Leptospirosis has been recognized as a major public health concern in Thailand following dramatic outbreaks. We analyzed human leptospirosis incidence between 2004 and 2014 in Mahasarakham province, Northeastern Thailand, in order to identify the agronomical and environmental factors likely to explain incidence at the level of 133 sub-districts and 1,982 villages of the province. We performed general additive modeling (GAM) in order to take the spatial-temporal epidemiological dynamics into account. The results of GAM analyses showed that the average slope, population size, pig density, cow density and flood cover were significantly associated with leptospirosis occurrence in a district. Our results stress the importance of livestock favoring leptospirosis transmission to humans and suggest that prevention and control of leptospirosis need strong intersectoral collaboration between the public health, the livestock department and local communities. More specifically, such collaboration should integrate leptospirosis surveillance in both public and animal health for a better control of diseases in livestock while promoting public health prevention as encouraged by the One Health approach.

Leptospirosis is an endemic disease with moderate to high incidence in Mahasarakham province, Thailand. The present study was designed to assess the policy implementation mission regarding leptospirosis prevention and control from the national level to the local administrative levels, through a One Health perspective. A qualitative study was conducted, using documentation review, individual in-depth interviews with public health officers, local government officers, livestock officers who developed policy implementation tools or have responsibilities in leptospirosis prevention and control. The results show that Thailand has progressively developed a leptospirosis prevention and control policy framework at the national level, transferring the responsibility of its implementation to the local level. The province of Mahasarakham has decided to foster cooperation in leptospirosis prevention and control at the local level. However, there are insufficient linkages between provincial, district and sub-district departments to ensure comprehensive disease prevention activities at the local level concerning leptospirosis patients and the whole population.

Background:This study was carried out in Mahasarakham Primary Healthcare Center, Mahasarakham province in the area of Northeastern of Thailand. The experiment was randomized control trial clinical study in order to examine the side effects of Areca catechu Linn., Thai traditional formulae medicine, mebendazole in the treatment of anti-helmintic activity of mixed worms infection in human.Materials and Methods:The experimental group consisted of 15 patients and 5 patients for control group with inclusion and exclusion criteria, which were screened by parasitologist with the selection of mixed worm infection patient samples. The investigation of side effects was recorded after the treatment of each group of patient with different kinds of 4 group of medicine.Results:The percentage of side effects was collected by nurses and confirmed by the physician at Mahasarakham Health Center, which were diarrhea and nausea side effects. The percentage of side effects by the treatments of Areca catechu Linn., Thai traditional formulae medicine, mebendazole were investigated by the physician and the pharmacist, which the result showed 20% of diarrhea in Areca catechu Linn., 20% of nausea in Areca catechu Linn, 20% in side effect of diarrhea in mebendazole treatment, and no side effects were found by the treatment of TTFM. The result showed that Areca catechu Linn. had higher side effects among the 3 anti-helmintic drugs.Conclusion:The findings indicate to increase the numbers of samples of worm-infected patients, which the samples can be identified with the specification of helminthes genus and species in order to obtain the efficacy by the treatment using Areca catechu Linn and also indicates to increase various forms of dosage preparations and various demographic locations in Thailand.

This Participatory Action Research aimed at 1) exploring the basic data of community health promotion; 2) developing the community health promotion model towards Thailand 4.0; 3) experimenting with the health promotion model; and 4) assessing and improving the community health promotion model. A quantitative study to explore health promotion lifestyles was conducted with a sample of 367 persons chosen using stratified random sampling. A qualitative study was conducted with 30 key informants ere purposively included developing the community health promotion. The research tools included the test, questionnaire, in-depth interview, and focus group discussion. The statistics were frequency, percentage, arithmetic mean, standard deviation, and t-test. The results of this research were as follows: 1) Overall, the sample mean on the social aspect of health was found at the highest level. Meanwhile, health behavior, health promotion participation, technology skills, and active network practices were the aspects with a high level; 2) The "SMARTER Model: Sustainability, Management, Active Networks, Regular Health Behaviors, Technology Skills, Enabling factors, and Re-enforcing factors," was developed and verified as community health promotion model towards Thailand 4.0; 3) The post-test knowledge, attitude, and health promotion were higher than pre-test ones the statistical significance at .01 level; and 4) The participant's overall satisfaction with all aspects of health promotion model was at the highest level. In conclusion, the results revealed the progress of community health promotion in health behavior, health promotion management, technology skills, and interpersonal practices. Thus, this model could be further applied in other communities.

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