| Objective:Malaria is one of public health problems globally. China-Myanmar border areas is in Great Mekong Sub-regions, which is one of malaria endemic areas in the world. The purpose of the study is:(1)To investigate the malaria infection and its influencing factors among Wa Ethnic in northern Wa state areas of Myanmar; (2)To study the health-seeking behavior and its influencing factors among Wa Ethnic in northern Wa state areas of Myanmar. Methods:(1) The study area was chosen in the Gelongba district and Mangdong district, Mengmao county, Wa state. Most people were Wa Ethnic minority. (2) the samples were calculated by Handbook Designing Household Sample Surveys 2003;(3) The study was conducted by the combination of anthropology and epidemiology: To explore the malaria infection and its influencing factors by epidemiology, To study the malaria knowledge and concept, consciousness of malaria prevention,health-seeking behavior and its influencing factors by anthropology. (4) The combination of qualitative and quantitative, The quantitative study methods used included the survey of malaria infection and household questionnaire. The qualitative survey methods used included semi-structure in depth discussion (SSI), Focus group discussions(FGD) and directly unstructured observation (DUSO). (5) The combination of statistical analysis and description, The quantitative data were entered by using Epidata2.1 software to create the dataset, and with double entry methods. And then analyzed using the Epi Infor2000 software package. The qualitative information was categorized, analyzed and summarized. Results:(1) We surveyed adults in a randomly selected sample of 719 households in 23 villages. (2)Totally 369 fever patients were found and tested,91 malaria cases were confirmed, and in which 74 infected with Plasmodium falciparum,13P. vivax and 4 P. malariae. The positive rate of tests was 24.7%(95%CI:20.35-29.39%),The proportion of Plasodium falciparum among malaria cases was 20.1% (95%CI:16.2-24.6%). The low age groups has higher incidence than the high age groups, low elevation has higher incidence. (3) malaria was considered as one of common diseases among Wa Ethnic minority, But the Wa people lack the knowledge of malaria, They think that malaria was often infected by the person of labored usually in the field, Mostly people think that mosquito only bite man,72.8%(95%CI:69.3-76.0%). The Wa people know well the symptom of malaria, About half of the respondents knew more 3 items of symptoms of malaria. few of Wa people use prevention measures for malaria.299 respondents 41.7%(95%CI:38.1-45.4%) reported taking no actions to prevent malaria,30.5%(95%CI:27.2-34.1%) of the respondents knew prevent malaria use bed net. (4) 53.2% (95%CI:49.5-56.9%) of the respondents did not seek any treatment when they were fever, health-seeking rates in 24 hours was 34.0% (95%CI:29.1-39.3%).The reasons of they did not health-seeking in 24 hours as follows:no money, no well road, no doctors, superstition. When they infects malaria,T hey bought drugs firstly.When the disease continue, They did not went to the good hospital, But they bought drugs again or superstition or others. The family decision-makers mainly were the husbands in the survey areas. Mainly respondents considered that their medical conditions were bad 65.0%(95%CI:61.3-68.5). (6)The factors that affect malaria infection:Univariate logistic regression analysis, Of the nine variables investigated, There are seven factors that affect malaria infection:less than 800 meters above sea level, Age less than or equal to 15 years of age, Number of household members is less than or equal to 3, Head of the household poor knowledge of malaria. Multivariate logistic regression analysis, less than 800 meters above sea level that adjusted odds ratio (OR) is 5.15 (95%CI:1.94-13.61), P< 0.01, So it is an influencing factor of malaria infection. Possible factors of malaria infection as follows:Male, age less than or equal to 15-year-old, Head of the household poor knowledge of malaria transmission, Poor health-seeking behavior, The family decision-makers is the husband. (7) Health-seeking behavior of the factors affecting:Univariate logistic regression analysis influencing factors as follows:Head of household knowledge of malaria, Head of household awareness of the prevalence of malaria, Awareness of the convenience of medical care. Multivariate logistic regression analysis, Influencing factors were head of household decision of the prevalence of malaria (OR:1.64 (95%CI:1.08-2.50), P< 0.05) and awareness of the convenience of medical care(OR:2.11 (95%CI:1.28-3.49), P<0.01), Possible factors of health-seeking behaviour as follows:Head of household age, Head of household knowledge of malaria transmission, Head of the household perceptions about the attitude of medical.Conclusion:(1)In Wa Ethnic in northern Wa state areas of Myanmar, Malaria infection rate is high. The main effect factors of malaria infection as follows:altitude, gender, age, malaria knowledge of head of the household, Poor health-seeking behavior. (2) In Wa Ethnic in northern Wa state areas of Myanmar, Poor health-seeking behaviour. The main effect factors of health-seeking behaviour as follows:The family decision, poverty, poor medical conditions, poor transportation, poor awareness of prevention and treatment of malaria, lack of the concept of disease, poor knowledge of malaria, traditional superstition,. |
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