The cost of dengue hemorrhagic fever in Thailand.

The economic burden of DHF patients and of the Thai government in providing treatment and prevention and control of dengue hemorrhagic fever were assessed. Patient burden was reported by caretakers who stayed with the patients when they were admitted to three hospitals: Children's Hospital in Bangkok; Suphan Buri Provincial Hospital and Don Chedi Community Hospital, Don Chedi District in Suphan Buri Province. The hospital costs--medicine and laboratory costs--were collected from the treatment forms and the routine service cost was estimated by the staff of the hospitals. Cost of prevention and control were compiled from the budget report of Departments of the Ministry of Public Health and the Ministry of Interior. Based on 184 DHF patients admitted at the three hospitals, the direct patient costs--treatment cost and the costs of travel, food and lodging--was 66.99 US$ and 61.02 US$ per patient for one episode of DHF in Bangkok and Suphan Buri, respectively. The total patient costs--direct patient costs and opportunity costs were 118.29 US$ for a child patient and 161.49 US$ for an adult patient in Bangkok, 102.82 US$ for a child patient and 138.02 US$ for an adult patient in Suphan Buri. The net hospital cost in providing treatment for each DHF patient was 54.6 US$ and 38.65 US$ in Bangkok and Suphan Buri, respectively. The total cost of prevention and control of DHF in Thailand from government agencies in 1994 was 4.8724 million US$. Based on these findings, the whole expenditure of Thailand for DHF in 1994, would be at least 12.596 million US$, of which 54.8% was from the government budget, the rest, 45.2%, was the expenses paid by 51,688 patients and their families. The study concluded that in recording the economic-loss of DHF both the expenditures of the government and also the patient costs--direct and indirect--should be taken into account.

Treatment seeking behavior of DHF patients in Thailand.

A study on treatment seeking behavior of dengue hemorrhagic fever (DHF) patients was made from 184 clinically diagnosed patients in three hospitals: Children's Hospital, Bangkok; Suphan Buri Provincial Hospital, Suphan Buri Province and Don Chedi Community Hospital in the district of Don Chedi, Suphan Buri Province. The information was collected by interviewing the patients' caretakers while they were attending the patients in the hospitals, using a series of closed- and open-ended questions. Based on the first place of treatment, five patterns of treatment seeking behavior were identified, the most common one was using the clinic as the first step. Different patterns of treatment seeking behavior had the impact on the duration of illness, the number of steps in seeking treatment and the direct patient costs. The socio-demographic characteristics of the patient's caretaker that influenced the decision making to take treatment alternatives included the level of education, occupation, residential area and lay symptom assessment. In addition, economic factors: the capability to reimburse the cost of treatment, the family income and the financial sources, were also important for caretakers to take into consideration when making treatment choices.

Community participation in the malaria control program in Thailand: a review.

The focus of this paper is on community participation in the Thai Malaria Control Program. Two projects concerned are reviewed. First, the Village Voluntary Malaria Collaborator Program has been established for case detection. Second, the Village Malaria Self-Reliance Project aims at malaria prevention. Both projects have been able to get community participation at a certain level. The success of the projects depend on the community, the structures of the projects and the malaria situation in the communities.

The role of folk healers in the malaria volunteer program in Thailand.

In the Malaria Control Program of Thailand, villagers were recruited as village malaria volunteers to assist and participate in passive case detection at the community level by preparation of blood smears and provision of presumptive treatment to suspected cases. Among these volunteers, there were some folk healers. This study was intended to investigate the role of the folk healer volunteer in the Malaria Control Program in the northern area under the responsibility of the Malaria Zone 1, Region 2 in Fang, Mae Ai and Chiang Dao Districts of Chiang Mai Province. The combination of qualitative and quantitative research methodologies (participant and non-participant observations and structured questionnaires) were used to get information from 246 volunteers, of whom 113 were folk healers. Most of the volunteers were male and more than half were in the age group 30-50 years. Almost all volunteers had completed the compulsory education and farming was their main occupation. Folk healer volunteers were older and had been in the service longer than the non-folk healer volunteers. Both groups of volunteers shared some negative attitudes towards the Malaria Control Program, such as the interference with their occupation and the waste of time. However, the folk healer volunteers had more positive attitudes towards the program in terms of gaining social respect and the willingness to stay on. It was also found that the folk healer volunteers performed their assignment better than the non-folk healer volunteers.(ABSTRACT TRUNCATED AT 250 WORDS)

Migration and disease problems: a study of pattern of migration in an endemic area of malaria in Thailand.

The preliminary results of a study of rural-rural migration in an endemic area of malaria is reported. The study on socio-economic status of migrant workers was made during the post planting season of sugarcane plantation in Tambon Nong Rhee Kanchanaburi Province. Among 9,311 population in four villages of this Tambon, 15.4% were migrants and 45.5% were from the northeast provinces of Thailand. Almost half of the migrant population came to the area for the first time and stayed for six months mostly during the sugarcane cutting season. No significant difference in experience with malaria (as recognized by the people not from blood examination) between the local population and the migrants was observed from the interview. However, the duration of migration seemed to relate with the risk of contracting malaria.