Virasakdi Chongsuvivatwong

Background: Poor housing has been linked to tuberculosis (TB), yet details of living conditions are less well studied. Methods: This community-based case–control study examined household and individual factors associated with active pulmonary TB among households with a prior TB patient in Padang City, West Sumatra, Indonesia. Confirmed TB cases (CS, 105), symptomatic confirmed non-TB controls (CN1, 104), and asymptomatic controls (CN2, 102) were recruited at primary health centres from August to December 2024. Inclusion criteria were informed consent and ability to communicate; controls with a history of active TB were excluded from analysis. Participants were interviewed regarding individual characteristics, and a home visit made to record household conditions (temperature, humidity, carbon dioxide content and wind speed of living room air, house dimensions and construction materials). Multivariable multinomial logistic regression identified associations (relative probability ratios) of individual and household variables between cases and each control group. Results: Case status was associated with small bedroom volume (< 12m ³ ), compared with CN2 (3.74 [1.25, 11.20]), and with gypsum/plaster ceilings compared with CN1 (11.24 [2.52, 50.10]. In both comparisons, case status was associated with outdoor occupation (10.13, [1.69, 60.61] and 18.60, [2.53, 137.0]), frequent coffee shop visits (10.17 [1.32, 78.55] and 24.06 [2.22, 261.0]), and time elapsed of > 1 year since the prior TB patient (21.64 [8.73, 53.64] and 13.91 [5.82, 33.24]). Compared with CN1, case status was associated with the prior patient being a sibling (8.72 [2.33, 32.57]), grandparent/parent (5.31 [1.51, 18.70]) or other relative (4.23 [1.16, 15.45]) rather than spouse. The relative probability of outdoor activity was lower among cases (0.25, [0.10, 0.62] compared with CN2), and that of being underweight higher (4.71 [1.77, 12.53] and 6.35 [2.35, 17.18]), possibly consequences of ill-health. Conclusion: Among this population, small bedroom volume, gypsum/plaster ceiling, frequent coffee shop visits, outdoor occupation, non-spousal relationship with the prior TB patient and elapsed time of > 1 year increased the relative probability of being a TB patient. These findings suggest interventions such as improving bedroom space and targeted screening in households with prior TB, especially after one year. Housing improvements, though long-term, may usefully complement behavioural interventions for sustainable TB control.

Background: Assessing the readmitted diseases and survivors in patients hospitalized with pulmonary tuberculosis (TB) is crucial for healthcare strategies tailored to TB survivors. This study aims to compare readmissions and survival of hospitalized pulmonary TB patients with those of their matched controls in Thailand. Methods: We retrieved inpatient drug-sensitive pulmonary TB cases from the Thai Health Information Portal database (2017–2022), which included all hospitalized admissions in Thai hospitals. Non-TB controls were selected using 1∶1 propensity score matching by admission date, location, sex, age, and comorbidities. Time to readmission and to death event were the outcome variables. Cox regression with a robust variance sandwich estimator was used and then the E-value was computed. E-values indicate the strength of possible unexplained confounders. Results: From the propensity score matching, a total of 59,027 patients newly admitted for TB could be matched with 59,027 non-TB inpatient controls. Hazard ratios (HR) with 95% confidence intervals ( CI ) and E-values for causes of readmission among TB patients were 5.4 (2.1–14.3) and 10.2 for pericarditis, 5.4 (4.1–7.2) and 10.2 for pneumothorax, 3.8 (2.9–4.9) and 7.1 for bronchiectasis, 3.1 (2.4–4.2) and 5.6 for hyperfunction of the pituitary gland, and 2.4 (2.1–2.8) and 4.2 for inflammatory liver diseases. The TB cohort also had a higher risk of death [HR = 1.5 (95% CI: 1.4–1.6) and E-value = 2.3]. Conclusions: Hospitalized TB patients in Thailand are at higher risk than their non-TB controls in getting readmissions for thoracic problems and death. These problems call for improvement of TB care.

Tuberculosis remains a major cause of mortality in people living with HIV (PLWH), yet early diagnosis remains challenging. This study aimed to identify novel biomarker combinations and develop machine learning models, and to predict active TB in PLWH in a random and a chronological subset. We enrolled 760 PLWH with pulmonary symptoms. Demographic and clinical data and cytokine profiles were analyzed. Participants were first randomly split into training and validation sets. Subsequently, the whole dataset was re-analysed using the first 609 records as the training set and subsequent 151 records as the test set. Four models were developed with 10-fold cross-validation, incorporating feature selection and hyperparameter optimization. Model performance was assessed through ROC-AUC, sensitivity, specificity, and variable importance analysis. For the randomly split datasets, with active TB patients showed significantly elevated IFN-γ (median 5.7 vs 3.9 pg/mL, P<0.001) and IL-6 levels (25.3 vs 13.2 pg/mL, P<0.001) compared to without active TB cases. These two biomarkers were strong predictors based on the gradient boosting machine (GBM) model. AUCs (95% CI) on the randomly selected training dataset, was 0.96 (0.95, 0.97). That on the randomly selected test dataset was 0.73 (95% CI: 0.65–0.81). However, on chronological order, GBM model trained from the first 609 records AUC of 0.92 (0.91, 0.94) poorly predicted the 151 final records with the AUC of 0.66 (0.58, 0.75). TB might have activated the two inflammatory biomarkers among the PLWH. The best predictive machine learning method still have limitation in generalizability to predict the outcome on other data sets.

The global rise in vaping has become a significant public health concern among the young population. This study aims to investigate vaping behaviours among

Free-roaming dogs are a neglected population that poses public health concerns in tourist areas. This study, conducted during both the high and low tourist seasons, aimed to (i) investigate the movement patterns of free-roaming dogs on the Lipe tourist destination island, southern Thailand, focusing on their daily distance, and (ii) identify habitat land type preferences. Between September and December 2024, eight owned and seven unowned dogs were fitted with Catlog GPS devices. Tracking data were collected for the dog’s coordinates every 15 min for at least four consecutive days. Data analysis and visualization were performed using R software. On average, dogs traveled 5300 m daily. Unowned dogs exhibited their highest speed on beaches (median = 70, IQR = 44–79 m per 15 min). Free-roaming dogs spent most of their time in human habitats. The time of day influenced dogs’ appearance across different land types. In conclusion, free-roaming dogs on the island traveled longer distances than in most previous studies. The dogs mostly preferred being around human habitats. Land types influenced dogs’ speed. Dogs appeared on different land types at different times of day. Guided by these data, we recommend (i) better dog registration and other measures to reduce free-roaming activities of dogs and (ii) regular blanket coverage of dog rabies immunization to make the island safer for tourists and residents.

Drug-resistant tuberculosis (TB) pose a significant impact on public health challenge in China. This study aimed to characterize the drug resistance patter

Purpose: To evaluate the survival outcomes of patients with intermediate to advanced hepatocellular carcinoma (HCC), patients who underwent transarterial chemoembolization (TACE) alone were compared with those who underwent a combination of TACE and ablation therapy. Patients and Methods: This study retrospectively evaluated 536 HCC patients in our hospital from July 2016 to November 2022. All patients underwent TACE, with a subset also receiving ablation therapy. To ensure comparability, propensity score matching (PSM) was performed. We then compared overall survival (OS) and progression-free survival (PFS) between these two groups. Survival outcomes were analyzed utilizing Kaplan-Meier curves and compared via the Cox regression. Results: 200 among these 536 HCC patients received TACE combined with ablation whereas the remaining 336 received TACE alone. With PFS analysis, the numbers were reduced to 176 in combination therapy group and 250 in TACE alone group. With and without PSM, the OS and PFS were consistently and significantly better in the former than the latter group. In patients with Barcelona Clinic Liver Cancer (BCLC) stage B or C, those who received combination therapy demonstrated significantly higher OS compared to those treated with TACE alone. For stage B patients, PFS was also significantly longer in the combination therapy group, before and after PSM [hazard ratio (HR), 0.563; 95% CI: 0.360– 0.879; P = 0.012, HR, 0.613; 95% CI: 0.382– 0.985; P = 0.043]. However, after PSM, no statistical difference in survival outcomes was observed between the two groups for stage C patients (HR, 0.673; 95% CI: 0.395– 1.146; P = 0.145). Conclusion: Our data suggested that for OS, the combination therapy has sustained benefits for both patients with stage B and C, But for PFS, the benefits of the combination therapy among the stage C patients, could not be persistently demonstrated by the current datasets.