Yunnan Institute of Parasitic Diseases, Yunnan Provincial Key Laboratory of Vector-Borne Disease Control and Research; Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia; Yunnan International Joint Laboratory of Tropical Infectious Diseases, Puer, 665000, China.
Malar J. 2023 Oct 14;22(1):309. doi: 10.1186/s12936-023-04747-4.
Appropriate malaria treatment-seeking behaviour (TSB) is critical for timely detecting malaria, prompt treatment, and prevention of onward transmission of the disease in a community. This study aimed to compare treatment-seeking behaviours between malaria patients and non-malaria febrile patients, and to analyse the factors associated with appropriate TSB along the China-Myanmar border.
A cross-sectional study was carried out to investigate the appropriate TSB of microscopy-confirmed malaria patients versus non-malaria febrile (NMF) patients. An unconditional logistic regression analysis (LRA) was used to identify factors associated with appropriate TSB.
Among 223 malaria patients and 446 NMF patients, 129 (57.8%) of the malaria patients versus 163 (36.5%) of the NMF patients firstly sought treatment in health facilities without laboratory testing for malaria (P < 0.0001). A total of 85(38.1%) of the malaria patients versus 278 (62.3%) of the NMF patients had appropriate TSB, namely, seeking treatment in health facilities with laboratory testing for malaria within 48 h (P < 0.0001). Multivariate LRA identified that the malaria patients with Chinese nationality had less appropriate TSB compared to those with other nationalities (adjusted odds ratio [AOR]: 0.21, 95% confidence interval CI 0.07-0.68, P = 0.0097), and malaria patients residing in urban areas had more appropriate TSB compared to those living in rural areas (AOR: 2.16, 95%CI 1.06-4.39, P = 0.0337).
TSB was not appropriate in malaria patients. Chinese citizenship and rural residence were two independent factors associated with inappropriate malaria TSB. It is urgently necessary to improve appropriate malaria TSB through effective campaigns of information, education, and communication for malaria control in Myanmar and preventing reestablishment of malaria transmission in Yunnan, China.
适当的疟疾求医行为（TSB）对于及时发现疟疾、及时治疗以及防止疾病在社区内进一步传播至关重要。本研究旨在比较中缅边境地区疟疾患者和非疟疾发热患者的求医行为，并分析与适当 TSB 相关的因素。
采用横断面研究方法，调查经显微镜确诊的疟疾患者与非疟疾发热（NMF）患者的适当 TSB。采用非条件逻辑回归分析（LRA）确定与适当 TSB 相关的因素。
在 223 例疟疾患者和 446 例 NMF 患者中，129 例（57.8%）疟疾患者和 163 例（36.5%）NMF 患者首先在没有进行疟疾实验室检测的医疗机构就诊（P<0.0001）。85 例（38.1%）疟疾患者和 278 例（62.3%）NMF 患者具有适当的 TSB，即在 48 小时内到有疟疾实验室检测的医疗机构就诊（P<0.0001）。多变量 LRA 确定，与其他国籍的疟疾患者相比，中国国籍的疟疾患者求医行为不太恰当（调整后的优势比 [AOR]：0.21，95%置信区间 CI 0.07-0.68，P=0.0097），与居住在农村地区的疟疾患者相比，居住在城市地区的疟疾患者求医行为更恰当（AOR：2.16，95%CI 1.06-4.39，P=0.0337）。
疟疾患者的求医行为并不恰当。中国国籍和农村居住是与不适当的疟疾求医行为相关的两个独立因素。迫切需要通过开展有效的信息、教育和宣传活动，加强中缅边境地区的疟疾控制，防止疟疾在中国云南重新传播。
