Malaria prevalence, knowledge, perception, preventive and treatment behavior among military in Champasak and Attapeu provinces, Lao PDR: a mixed methods study
Malaria prevalence, knowledge, perception, preventive and treatment behavior among military in Champasak and Attapeu provinces, Lao PDR: a mixed methods study
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DOI：
10.1186/s41182-019-0138-9
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发表时间：
2019-01-25
影响因子：
4.5
通讯作者：
Kano, Shigeyuki
中科院分区：
文献类型：
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作者：
Vilay, Phoutnalong;Nonaka, Daisuke;Kano, Shigeyuki
背景：疟疾是老挝人民民主共和国(老挝人民民主共和国)的一个主要健康问题，在偏远和森林地区，特别是在南部，疟疾的传播率很高。军队面临感染疟疾的风险，特别是部署在林区的军队。本研究确定了老挝两个南部省份军人的疟疾感染率，并评估了军人对疟疾的知识、认知和防治行为。方法：2017年在尚帕萨省和阿塔普省进行了定量和定性研究。对313名军人进行问卷调查，采集血样，用聚合酶链式反应(PCR)进行寄生虫检测。通过7次焦点小组讨论和对49名军事人员的17次深入访谈收集了定性数据。用Fisher‘s Exact检验和Mann-Whitney U检验来评估疟疾感染与参与者特征之间的关系。结果：疟疾感染率为11.2%，其中恶性疟原虫1.3%，间日疟9.3%，混合感染0.6%。许多与会者了解疟疾是通过蚊子叮咬传播的，尽管他们不一定知道媒介蚊子(按蚊)的名字。令人惊讶的是，超过一半的人还认为疟疾是通过饮用溪水传播的。三分之一的参与者使用了长效杀虫蚊帐。由于供应有限，参与者在必要时往往无法使用驱蚊剂和线圈。由于参与者无法在营地得到及时的疟疾诊断和适当的治疗，他们通常使用抗生素、止痛药和/或传统药物进行自我治疗。他们只有在病情恶化时才会通过他们的监督者去医疗机构。结论：有症状和无症状的疟疾在林区部队中的流行是明显的。许多与会者认为，疟疾不仅通过蚊子叮咬传播，还通过饮用溪水传播。预防设备往往不足。在提到医疗机构之前，先进行自我治疗。为进一步预防军队感染疟疾，国家疟疾防治规划和军事机构应提供足够和适当的健康教育、防护装备和现场疟疾病例管理。
Background: Malaria is a major health problem in Lao People's Democratic Republic (Lao PDR) with high transmission in remote and forest areas, particularly in the South. The military is at risk of malaria infection especially those deployed in forest areas. This study determined the prevalence of malaria infection and assessed knowledge, perception, and preventive and treatment behavior regarding malaria among military personnel in two southern provinces in Lao PDR.Methods: Quantitative and qualitative approaches were undertaken in Champasak and Attapeu provinces in 2017. From 313 military personnel, quantitative data were collected through questionnaire-based interviews and blood samples used for parasite detection by polymerase chain reaction (PCR). Qualitative data were collected through 7 focus group discussions and 17 in-depth interviews among 49 military personnel. Fisher's exact test and Mann-Whitney U test were used to assess the association between malaria infection and participant characteristics. Content analysis for qualitative data was performed to explore perception and treatment behaviors regarding malaria.Results: The prevalence of malaria infection was 11.2% (Plasmodium falciparum: 1.3%, Plasmodium vivax: 9.3% and mixed infections: 0.6%). Many participants understood that malaria is transmitted through mosquito bites, although they did not necessarily know the name of vector mosquitoes (Anopheles). Surprisingly, more than a half also believed that malaria is transmitted through drinking stream water. One-third of the participants used long-lasting insecticidal nets. Due to limited supply, participants were often unable to use mosquito repellent and coils when necessary. Because participants were unable to receive timely diagnosis and appropriate treatment for malaria in their camps, they commonly practiced self-treatment using antibiotics, painkillers, and/or traditional medicines. They only go to a healthcare facility through their supervisor if their conditions worsen.Conclusions: The prevalence of symptomatic and asymptomatic malaria was conspicuous among military in forest areas. Many participants believed that malaria is transmitted not only by mosquito bites but also from drinking stream water. Preventive equipment was often insufficient. Self-treatment was practiced before referring to healthcare facility. To further prevent military from contracting malaria, the National Malaria Control Program and military body should provide adequate and suitable health education, protective equipment, and on-site malaria case management.