Research and Education Center for Prevention of Global Infectious Diseases of Animals, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo, 183-8508, Japan.
Graduate Education and Research Training Program in Decision Science for Sustainable Society, Kyushu University, Motooka 744, Nishi-ku, Fukuoka-shi, Fukuoka, 819-0395, Japan.
BMC Public Health. 2018 Oct 26;18(1):1206. doi: 10.1186/s12889-018-6123-0.
Malaria incidence has been steadily declining in Cambodia, where the government is aiming to eliminate malaria by 2025. Successful malaria elimination requires active engagement and participation of communities to recognize malaria symptoms and the development of prompt treatment-seeking behavior for early diagnosis and appropriate treatment. This study examined malaria knowledge, preventive actions, and treatment-seeking behavior among different groups of ethnic minorities and Khmer in Ratanakiri Province, Cambodia.
Face-to-face interviews were conducted in December 2015, targeting 388 mothers with children under 2 years old, who belonged to ten ethnic minority groups or the Khmer group living in 62 rural villages in Ratanakiri. In addition to describing mothers' knowledge and actions for malaria prevention, logistic regression analysis was performed to identify determinants of fever during the most recent pregnancy and among children under two.
Overall 388 mothers were identified for enrollment into the study of which 377 (97.2%) were included in analyses. The majority of mothers slept under bed nets at home (95.8%) and wore long-sleeved clothes (83.8%) for malaria prevention. However, knowledge of malaria was limited: 44.6% were aware of malaria symptoms, 40.6% knew the malaria transmission route precisely, and 29.2% knew of mosquito breeding places. Staying overnight at a farm hut was significantly associated with having fever during the most recent pregnancy (adjusted odds ratio [AOR] 2.008, 95% confidence interval [CI]: 1.215-3.321) and a child having fever (AOR 3.681, 95% CI 1.943-6.972). Mothers' partaking in a variety of malaria preventive actions was protective against fever in children (AOR 0.292, 95% CI: 0.136-0.650). Among those who had fever during pregnancy, 39.4% did not seek treatment.
Although the majority of mothers took malaria preventive actions, knowledge of malaria epidemiology and vector ecology and treatment-seeking behavior for fever were limited. Staying overnight at farm huts, regardless of the differences in socio-demographic and socio-cultural characteristics, was strongly associated with fever episodes during pregnancy and childhood. This study indicates the necessity of spreading accurate malaria knowledge, raising awareness of health risks related to agricultural practices, and promoting treatment-seeking behavior among ethnic minorities to strengthen their engagement in malaria elimination.
柬埔寨的疟疾发病率一直在稳步下降，政府计划在 2025 年消除疟疾。成功消除疟疾需要社区积极参与和参与，以识别疟疾症状，并养成及时寻求治疗的行为，以便早期诊断和适当治疗。本研究调查了柬埔寨拉塔纳基里省不同少数民族和高棉族群体的疟疾知识、预防措施和治疗寻求行为。
2015 年 12 月，对属于十个少数民族群体或居住在拉塔纳基里省 62 个农村村庄的 388 名 2 岁以下儿童的母亲进行了面对面访谈。除了描述母亲预防疟疾的知识和行动外，还进行了逻辑回归分析，以确定最近一次怀孕和 2 岁以下儿童发热的决定因素。
共确定了 388 名母亲参与了这项研究，其中 377 名（97.2%）母亲纳入了分析。大多数母亲在家中睡在蚊帐下（95.8%），穿着长袖衣服（83.8%）预防疟疾。然而，疟疾知识有限：44.6%的母亲知道疟疾症状，40.6%的母亲知道疟疾传播途径，29.2%的母亲知道蚊子滋生地。在农舍过夜与最近一次怀孕时发热（调整后的优势比[OR]2.008，95%置信区间[CI]：1.215-3.321）和儿童发热（OR 3.681，95%CI 1.943-6.972）显著相关。母亲采取多种疟疾预防措施可预防儿童发热（OR 0.292，95%CI：0.136-0.650）。在怀孕期间发热的母亲中，39.4%未寻求治疗。
尽管大多数母亲采取了疟疾预防措施，但对疟疾流行病学和媒介生态学以及发热治疗的认识有限。无论社会人口学和社会文化特征的差异如何，在农舍过夜与怀孕和儿童时期的发热发作强烈相关。本研究表明，有必要传播准确的疟疾知识，提高对与农业实践相关的健康风险的认识，并促进少数民族寻求治疗，以加强他们对消除疟疾的参与。
