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Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones.

Wangroongsarb P, Satimai W, Khamsiriwatchara A, Thwing J, Eliades JM, Kaewkungwal J, Delacollette C - Malar. J. (2011)

Bottom Line: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance.In comparison, the majority of Cambodian migrants are short-term (72%).Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Bureau for Vector-borne Diseases, Ministry of Public Health, Bangkok, Thailand.

ABSTRACT

Background: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging.

Methods: A survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS) to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours.

Results: The majority of migrants from Myanmar are long-term residents (98%) with no plans to move back to Myanmar, understand spoken Thai (77%) and can therefore benefit from health messages in Thai, have Thai health insurance (99%) and accessed public health services in Thailand (63%) for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%). Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

Conclusion: Most highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of artemisinin-resistant P. falciparum.

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Location of the 5 study sites. Falciparum resistance to artemisinin has been documented in the hotspot Zone 1 where intensive containment operations are ongoing.
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Figure 1: Location of the 5 study sites. Falciparum resistance to artemisinin has been documented in the hotspot Zone 1 where intensive containment operations are ongoing.

Mentions: Three out of the seven Thai provinces targeted by the containment project were chosen along the Thailand-Cambodia border based on their large migrant populations to target both migrants from Cambodia and from Myanmar [12]. Five study sites were chosen: two in communities that had a high proportion of migrants from Myanmar and three with a high proportion of Cambodian migrants close by areas where artemisinin resistance to falciparum malaria has been first documented [2]. The study population included both M1 and M2 migrants. The survey was conducted from September to December 2009 in locations in Thailand on the border with Cambodia (Figure 1).


Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones.

Wangroongsarb P, Satimai W, Khamsiriwatchara A, Thwing J, Eliades JM, Kaewkungwal J, Delacollette C - Malar. J. (2011)

Location of the 5 study sites. Falciparum resistance to artemisinin has been documented in the hotspot Zone 1 where intensive containment operations are ongoing.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3116495&req=5

Figure 1: Location of the 5 study sites. Falciparum resistance to artemisinin has been documented in the hotspot Zone 1 where intensive containment operations are ongoing.
Mentions: Three out of the seven Thai provinces targeted by the containment project were chosen along the Thailand-Cambodia border based on their large migrant populations to target both migrants from Cambodia and from Myanmar [12]. Five study sites were chosen: two in communities that had a high proportion of migrants from Myanmar and three with a high proportion of Cambodian migrants close by areas where artemisinin resistance to falciparum malaria has been first documented [2]. The study population included both M1 and M2 migrants. The survey was conducted from September to December 2009 in locations in Thailand on the border with Cambodia (Figure 1).

Bottom Line: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance.In comparison, the majority of Cambodian migrants are short-term (72%).Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

View Article: PubMed Central - HTML - PubMed

Affiliation: Bureau for Vector-borne Diseases, Ministry of Public Health, Bangkok, Thailand.

ABSTRACT

Background: Population movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging.

Methods: A survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS) to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours.

Results: The majority of migrants from Myanmar are long-term residents (98%) with no plans to move back to Myanmar, understand spoken Thai (77%) and can therefore benefit from health messages in Thai, have Thai health insurance (99%) and accessed public health services in Thailand (63%) for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%). Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).

Conclusion: Most highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of artemisinin-resistant P. falciparum.

Show MeSH
Related in: MedlinePlus