Human behavior in relation to selection of malaria treatment.

People in rural areas usually help themselves when malaria attacks by using a drug preparation under the name of "ya-chud" bought from the grocery in the village. The objective of this study was to determine the behavior towards malarial treatment of local inhabitants in two malarious areas in eastern Thailand. Groups of 271 and 131 local inhabitants in villages in Pong Nam Ron and Bo Thong Districts, respectively, aged more than 15 years were interviewed regarding health behavior in seeking care when they became ill with malaria. Forty-two percent of the population at Pong Nam Ron and fifteen percent at Bo Thong went to drug-stores or groceries when they developed minor illness, while 85.2% of the subjects interviewed at Bo Thong went to the local health center. However, when they became severely ill, treatment-seeking patterns were similar in the two study areas. Ninety-four percent of the subjects interviewed at Bo Thong and eighty-seven percent at Pong Nam Ron gave a history of having used ya-chud in the past. On average, a set of ya-chud for malaria infection consists of 3-5 drugs: antimalarial drugs together with others such as analgesic-antipyretics, steroids, anti-histamines, vitamins and antimicrobial agents (tetracycline). The price of one ya-chud varied from 3-9 baht. Such improperly use of antimalarial drugs in malarious areas can result in treatment failure and cause the development of drug resistance, which is a problem in the malaria control program in Thailand.