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缅甸移民在泰国获得疟疾服务的人口和社会经济障碍。

Demographic and socioeconomic obstacles to access to malaria services for Myanmar migrants in Thailand.

机构信息

Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

出版信息

Malar J. 2024 Aug 11;23(1):239. doi: 10.1186/s12936-024-05066-y.

Abstract

BACKGROUND

Typically mobile and vulnerable, migrants face significant barriers to access to routine malaria prevention, diagnostics and treatment, which leads to unchecked malaria transmission, particularly in border regions with a high population displacement. This study aimed to investigate the demographic and socioeconomic obstacles to access to malaria services among Myanmar migrants residing in the Thailand-Myanmar border areas.

METHODS

A cross-sectional study was conducted in early 2024 across three districts near the Thailand-Myanmar border. Quantitative data were collected from Myanmar migrants using standardized questionnaires through structured surveys. Data analysis included descriptive statistics and simple and multiple logistic regression models.

RESULTS

Out of 300 participants, approximately a quarter (27.3%) reported adequate access to comprehensive malaria services, including prevention, diagnostics, treatment and malaria-related health information. In multiple logistic regression models, factors associated with inadequate access included Myanmar migrants aged over 60 years (aOR: 7.63, 95% CI 1.74-20.58), accompanied by one to three family members (aOR: 3.33, 95% CI 1.06-8.45), earning monthly incomes below 3000 THB (aOR: 5.13, 95% CI 1.38-19.09) and 3000 to 6000 THB (aOR: 3.64, 95% CI 1.06-12.51), belonging to the Karen ethnicity (aOR: 2.13, 95% CI 1.02-3.84), with poor perception toward malaria (aOR: 2.03, 95% CI 1.03-4.01) and with poor preventive and health-seeking practices (aOR: 5.83, 95% CI 2.71-9.55).

CONCLUSIONS

A significant proportion of Myanmar migrants encounter demographic and socioeconomic barriers to access to routine malaria services in Thailand. Tailored interventions are required to expand such access, including the recruitment of worksite health volunteers, strengthening the role of ethnic health organizations across the border and collaboration with private sector stakeholders (e.g. farm/company owners) to distribute preventive tools and ensure timely referral of suspected malaria cases to health facilities.

摘要

背景

流动人口通常处于弱势地位,他们在获得常规疟疾预防、诊断和治疗方面面临重大障碍,这导致疟疾传播无法得到控制,特别是在人口流动率高的边境地区。本研究旨在调查居住在泰国-缅甸边境地区的缅甸移民获得疟疾服务的人口统计学和社会经济障碍。

方法

2024 年初,在泰国-缅甸边境的三个地区进行了一项横断面研究。通过结构调查,使用标准化问卷从缅甸移民那里收集定量数据。数据分析包括描述性统计和简单及多元逻辑回归模型。

结果

在 300 名参与者中,约四分之一(27.3%)报告说能够充分获得全面的疟疾服务,包括预防、诊断、治疗和疟疾相关健康信息。在多元逻辑回归模型中,与获得不足相关的因素包括年龄超过 60 岁的缅甸移民(优势比[OR]:7.63,95%置信区间[CI] 1.74-20.58)、随行一至三名家庭成员(OR:3.33,95% CI 1.06-8.45)、月收入低于 3000 泰铢(OR:5.13,95% CI 1.38-19.09)和 3000-6000 泰铢(OR:3.64,95% CI 1.06-12.51)、属于克伦族(OR:2.13,95% CI 1.02-3.84)、对疟疾的认识较差(OR:2.03,95% CI 1.03-4.01)和预防及求医行为较差(OR:5.83,95% CI 2.71-9.55)。

结论

相当一部分缅甸移民在泰国获得常规疟疾服务方面面临人口统计学和社会经济障碍。需要采取有针对性的干预措施来扩大这种获取途径,包括招聘工作场所健康志愿者、加强边境地区族裔卫生组织的作用以及与私营部门利益相关者(例如农场/公司所有者)合作,分发预防工具并确保及时将疑似疟疾病例转介到卫生机构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cc4/11318331/d88a7b237e97/12936_2024_5066_Fig1_HTML.jpg

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