Naing Phyo Aung, Maung Thae Maung, Tripathy Jaya Prasad, Oo Tin, Wai Khin Thet, Thi Aung
Department of Medical Research, Ministry of Health and Sports, No. 5, Ziwaka Road Dagon Township, Yangon, 11191 Myanmar.
International Union Against Tuberculosis and Lung Disease, The Union South-East Asia Regional Office, New Delhi, India.
Trop Med Health. 2017 Dec 4;45:31. doi: 10.1186/s41182-017-0070-9. eCollection 2017.
Myanmar has a high burden of malaria with two-third of the population at risk of malaria. One of the basic elements of the Roll Back Malaria Initiative to fight against malaria is early diagnosis and treatment within 24 h of fever. Public awareness about malaria is a key factor in malaria prevention and control and in improving treatment-seeking behaviour.
A large community-based survey was carried out in 27 townships of malaria endemic regions in Myanmar in 2015 which reported on the knowledge, behaviour and practices around malaria in the general population. We used the data already collected in this survey to assess (i) general public awareness of malaria and (ii) treatment-seeking behaviour and associated factors among persons with acute undifferentiated fever.
A total of 6597 respondents from 6625 households were interviewed (response rate of 99.5%). About 85% of the respondents were aware that mosquito bite was the mode of transmission of malaria and 90% mentioned that malaria was preventable. However, only 16% of the respondents knew about anti-malaria drug resistance. There were certain misconceptions about the transmission of malaria such as dirty water, same blood group, sharing shelter, sleeping/eating together and poor hygiene. Health facility staff were the most common source of information about malaria (80%). Nearly one-fourth (23%) of the respondents with fever resorted to self-medication. Around 28% of the respondents with fever underwent blood testing, less than half of whom (44%) were tested within 24 h. Elderly age group, females, those with poor knowledge about malaria and those residing in non-Regional Artemisinin Resistance Initiative townships were associated with poor treatment-seeking behaviour in case of fever.
Although there is fair knowledge on mosquito bite as a mode of transmission and prevention of malaria, there are some misconceptions about transmission of malaria. Those having poor knowledge about malaria have poor treatment-seeking behaviour. A considerable number of respondents seek care from informal care providers and seek care late. Thus, there is a need to promote awareness about the role of early diagnosis and appropriate treatment and address misconceptions about transmission of malaria.
缅甸疟疾负担沉重,三分之二的人口面临疟疾风险。抗击疟疾的“遏制疟疾”倡议的基本要素之一是在发热24小时内进行早期诊断和治疗。公众对疟疾的认知是疟疾预防控制以及改善就医行为的关键因素。
2015年在缅甸疟疾流行地区的27个乡镇开展了一项大型社区调查,报告了普通人群对疟疾的知识、行为和实践情况。我们利用该调查中已收集的数据来评估:(i)公众对疟疾的认知;(ii)急性不明原因发热患者的就医行为及相关因素。
共采访了来自6625户家庭的6597名受访者(应答率为99.5%)。约85%的受访者知道蚊虫叮咬是疟疾的传播方式,90%的受访者提到疟疾是可预防的。然而,只有16%的受访者了解抗疟药物耐药性。对于疟疾传播存在一些误解,如脏水、相同血型、共用住所、一起睡觉/吃饭以及卫生条件差等。卫生机构工作人员是关于疟疾信息的最常见来源(80%)。近四分之一(23%)的发热受访者采用自我药疗。约28%的发热受访者接受了血液检测,其中不到一半(44%)在24小时内进行检测。老年人群、女性、对疟疾知识了解较少的人群以及居住在非“青蒿素耐药性倡议”地区的人群在发热时就医行为较差。
尽管对于蚊虫叮咬作为疟疾传播方式和预防方面有一定认知,但对于疟疾传播仍存在一些误解。对疟疾知识了解较少的人群就医行为较差。相当数量的受访者向非正规医疗服务提供者寻求治疗且就医较晚。因此,有必要提高对早期诊断和适当治疗作用的认识,并消除对疟疾传播的误解。