OBJECTIVE:To describe a subconjunctival granuloma caused by Dirofilaria repens in a dog from Rayong province, eastern Thailand, along with the successful treatment outcomes. The causative nematode was identified through morphological examination and molecular techniques. ANIMAL STUDIED:A 5-year-old female mixed-breed dog was presented with a subconjunctival mass at the temporal part of the left bulbar conjunctiva. The dog lived indoors with its owner. METHODS:A complete ophthalmic examination was performed. The mass was surgically removed and submitted for histopathological examination. During the surgery, a long, slender, white-creamy nematode emerged from the mass, which was sent for parasitology examination and molecular identification. The left eyelids were closed using temporary tarsorrhaphy. Selamectin spot-on and doxycycline were prescribed. RESULTS:Two weeks after surgery, the temporary tarsorrhaphy was removed. The excision site had healed completely without recurrence. The histopathological examination revealed eosinophilic granulomatous inflammation. A parasitic nematode was identified in the genus Dirofilaria spp. The full-length mitochondrial genome analysis showed 99.8% coverage of Dirofilaria repens sequences. CONCLUSION:D. repens infection caused a subconjunctival granuloma in the current case. The treatments, combined with surgical excision and selamectin spot-on, resulted in a good response. The conjunctival wound had healed completely within 2 weeks, without complications or recurrences. To the authors' knowledge, this was the first report of canine subconjunctival dirofilariasis caused by D. repens in Thailand. The vector-borne transmission of D. repens, a zoonotic nematode, via mosquito bites in humans, should be a concern in Thailand, particularly in the eastern region.
Objectives Personal protective equipment (PPE) use is associated with reduced risk of SARS-CoV-2 infection among healthcare personnel (HCP). There are limited data on the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on the PPE use of HCP. We describe the changes in PPE use from just before the widespread of community outbreaks ('pre-pandemic') to intra-pandemic time points, and examine factors associated with not changing in PPE use behavior among HCP in four Thai hospitals. Methods We performed a retrospective cohort evaluation using two-time points: (i) February-March 2020 (pre-pandemic period); and (ii) January-March 2021 (intra-pandemic period). Self-reported frequency of appropriate PPE use was measured by a Likert scale. We used multivariable logistic regression to identify factors associated with no increase in self-reported PPE use. Results Of 343 HCP, the proportion of participants reporting 'always' using PPE rose from 66% during the pre-pandemic period to 80% during the pandemic. Factors associated with HCP who did not increase in PPE use included having high baseline reported PPE, being a non-registered HCP (e.g. nurse assistants, dental assistants, porters), being male, and having a low perceived risk of becoming infected with any respiratory virus while working in the hospital. Conclusion PPE education, training, and risk communication content should target all cadres of HCP, regardless of registered/non-registered status, with a focus on behavior change for improved prevention and control of SARS-CoV-2 and other respiratory viruses in healthcare settings.
Introduction: Vector-borne diseases (VBDs) account for around 17% of global infectious diseases, with malaria and dengue being the most prevalent. Effective VBD prevention involves controlling mosquito populations by spraying micro-bubble (MB) insecticide. Quality control measures for MB size are essential, but few centers can assess MB size measurement. Machine learning (ML) is a powerful tool for automating and enhancing image analysis tasks, including measuring MB size. In this study, we train and evaluate ML models using an MB image dataset to assess their performance.Methods: Our experimental study used an MB image dataset labeled by specialists, with images resized and randomly assigned to train, validate, and test datasets. We employed various evaluation metrics, such as recall, precision, and mean average precision (mAP). Image augmentation techniques were applied to increase the number of unqualified MBs. Pretrained models from Detectron2 (D2), MMDetection (MM), and YOLO libraries were used for training and evaluation.Results: We identified severe class and scale imbalances in the dataset. Single-stage and two-stage CNN models demonstrated superior performance in MB detection compared to DCN and transformer-based models. D2 outperformed MM, and training Faster-RCNN R-50 on an augmented dataset improved performance for unqualified MB detection. Considering multiple evaluation metrics, YOLO v7 exhibited the highest accuracy and effectiveness in detecting MBs.Conclusion: Our study revealed the effectiveness of CNN models in MB detection and the importance of selecting appropriate libraries and pretrained weights. Image augmentation improved unqualified MB detection while considering multiple evaluation metrics provided a more comprehensive understanding of model performance. Models like YOLO v7 and Faster-RCNN R-50 and X-101 are recommended for practical MB quality assessment tasks, as they demonstrate high precision and recall performance for qualified and unqualified MBs.
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 (<THB 15,000 or <USD 450) was also negatively statistically significant with encountering rodents (Adjusted OR = 0.57, 95% CI 0.33-0.99, p = 0.04). Additionally, the villagers had a low level of knowledge toward zoonotic diseases and inappropriate attitudes and practices toward contacting rodents and zoonotic diseases. Thirty-five qualitative study participants (N2) participated in the KIIs and FGDs. Various rodent contact activities were also reported among the qualitative research participants, such as hunting, consumption, and selling them to their friends and neighbors. However, these rodents also destroyed their belongings, crops, and plants. Some participants also reported that rodents accounted for leptospirosis transmission. As a result, communication intervention should be planned to provide appropriate knowledge and attitude to the villagers, especially among those who have close contact with rodents in the understudied area.
Generally, hypertension control programs are cost-effective, including in low- and middle-income countries, but country governments and civil society are not likely to support hypertension control programs unless value is demonstrated in terms of public health benefits, budget impact, and value-for-investment for the individual country context. The World Health Organization (WHO) and the Pan American Health Organization (PAHO) established a standard, simplified Global HEARTS approach to hypertension control, including preferred antihypertensive medicines and blood pressure measurement devices. The objective of this study is to report on health economic studies of HEARTS hypertension control package cost (especially medication costs), cost-effectiveness, and budget impact and describe mathematical models designed to translate hypertension control program data into the optimal approach to hypertension care service delivery and financing, especially in lowand middle-income countries. Early results suggest that HEARTS hypertension control interventions are either cost-saving or cost-effective, that the HEARTS package is affordable at between US$ 18-44 per person treated per year, and that antihypertensive medicines could be priced low enough to reach a global standard of an average
