Poster Session II

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Poster Session II 

Continuous Quality Improvement for Service Enhancement of Registered Nurses in Fort

Prachaksinlapakom Hospital Udon Thani, Province Thailand

Thanamontachanok Charoensawat, Prachak Bouphan Khonkaen University, Thailand

This cross–sectional Descriptive study aimed to study motivation affecting the continuous quality improvement for service enhancement of registered nurses in Fort Prachaksinlapakom hospital Udon Thani province.The Simple random sampling was the sampling technique which randomise from 85 registered nurses in this hospital.The study was conducted between 1 December 2008 to 30 January 2009.The percentage,average and standard deviation were analysed the descriptive data. Moreover,Pearson Correlation Coefficient and Stepwise Multiple Regression were also used for answer the research question.The study found that the motivated factor and the support factor were high (3.81 (S.D.=0.47) and 3.72 (S.D.= 0.44)).The continuous quality

improvement for service enhancement of registered nurses in Fort Prachaksinlapakom hospital Udon Thani province was 3.77 (S.D.=0.47).There were age,the experience were moderate significantly at 0.05(r = 0.354 p-value=0.01,r = 0.345p-value=0.01,respectively). Furthermore,total motivation,motivation factors and hygiene factors were the positive relation significantly at 0.05 (r = 0.705 p-value < 0.01, r = 0.662 p-value< 0.001 , p-value < 0.001 and p-value = 0.005,respectively) which were 43.1% for incorporate prediction in continuous quality improvement for service enhancement.

SP-002

Impact of Global Warming and Climate Change to the Incidence of Malaria at Pacitan Regency East Java Indonesia

Jojok Mukono1, Ririh Judastuti2

1. Airlangga University, Indonesia 2. IAKMI, Indonesia

To day global warming and climate change as the world main issues, its can influenced to human lifes. Global warming caused by mainly (80%) burn fossil fuels, such as coal, oil and gas and secondarily (20%) caused by cut down forest. Protocol Kyoto in the 1997 as the results of international commitment for preventing and

managements of global warming and climate change. Developed country as Annex 1 country and developing country such as Indonesia as Non-Annex 1 country. The impacts of global warming and climate change, included vector borne diseases such as Malaria and Dengue Haemorragic Fever. Incidence of malaria in the reaserch area has trend increase. Nationally In the 1997 and 1999 incidence of Malaria increasing from 0.12%o to 0.38 %o respectively. And the 1998/1999 Indonesia has out break

of Malaria at the 10 province ( 84 villages) a number of suffers are 19.688 person) and 71 person was die. At East Java province in the 1998, incidence of Malaria is 0.03%o and in the 2000 incidence of Malaria increase to 0.14 %o. This research used time series of ecological study method. The subject of research must equal population area. Localization of researh in the 4 district ( 32 villages) at Pacitan Regency East Java Indonesia. Variables included incidence of Malaria and

environmental factor such as climate, rain fall, temperature, humidity, water river salinity and pH of lagun. Data analysis used discriptive and analytic . Results of the research are decreasing rainfall (increasing temperature) can increasing cases of Malaria. According to logistic regression test, that is significant result between increasing cases of Malaria and physical environment such as rain fall, water lagun pH and salinity. Physical environment index > 1.792 is high risk and physical environment index ≤ 1.792 is law risk Recomendation to be decreasing incidence of malaria that is the government should implemented of mitigation and adaptation method.

SP-003

Comparison of Height and Body Weight Children’s and Teenagers of Ulaanbaatar and Rural Region

Otgon Galsanjav, Shatar Shaariibuu

Health Sciences University of Mongolia, Mongolia Physical and biological development of children are unique parameters of health children’s. The purpose of our work is to make compare of height and body weight children’s, living in ecologically various regions of Mongolia. Methods of research: For anthopometrical research used the classical standard methods. We survey 3000 children on 4 regions of Mongolia and Ulaanbaatar. Results: Were lower height of boys surveyed aimag’s at the majority age to compare with boys Ulaanbaatar’s. Height of boys and girls East and Bulgan, Govi-Altay, Middle-Govi aimag’s lower from boys Ulaanbaatar on 0,18sm-4,82sm. (p> 0,05).Height boys Ulaanbaatar’s was higher on 4,82sm -4,45sm at 13-17 years of age. Body weight of boys Ulaanbaatar at 4,6,7,10-13year old were more, than body weight boys of others aimag’s. After 14 years was more body weight boys Govi-Altay and Middlegovi. Body weight of girls were more of girls Ulaanbaatar at 4-7,11-12 and 17 years and at 8 years boys Bulgan and Govi-Altay aimag’s on 1,1-2,01kg from other girls. Prevails the body weight girls at 9,10 years age girls Govi-Altay aimags, at 13-15 years-girls Middlegovi aimags, at 16-17 year -girls Govi-Altay aimags. Is similar body weight girl’s at 17 years girls Govi-Altay aimags and Ulaanbaatar (p > 0,05) .

Conclusion: 1. Boys and girls Ulaanbaatar at the majority of age were higher, than boys of others aimags. 2. Boys Ulaanbaatar’s before 14year, girls before 12 year were with more body weight.

SP-004

Ambient Temperature and Mortality in Korea: The Effect of Pm10 in Elderly

Joo Youn Chung, Ho Kim

Seoul National University, South Korea

Extreme ambient temperature has been associated with increased daily mortality across the world. We describe the ambient temperature-mortality association adjusting PM10 for three cities in Korea, Seoul, Daegu and Busan, and identify a threshold temperature and the percent increase in mortality. We observed that threshold temperatures vary by the age and cities. We adapted generalized linear modeling with natural cubic splines to examine the association between daily mean temperature and total mortality in a threshold model. We also conducted a time-series analysis adjusting for day of the week, humidity, influenza and long-term time trend. The threshold temperature for all age was estimated to be 25.2°C – 28.6°C, during study period 2000-2007. For the daily mean temperature increase of 1°C above the thresholds estimated percentage increases in total mortality were 2.39 – 9.16 for all age group and 2.4-12.8 for elderly group. The threshold temperature for elderly (age above 65) was estimated to be 25°C – 28.7°C.We found higher percent increases for elderly rather than all age group. This study identified increased mortality due to exposure to elevated ambient temperature adjusting PM10. The importance of effects of daily mean temperature and age-specific threshold temperatures suggests that analyses of the impact of climate change should take special susceptibility of elderly to environmental risks into consideration.

SP-005

A Conceptual Framework for the Provision of Non-Local Based Emergency Medical Relief Service During Acute Emergency Phase Post Natural Disaster in Low & Middle Income Countries

Ying Yang Emily Chan

The Chinese University of Hong Kong, Hong Kong Background: Whilst an array of international/non-local health actors might be supporting medical relief actions and health system recovery during acute emergency phase post natural disaster in low/middle income countries, limited analysis has been conducted to examine the role of these non-local actors might have played in emergency medical service delivery. The goal of this paper is to review existing literature and evidence so as to conceptualize how these non-local attempts might have addressed population health needs and potentially assisted in the recovery of the disrupted health systems.

Methods: Literature review was performed by keyword search in PUBMED, MEDLINE and ELDIS during April-May 2009.

Results: Search results indicated a major gap in

documented evidences and discussions to conceptualize

issues around non-local health/medical relief activities during post natural disasters in low & middle income countries. Based on study findings, three different post disaster medical/health service delivery models were proposed to characterize the role of non-local

health/medical actors and actions during acute phase post disaster.

Conclusion: Findings may assist policymakers and emergency response planners to maximize efficiency in natural disaster medical responses. It might also provide a decision making framework for non-local based health relief actors to evaluation their participations during early health sector recovery post natural disaster in middle/low income settings.

SP-006

The Effects of Virgin Coconut Oil in the Embryological Development of ICR Mice (Mus Musculus)

Patricia Rae T. A Paulino, Rachelle Ean A. Ngo, Abdelsimar T. Omar Ii, Faustine Richelle C. Ong, Mc Deansem A. Pabalinas, Ivan N. Paner, Pocholo Iñigo B. Morales, Maria Josefa Z. Nantes, Marisse J. Nepomuceno, Ericka Joan R. Nera, Blessie Dana C. Noroña, Maria Monette S. Ong, Patricia Ysabel G. Oreta, Nikka Leia G. Padilla, Jayson R. Paragas, Toni Rose M. Pascual, Michael Lawrenz F. Co

University of the Philippines, College of Medicine, Philippines

Virgin coconut oil (VCO), a natural oil mechanically extracted from fresh coconut meat, boasts of various proposed health benefits. The study aims to determine the teratogenic effects of VCO on ICR mice and the anti-teratogenic effects of VCO on urethane-treated ICR mice. Forty nulligravid mice were synchronized of their estrus cycles. After which, they were randomly allocated to ten clusters of four mice each, with one male mouse for mating in each cluster. Random allocation to one of the four treatment groups: a negative control group treated with only water, a positive control group treated with only urethane, a VCO-treated group, and a group treated with both VCO and urethane, was done after copulation. VCO was administered through oral gavage daily from day 0 to 18 of gestation, at a dosage of 4.6g VCO/kg body weight. Urethane, was administered subcutaneously only on the 10th day of gestation, at a dosage of 1mg urethane/g body weight. On the 19th day of gestation, mice were sacrificed and hysterectomy was performed. Number of resorbed and developed fetuses was counted for each group. Only developed fetuses were analyzed for mean weight and observed for presence of developmental malformations. Results indicate that VCO is non-teratogenic in ICR mice as frequency of structural aberrations in VCO-treated fetuses was statistically comparable to fetuses of the negative control. VCO treatment significantly reduced urethane-induced cleft palate incidences and fetal

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resorption, suggesting a protective action of VCO against teratogenicity and generalized fetal toxicity.

SP-007

What Make Doctors Suggest an End-Stage Renal Disease Patient with Multiple Organ Failures to Withhold Hemodialysis (HD)? A Comparative Qualitative Analysis

Bih-Jeng Chang1, Duan-Rung Chen2, Hou-Tai Chang3,

Kwan-Dun Wu2, Shih-Hua Lin4

1. Sanchong City Public Health Center, Taiwan 2. National Taiwan University, Taiwan

3. Far Eastern Memorial Hospital, Taiwan 4. National Defense Medical Center, Taiwan

Objective: End-Stage Renal Disease (ESRD) incidence in Taiwan ranked first and prevalence ranked second in the world from 2002 to 2005. Under the National Health Insurance, more ESRD patients with severe multiple organ failures undergo HD without regards to the quality of end-of-life.

The purposes of this study are: Firstly, to examine the conditions that doctors would suggest their patients to consider withholding HD. Secondly, to examine the conditions that doctors had suggested their patients to consider withholding HD but patients’ family declined. Methods: Eight nephrologists and ICU specialists were asked to provide detailed information about their ESRD patients without revealing names and ID. Thirty-one clinical cases were collected. The Qualitative

Comparative Analysis (QCA) method was employed to analyze the qualitative data.

Results: The crucial factor associated with the condition that doctors would suggest patients to withhold HD is that they found the patient is in a combination of being in critical condition, presenting emotional problem, and with no family issue. However, when the patient is in a combination of being in critical condition, presenting emotional problem, yet with family issue, the family members of the patients would decline doctors’ suggestion of withholding HD.

Conclusions: When a patient suffers from emotional problems, being in critical condition, aged and with no family issue around, patients and doctors would agree on withholding HD for a better quality of end-of-life. However, giving the same conditions, yet with family issue involved, shared decision-making is recommended to reach consensus and reserve better quality.

SP-008

Association between Body Mass Index at Different Age and the Risk of Dementia

Yen-Ching Chen1, Jen-Hau Chen2, Ta-Fu Chen2,

Ping-Keung Yip3, Chi-Yin Hu1

1. National Taiwan University, Taiwan

2. National Taiwan University Hospital, Taiwan 3. Cardinal Tien’s Hospital, Taiwan

Background: Body mass index (BMI) change over lifetime and BMI at early age have not been investigated for dementia risk.

Method: This is a case-control study including 169 Alzheimer’s disease (AD) patients, 97 vascular dementia (VaD) patients, and 215 controls from National Taiwan University Hospital and Cardinal Tien’s Hospital from 2007 to 2009. BMI information was collected from medical records and questionnaires.

Results: People with a low BMI (<-5 kg/m2 was associated with a 2.24-fold risk of VaD (95% CI=2.24-4.70) as compared to those with BMI change>0.BMI change from age 40s to current age between 0 and -5 kg/m2 showed a 0.35 and 0.33-fold risk of AD and VaD (95% CI=0.18-0.69 and 0.14-0.80, respectively).

Conclusions: BMI at age 40 is a stronger predictor of AD and VaD than BMI at age 20 and current age. A U-shape association was observed between BMI change from age 20s or age 40s to current age.

SP-010

Premenstrual Symptoms among Thai Women

Nutta Taneepanichskul, Surasak Taneepanichskul Chulalongkorn University, Thailand

Objective: To evaluate the prevalence and severity of premenstrual symptoms (PMS) among Thai women. Method: A cross-sectional study was carried out among Thai women who lived in Bangkok, aged 18-45 years. One hundred subjects were asked to complete a questionnaire assessing premenstrual symptoms. The criteria of American College of Obstetricians and Gynecologists (ACOG) were used to diagnose premenstrual symptoms. The Women’s Health Assessment Questionnaire (WHAQ) was used to evaluate the premenstrual symptoms and severity. The scoring system of severity from absent to strong is 0-4. Results: Of the 100 subjects, 58% were diagnosed PMS by using ACOG criteria. The mean aged of subjects was 26.8 years. According to WHAQ six categories, during the premenstrual phase, the mean score of negative effect category was 4.5 +/- 4.2. The mean score of water retention category was 2.9+/- 2.4 and impaired concentration category was 3.7 +/- 2.1. The three additional categories which are increased appetite, felling of well being, and undesirable hair change had mean score 1.3+/-0.9, 1.6+/-0.9 and 0.2+/-0.1 respectively. The severity of symptoms was negative effect followed by impaired concentration and water retention.

Conclusion: High prevalence of premenstrual symptoms was found among Thai women in this study sample. The negative effect was the leading severity of PMS. Education, prevention and appropriate management for PMS are highly recommended to improve quality of life among reproductive aged women.

SP-012

Evaluation of Potent Dexamethasone-Suppressed Wound Healing Activity, Antioxidant and Anti Inflamatory Activity of Hyptis Suaveolens in Rat Models

Ujjal Bose, A Laxminarayan Udupa, Ravindra S Rajput, Manjusa Brahma

Kasturba Medical College International Center, Manipal University, India

Dexamethasone plays an important role in retarding the wound healing process ranging from avascular/aseptic necrosis to attenuation of collagen synthesis at the site of injury. Dexamethasone can hinder quality of life in patients inevitably under steroid coverage. Ethanolic extract of Hyptis suaveolens has been shown to exhibit Dexamethasone suppressed wound healing, independent antioxidant and antiinflamatory activity. The purpose of this study is to examine whether or not Hyptis

suaveolens extract could exihibit significant, wound healing in the dexamethasone challenged surface wound. The Study would expose the significant ROS scavenging and collegen synthesis potentiating property of this cost efficient pharmacological agent, to the scientific community. By using rat models for incision, excision and dead space wounds the protocol was standardized. Recruitment of standard antioxidant markers SOD, Catalase, Peroxidase and

Hydroxyproline(OHP)determination protocols the above mentioned proterties of Hyptis suaveolens were

substantiated. This report is one of the pioneering demonstrations which showed Hyptis suaveolens alcoholic extract bring about significant and expeditious Dexamethasone suppressed wound healing. This widely available herb extract also effectively scavenged ROS and provided the necessary anti inflammatory coverage promote immediate wound healing in the presence of a synthetic glucocorticoid in rat models.

SP-013

What Is the Need of Health Staff at Public Health Center?

M. Alimin Maidin1, Ahmad Muttaqien2

1. Hasanuddin University, Indonesia 2. NGO "YASIN", Indonesia

Objectives: The aim of the study was to analyze the needs of health staff at seven public Health centers in central Halmahera, North Maluku, Indonesia; to know the dominant diseases and outputs of public health center.

Method: The study was a qualitative and quantitative using a case study approach, conducted in April to July 2008. The data were collected through in-depth interview, documents and analyzed descriptively.

Results: The result of the study indicated that health staff was not distributed equally both in numbers and types. The highest number of health staff at Health center was 28 (24%) and the lowest was 3 staff (3%). The type of diseases were dominated by infectious diseases (upper

respiratory tract infection, clinical malaria, skin disease, diarrhea, and lung TB). The ratio of staff per patient was 4-5. The total output of health center service activity was between 4.207 to 28.056 patients per annually.

Conclusion: The health staff need was to increase numbers and types of health staff. The infectious diseases were the big problem and become even more difficult to solve since the chronic disease also a new problem of the community at the rural area.

SP-014

Fauna Succession on Monkey Carcasses in Buried Condition in Forested Area, Ulu Gombak, Selangor State, Malaysia

Chee Dhang Chen1, Wasi Ahmad Nazni2, Han Lim

Lee2, Rosli Ramli1, Mohd Sofian-Azirun1

1. University of Malaya, Malaysia

2. Medical Entomology Unit, Institute for Medical Research, Malaysia

A forensic entomological study was conducted to study the post mortem interval (PMI) of buried carcasses in forested area. The study was conducted in Wildlife Research Centre of University of Malaya located in Ulu Gombak, Selangor, Malaysia. Monkeys (Macaca fascicularis, Raffles) were used as a model for human decomposition in this study. Initially, the monkey was euthanized by the Department of Wildlife and National Parks (PERHILITAN) of Peninsular Malaysia, Ministry of Natural Resources and Environment Malaysia. The study protocol was approved by Institute for Medical Research’s Unit of Animal Care and Use Committee [ACUC/KKM/02(2/2008)]. After death was confirmed, the monkey carcasses were immediately clothed to simulate human cadavers. The monkey carcasses were buried in a well [2 ft (width) x 3 ft (length) x 3ft (depth)] and covered tightly to simulate cadavers being buried in the ground. The carcasses were monitored daily until no more larvae and body remains were observed. A total of 2 replicates were used. No flies were observed inside and around the well on the first 3 days. On Day-2 (Fresh), ants were observed attracted to the bloodstain of the carcasses. On Day-5 (Bloating), 3rd instar of

Hypopygiopsis sp., Chrysomya pinguis and Chrysomya chani larvae were recovered. From Day-6 (Bloating / Decay) to Day-15 (Remains), larvae of Hypopygiopsis sp., Ch. pinguis, Ch. chani, Ch. villeneuve, Ch. rufifacies, Fannia sp. and sarcophagid were recovered. This study indicated that PMI was delayed at least 1 day on carcasses in buried condition.

SP-015

Effect of Different Length of Life Expectancy on Time Trade-Off and Standard Gamble after Traumatic Spinal Cord injury

Shih-Chieh Wang, Chih-Yi Chen, Mau-Roung Lin Taipei Medical University, Taiwan

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Purpose: This study was to evaluate the effect of different length of life expectancy on health utility, measured by time trade-off (TTO) and standard gamble (SG) methods in patients with traumatic spinal cord injury (SCI).

Methods: Patients with SCI were recruited in a 5-year period of from July, 1999 to June, 2004 by reviewing hospital records of 5 medical centers, with codes of International Classification of Diseases. Of 713 subjects who were registered, 270 completed the telephone interview. A structured questionnaire was used to collect demographics, injury-related characteristics, risk-taking propensity, TTO and SG. The TTO and SG were

evaluated under three conditions of life expectancy of 10, 20 and 30 years, respectively.

Result: TTO values were significantly different among the three conditions of life expectancy and they were lower at longer life expectancy than at shorter life expectancy. On the other hand, SG values were not significantly different among the three conditions of the life expectancy. When the life expectancy increased from 10 years to 20 years, subjects who were young people, sustained injury less than one year, and had lower risk taking levels were significantly association with lower TTO values. When the life expectancy increased from 20 years to 30 years, higher Injury Severity Score values were independently associated with more changes in TTO scores.

Conclusion: Our study suggests that proportional trade-off assumption for the TTO is violated. On the other hand, SG values may be indifferent between different lengths of life expectancy.

SP-016

Application of Brain Tissue Oxygen Monitoring in Patients with Traumatic Brain Injury

Ching-Shuan Sun, Richard Yao-Chin Wang, Wen-Ta Chiu

Taipei Medical University, Taiwan

Purpose: The applications of brain tissue oxygen monitoring system in traumatic brain injury have reduction of mortality rate and improved patient outcome.

Method: This retrospective randomized-controlled clinical trial from January 01, 2008 to May 01, 2009. All subjects are moderate-severe traumatic brain injury patients with GCS 3-12, age greater than 17 years old, admitted to neurological critical intensive units in 6 medical centers. Case group used brain tissue oxygen monitoring system and intracranial pressure monitoring system Control group use only intracranial pressure monitoring system

Result: There are 60 patients included in this trial. (43 males and 17 females) Case group consists of 20 patients with mean age of 49.8± 24.1 years. Control group consists of 40 patients with mean age of 51.4± 21.5 years. This study shows when there is pulmonary complication in traumatic brain injury patients, continue use of brain

tissue oxygen monitoring system to adjust FiO2 to increase PaO2 thus maintain PbtO2 can effectively preserve and improve pulmonary function. The mortality rate is 10% for the case group which is significantly lower than the control group with mortality rate 35% (P< 0.05). Evaluation of GOS/GOSE 6 months after the injury shows (67%) have better prognosis than the control group (35%). There is 32% difference between case group and control groups (P< 0.05).

Conclusion: Patient with brain tissue oxygen monitoring system continuously monitoring all parameters to maintain pulmonary function have better results on reduction of mortality rate and improved functional outcome.

SP-017

Preference Survey Results in Our Hospital

Hiromi Ikeda

Kagawa Nutrition University, Japan

Purpose: To aim at providing such solid food services that inpatients enjoy their meals and nutritious diets help early recovery from their disease, the following items were surveyed: quantity and quality of the meal on August, 2008, and usage of the dining hall and the tea dispensers installed in the hall.

Method: Subjects were all hospital wards of inpatients who were allowed to eat.

Results: There were 158 questionnaire sheets collected. The meal under this survey consisted of the followings: seasoned rice, deep-fried sliced eggplant for the main dish, vinegared salad for the side dish, and pickled, fruit, jelly or juice for the additional side dish. Focusing on respective wards, it was significant in the surgery ward that the percentage of the patients who ingested one third of the amount of the staple diet was largest. In addition, significantly more surgical patients remained the main dish than patients in other wards. In the pediatrics and internal medicine departments, there were significantly more patients who did not eat the side dish. Regarding occupancy rate, about 60 percent of patients used the dining hall and about 90 percent used the tea dispensers. Discussion: The surgical patients ingested a little. We will continue to visit the ward frequently and keep communicated with the patients, their families, doctors and ward nursing staff to improve trophic conditions of the patients. They say that seasonally changing

tablecloths and decoration in the dining hall creates good atmosphere. We continue to provide what patients are pleased at.

SP-018

Improving the Performance of Claims-Based Comorbidity Measures in Predicting In-Hospital Mortality

Shiao-Chi Wu, Yu-Tseng Chu National Yang-Ming University, Taiwan

Background: Comorbidity is an important controlling factor in health services research using administrative data. Our aim was to improve the performance of various claims-based comorbidity measures in predicting in-hospital mortality.

Methods: Five different comorbidity measures, including three different adaptations of the Charlson comorbidity index (CCI), one method developed by Elixhauser et al., and the Chronic Disease Score (CDS), were selected for investigation in this retrospective cohort study. New empirical weights were derived from Cox’s regression models of all inpatients in 2001. The performance of comorbidity methods with new weights was validated and compared using the c-statistics derived from multiple logistic regression models among each of the following inpatients in 2002: AMI (n=8,961), type 2 DM

(n=32,687), and CHF (n=15,972).

Results: We derived new weights for five comorbidity measures from 1,214,014 inpatients in 2001. For all the adaptations of CCI, some comorbid conditions had smaller weights than the original weights, such as rheumatologic disease, ulcer disease, hemiplegia or paraplegia, and AIDS, while dementia had larger weight than the original. The empirically derived weights of the CCI and the Elixhauser method outperformed than the methods with the original definition among each of study populations in 2002.

Conclusions: The findings of this study have indicated that CCI should be reassessed in cohorts with larger sample size. The empirically derived weights of CCI performed better than the original one, and suggest that the new weights should be used in further researches.

SP-019

The Association of Weight Status and Sedentary Time with Diagnosed Asthma and Respiratory Symptoms in Taiwan

Hsin-Jen Tsai

I-Shou University, Taiwan

Objectives: The study aimed to evaluate the association of weight status and sedentary status with asthma and respiratory symptoms (RS) in schoolchildren in Kaohsiung, Taiwan.

Method: A questionnaire study elicited episodes of RS and data on lifestyle and anthropometric parameters in 1329 5th grade schoolchildren.

Results: Results showed that 12.4% of boys and 9.5% of girls had physician-diagnosed asthma whereas 15.1% of boys and 12.4% of girls had suspected asthma. Boys experienced more non-exercise-induced RS than girls (P<0.05). The number of RS was positively correlated with TV-watching time per day and self-reported sedentary time per weekend-day in girls (P<0.05). Underweight was positively associated with one of the seven RS in girls (P<0.05). At risk of overweight was positively associated with two of the seven RS in boys and one of the seven RS in girls (all P<0.05). The risk of having physician-diagnosed asthma and suspected

asthma increased 93% and 72%, respectively, in schoolchildren at risk of overweight (P<0.05). Overweight was associated with a 78% increase in physician-diagnosed asthma (P<0.05). Higher sedentary time was significantly associated with more occurrences of one of the seven RS in girls (P<0.05). Higher body mass index was significantly correlated with longer TV-watching time per day in girls and longer self-reported sedentary time per weekday in boys (P<0.05).

Conclusion: Schoolchildren who are at risk of overweight or overweight and/or have more sedentary time have increased risk of RS and asthma. Weight and sedentary statuses of schoolchildren can impact on their respiratory health.

SP-020

Survival Analysis of Different Treatments in Patients with Advanced Oral Cavity Cancer from

Administration Database in Taiwan

Mei-Tzu Huang, Shiao-Chi Wu, Chiu-Fen Wu, Yen-Ni Hung

National Yang-Ming University, Taiwan

Background: Oral cavity cancer has become one of the main causes of cancer-related deaths in Taiwan. Most cases of oral cavity cancer are squamous cell carcinoma, diagnosed at stage Ⅲ/Ⅳ. Besides of operation,

"radiation therapy (RT)" or "concurrent

chemoradiotherapy (CCRT)" are usually performed after surgical treatment. Several studies have discussed the prognosis of the patients under different treatments in western countries. However, there are few studies concerning the territory in Taiwan. This study is to explore this issue further by using the secondary databases of government.

Objective: To explore the RT or CCRT effect on the survival condition among patients with advanced oral squamous cell carcinoma.

Methods: A historical cohort method is adopted to conduct the study. After identification of newly operated advanced oral cavity squamous cell carcinoma from Taiwan Cancer Database (TCDB), the information will connect with the census registry, mortality registry and databases of the Bureau of National Health Insurance (BNHI) in 2004. The Cox’ s proportional hazard regression was used to analysis the survival rate after adjusting the patient and hospital characteristics. Results: The study will show the utilization and survival of patients with oral cavity squamous cell carcinoma after receiving post-operational radiotherapy or concurrent chemo radiotherapy in Taiwan.

SP-021

The Association of Obesity, Hs-CRP and Gene with Adult Asthma and Prognosis in A Hospital-Based Case-Control Study

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Ting-Chia Lien1, Meng-Chih Lin2, Chao-Chien Wu2,

Tsu-Nai Wang1

1. Kaohsiung Medical University, Taiwan 2. Chang Gung Memorial Hospital, Taiwan Previous studies suggested that there is an association between obesity and asthma, also indicated that adipose tissue from obese individuals expresses a number of proinflammatory molecules, such as CRP, which is considered to induce asthma symptoms. But the mechanism is still unknown. The CRP gene SNP is thought to be related to inflammation diseases. Our study is the first to discuss CRP gene and asthma. We

determined the relationship between obesity, hs-CRP level and adult asthma. We also analyzed the risk of obesity, high levels of hs-CRP and interaction of CRP gene and obesity on asthma. This is a hospital-based case-control study. We enrolled 473 adult asthmatic patients from two hospitals in Taiwan and with 473 community-based controls. A significant association between obesity and asthma has been found. After controlling for confounding factors, the risk of BMI, WHR, waist circumference(WC) on asthma are 3.05, 3.20, 2.83. And the asthma risk for compared quartile 4 to 1 of hs-CRP level is 2.04. The interaction effects between CC genotype and central obesity with WHR and WC were 7.22 and 5.77 of OR on asthma compared to the CT/TT genotype and the normal weight group. The results show that obesity and high levels of hs-CRP could increase asthma risk. We didn’t observe that obesity and hs-CRP are related to lung function, medication use or asthma severity. The interaction effects between SNP rs1205 CC genotype and obesity on asthma were observed.

SP-022

Survival Analysis of Embolization with or without Radiotherapy in Patients with Hepatocellular Carcinoma from Administration Database in Taiwan

Ya-Wei Yu, Shiao-Chi Wu, Chiu-Fen Wu, Yen-Ni Hung

National Yang-Ming University, Taiwan

Background: 90% of liver cancers are hepatocellular carcinoma(HCC) in Taiwan. Transcatheter arterial embolization /Transarterial chemoembolization (TAE/TACE) is widely used in the treatment of unresectable hepatoma. For the tumor grown in the capsule, TACE/TAE with radiotherapy is used to eradicate the residual tumor cell to avoid the high recurrence rate in literature reports. However, there is a lack of reporting outcome of TACE/TAE with

radiotherapy in the patients with hepatoma based on secondary database of government.

Aim: Comparison survival between TACE/TAE alone and TACE/TAE combined with radiotherapy for hepatocellular carcinoma.

Method: A historical cohort study was adopted to conduct the study. After identification of newly

diagnosed hepatocellular carcinoma from Taiwan Cancer Database (TCDB), the information will linked with the census registry, mortality registry and databases of the Bureau of National Health Insurance (BNHI) in 2004. Then, the patients are divided into 2 groups— group A with TACE/TAE alone and group B with combined therapy of TACE/TAE and radiotherapy. The Cox’s proportional hazard regression was used to analysis the survival rate after adjusting the patient and hospital characteristics.

Results: The study will show the survival of patients with hepatocellular carcinoma receiving TACE/TAE alone or TACE/TAE combined with radiotherapy in Taiwan.

SP-023

Estimations of Allele and Haplotype Frequencies of the HLA-A, HLA-B, and HLA-DRB1 LOCI Based on the Marrow Donors of TCTMDR

Ya-Huei Lin, Shu-Hui Wen Tzu-Chi University, Taiwan

Until 2005, a total of 56176 unrelated healthy Taiwanese individuals from the BTCSCC (Buddhist Tzu Chi Stem Cells Center) were typed for HLA-A, -B, -DRB1 at allelic resolution. In this study, we estimated the HLA allele and 3-locus haplotype frequencies among the majority of Minnan, Hakka, Mainlander and Aborigines ethnic groups in Taiwan. We found 51 HLA-A alleles, 121 HLA-B alleles and 53 HLA-DRB1 alleles in Taiwanese population. The heterogeneous exists among four different ethnicities. Take HLA-DRB1 for example, the most frequent HLA-DRB1 alleles in Minnan and Hakka were DRB1*0901 (15% and 16%) and DRB1*0301(both of 11%). In Mainlander, the most common HLA-DRB1 alleles were DRB1*0901(16%) and DRB1*1202(10%). For Aborigines, the most frequent HLA-DRB1 alleles(12%) were DRB1*1101 and DRB1*1454. 3-locus haplotype frequencies estimated by the Expectation-Maximum method. For Minnan, Hakka and Mainlander, the first two common haplotypes were A*3303-B*5801-DRB1*0301 (>5.7%) and

A*0207-B*4601-DRB1*0901 (>4.3%). In Aborigines, A*3401-B*5601-DRB1*1502 (5.8%) was the top one haplotype which rarely occurred in other three groups. These results revealed high diversity of HLA alleles and haplotypes among the four ethnic groups in Taiwan. Principal component analysis and clustering analysis based on HLA allele frequencies suggested that Minnan, Hakka and Mainlander were more genetic homogeneous while the Aborigines is a characteristic group.

SP-024

A Survey of Outcome of Bariatric Surgery

Chiu Yin Lai1, Fen-Ju Chen1, Chih-Kun Huang2

1. I-Shou University, Taiwan

2. E-Da Hospital, International Endoscopic Obesity Center, Taiwan

Bariatric surgery is a popular service for the weight reduction. This research intends to analyze demographic characteristics of bariatric surgery patients and effects in changing BMI (Body Mass Index). Secondary data is derived from patients’ pre-operation assessment

information from a regional hospital in southern Taiwan. The total number of study subject is 194 patients receiving bariatric surgery, which included 27 male and 167 female. The average age is 32.34 years old. The major group of occupation could not be identified from the data (45.4%) and the next occupation group is student (18%). More than half of their education level is above college (56.2%). Most of study subjects have no children (66.5%). 34% of study subjects express that they gained weight before 12 years old. Most patients have experiences in trying any mean to reduce body weight (77.8%). 56 study subjects (28.9%) had diseases related to obese. 143 study subjects (73.7%) have the family medical history. One or both of their parents are obese (57.7%). The average pre-operative BMI of study subjects is 38.27. The average percentage change of BMI at post-operation follow-up in first, third, sixth, and ninth month decreases by 9.4%, 18%, 29%, and 32%

respectively. Among three different types of bariatric surgery, laparoscopic Roux-en Y gastric bypass shows better effect in reducing BMI. The result provides brief information of effects and patient characteristics of bariatric surgery for evaluating a new medical service in health service market.

SP-025

Sexual Risk Behaviors among Undergraduate Students in Nakhon Ratchasima Province, Thailand

Tanida Phatisena

Dr.Samnao Phatisena, Thailand

The purposes of this research were to study sexual risk behaviors among undergraduate students, Nakhon ratchasima province, and to study the related factors that caused sexual risk behaviors of the target students. The samples were 397 students in academic year 2008 which were drawn by multistage random sampling. The instruments for data collecting were chick-list questionnaire and percentage had been used. It was found that 56.4 percent of the samples had sexual relation. About 31.7 percent of them had their first sexual relation between 16-18 years. Most of them about 90.6 percent were their lovers or their boy/girl friends and 74.1 percent want to make relationship. Their first sexual relation without condom was 34.4 percent. Sexual relation with more than one partner was 73.7 percent . Sexual without condom together with alcoholic drink were found about 70.4 percent. There were three socio-psychological factors that caused sexual risk behaviors. Firstly, the family relation factor. Male samples of 35.2 percent did not make any consultation on sexual matters and 36.6 percent female samples consult their parents. Secondly, the influence of peer group factor. About 72.8 percent of the samples did not

consult with close persons and 62.6 percent were invited to visit the sex service houses. Finally, the social behavior factor. They learned about the sexual relation from C.D. and videos, internet, and T.V. approximately 63.5, 61.7, and 59.3 percents respectively.

SP-026

Sexual Behaviour, Knowledge, and Attitude of Adult at Makassar City, Indonesia

M. Alimin Maidin1, Sudirman Sudirman2

1. Hasanuddin University, Indonesia 2. NGO "YASIN", Indonesia

Objectives: The aim of the study was to observed the sexual health behaviour, knowledge and attitude of adult (15-25 years old), which very much related to the health prevention and promotion especially to sexual

transmitted diseases (HIV-AIDS, Syphilis, Gonorrhoe, Clamedia).

Method: The study was a survey descriptive, conducted in April to Mei 2008 at five sub-districts, five villages, and 5 sub-villages within Makassar city, involving 100 adult samples. Results: 51% of the sample understand very well about the sexuality, 79% watched blue-movie, 60% masturbated or onani, 89% have boy or girl friend, 19% have sexual relationship which 76% out of them with girl or boy friend. Although 88% of the sample do not agreed with free sex, but 23% of them have ever got syphilis.

Conclusion: the sexual behaviour of youth in Makassar was very risk to get sexual transmitted diseases, such as HIV-AIDS, Syphilis, Gonorrhoe, and Clamedia.

SP-027

Body Weight Perception and Risky Slimming Behaviour of University Freshmen

Ka Chun Tony Yung, Jasmine Wong, Jean Kim, Sian Griffiths

The Chinese University of Hong Kong, Hong Kong Background and Objective: For many young people, the desire of having a slimmer body distorts their perception of a healthy body weight. It also triggers the attempt to many risky slimming behaviours. This study aims at exploring the body weight perception among university freshmen in Hong Kong and the prevalence of using risky slimming behaviours. Study design Cross-sectional survey.

Method: Anonymous questionnaire was given randomly to entrants of a comprehensive university via admission package. During the compulsory health check, students returned their questionnaire which was cross-checked onsite. Body weight and height were measured using standardized method during the same occasion. Results: A total of 1228 (53.8% female) students successfully completed the questionnaire. Among female students who were trying to lose weight, 78.4% of them were actually on the Normal (70.2%) and Underweight

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(8.2%) weight categories. For those female students who perceived themselves as overweight, 66.4%of them were actually on the Normal (64.8%) and Underweight (1.6%) categories. Substantial proportion of these students were using inappropriate methods of losing weight include dieting (64.2%) , skip meals (27.5%), popular diet regime (10.9%) and diet plan from the Internet (4.9%). Some of them had experiences of risky slimming method include fasting, over-the-counter drugs, meal

replacement and self-induced vomiting.

Conclusion: This study revealed a majority of university entrants have had wrong concept of healthy body weight despite their education attainment. Inappropriate and risky slimming methods were frequently practiced by this group of people.

SP-028

Health-Related Risk Perception among University Students in Sri Lanka

Hiroko Yamashina1, Sujatha Wattegama2, Koji Kanda1,

Yoshi Ohbayashi1, Hiko Tamashiro1

1. Hokkaido University, Japan

2. University of Peradeniya, Sri Lanka

Introduction: Public health depends on how laypeople perceive health-related risks. Individual differences in risk perception are related to regional, ethnic,

socio-economic or gender distinctions. The purpose of the study is to understand how the university students in Sri Lanka perceive health-related risks such as infectious diseases and other socio-environmental events.

Methods: 1,774 university students were asked to identify the risk level of nineteen health-related risks with a four-point likert scale in two different situation: for individual and for society. The difference between risk perception for social and individual was analyzed using chi-squared test. T-test was used to examine the effect of socio-demographic variables on perceived levels of risks.

Results: Bomb blast was perceived as the most serious risk for both social and individual: the mean score was 2.53 and 1.98, respectively. In contrast, snake bite was the lowest for social and HIV/AIDS for individual. Social risks were significantly higher than individual ones in all 19 listed items (p<0.05). In addition, socio-demographic variables were associated with level of risk perception. Male had statistically higher risk perception than female, and students of Science faculties than Arts.

Discussion: There was higher risk perception for society than individual. It indicates that people tend to believe they are less at risk than the average person of society. In addition, socio-demographic variables had a significant influence on risk perception. It is desirable to take these characteristics into account when developing a school health strategy.

SP-029

Bachelor of Science in Health Promotion and Disease Prevention Studies

Elahe Nezami

University of Southern California, USA

Issues Since its founding in 1997, the Health Promotion and Disease Prevention Studies program at the

University of Southern California has sought to improve public knowledge of public health issues, create a stronger public health workforce, and provide public health training to future clinicians. This paper describes the structure and mission of our program, the lessons learned about undergraduate public health education, and future plans for the program. Description The Health Promotion program is designed to provide undergraduate students with a critical, holistic view of health to broaden their understanding of public health and healthcare. Students learn about the socio-cultural, behavioral, psychological, economic, and biological factors that contribute to wellness and disease. Our program serves all students with professional interests in health. In addition to the HP major, the department offers six minors and three progressive degree programs in which students enroll in graduate courses while pursuing their undergraduate degrees. Program administrators have recently developed a Bachelor of Science in Global Medicine, an interdisciplinary major that focuses on understanding and investigating the factors that determine global health. The B.S. in Global Health is ideal for students who wish to work abroad in the future, as well as students who are interested in pursuing international relations and global policy issues with a focus on health and healthcare. Lessons learned Alumni have become physicians, dentists, pharmacists,

researchers, health educators, lawyers, and health reporters, as well members of other professions. Many describe the program as valuable for the knowledge and perspective it

SP-030

Master of Science in Global Medicine Program

Elahe Nezami

University of Southern California, USA

Launched in 2008 by the Keck School of Medicine, the Master of Science in Global Medicine (MSGM) program addresses the urgent, worldwide need for training in global medicine among health professionals. This paper describes the structure and mission of our program, lessons learned about the needs of a global medicine education, and future plans for the program. Description The MSGM curriculum teaches students to analyze and address issues in global medicine, focusing on methods used to create solutions and responses to global health challenges. Students gain a strong medical science foundation as they focus on such topics as malaria, tropical disease, HIV/AIDS, and maternal and child health. The program is useful for students interested in

medical school, public health, or other areas of health outreach. The department offers the MSGM program as a progressive degree option for students in the Health Promotion and Disease Prevention Studies undergraduate program at the University of Southern California. Lessons learned In May 2009, the MSGM program graduated its first cohort of students. Most graduates had taken their MCAT tests and applied to medical school. Some graduates had plans to join the workforce in the health sector or in government agencies focusing on public health. Next steps The MSGM program continues to expand its course offerings and has experienced increased enrollment. Clearly there is a significant demand for professionals with global medicine perspectives, from medical schools, employers, and government agencies, and the MSGM program is positioned to continue training students to meet that demand.

SP-031

The Efficiency and Effectiveness of

Computer-Assisted Instruction “Fun with Nutrition” for Prevention of Childhood Obesity

Khanitta Thepprasit, Chutima Sirikulchatanonta, Piangchan Rojanavipart, Rachada Kasemsup Mahidol University, Thailand

The purpose of this quasi experimental research was to study the efficiency and effectiveness of a

computer-assisted instruction (CAI) entitled “Fun with Nutrition” which was designed to prevent childhood obesity for grade 5th students. The research consisted of two groups and a pre and post test design. The sample was comprised of 247 students (134 in intervention group, 113 in control group), ages 10-12, who were studying at a private school in Bangkok. The intervention group received CAI in 5 chapters: childhood obesity, nutrition guideline, fat and sugar, vegetable and fruit and physical activity. The intervention was done weekly (40-50 minute class) for 5 weeks. Data regarding the characteristics of the students, nutritional status, nutrition knowledge, eating behavior, physical activity and students’ satisfaction with CAI were collected.

Independent t-test, paired t-test and Chi-square test were applied for statistical analysis.

The results revealed that students in the intervention group increased their knowledge after using CAI more than control group. But no change in the intervention group was found concerning eating behavior and physical activity. After the intervention, the nutritional status of students in the intervention group showed no significant change.

These findings suggest that the CAI was able to enhance learning achievement in students regarding childhood obesity and nutrition knowledge. However, subsequent stimulation by teachers and parents should be

encouraged to improve the eating and exercise behavior of children.

SP-032

Student-Led Tutorials: Diversity and Creativity in Postgraduate Learning of Major Public Health Issues in Developing Countries- The MIPH Way!

Manalo M Giselle

University of Sydney, Australia

Since the inception of the Masters of International Public Health (MIPH) Program in 2000, the number of

international students mostly from developing countries (Pacific Islands, Asia, Africa and Middle East regions) has significantly increased. Currently, nearly half are international students; 70% come from developing countries. Students’ experiences range from highly experienced in the international arena having worked in their home countries/overseas to limited or virtually no working experience. As enrolments dramatically increased in 2003, effective learning tools had to be employed to maximize peer interaction and learning to address the needs of our culturally diverse student populace. Thus, student led tutorials were implemented. In 2000, the MIPH commenced with 13 students. To date, there are 123 students enrolled with about 45% being international students. Each tutorial group of allocated 10-12 students meet for 9 weeks; a student facilitates the discussion based on international public health issues generated from lectures and readings. Creative methods such as debates, problem solving case scenarios, role playing, educational games and mini icebreaker quizzes have been prepared and conducted by the students. This presentation looks at the impact of student-led tutorials in learning major public health issues within a

developing country context and describes skills developed outside a traditional didactic method of teaching. It also describes the impact of student-led tutorials on the mentoring process and pastoral support of postgraduate students.

SP-033

Environment and Health Impact of Hot Mud Volcano in the Subdistric Porong, East Java Indonesia

Jojok Mukono

Airlangga University, Indonesia

Subdistric Porong is located at Sidoarjo regency East Java.Indonesia, 20 km south of Surabaya. The Sidoarjo mud flow is informally abbreviated as Lusi, a contraction of Lumpur Sidoarjo (limpur is the Indonesian word for mud), is an eruption of gas and mud that has been going since May 2006. It is considered to be mud volcano. In the first stage of drilling, the drill first went through a thick clay seam (500-1,300 m deep), then sands, shells, volcanic debris and finally into permeable carbonate rock. At this stage the borehole was surrounded by a steel casing to help stabilise it. A second stage of drilling began and the drill string went deeper , to about 2,834 m (9,298 ft). Unportunatelly at that time without a

protective casing, after which water, steam and a small amount of gas erupted at a location about 200 m

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southwest of the well. During the eruption hydrogen sulphide gas was release and local villagers observed hot mud, thought to be at temperature is around 60o C ( 14Oo F ). Because of the second stage of drilling without a protective casing, the most likely cause of these hydraulic fractures was unprotective drill string in the second stage of drilling. The impact of these volcano such as physical, biological and health impact. The aim of the research are identification of the impact of hot mud volcano to the community health and environment. Method of the research is the observation study included cross-sectional study. Primary data that are quality of air, hot mud volcano, environmental condition (building status) and health status. Secondary data included health status of the people living in the research area and physical environment condition in the research area. The research analysis by descriptive method. Results of the research are identified symptoms of the H2S exposure, skin symptoms because of mud contact , respiratory symptoms impact and also the environmental impact included physical and biological impact. The subcidence range 30-100 cm and building disorder is about 22%. Water and Air pollution such as concentration of HC is 55000ppm (standard 0.24 ppm), NO2 is 0.116 ppm (stadard 0.05 ppm), Cl is 2896.63 mg/L (std 600 mg/L), Cd is 0.15 mg/L (std 0.005 mg/L) and Mn is 5.14 mg/L (std 0.5 mg/L). The disease dominated by respiratory infection, neuritis, gastritis, skin infection and diarrhea. Impact of vulcano was managed by spesific method.

SP-034

Morbidity and Mortality of Multidrug Resistant Tuberculosis in Mongolia

Dambadarjaa Davaalkham1, Dorj Gantsetseg2

1. Health Sciences University of Mongolia, Mongolia 2. National Center for Communicable Diseases, Mongolia

Introduction: Mongolia is one of the countries with the highest prevalence of tuberculosis in the Westren Pacific Region. In the recent years the spread of multidrug resistant tuberculosis (MDR-TB) emerges challenges in TB control in most countries including Mongolia. The aim of this study was to investigate the incidence of MDR-TB since the introduction of drug sensitivity testing in 2003.

Materials and Methods: A descriptive method was used in this study and information regarding the patients were abstracted from official report.

Results: Totally 419 MDR-TB cases (1.6 cases per 10 000 population) have been registered during 2003-2008. More than 60% of MDR-TB cases were reported in capital-Ulaanbaatar city. An average age (±SD) was 32.3±10.9 and people aged 16-44 years were mainly (85.5%) affected with the MDR-TB the majority of whom were men. While only 63 cases (15%) were registered in 2003-2005 the remaining (85%) were reported in the last 3 years, probably due to increase in the incidence of MDR TB as well as better screening.

Only 43% of all MDR TB patients have received treatment whereas 32% died prior to the treatment. High proportion (61.8%) of deaths among MDR TB cases have been reported until 2006 that decreased to 22.3% after opening of the special ward in central TB clinic. Conclusion: In conclusion, MDR TB has been increasing in Mongolia and treatment should be started immediately after the drug sensitivity test to prevent from further disease burden.

SP-035

H5N1 Virus and World System Theory: The Case of Indonesia

Oedojo Soedirham

Airlangga University, Indonesia

World-system theory is a macrosociological perspective that seeks to explain the dynamics of the “capitalist world economy” as a “total social system.” The system divides the world (economy) into three zones: core, semi-peripheral, and peripheral countries. Chirot (1986) lists the five most important benefits coming to core nations from their domination of periphery nations: access to a large quantity of raw material, cheap labor, enormous profits from direct capital investments, a market for exports, and skilled professional labor through migration of these people from the noncore to the core. The blood sample that contains H5N1 Indonesian strain could be counted as raw materials that have enormous economic value especially for medical industries. The paper discuss that the case is actually part of the theory in practice.

SP-036

Prevalence and Risk Factors of Intestinal Parasite Infestation among Hilltribe Student

Weerayuth Siriratruengsuk, Tawatchai Apidechkul Mae Fah Luang University, Thailand

A cross-sectional study of prevalent rates, risk factors and re-infection rate of intestinal parasitic infestations among hill-tribe schoolchildren. Target populations were level one to level six primary schoolchildren who attended ten Border Patrol Police Schools in Chiang-Rai province, Thailand. Three hundred and thirty nine subjects were recruited by simple random sampling out of a total population of 2,194 children. All three questionnaires were tested for validity and reliability. Stool specimens were examined qualitatively and qualitatively for intestinal parasites using cellophane-covered thick smear technique.

Unconditional multiple logistic regression at α = 0.050 method was applied to statistical analyses.

Results: subjects were 51.92% male, 48.08% female, 31.2% Akha, 30.38% Kmong, 66.08% Buddhist, and 33.92 Christian. Prevalent rate of parasitic infestation was 9.75%, of which 7.97% was from Ascaris lumbricoides, 0.88% Hookworms, 0.29% each of

Trichuris trichiura, Enterobious vermicularis, and Taenia solium. Re-infection rate was 0.00% at one and three months after treatment with a single dose of 2 tablets of albendazole (200 mg). Only one risk factor for intestinal parasitic infections was identified after controlling for confounding factors of age, sex, parents’ education levels and occupations; which was the source of the child’s household drinking water. Those who drank water from wells had an increased risk of 9.83 (ORadj=8.22 95% CI 0.93-104.12), while those who drank from piped mountain water was 8.22 (ORadj=8.22 95% CI 1.07-63.18) as compared with drinking only commercially bottled water.

It is concluded that an improvement of the quality of household drinking water is essential to the prevention and control of primary schoolchildren attending Border Patrol Police Schools in Chiang-Rai province, Thailand.

SP-038

Risk Factors Tb in South Sulawesi Indonesia 2007

Ridwan Amiruddin

Hasanuddin University, Indonesia

Lung tuberculosis in Indonesia are predicted 450,000 cases with 175,000 victim. It is predicted that nationally incidence rate is about 130 people with sputum BTA (+) among 100.000 people. Based on Basic Health Research Survey in 2007, it was found that the prevalence of lung tuberculosis was 0,99%, detection rate was 53% of 70% national detection rate that shows the risk of transmitted in community is still high. Aim of the study is to investigate related factor of lung tuberculosis in South Sulawesi province in 2007. It consists of age, sexes, educational background, job, nutrient status, domicile, and smoking habit. The research design is cross-sectional involving 41.641 samples with 110 samples suffered lung tuberculosis. Source of data are the result of Basic of Research Survey, 2007 conducted by Indonesia Health Department. Then data are analyzed by SPSS and statistical test is using Chi square and logistic regression. Base on statistical test it is found high correlation of nutrient status (p=0.000) (Exp B = 3,180), age (p=0,000, sexes (p=0,000), educational background (p=0,001), job (p=0, 28), domicile (p=0,047), smoking (p=0,002) with the incidence of lung tuberculosis. Suggestion, the prevention and promotion of lung tuberculosis should been improved, particularly on improving nutrient status of community.

SP-039

Brucella Melitensis Antibody Prevalence in Goat Farmers Who Had Contact with Infected Animals in Four Districts of Kanchnaburi Province, Thailand

Charnchudhi Chanyasanha1, Wiraphatsara Kaewket1,

Monaya Ekgatat2, Dusit Sujirarat1, Teerasak

Chuxnum3, Unchalee Tansupasiri1

1. Mahidol University, Thailand

2. National Institute of Animal Health, Thailand

3. Ministry of Public Health, Thailand

Brucellosis is one of the zoonoses caused by Brucella melitensis which is related not only with agriculture but also with the public health field. The disease can be transmitted from animals to humans via several routes. Humans who are infected with brucellosis show many signs, symptoms and pathogenesis such as undulant fever, orchitis and abortion. The risk group is persons who have contact with goats, which may be infected with

brucellosis.

This study utilized a cross sectional analytic design. The objectives were to find the prevalence and risk factors of Brucella melitensis seropositivity in goat farmers from different size farms where positive Brucella melitensis was found in goats. The research was

approved by the Human Ethical Review Research Committee. Blood samples were collected and tested for related variables. Serum samples were tested for B. melitensis antibodies using Rose Bengal Test (RBT), CFT, EDTA-Tube Agglutination Test (EDTA-TAT), Indirect ELISA IgG and IgM against B. Melitensis. Univariate by Chi-square and multivariate by multiple logistic regressions were used to analyze data with significant statistical difference (P-value < 0.05). On 45 farms that were tested, 172 goats were found to be positive. Of the 70 goat farmers that had contact with the animals, 18 tested positive (prevalence 25.71%). Using multiple logistic regression, no significant associations were found between factors associated with positive antibody. However, when using univariate analysis a positive significant (P-value < 0.05) association was found for those who cook goat meat (P-value = 0.011).

Results showed that positive prevalence of B.

Melitensis in goat farmers in contact with infected goats was two times higher than positive goats. Results of this study will be useful in planning for control and

prevention of brucellosis in goat farmers by prevention of infection transmission of the disease from goats to humans.

SP-040

The Limitations of International Health Regulation 2005- The Timeliness Gap of Global Surveillance System

Feng-Jen Tsai1, Chang-Chuan Chan1, Eva Tseng2

1. National Taiwan University, Taiwan 2. Tufts University School of Medicine, USA

Objectives: Disease knows no borders. For the increasing awareness of the importance of disease surveillance, prevention and control, the WHO--the preeminent governing body of international health, established the Global Outbreak Alert & Response Network (GOARN) in 2000 to keep the international community alert to the threat of possible outbreaks. Furthermore, the revised International Health Regulations (2005) of WHO went into infect in June 2007 with the aim of enhancing

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national, regional and international public health security. However, from the difficult position of Taiwan during SARS caused by political issue which remains excluded from participating in many international meetings reflected the insufficient function of this system. So the object of this study is to identify the limitations of the WHO's GOARN and the implications of the IHR (2005). Method: We conducted a comprehensive survey of outbreak reports from the WHO surveillance system, and matched report from ProMED-mail --an unofficial, non-governmental monitoring system with the aim of providing an early warning system for outbreaks of emerging diseases-- to find the timeliness gap between these two systems. And we further found out the association between democracy and the timeliness gap. Results: The disease outbreak report of ProMED was earlier than of WHO, and the timeliness gap between these two systems was averaged to 10 days. Also, the timeliness was associated with the medical capacity and the democracy level of the nations.

Conclusion: Though IHR (2005) try to eliminate the gap of the global infectious disease network, but the

limitations of it still remained by the political issue.

SP-041

Estimating Population Size of Endangered Deer TB in Korea

Seon-Ju Yi

Seoul National University, South Korea

The Republic of Korea is the country consumes the above 85% of world-wide deer antler production volume. The annual amount of consumption reaches to 1,600 billon won ($ 1,300 million). The Breeding number was 50,000 in 1990, but it became 150,000 as three times as 1990’s, and about 100,000 are bred to recently in Korea.Since bovine tuberculosis was first detected among 22 deer in 2005, 238 were reported in 2008, recently, 159 were reported until 2009 May. The occurrence area is also extended. It is a number which it accomplishes to the 0.25% of whole breeding number. At first, incidence cases were reported from Cheon-buk province (southern area of Korea), however bovine TB in deer has been spread to Gyeong-gi province (the central area of Korea). The deer is maintenance host of the bovine TB (Mycobacterium bovis) which is a zoonotic infectious disease. Consequently, the deer tuberculosis can infect human through oral/ gastronintestinal transmission by ingestion of deer antler and deer blood or respiratory/ cutaneous transmission to veterinarian and farmer.Particularly, the death cases from TB (respiratory TB and other TB) was suddenly increased from 2000 to 2002, when the deer breeding number also reached the peak. For these reason, the purpose of this study is to estimate the endangered population of TB infection in Korea from the correlation between TB incidence and ingestion of deer antler and deer blood.

SP-042

Tooth Loss and Associated Factors in Urban Khon Kaen Thai Adults

Supaporn Chatrchaiwiwatana Khon Kaen University, Thailand

Tooth loss is an important oral health problem affecting Thai people and people of other nations as well. Not much of epidemiologic evidence concerning factors associated with tooth loss among Thai people has been reported although severity of tooth loss among Thai people still exists. This study evaluated relation between tooth loss and several variables among the Thai people residing in Khon Kaen Province, Thailand during the year 2006. The study subjects included 858 males and 303 females, aged 18-72 years, who volunteered to take part in the study. The data were obtained through oral examination and interview. Results were employed by means of descriptive, bivariate, and multivariable Poisson regression analyses. The results showed that approximately 53.2 per cent of people experienced one or more tooth loss. Findings from the final multivariable Poisson regression model showed that decayed and filled teeth, systemic disease, older age-group, female gender, higher education, higher income, occupation (military recruits) and the interaction between gender and income were significantly related to tooth loss, with the odds ratio (95% CI) being 2.04 (1.74, 2.42), 1.16 (1.01, 1.33), 2.27 (1.78, 2.93), 0.65 (0.52, 0.80), 0.90 (0.84, 0.95), 0.47 (0.31, 0.71), 0.13 (0.09, 0.20) and 1.42 (1.09, 1.86) for decayed and filled teeth, systemic disease, older age-group, female gender, higher education, higher income, occupation (military recruits) and the interaction between gender and income, respectively. The findings highlight importance of several factors relating to tooth loss. Therefore, implementation of the community programs based on this evidence may be achieved to reduce tooth loss in the population.

SP-043

The Impact of Oral Health on Daily Performance among 10-12 Year-Old School Children in Mangalore

Ashish Shrestha1, Jyotsna Rimal1, Ashwini Rao2, Peter

Sequeira3, Ramya Shenoy2

1. B.P. Koirala Institute of Health Sciences, Nepal 2. Manipal College of Dental Sciences, India 3. Coorg institute of Dental Sciences, India

Background: Primary school children represent the major focus of dental public health research and practice. It is necessary to assess the characteristics and severity of impacts of oral health in primary school children as well as to identify subgroups of children with oral health needs in terms of prevention, treatment and oral health promotion. The aim of this study was to assess the impact of oral health on daily performance among 10-12 year-old school children in Mangalore.

Methods: A cross-sectional study was conducted in primary school children of the municipal area of Mangalore, using the Child-Oral Impact on Daily