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Predictors of malaria-association with rubber plantations in Thailand.

Satitvipawee P, Wongkhang W, Pattanasin S, Hoithong P, Bhumiratana A - BMC Public Health (2012)

Bottom Line: For a combination of ITNs/LLINs, there were 74% of malaria-affected households covered and 46% of malaria-unaffected households.Human practices such as revisiting rubber plantations while exposed to multiple bites at multiple locations are more likely to apply to daily workers than to rubber farmers/tappers and others.This information supports the conclusion that GFM program implementation in Thailand or elsewhere for malaria-associated with rubber plantations would benefit from the potential use of ITNs/LLINs and changes in personal protection behaviors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand.

ABSTRACT

Background: The national Global Fund-supported malaria (GFM) program in Thailand, which focuses on the household-level implementation of vector control via insecticide-treated nets (ITNs)/long-lasting insecticidal nets (LLINs) combined with indoor residual spraying (IRS), has been combating malaria risk situations in different provinces with complex epidemiological settings. By using the perception of malaria villagers (MVs), defined as villagers who recognized malaria burden and had local understanding of mosquitoes, malaria, and ITNs/LLINs and practiced preventive measures, this study investigated the predictors for malaria that are associated with rubber plantations in an area of high household-level implementation coverage of IRS (2007-2010) and ITNs/LLINs (2008-2010) in Prachuap Khiri Khan Province.

Methods: A structured questionnaire addressing socio-demographics, household characteristics and health behavioral factors (knowledge, perceptions and practices) regarding the performed interventions was administered to the 313 households (70 malaria-affected and 243 malaria-unaffected) that had respondents aged ≥18 years of both genders. In the univariate and multivariate analyses, only 246 (78.6%) MV respondents (62 malaria-affected and 184 malaria-unaffected) were analyzed to determine the predictors for risk (morbidity).

Results: The majority (70%) of households were covered by IRS. For a combination of ITNs/LLINs, there were 74% of malaria-affected households covered and 46% of malaria-unaffected households. In a logistic regression analysis using odds ratios (aORs) adjusted on the variables and a 95% confidence interval (CI), malaria affecting MVs was associated with daily worker (i.e., earning daily income by normally practicing laborious activities mostly in agriculture such as rubber tapping and rubber sheet processing at the smallholdings of rubber plantations) (aOR = 2.9, 95% CI: 1.1-7.4), low-moderate level of malaria knowledge (aOR = 2.4, 95% CI: 1.1-5.0) and sleeping under mosquito-nets (nets/ITNs/LLINs intermittently and ITNs/LLINs only) (aOR = 2.0, 95% CI: 1.0-3.7).

Conclusions: The MV predictors for malaria-association with rubber plantations included occupation (daily worker), misconceptions about malaria (mosquito and prevention) and the use of mosquito-nets. Human practices such as revisiting rubber plantations while exposed to multiple bites at multiple locations are more likely to apply to daily workers than to rubber farmers/tappers and others. The promotion and use of ITNs/LLINs depends substantially on cultural factors and defensive behaviors relevant to their occupational risk despite the perceived threats of malaria and the perceived benefits of ITNs/LLINs. This information supports the conclusion that GFM program implementation in Thailand or elsewhere for malaria-associated with rubber plantations would benefit from the potential use of ITNs/LLINs and changes in personal protection behaviors.

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Related in: MedlinePlus

The fluctuating trend of malaria incidence in the study village during the years 2006–2010. A total of 130 malaria cases were reported. The established alliance corroborated malaria prevention/control campaign activities by which the affected malaria cases (dashed lines) are shown between years before (2008) and after (2009) horizontally implemented. Data were retrieved from the electronic reporting system for notifiable diseases maintained by Chaiyarat Subdistrict Health Promoting Hospital.
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Figure 2: The fluctuating trend of malaria incidence in the study village during the years 2006–2010. A total of 130 malaria cases were reported. The established alliance corroborated malaria prevention/control campaign activities by which the affected malaria cases (dashed lines) are shown between years before (2008) and after (2009) horizontally implemented. Data were retrieved from the electronic reporting system for notifiable diseases maintained by Chaiyarat Subdistrict Health Promoting Hospital.

Mentions: Supported by the GFM program since 2004[9], Prachuap Khiri Khan Provincial Health Office has adopted the implementation of global malaria control strategies (RDT, ITNs/LLINs and IRS) at the provincial level (Figure 1) and has focused predominantly on reducing the mortality attributed to P. falciparum malaria in the 37 endemic villages (high-transmission A1/A2) (Figure 1). Subsequent to the initiation of operation coverage in the malaria transmission risk areas, the Moo 2 village effort commenced in mid-2008 because the number of malaria cases periodically reported for three consecutive years (2006–2008) had surged (Figure 2). The vector-borne disease control initiative centered not only on strengthening the capacity building of the communities, but also on promoting multisectoral partnerships under the supervision of the director of Bang Saphan Noi Hospital. The established alliance consisted of the Chaiyarat Subdistrict Administrative Organization, the Vector-borne Disease Control Unit (Bang Saphan) and two primary care units (formerly health centers), Chaiyarat Subdistrict Health Promoting Hospital and Ban Bang Charoen Subdistrict Health Promoting Hospital. The operational objective was to increase vector surveillance and control focused toward malaria prevention/control campaign activities that governed the household-level implementation of IRS and ITNs/LLINs together with public relations, community participation and health education, prior to and during the malaria transmission season.


Predictors of malaria-association with rubber plantations in Thailand.

Satitvipawee P, Wongkhang W, Pattanasin S, Hoithong P, Bhumiratana A - BMC Public Health (2012)

The fluctuating trend of malaria incidence in the study village during the years 2006–2010. A total of 130 malaria cases were reported. The established alliance corroborated malaria prevention/control campaign activities by which the affected malaria cases (dashed lines) are shown between years before (2008) and after (2009) horizontally implemented. Data were retrieved from the electronic reporting system for notifiable diseases maintained by Chaiyarat Subdistrict Health Promoting Hospital.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672016&req=5

Figure 2: The fluctuating trend of malaria incidence in the study village during the years 2006–2010. A total of 130 malaria cases were reported. The established alliance corroborated malaria prevention/control campaign activities by which the affected malaria cases (dashed lines) are shown between years before (2008) and after (2009) horizontally implemented. Data were retrieved from the electronic reporting system for notifiable diseases maintained by Chaiyarat Subdistrict Health Promoting Hospital.
Mentions: Supported by the GFM program since 2004[9], Prachuap Khiri Khan Provincial Health Office has adopted the implementation of global malaria control strategies (RDT, ITNs/LLINs and IRS) at the provincial level (Figure 1) and has focused predominantly on reducing the mortality attributed to P. falciparum malaria in the 37 endemic villages (high-transmission A1/A2) (Figure 1). Subsequent to the initiation of operation coverage in the malaria transmission risk areas, the Moo 2 village effort commenced in mid-2008 because the number of malaria cases periodically reported for three consecutive years (2006–2008) had surged (Figure 2). The vector-borne disease control initiative centered not only on strengthening the capacity building of the communities, but also on promoting multisectoral partnerships under the supervision of the director of Bang Saphan Noi Hospital. The established alliance consisted of the Chaiyarat Subdistrict Administrative Organization, the Vector-borne Disease Control Unit (Bang Saphan) and two primary care units (formerly health centers), Chaiyarat Subdistrict Health Promoting Hospital and Ban Bang Charoen Subdistrict Health Promoting Hospital. The operational objective was to increase vector surveillance and control focused toward malaria prevention/control campaign activities that governed the household-level implementation of IRS and ITNs/LLINs together with public relations, community participation and health education, prior to and during the malaria transmission season.

Bottom Line: For a combination of ITNs/LLINs, there were 74% of malaria-affected households covered and 46% of malaria-unaffected households.Human practices such as revisiting rubber plantations while exposed to multiple bites at multiple locations are more likely to apply to daily workers than to rubber farmers/tappers and others.This information supports the conclusion that GFM program implementation in Thailand or elsewhere for malaria-associated with rubber plantations would benefit from the potential use of ITNs/LLINs and changes in personal protection behaviors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand.

ABSTRACT

Background: The national Global Fund-supported malaria (GFM) program in Thailand, which focuses on the household-level implementation of vector control via insecticide-treated nets (ITNs)/long-lasting insecticidal nets (LLINs) combined with indoor residual spraying (IRS), has been combating malaria risk situations in different provinces with complex epidemiological settings. By using the perception of malaria villagers (MVs), defined as villagers who recognized malaria burden and had local understanding of mosquitoes, malaria, and ITNs/LLINs and practiced preventive measures, this study investigated the predictors for malaria that are associated with rubber plantations in an area of high household-level implementation coverage of IRS (2007-2010) and ITNs/LLINs (2008-2010) in Prachuap Khiri Khan Province.

Methods: A structured questionnaire addressing socio-demographics, household characteristics and health behavioral factors (knowledge, perceptions and practices) regarding the performed interventions was administered to the 313 households (70 malaria-affected and 243 malaria-unaffected) that had respondents aged ≥18 years of both genders. In the univariate and multivariate analyses, only 246 (78.6%) MV respondents (62 malaria-affected and 184 malaria-unaffected) were analyzed to determine the predictors for risk (morbidity).

Results: The majority (70%) of households were covered by IRS. For a combination of ITNs/LLINs, there were 74% of malaria-affected households covered and 46% of malaria-unaffected households. In a logistic regression analysis using odds ratios (aORs) adjusted on the variables and a 95% confidence interval (CI), malaria affecting MVs was associated with daily worker (i.e., earning daily income by normally practicing laborious activities mostly in agriculture such as rubber tapping and rubber sheet processing at the smallholdings of rubber plantations) (aOR = 2.9, 95% CI: 1.1-7.4), low-moderate level of malaria knowledge (aOR = 2.4, 95% CI: 1.1-5.0) and sleeping under mosquito-nets (nets/ITNs/LLINs intermittently and ITNs/LLINs only) (aOR = 2.0, 95% CI: 1.0-3.7).

Conclusions: The MV predictors for malaria-association with rubber plantations included occupation (daily worker), misconceptions about malaria (mosquito and prevention) and the use of mosquito-nets. Human practices such as revisiting rubber plantations while exposed to multiple bites at multiple locations are more likely to apply to daily workers than to rubber farmers/tappers and others. The promotion and use of ITNs/LLINs depends substantially on cultural factors and defensive behaviors relevant to their occupational risk despite the perceived threats of malaria and the perceived benefits of ITNs/LLINs. This information supports the conclusion that GFM program implementation in Thailand or elsewhere for malaria-associated with rubber plantations would benefit from the potential use of ITNs/LLINs and changes in personal protection behaviors.

Show MeSH
Related in: MedlinePlus