โครงการศึกษาระบาดวิทยาโรคหลอดเลือดสมองในประเทศไทย

Thai Epidemiologic Stroke (TES) Study

Investigator

รายนามผู้วิจัย

Background and objective

  • According to The WHO Stroke Surveillance System, Stroke is among the five most important causes of disability in both developing and developed countries
  • Stroke is to a large extent preventable, but prevention relies on good epidemiologic data
  • In Thailand, stroke is still a leading cause of death and disability
  • Good Epidemiologic data regarding stroke in Thailand is limited

Objective

  • To determine the risk factors of stroke in Thailand
  • To determine the associations between various risk/ potential factors of the stroke

Designs & Methods

  • The TES Study was a large community based prospective cohort study which have been conducted in five geographic regions of Thailand.
  • The baseline health status survey was started in 2004 and enrollment continued until the end of 2006.
  • Baseline health status survey included standardized measurement of blood pressure and anthropometric data, collection of blood sample after overnight fast, and face- to- face interview using standardized questionnaires.
  • All participants who were suspected to have a stroke, their stroke status were verified by a board-certified neurologist.
  • Stroke and cause of death are the major interesting events

Study population

  • General population aged 45 – 80 years
  • Living in study community region
      • Bangkok
      • Chachoengsao
      • Chiang Mai
      • Khon Kaen
      • Nakhon Si Thammarat
  • Intention to cooperate well with long term follow up part of the study

Proportion of study sample compared with Thai population

Baseline survey of health status

  • Survey was performed at local community health center
  • Number of subjects is about 80 persons/ day
  • Number of working staff is about 30 persons/ day
  • Health status survey data :
  • Blood pressure measurement
  • Anthropometry
    • – Body weight- Height- Hip& waist circumference
  • Blood collection
  • Interview

The questionnaire contained questions that elicited the following items

1. Previous stroke

2. Socioeconomic status

3. Medical history

4. Family history

5. Smoking status

6. Alcohol consumption

7. Physical activity

8. Snoring status

9. Contraceptive pills

10. Hormonal replacement therapy

11. Mental stress

12. Mood depression

13. Food frequency

Sequence of data collection& stations at the survey site

Data quality control

Before survey

  • Standard well designed case record form
  • Standard manual of operation
  • Standard Operating procedure
  • Only well trained staff allowed to participate with the study

During survey

  • At each survey, Quality Control Team (5 auditors) visit to the survey sites and observe the measurers, recording the compliance with the protocol in 8 standard performance checklist forms ( 48 items)
  • Check and correct all case record forms for completeness and consistency of data at the survey sites
  • Each survey, measurement device was calibrated before and after use
  • Inform and correct the missing points to field working staff at the end of each survey
  • Plasma/ serum was centrifuged at survey site, and shipped to central CDC certified laboratory at Faculty of Medicine, Ramathibodi Hospital, Mahidol university and was analyzed on the day of sample collection
  • A random sample of specimens (5%) was selected for split into two sample, for precision analysis

After survey

  • Statistical analysis of data quality control record form
  • Digit preference analysis ( hip/waist circumference, height, weight, blood pressure)
  • Bland-Altman plot analysis (blood sugar, cholesterol, triglyceride, HDL, LDL level)

Case ascertainment

  • Multiple overlapping sources are used to identify the interesting events
  • We have a plan to follow all subject at least until year 2012
  • Interesting events include stroke (WHO criteria) and cause of death
      • A system include :1. Self-report by subject/ family2. Report by health personel3. Contact by letter/ telephone/ home visit at each year

4. Discharged summary from hospital in the study area (ICD 160- 169, I63, I67.8, I61,

I60, and death)

5. Death certificate from National Data Base system

6. Each medical records/ information were verified by 2- 3 neurologists

Publications 

1.Prevalence of Stroke and Stroke Risk Factors in Thailand: Thai Epidemiologic Stroke (TES) Study

2.Risk of Metabolic Syndrome for Stroke Is Not Greater than the Sum of its Components: Thai Epidemiologic Stroke (TES) Study 

3.Appropriate Body Mass Index and Waist Circumference Cutoffs for Middle and Older Age Group in Thailand: Data of 19,621 Participants from Thai Epidemiologic Stroke (TES) Study

4.Factors Predicting High Estimated 10-Year Stroke Risk: Thai Epidemiologic Stroke Study

5.Research Data Quality Control: The Thai Epidemiologic Stroke (TES) Study

6.Association between Socioeconomic Status and Major Risk Factors of Stroke: Thai Epidemiologic Stroke (TES) Study

Contact us

Principal Investigator : Suchat Hanchaiphiboolkul M.D.
Coordinating Investigator : Pimchanok Puthkhao BPA.,B Sc., M Sc.
TES Study office, Prasat Neurological Institute Research Center
Prasat Neurological Institute. Bangkok, THAILAND
Tel. (+66) 0-2354-7076 # 2407
Fax. (+66) 0-2354-5357
E-mail :p pimcha@yahoo.com
Site Coordinator :
Chachoengsao province Mrs. Hataya Jamvathanachai
Muang Chachoengsao Hospital, Chachoengsao province.
Chiang Mai province Mrs. Supaporn Somphan
San Kamphaeng Hospital, Chiang Mai province.
Khon Kaen province Mrs. Nopawan Dunghussadee
Khon Kaen Hospital, Khon Kaen province
Nakhon Si Thammarat province
Mrs. Orapan Khongsrichay
Provincial Public Health office of Nakhon Si Thammarat province