Epidemiological characteristics and factors related to malarial disease in Thai and migrant patients in the upper part of southern Thailand
Malaria is a public health problem in Thailand. The purpose of this study was to investigate epidemiological characteristics of malaria transmission and factors related to illness among Thai and migrant patients in Thailand’s upper south. The secondary data of malaria cases derived from malaria online program comprising 5,541 new cases during 2013-2016 were analyzed to determine factors related to malaria incidence using R-program. The study indicated that epidemiological characteristics of malaria in Thai and migrant patients were similar. Most cases were males of working age group and rubber plantation workers. Most migrant patients were reported in Ranong Province (64.4%), whereas most Thai patients were reported in Surat Thani Province (40.2%). Malaria cases typically peaked in May and June. Majority of cases contracted malaria in periodic transmission areas (A2 area). Plasmodium falciparum was the most common parasites (60.1%) among Thai cases, whereas Plasmodium vivax was the most common parasites among non-Thai migrant patients (56.7%). Majority of Thai patients were found in Surat Thani, Phang-Nga, Nakhon Si Thammarat and Krabi Provinces, whereas most migrants patients were found in Phuket, Ranong and Chumphon Provinces. Migrant patients had 3 times higher history of traveling outside their area of residence than Thai patients. The rates of sleeping under mosquito nets and use of mosquito repellents were higher among the Thais than the migrants. Residual spraying of houses and case detection in communities were conducted for Thai patients at higher rates than those of the migrants. Factors significantly related to contracting malaria in Thai patients and migrants were gender, age, occupation, travel history, sleeping under mosquito net, place of malaria transmission, ecological characters, insecticide spraying in malaria transmission foci, focal spraying of patient house, and active case detection of new cases in the community. The study results can be used for planning, surveillance, prevention and control, risk communications to influence behavioral change relating to personal protection from mosquitoes while tapping rubber and at home so as to achieve elimination goal of the malaria program in Thailand.
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