Materials and MethodsA community-based cross-sectional study wasconducted among 405 elders aged 60 years old andabove, between September 2012 and July 2014 inSurin province where is located in the northeasternregion of Thailand. A total area about 8,124 kilometer2,approximately 450 kilometers away from Bangkok city(the capital of Thailand) by cars and 420 kilometersby train. The province is subdivided into 17 districts;Mueang Surin, Chumphon Buri, Tha Tum, Chom Phra,Prasat, Kap Choeng, Rattanaburi, Sanom, Sikhoraphum,Sangkha, Lamduan, Samrong Thap, Buachet, PhanomDong Rak, Si Narong, Khwao Sinarin, and Non Naraidistrict. All participants were randomized selected throughsystematic sampling method. Necessary permissionfrom the concerned authorities was taken and a surveywas conducted using pre-designed questionnaires. Priorinformed consent was taken. For those not available inthe first interview another visit was made to minimizenonresponse. All of participants was completed the predesignedquestionnaire with the general information,food recorded, and knowledge, attitude, and practiceregarding to food consume related to liver fluke infection.Reliability and validity of questionnaire was analyzed,knowledge (Kruder-Richardon-20) = 0.89, attitude andpractice (coefficient of Cronbach’s alpha) = 0.80 and0.78, respectively. Weight and height were computed andassessed for body mass index (BMI) following WorldHealth Organization (WHO) reassesses appropriate body–mass index for Asia Population (Choo 2002). Briefly, BMIwas classified to under-nutrition; <18.50 kg/m2, normal;18.50-24.99 kg/m2, over-nutrition; >24.99 kg/m2, andobesity; >29 kg/m2. Waist circumference was computedand assessed by using the interpretation of anthropometryfollowing WHO assessment (1995). Waist circumferencewas classified to normal and higher than normal level,(male; normal level ≤94 higher than normal level >94cm, female; normal level ≤80 higher than normal level >80 cm). Evaluation of knowledge, attitude, and practicelevel regarding to food consume related to liver flukeinfection, was calculated and analyzed according toBloom et al. (1971), answer correct=1, incorrect=0, andinterpreted to high level; 19-21 point, fair level; 13-18point, 0-12; low level. Evaluation of attitude and practicelevel were calculated and analyzed according to Best etal (1997), attitude with 3 choices (agree, moderate, disagree):positive question=3,2,1, negative question=1,2,3and interpreted to good level; 2.67-3.00 point, moderatelevel; 1.33-2.66 point, 1.00-1.32 point; poor level. Practicewith 3 choices (regular, irregular, and never): positivequestion=3,2,1, negative question=1,2,3 and interpretedto good level; 2.67-3.00 point, moderate level; 1.33-2.66point, 1.00-1.32 point; poor level. Descriptive statisticaland Spearman’s rank correlation coefficients wereanalyzed with SPSS software. The protocol was approvedby the ethical review committee of Suranaree Universityof Technology, 2012
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