Sonkong Krit, Chaiklieng Sunisa, Neave Penny, Suggaravetsiri Pornnapa
Department of Epidemiology, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
Malar J. 2015 Jan 7;14:3. doi: 10.1186/1475-2875-14-3.
Malaria is a major health problem in Thailand, especially in areas adjacent to the borders of Myanmar. Delay in seeking treatment is an important factor in the development of severe complications, death and the transmission of the disease. This study aimed to investigate factors affecting delays in seeking treatment of malaria patients.
A cross-sectional analytic study was conducted in 456 malaria patients along the Thailand-Myanmar border. Patients were selected by stratified sampling from 11 malaria clinics and five public hospitals in Tak Province, Thailand. Data were collected by the use of a structured interview questionnaire and from patient's medical records.
The majority of patients were categorized with an ethnicity of 'hill tribe' (65.8%), followed by Thai (34.2%). Seventy-nine per cent of patients delayed seeking treatment. A simple logistic regression identified significant factors affecting delays in seeking treatment: people of "hill tribe" ethnicity; plasmodium species; self-treatment; visiting sub-district health promotion hospital/malaria post before visiting a malaria clinic or public hospital; and low to medium social support. After being subjected to multivariate analysis, factors significantly associated with the delay were "hill tribe" ethnicity (ORadj = 2.32, 95% CI: 1.34-4.04); infection with P.vivax (ORadj=2.02, 95% CI: 1.19-3.41; self-treatment (ORadj = 1.73, 95% CI: 1.04-2.85); and receiving a low degree of social support (ORadj = 2.58, 95% CI: 1.24-5.35).
Emphasis should be placed on need for early diagnosis and treatment in malaria patients as well as on ensuring the first facility for detection and treatment of malaria is a malaria clinic or public hospital, and the promotion of social support. These are especially important issues for the health of hill tribe people.
疟疾是泰国的一个主要健康问题，尤其是在与缅甸接壤的地区。延迟就医是严重并发症发生、死亡以及疾病传播的一个重要因素。本研究旨在调查影响疟疾患者延迟就医的因素。
在泰国-缅甸边境沿线的456名疟疾患者中开展了一项横断面分析研究。通过分层抽样从泰国夜丰颂府的11家疟疾诊所和5家公立医院选取患者。通过使用结构化访谈问卷并从患者病历中收集数据。
大多数患者的族裔为“山地部落”（65.8%），其次是泰国人（34.2%）。79%的患者延迟就医。单因素逻辑回归确定了影响延迟就医的显著因素：“山地部落”族裔的人；疟原虫种类；自我治疗；在前往疟疾诊所或公立医院之前先到分区健康促进医院/疟疾防治站就诊；以及社会支持程度低至中等。经过多因素分析，与延迟显著相关的因素为“山地部落”族裔（校正比值比=2.32，95%置信区间：1.34 - 4.04）；感染间日疟原虫（校正比值比=2.02，95%置信区间：1.19 - 3.41）；自我治疗（校正比值比=1.73，95%置信区间：1.04 - 2.85）；以及获得的社会支持程度低（校正比值比=2.58，95%置信区间：1.24 - 5.35）。
应强调疟疾患者早期诊断和治疗的必要性，以及确保疟疾检测和治疗的首个机构是疟疾诊所或公立医院，并促进社会支持。这些对于山地部落人群的健康尤其重要。
