Healthcare seeking preferences of Myanmar migrant seafarers in the deep south of Thailand.

BACKGROUND: The Thai marine fishing industry depends on migrant workers. Public healthcare services are officially available to all registered migrant workers, but the extent of their utilisation by migrant seafarers is unknown. The aim of the study was to document sociodemographic characteristics, working conditions, illness history and healthcare-seeking preference among Myanmar migrant seafarers in southern Thailand. MATERIALS AND METHODS: Questionnaire-based interviews were conducted among 385 migrant seafarers and selected participants qualitatively interviewed. Factors related to illness experience and to healthcare- -seeking preference were identified using logistic regression. RESULTS: Past-one-year illness was reported by 307 (80%) participants, among whom 91% had illness while at sea and 22% an emergency condition requiring immediate transfer ashore. Only 118 (38%) illness events involved visiting a public hospital; another 38% involved private healthcare facilities or drug stores. Illness was associated with supervisory job, alcohol consumption habit, age > 20 years, ethnicity and exposure to hazardous marine life. Compared with the choice of public hospital, use of private healthcare facilities was associated with having at least primary school education and shorter-duration trips at sea. Obtaining medications from a drug store was associated with the job of sorting, packing/storing the catch, non-drinking and low income. Not holding their identity and health-insurance documents and language barrier were major reasons for reluctance to seek treatment at a public hospital. CONCLUSIONS: Illness was common among the migrant seafarers. Utilisation of public hospitals was low. Allowing migrants to keep their identity and health insurance documents themselves and providing materials in the Myanmar language might promote utilisation of public health facilities.

High vaccination coverage, inadequate knowledge and high vector density: Findings from a community-based cross-sectional study on Japanese Encephalitis in Yangon, Myanmar.

Background: Japanese encephalitis (JE) is a mosquito-borne disease with high case fatality and no specific treatment. Little is known about the community's (especially parents/guardians of children) awareness regarding JE and its vaccine in Yangon region, which bears the highest JE burden in Myanmar. Methods: We conducted a community-based cross-sectional study in Yangon region (2019) to explore the knowledge and perception of parents/guardians of 1-15 year-old children about JE disease, its vaccination and to describe JE vaccine coverage among 1-15 year-old children. We followed multi-stage random sampling (three stages) to select the 600 households with 1-15 year-old children from 30 clusters in nine townships. Analyses were weighted (inverse probability sampling) for the multi-stage sampling design. Results: Of 600 parents/guardians, 38% exhibited good knowledge of JE , 55% perceived JE as serious in  children younger than 15 years and 59% perceived the vaccine to be effective . Among all the children in the 600 households, the vaccination coverage was 97% (831/855). Conclusion: In order to reduce JE incidence in the community, focus on an intensified education program is necessary to sustain the high vaccine coverage in the community.

High vaccination coverage and inadequate knowledge: Findings from a community-based cross-sectional study on Japanese Encephalitis in Yangon, Myanmar.

Background: Japanese encephalitis (JE) is a mosquito-borne disease with high case fatality and no specific treatment. Little is known about the community's (especially parents/guardians of children) awareness regarding JE and its vaccine in Yangon region, which bears the highest JE burden in Myanmar. Methods: We conducted a community-based cross-sectional study in Yangon region (2019) to explore the knowledge and perception of parents/guardians of 1-15 year-old children about JE disease, its vaccination and to describe JE vaccine coverage among 1-15 year-old children. We followed multi-stage random sampling (three stages) to select the 600 households with 1-15 year-old children from 30 clusters in nine townships. Analyses were weighted (inverse probability sampling) for the multi-stage sampling design. Results: Of 600 parents/guardians, 38% exhibited good knowledge of JE , 55% perceived JE as serious in  children younger than 15 years and 59% perceived the vaccine to be effective . Among all the children in the 600 households, the vaccination coverage was 97% (831/855). Conclusion: In order to reduce JE incidence in the community, focus on an intensified education program is necessary to sustain the high vaccine coverage in the community.