2019 to determine in-depth contact characteristics between humans and LTMs in the communities. Key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with 35 villagers who reported close contact with LTMs in this study location. The results showed that villagers had different levels of contact with LTMs, depending on their occupations, perceptions, beliefs, religions, previous experiences, and local regulations. Monks in temples and vendors selling food for LTMs were reported to have the closest contact with them. LTMs have been reported to destroy personal property, houses, buildings, and crops. However, the villagers do not hurt them due to their religious beliefs relating to a respected abbot (a man who headed an abbey of monks). Even community members have had extensive interaction with LTMs, but they lacked awareness and information regarding diseases transmitted to humans directly or indirectly by non-human primates. Therefore, individuals who have frequent and close contact with LTMs should be provided health education, and appropriate behavioral change communication interventions should be performed. Furthermore, the results could be used to develop future disease prevention strategies and public awareness campaigns in the area. [ABSTRACT FROM AUTHOR]

The identification and characterization of the viruses of the genus Enterovirus in healthy and infected livestock, including cattle and goats, have been increasing. Enterovirus E (EV-E) and F (EV-F) are commonly found in cattle, whereas Enterovirus G (EV-G) is found in goats. In this study, molecular and phylogenetic analyses were performed to determine the prevalence of EVs in cattle and goat feces from the Kanchanaburi Province, Thailand. The presence of EVs in water samples and feces of other animals collected from the areas surrounding cattle and goat farms was also investigated. Using 5'-UTR real-time RT-PCR, EVs were detected in 39.5% cattle samples, 47% goat samples, 35.3% water samples, and one pool of chicken feces. Phylogenetic analysis revealed the presence of EV-E and EV-F in cattle, EV-E and EV-G in goats, and EV-F in water samples and chicken feces. The analysis of enteroviral VP1 sequences from cattle revealed that the EV-E genotypes circulating in the study region were EV-E1, with a possible new genotype that is closely related to that of EV33 E2. The analysis of enteroviral VP1 sequences from goat suggested the circulation of EV-G5 and a possible new genotype that is closely related to EV-G20. Sequence analyses also suggested that, although the VP1 sequences from goats were closely related to those of EV36 G, which were considered as porcine enterovirus, their 5'-UTR form a separated cluster with the sequences of sheep and goat origins, suggesting a new classification of the ovine/caprine38 specific enterovirus group. [ABSTRACT FROM AUTHOR]

Highlights • Co-infection of DENV/ CHIKV and DENV/ ZIKV was observed in Thailand. • DENV-2 is predominantly distribution in Southern Thailand. • The evidence of co-circulation of DENV, ZIKV and CHIKV in Thailand. • Diarrhea is significant clinical manifestation in DENV-2 cases. Abstract Infections caused by arboviruses such as dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) frequently occur in tropical and subtropical regions. These three viruses are transmitted by Aedes (Ae.) aegypti and Ae. albopictus. In Thailand, the highest incidence of arbovirus infection and the high circulation of Aedes mosquito mainly occurs in the Southern provinces of the country. Few studies have focused on the incidence of co-infection of arboviruses in this region. In the present study, a cross-sectional study was conducted on a cohort of 182 febrile patients from three hospitals located in Southern Thailand. Surveillance of DENV, CHIKV and ZIKV was conducted from May to October 2016 during the rainy season. The serological analysis and molecular detection of arboviruses were performed by ELISA and multiplex RT-PCR respectively. The results demonstrated that 163 cases out of 182 patients (89.56%) were infected with DENV, with a predominance of DENV-2. Among these DENV positive cases, a co-infection with CHIKV for 6 patients (3.68%) and with ZIKV for 1 patient (0.61%) were found. 19 patients out of 182 were negative for arboviruses. This study provides evidence of co-infection of arboviruses in Southern Thailand and highlight the importance of testing DENV and other medically important arboviruses, such as CHIKV and ZIKV simultaneously. [ABSTRACT FROM AUTHOR]