Migrants and malaria risk factors: a study of the Thai-Myanmar border.

Rungrawee Tipmontree, Wijitr Fungladda, Jaranit Kaewkungwal, M A Sandra B Tempongko, Frank-Peter Schelp
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Abstract

The objective of this study was to investigate factors influencing self-reported malaria among migrants living along the Thai-Myanmar border. Songkaria Village, with 1600 inhabitants and 290 households in Sangkhla Buri District, Kanchanaburi Province, was selected for the study due to its intense malaria transmission. One hundred twenty-five households were randomly selected. Household members were interviewed about the history of malaria, socioeconomic status and knowledge and practices in regard to malaria using a structured questionnaire. Of the respondents, 10%, 42%, and 48% belonged to the Thai, Mon, and Karen ethnic groups, respectively. About 40 % of Thai and Karen migrants and almost 30% of Mon migrants reported having suffered from malaria at least once. Multivariate analysis focused on migrants. The results identified three independent factors for previous malaria: a high risk occupation, ie working primarily in the forest [odds ratio (OR), 3.55; 95% confidence interval 1.3-10.0], ability to read Thai [OR, 4.13 (1.5-11.7)], and correct knowledge about malaria symptoms [OR, 5.18 (1.1-23.5)]. Working conditions among migrants played a major role in acquiring malaria. They could not afford to apply additional preventive measures, such as using a mosquito net or repellent to be used while working. The concept of enhancing the environment for migrants to enable them to protect themselves against malaria needs to be examined. Ways and means of improving the economic conditions of migrants should be considered to minimize exposure to the vector.

移民和疟疾风险因素:对泰缅边境的研究。
本研究的目的是调查影响泰缅边境移民自我报告疟疾的因素。北碧府Sangkhla Buri区有1600名居民和290户家庭的Songkaria村因疟疾传播严重而被选为研究对象。随机抽取125个家庭。使用结构化问卷对家庭成员进行了关于疟疾病史、社会经济状况以及疟疾知识和做法的访谈。在受访者中,泰族、孟族和克伦族分别占10%、42%和48%。大约40%的泰国和克伦移民以及近30%的孟族移民报告至少患过一次疟疾。多变量分析侧重于移民。结果确定了导致既往疟疾的三个独立因素:高风险职业,即主要在森林工作[比值比(OR), 3.55;95%置信区间为1.3-10.0],阅读泰语的能力[OR, 4.13(1.5-11.7)],以及对疟疾症状的正确认识[OR, 5.18(1.1-23.5)]。移徙者的工作条件是感染疟疾的主要因素。他们没有能力采取额外的预防措施,例如在工作时使用蚊帐或驱蚊剂。需要审查改善移徙者环境以使他们能够保护自己免受疟疾侵害的概念。应考虑改善移徙者经济条件的方法和手段,以尽量减少对病媒的接触。
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