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TB is a leading public health concern in Indonesia which ranks second on the list of high burden TB countries. In West Sumatra 47% of TB cases are undetected, diagnosed late, or received incomplete treatment because of low-level awareness and knowledge especially among the hardest to reach populations. Community empowerment against tuberculosis project funded by USAID and lead by Networking For Community Welfare & Health was implemented in West Sumatra, Indonesia, focuses on identify the best communication channel to reach those who lived vulnerable and remote areas. Afterwards, the leaders conducted community outreach to increase community awareness and knowledge about TB and improve community health-seeking behaviour. Our strategies included empowerment, capacity building, and socialization TB through Traditional Music Media by conducted edutainment with free traditional music and ethnic theatricals, integrating information regarding TB signs and symptoms and the impact of non-treatment of cases and transmission to the music. The involvements of religious and informal leaders and the use of traditional music as communication channel improves the population’s awareness of TB symptoms and access to TB testing and treatment. We observed an increase in the case detection rate from 47% to 85% during the study period. Religious, informal leaders and traditional music were the best communication channel to reach the vulnerable population especially those who lived in remote areas

Outbreaks of H5N1 avian influenza show strong seasonality. It is not clear where the source of virus originates from in each new outbreak season. This study sought to understand the nature of viral resurgence in recent outbreak seasons in Thailand, where the epidemic is relatively well controlled. In such a situation, indigenous viruses surviving the inter-outbreak season would have to pass through a bottleneck. In order to look for evidence of the bottleneck effect, viral genome sequences from recent outbreaks in the country were analysed. H5N1 avian influenza viruses were isolated from six outbreaks in the rainy season and winter of 2007 through to early 2008. Most of the outbreaks were in the Yom-Nan River basin in the southern part of the northern region of the country. Sequences of these viral isolates were identified as clade 1, genotype Z, similar to viruses from previous years in the central region of the country. The sequences clustered into two groups, one of which was closely related to viruses isolated from the same area in July 2006. These analyses indicated that there was a strong bottleneck effect on the virus population and that only a few lineages remained in the area. In addition, evidence of reassortment among these viruses was found. These indicated re-emergence of viruses from a small pool of indigenous sources that had been silently perpetuated over the dry summer months. Therefore, an approach to eradicate H5N1 avian influenza from the area by eliminating these local reservoirs may be feasible and should be seriously considered.

Background. Reduction of cortical thickness and Hippocampal volume (HV) in Methamphetamine abusers (MA) has been reported. However, change of white matter volume (WMV) in MA group is inconclusive. We aim to compare cortical thickness, Hippocampal volume (HV), and WMV per intra-cranial volume (ICV) among MA in Thai adolescents. Methods. 3D T1-wighted high resolution MR images from 11 MAs and 10 HCs with gender and age match with mean age 25.48 ±4.9 were acquired on a 1.5T Philips MR scanner. Automated Talairach transform and images group analysis with general linear model (GLM) were performed using FreeSurfer software. HV, FWMV/ICV, and WMV/ICV between MA and HC groups were compared. Results. Significant thinner regions (p < 0.05) of cortical thickness in MA group were found at the right temporal and parietal lobes. Trends of smaller Hippocampal volume on left and right by 5.1% and 4.3% and increasing of Left FWMV/ICV, right FWMV/ICV, and tWMV/ICV by 3.1%, 4.5% and 3.8% respectively in MA group compared to HC group. Conclusions. The results demonstrated significant thinner of cortical thickness at the right temporal and parietal lobes and the trend of WM hypertrophy and smaller Hippocampus in MA group.

Background. Cerebral injury from MA use and HIV infection are well established. Frontal or the executive brain functions are most affected in MA abusers with development neurological conditions of inability to attend and concentrate slowness in thinking and moving. HIV infection, on the other hand, is thought to be indirect process due as neurons are not infected by the virus. Cells including brain microphages, microglia is infected and a reactive astrocytosis is often present. Methods. Fifteen healthy volunteers, 15 HIV seropositive patients with no history of MA use, 15 MA users with no HIV infection and 15 MA users who are HIV infected during the next 15 months. This is cross-sectional study, each participant will undergo MRI/MRS scans and neuropsychological evaluation. We present results of single voxel proton MRS in MA users's brain. Results. Significant reduction (p = 0.041) for neuronal marker, N-acetylaspartate in the frontal white matter was observed with mean NAA/Cr for healthy control and MA users of 0.855 and 0.746, respectively. Similar reduction (p = 0.028) was also observed in the basal ganglia with mean NAA/Cr for healthy control and MA users of 0.687 and 0.548 respectively. Conclusions. The results demonstrated significant neuronal loss in methamphetamine users.