Behaviors in self-prevention of malaria among mobile population in east Thailand.

The study investigated preventive behaviors among mobile villagers in Chanthaburi and Trat Provinces where the slide positive rates (SPR) of malaria in 1987 were 10.3 and 11.1%, respectively. The study was conducted in four villages namely Wang Thong, Khao Thong in Chanthaburi, and Manow and Khow in Trat by using a cross-sectional survey. Household and in-depth interviews with the movers were done together with field observations. The sizes of the villages were 52, 180, 184 and 209 households and the movement rates were 23.1, 12.2, 37.5 and 28.7%, respectively. The population involved in short term migration was 729 villagers living in 153 households or 23.7% of the total. Malaria prevalence rates in the four villages were 7.5%, 5.9%, 7.3% and 2.2%, respectively. The results indicate that the mobile population had a moderate 40% rating score of knowledge about malaria. Apparently, the rating score of preventive behaviors of the disease appeared to be as small as 20%. After six months of field investigations, 1,083 thick blood smears collected from the mobile population, there were 657 episodes (60.7%) of malaria that could be categorized with age specific prevalence of 60.3% in 19-29 years, 80.8% in 30-39 years, 54.8% in 40-49 years, 38.6% in 50-59 years and 35.7% in 60 years and over. Villagers aged between 30-39 years with frequent movement into the forest had the highest impact of malaria risk. Moderate levels of knowledge and attitude scores did not appear to enable the people to protect themselves against malaria.

Malaria clinics in Mae Sot, Thailand: factors affecting clinic attendance.

Clinics of the Anti-Malaria Program of Thailand play an important part in the control of malaria morbidity and mortality, treating over 60% of reported cases yearly. Interviews were conducted both with attenders at three clinics in Mae Sot District and among those reporting malaria illness but not attending. Distance travelled to the clinic, costs of travel and frequency of other treatment prior to clinic attendance were all highest among patients at the large centralized clinic, moderate in a peripheral fixed clinic, and lowest in a village-based mobile clinic. Reported length of illness prior to attendance was similar for all three clinics. As many as 91% of villagers interviewed chose not to treat their illness in a malaria clinic. These non-attenders reported longer illness time and higher expenditures on treatment than clinic patients. Provision of village-based clinics can improve access. However, the widespread reliance on non-Program treatment of malaria suggests the need for policies to address these alternative therapeutic modes.