泰国短期缅甸移民的疟疾就医行为及感染率

Malaria care-seeking behaviours and infection prevalence among short-term Myanmar migrants in Thailand.

作者信息

Aung Pyae Linn, Sripoorote Piyarat, Inthitanon Nichakan, Wattanagoon Yupaporn, Hamers Raph L, Van Nuil Jennifer Ilo, Cui Liwang, Nguitragool Wang, Jones Leigh, Sudewo Anindita Gabriella, Sattabongkot Jetsumon, Parker Daniel M

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 Sep 1;24(1):280. doi: 10.1186/s12936-025-05539-8.

DOI:10.1186/s12936-025-05539-8

PMID:40890748

Abstract

BACKGROUND

The recent resurgence of malaria in western Thailand has coincided with increased cross-border migration from Myanmar following political unrest. As short-term migrants from endemic areas may contribute to sustained local transmission, this study examined their malaria care-seeking behaviours and infection prevalence.

METHODS

A community-based cross-sectional study was conducted during March-April 2025 in six malaria-endemic villages of Tha Song Yang District, Tak Province, western Thailand. A structured questionnaire was administered, including a nine-item section on care-seeking behaviours. Malaria prevalence was determined by PCR testing of dried blood spot samples. Determinants of care-seeking scores were analysed using a generalized linear model, and infection risk was estimated using Firth logistic regression.

RESULTS

Among 300 participants (mean age: 34.5 ± 14.5 years; 47.3% male), over 60% recognised the need to seek care for fever or chills, yet only 35% reported doing so within 24 h of symptom onset. Although 98.0% preferred public health facilities, only 50.3% had ever visited one for suspected malaria. Higher care-seeking scores were associated with being a daily wage labourer (β = 0.66; 95% CI 0.01-1.31), infrequent return to Myanmar (β = 1.34; 95% CI 0.05-2.62), prior malaria experience (β = 1.08; 95% CI 0.59-1.58), and higher malaria knowledge (β = 0.34; 95% CI 0.24-0.44). Karen ethnicity was negatively associated with care-seeking (β = - 0.95; 95% CI - 1.74 to - 0.16). Six (2%) afebrile Plasmodium vivax infections were detected. Lower malaria knowledge (OR = 13.5; 95% CI 1.58-177.0) and care-seeking scores (OR = 5.86; 95% CI 1.15-57.7) were significantly associated with infection.

CONCLUSIONS

Despite generally positive attitudes toward malaria, self-reported timely care-seeking among short-term Myanmar migrants remained limited. Socioeconomic status, migration patterns, ethnicity, and malaria knowledge significantly influenced care-seeking behaviours. The detection of asymptomatic P. vivax underscores the need for migrant-focused surveillance and targeted health education to support malaria elimination efforts.

摘要

背景

泰国西部近期疟疾疫情的再度出现恰逢缅甸政治动荡后跨境移民增加。由于来自疟疾流行地区的短期移民可能会导致当地疟疾持续传播，本研究调查了他们寻求疟疾治疗的行为和感染率。

方法

2025年3月至4月期间，在泰国西部夜丰颂府达府的六个疟疾流行村庄开展了一项基于社区的横断面研究。采用了一份结构化问卷，其中包括一个关于寻求治疗行为的九项内容。通过对干血斑样本进行聚合酶链反应（PCR）检测来确定疟疾感染率。使用广义线性模型分析寻求治疗得分的决定因素，并使用费思逻辑回归估计感染风险。

结果

在300名参与者中（平均年龄：34.5±14.5岁；47.3%为男性），超过60%的人认识到发烧或寒战需要就医，但只有35%的人报告在症状出现后24小时内就医。尽管98.0%的人更喜欢公共卫生设施，但只有50.3%的人曾因疑似疟疾去过公共卫生设施。寻求治疗得分较高与日薪劳动者（β=0.66；95%置信区间0.01-1.31）、不常返回缅甸（β=1.34；95%置信区间0.05-2.62）、既往疟疾经历（β=1.08；95%置信区间0.59-1.58）以及较高的疟疾知识水平（β=0.34；95%置信区间0.24-0.44）有关。克伦族与寻求治疗呈负相关（β=-0.95；95%置信区间-1.74至-0.16）。检测到6例（2%）无症状间日疟原虫感染。较低的疟疾知识水平（比值比=13.5；95%置信区间1.58-177.0）和寻求治疗得分（比值比=5.86；95%置信区间1.15-57.7）与感染显著相关。