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Mueang Nonthaburi, Thailand

Pawun V.,Bureau of General Communicable Disease | Pawun V.,University of Pittsburgh | Visrutaratna S.,Chiang Mai Provincial Public Health Office | Ungchusak K.,Ministry of Public Health | And 7 more authors.
Journal of Travel Medicine | Year: 2012

Background. Up to 65% of travelers to less developed countries report health problems while traveling. International travel is an increasing concern for health practitioners. To date, there have not been any published analyses of mortality amongst foreign nationals visiting Thailand. Our objectives are to examine the magnitude and characterize the deaths among foreign nationals in Chiang Mai, a popular tourist province in Thailand. Methods. The study commenced with a review of the Thai death registration. Death certificates were retrieved, reviewed, and classified by the causes of death. Basic statistics and proportionate mortality ratio (PMR) were used to describe the pattern of deaths. Standardized mortality ratio (SMR) was used to assess the excess mortality risk among foreign nationals. Results. Between January 1, 2010 andMay 31, 2011, there were 1,295 registered deaths in ChiangMai City, of which 102 records (7.9%) were foreign nationals. Median age of decedents was 64 years (range 14-102 y). Female-to-male ratio was 1 : 5.4. The highest mortality was among Europeans (45.1%). Most of the deaths were natural causes (89.2%) including 36 cardiac diseases (PMR=35.3) and 20 malignancy diseases (PMR=19.6). Deaths due to external causes were low. The SMRs range between 0.15 and 0.30. Conclusion. Communicable diseases and injuries were not the leading causes of death among foreign nationals visiting Chiang Mai, Thailand. It is essential that travelers are aware of mortality risk associated with their underlying diseases and that they are properly prepared to handle them while traveling. © 2012 International Society of Travel Medicine, 1195-1982.


Pawun V.,Bureau of General Communicable Disease
Journal of travel medicine | Year: 2012

Up to 65% of travelers to less developed countries report health problems while traveling. International travel is an increasing concern for health practitioners. To date, there have not been any published analyses of mortality amongst foreign nationals visiting Thailand. Our objectives are to examine the magnitude and characterize the deaths among foreign nationals in Chiang Mai, a popular tourist province in Thailand. The study commenced with a review of the Thai death registration. Death certificates were retrieved, reviewed, and classified by the causes of death. Basic statistics and proportionate mortality ratio (PMR) were used to describe the pattern of deaths. Standardized mortality ratio (SMR) was used to assess the excess mortality risk among foreign nationals. Between January 1, 2010 and May 31, 2011, there were 1,295 registered deaths in Chiang Mai City, of which 102 records (7.9%) were foreign nationals. Median age of decedents was 64 years (range 14-102 y). Female-to-male ratio was 1 : 5.4. The highest mortality was among Europeans (45.1%). Most of the deaths were natural causes (89.2%) including 36 cardiac diseases (PMR = 35.3) and 20 malignancy diseases (PMR = 19.6). Deaths due to external causes were low. The SMRs range between 0.15 and 0.30. Communicable diseases and injuries were not the leading causes of death among foreign nationals visiting Chiang Mai, Thailand. It is essential that travelers are aware of mortality risk associated with their underlying diseases and that they are properly prepared to handle them while traveling. © 2012 International Society of Travel Medicine.


Muangchana C.,National Vaccine Institute | Riewpaiboon A.,Mahidol University | Jiamsiri S.,Bureau of Epidemiology | Thamapornpilas P.,Bureau of General Communicable Disease | Warinsatian P.,Bureau of General Communicable Disease
Vaccine | Year: 2012

Severe diarrhea caused by rotavirus is a health problem worldwide, including Thailand. The World Health Organization has recommended incorporating rotavirus vaccination into national immunization programs. This policy has been implemented in several countries, but not in Thailand where the mortality rate is not high. This leads to the question of whether it would be cost-effective to implement such a policy. The Thai National Vaccine Committee, through the Immunization Practice Subcommittee, has conducted an economic analysis. Their study aimed to estimate the costs of rotavirus diarrhea and of a rotavirus vaccination program, and the cost-effectiveness of such a program including budget impact analysis. The study was designed as an economic evaluation, employing modeling technique in both provider and societal perspectives. A birth cohort of Thai children in 2009 was used in the analysis, with a 5-year time horizon. Costs were composed of cost of the illness and the vaccination program. Outcomes were measured in the form of lives saved and DALYs averted. Both costs and outcomes were discounted at 3%. The study found the discounted number of deaths to be 7.02 and 20.52 for vaccinated and unvaccinated cohorts, respectively (13.5 deaths averted). Discounted DALYs were 263.33 and 826.57 for vaccinated and unvaccinated cohorts, respectively (563.24 DALYs averted). Costs of rotavirus diarrhea in a societal perspective were US$6.6 million and US$21.0 million for vaccinated and unvaccinated cohorts, respectively. At base case, the costs per additional death averted were US$5.1 million and US$5.7 for 2-dose and 3-dose vaccines, respectively, in a societal perspective. Costs per additional DALYs averted were US$128,063 and US$142,144, respectively. In a societal perspective, with a cost-effectiveness threshold at 1 GDP per capita per DALYs averted, vaccine prices per dose were US$4.98 and US$3.32 for 2-dose and 3-dose vaccines, respectively; in a provider perspective, they were US$2.90 and US$1.93. One-way and probabilistic sensitivity analyses were included. The budget required for vaccine purchase was calculated for all scenarios. © 2012 Elsevier Ltd.


Muangchana C.,National Vaccine Committee Office | Thamapornpilas P.,Bureau of General Communicable Disease | Karnkawinpong O.,Bureau of General Communicable Disease
Vaccine | Year: 2010

The Advisory Committee on Immunization Practice (ACIP) of Thailand, established nearly 40 years ago and currently consisting of 28 experts in immunization and related fields, develops written recommendations to the Ministry of Public Health (MoPH) regarding vaccines and immunization. Through careful review of available scientific data, compiled and analyzed by Working Groups set up to examine specific topics, the ACIP makes recommendations concerning the inclusion of new vaccines into the national immunization program, target groups and ages for administration, vaccine schedules, and precautions and contraindications. This paper includes a description of the composition of the ACIP; the process that the Committee uses to formulate recommendations, including required data; and areas for improvement. © 2010 Elsevier Ltd. All rights reserved.

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