Bangkok Centre

Personnel

• Dr Pakit Vichyanond

ISAAC in Thailand

In the early 1990, Richard Beasley visited me (Pakit Vichyanond) at my medical school (Faculty of Medicine Siriraj Hospital) to invite myself to function as a Thailand coordinator for starting ISAAC study in Thailand. The idea struck me so much and I immediately accepted the offer. Professor Montri Tuchinda – my predecessor – had earlier performed questionnaire survey among children and medical students in Bangkok and demonstrated prevalence of asthma among children in Thailand to be only 4%. Such figure seemed to be too low for specialists in the field. We were in need of more well defined questionnaire survey and the idea of ISAAC was the perfect match for us at that time.

We were earlier assigned to the West Asia (Prof Shah, India) section of the ISAAC. The translation and back transferred of the data was done very quickly by a group of pediatric allergists in Thailand. At this time, the group of pediatric allergist/immunologists in the Asia Pacific region was well organized and thus Thailand was transferred to the East Asia region under Chris Lai (Hong Kong) as the regional coordinator. The initial survey was earlier launched in Bangkok by my group. In order to spread the survey across the Bangkok Metropolitan area, we mapped out schools to be surveyed to cover the entire Bangkok region. In addition, we balanced the schools to be equally include private and public schools. The high prevalence of asthma prevalence from the first survey was made known to the public (13%). In fact this figure was not that much different from figures all over Asia. This brought about a high degree of publicity among the Thai medical community since it represented such a large increase in load of asthmatic children. Additional centers from various parts of the countries including Chiangmai, Khon Kaen, Nakorn Pathom, and others applied for participating in the survey. In total, 10 centers all over the country were included (however, not all data were submitted to ISAAC center in Auckland). Results from these centers confirmed that the high prevalence of asthma (around 10%), allergic rhinitis (40%) and atopic dermatitis (10%) were corrected throughout the country. Results from Chantaburi center (east of Thailand) showed prevalence of asthma of 16%!!!

The Bangkok center launched their own version of ISAAC-II but due to slight variation of their methods from the official ISAAC-II, the results were not included for ISAAC-II analysis. Results of this investigation are available from myself.

Two centers, Bangkok and Chiangmai participated in ISAAC Phase One and Three time trends. Increase in prevalence was documented from the Bangkok center whereas Chiangmai center showed plateau to slight decline. Results of environment and other factors in this ISAAC-III were used in subsequent analysis forming the report by the ISAAC committee. In addition, ISAAC questionnaire survey was conducted among University students in Bangkok and data among these students were quite similar to those in children

Overall, ISAAC investigation has been well received in Thailand. This has brought a great enthusiasm on allergic diseases in children. We are keen to participate in further investigations with ISAAC committee.