Opisthorchis viverrini infection remains a significant public health concern in Southeast Asia, particularly in rural communities of Northeast Thailand, where persistent environmental and behavioral factors sustain transmission. A quasi-experimental study aimed to identify environmental and behavioral risk factors for infection and to evaluate the effectiveness of a community-based intervention program. The intervention program study was conducted over 10 months and comprised three phases: baseline survey‚ health education intervention program implementation‚ and follow-up evaluation. The results were analyzed for the prevalence of parasitic infections, and multivariable logistic regression was performed to identify associated factors. The majority of study participants were female (67.94%)‚ aged 55 to 64 years (48.09%)‚ and farmers (89.31%). Parasitic infections‚ especially O. viverrini‚ substantially decreased during the follow-up period‚ and independent risk factors predicting infection included lower education‚ previous infection‚ raw fish consumption‚ and pesticide use‚ according to multivariable logistic regression analysis. This intervention considerably improved knowledge; mean knowledge score increased by 6.29 points (p < 0.001). Analysis of fecal sludge after treatment with the sand-drying system identified S. stercoralis larvae (20 eggs/L) and Taenia spp. eggs (12.4 eggs/g). These findings indicated that, despite treatment, integrated behavioral and environmental interventions can be effective in interrupting parasite transmission in rural endemic settings.

Lead (Pb) is a persistent environmental contaminant and a major public health concern. This cross-sectional study investigated self-reported health symptoms and estimated dietary Pb exposure from aquatic animal consumption among residents living around Nong Han Lake, Thailand. Sociodemographic characteristics, dietary behaviors, and health symptoms were collected using a structured questionnaire. Pb concentrations were measured in three commonly consumed aquatic species, and species-specific estimated dietary Pb intake (EDI) was calculated from Pb concentrations and reported consumption patterns. Multivariable logistic regression identified factors associated with symptom reporting. Pb concentrations in all aquatic species were below the permissible limit (0.3 mg/kg wet weight). Median EDI was 0.1004 µg/kg bw/day (IQR: 0.0645–0.1785). Musculoskeletal pain (79.73%) and joint and muscle pain (71.62%) were the most commonly reported symptoms. This study found that female sex (aOR = 2.62; 95% CI: 1.099–6.249; p = 0.030), a lack of lead hazard training (aOR = 3.39; 95% CI: 1.373–8.418; p = 0.008), consumption of more than 300 g of aquatic animals per meal (aOR = 2.47; 95% CI: 1.230–4.960; p = 0.011), and long-term consumption exceeding 30 years (aOR = 2.16; 95% CI: 1.065–4.398; p = 0.033) were each independently associated with symptom reporting. Estimated dietary Pb intake (EDI) was not significantly associated with symptoms after multivariable adjustment (aOR = 1.30; 95% CI: 0.657–2.578; p = 0.450). These findings suggest that consuming large portions of aquatic animals, consuming aquatic animals over prolonged periods, and having limited awareness of lead-related hazards are potential pathways for dietary Pb exposure in this lake-dependent community.

Background: The COVID-19 pandemic disrupted healthcare systems and antimicrobial stewardship, potentially altering antimicrobial resistance patterns. This study characterized temporal changes in the proportions of multidrug-resistant organisms (MDROs) and identified associated factors before and during the pandemic at a tertiary care hospital in northeastern Thailand. Methods: A single-center retrospective observational study was conducted at Roi Et Hospital, including 5458 culture-confirmed MDRO cases (2017–2022), stratified into pre-pandemic (2017–2019) and pandemic (2020–2022) periods. Pathogen-specific resistance proportions were compared using odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression identified independently associated factors within each period. Results: The proportion of MDRO cases classified as hospital-acquired increased from 40.71% to 57.41% (p < 0.001). Carbapenem-resistant Acinetobacter baumannii (CRAB) increased markedly (22.87% to 76.11%; OR 10.75, 95% CI 9.43–12.26), followed by carbapenem-resistant Enterobacterales (CRE) (4.05% to 21.61%; OR 6.54, 95% CI 5.84–7.32) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) (14.32% to 27.15%; OR 2.23, 95% CI 1.87–2.65; all p < 0.001). Vancomycin-resistant Enterococcus (VRE) declined significantly (OR 0.41, 95% CI 0.25–0.68; p < 0.001). Methicillin-resistant Staphylococcus aureus (MRSA) showed a higher proportion among clinical isolates (3.28% to 6.34%; OR 2.01, 95% CI 1.42–2.83), although without a consistent annual trend. In multivariable analyses, ICU admission was independently associated with lower odds of CRE (aOR 0.52) and CRPA (aOR 0.63) and with higher odds of CRAB (aOR 2.13; all p < 0.001). Conclusions: The COVID-19 pandemic was associated with a major proportional shift toward carbapenem-resistant Gram-negative pathogens, with distinct profiles of associated factors across CRAB, CRE, and CRPA. These findings highlight the need for pathogen-specific infection prevention and antimicrobial stewardship strategies during healthcare system disruptions.