泰国缅甸移民中的疟疾防控：对医疗服务提供者的定性研究

Malaria control among Myanmar migrants in Thailand: a qualitative study of healthcare providers.

作者信息

Inthitanon Nichakan, Sripoorote Piyarat, Wattanagoon Yupaporn, Petchvijit Pattamaporn, Anantjitsupha Ammarind, Win Kyawt Mon, Rachaphaew Nattawan, Htwe Khaing Zin Zin, Suk-Aum Kritsana, Watakulsin Peeriya, Cui Liwang, Sattabongkot Jetsumon, Parker Daniel M, Nguitragool Wang, Aung Pyae Linn

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. 2025 May 22;24(1):160. doi: 10.1186/s12936-025-05397-4.

DOI:10.1186/s12936-025-05397-4

PMID:40405144

Abstract

BACKGROUND

Thailand has experienced a recent surge in malaria cases, particularly along the Thailand-Myanmar border, likely driven by the importation of infections by Myanmar migrants. Implementing malaria control measures, especially surveillance among these high-risk populations, presents significant challenges. This study aimed to identify key obstacles and propose targeted solutions for enhancing malaria control among Myanmar migrants in border areas of Thailand.

METHODS

A cross-sectional qualitative study was conducted in early 2024. Semi-structured interviews were held with 20 government healthcare providers and village health volunteers involved in malaria control across three districts in western Thailand with the highest malaria caseloads. Data were analysed using thematic analysis.

RESULTS

Respondents consistently linked the rise in malaria cases to increased cross-border migration from Myanmar following recent political unrest. Key challenges included difficulty locating and following up with short-term or undocumented migrants, language barriers that hinder health education, and delays in diagnosis because of limited infrastructure and reliance on rapid diagnostic tests in areas without electricity. Suggested solutions included deploying mobile malaria posts near informal border crossings, mandating malaria testing before worksite entry, and engaging local employers and community leaders to register new arrivals and support treatment adherence among migrants.

CONCLUSIONS

Ongoing political instability in Myanmar continues to drive a large and dynamic population of migrants into Thailand's border regions, sustaining malaria importation and complicating elimination efforts. Tailored, migrant-responsive strategies, such as mobile surveillance near border crossings, community-based follow-up mechanisms, and infrastructure improvements, are urgently needed to close coverage gaps and achieve malaria elimination by 2030.

摘要

背景

泰国近期疟疾病例激增，尤其是在泰缅边境地区，这可能是由缅甸移民输入感染所致。实施疟疾控制措施，特别是对这些高危人群进行监测，面临重大挑战。本研究旨在确定关键障碍，并提出针对性解决方案，以加强泰国边境地区缅甸移民中的疟疾控制。

方法

2024年初开展了一项横断面定性研究。对泰国西部疟疾病例数最多的三个地区参与疟疾控制的20名政府医疗服务提供者和乡村卫生志愿者进行了半结构化访谈。采用主题分析法对数据进行分析。

结果

受访者一致将疟疾病例的增加与近期政治动荡后来自缅甸的跨境移民增加联系起来。关键挑战包括难以找到短期或无证移民并对其进行随访、阻碍健康教育的语言障碍，以及由于基础设施有限且在无电地区依赖快速诊断检测而导致的诊断延迟。建议的解决方案包括在非正式边境口岸附近设立流动疟疾检测点、强制要求在进入工作场所前进行疟疾检测，以及让当地雇主和社区领袖登记新抵达者并支持移民坚持治疗。