Epidemiology Research Division, Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
Int Health. 2010 Dec;2(4):275-81. doi: 10.1016/j.inhe.2010.09.008.
This study describes the use of a blood test, antimalarials and their determinants among 446 subjects with febrile illness in remote villages of Bago Division, Myanmar in 2006 after five months initialization of a rapid diagnostic test (RDT) and artemisinin-based combination therapy (ACT) programme. A structured questionnaire was used in a cross-sectional survey. Knowledge on malaria was asked of 357 key household respondents. The proportions of use of traditional medicine, modern medicine and both among febrile subjects were 31 (7.0%), 247 (55.4%) and 168 (37.7%), respectively. A blood test was taken by 41.0% of respondents and, of these, 81.4% were reported positive. Among 166 artesunate users, 45.8% reported positive test results and 18.1% were self-medicated. Only 37 (10.4%) key household respondents did not have misconceptions on malaria transmission. Predictors for having a blood test were being male (odds ratio [OR] = 1.96; 95% CI 1.20-3.22), having a higher knowledge on malaria (OR = 1.77; 95% CI 1.03-3.06) and aged 50 years or above (OR = 0.32; 95% CI 0.13-0.78). Predictors for having both a blood test and using artesunate were being male (OR = 2.71; 95% CI 1.31-5.59) and having a higher knowledge on malaria (OR = 2.49; 95% CI 1.27-4.92). The low coverage of proper clinical services and high prevalence of ineffective drug use confirmed the need for further strengthening of the programme.
本研究描述了在缅甸勃固省偏远村庄的 446 例发热患者中使用血液检测、抗疟药物及其决定因素的情况，这些患者是在快速诊断检测（RDT）和基于青蒿素的联合疗法（ACT）方案启动五个月后于 2006 年纳入研究的。采用横断面调查方法使用了一份结构化问卷。对 357 名关键家庭受访者进行了疟疾知识调查。发热患者中分别有 31 例（7.0%）、247 例（55.4%）和 168 例（37.7%）使用了传统医学、现代医学和两者结合的方法。有 41.0%的受访者进行了血液检测，其中 81.4%的检测结果为阳性。在 166 例青蒿琥酯使用者中，45.8%的检测结果为阳性，18.1%的患者自行用药。仅有 37 名（10.4%）关键家庭受访者对疟疾传播没有误解。进行血液检测的预测因素为男性（优势比 [OR] = 1.96；95%置信区间 1.20-3.22）、疟疾知识较高（OR = 1.77；95%置信区间 1.03-3.06）和 50 岁或以上（OR = 0.32；95%置信区间 0.13-0.78）。同时进行血液检测和使用青蒿琥酯的预测因素为男性（OR = 2.71；95%置信区间 1.31-5.59）和疟疾知识较高（OR = 2.49；95%置信区间 1.27-4.92）。适当临床服务的覆盖范围较低和无效药物使用的高流行率证实了进一步加强该方案的必要性。
