| Objective:This study determined the status of medical-seeking behavior in border areas between China and Myanmar. We measured influencing factors of medical seeking behavior in the region between China and Myanmar. The results will provid some evidences and commonts in improv of control and prevention of malaria and life quality of the local people.Methods:A cross-sectional questionnaire survey was carried out in border areas between China and Myanmar. Cluster sampling method was performed, and diagnosed malaria patients and suspects were relected from three villages of Nabang town Yingjiang county of Yunnan and3villages in Laza,Myanmar in ten year.Survey was conducted in the previous year confirmed and suspected malaria patients. Used to chi-square, rank sum test, logistic regression,principal component were used to analyze the medical-seeking behavior and its influencial factor.Result:(1)There were350people in this study, including174male(49.7%) and176female(50.3%), the number of Jingpo ethmic was262,accounting for74.9%,the number of other ethnic groups were88,accounting for25.1%.About59.7%of our target population was aged from25-34and35-44years, most of them only graduated from primary school or middle school. The economic situation of the households were divided into rich (33.3%), normal (33.3%) and poor(33.3%).118poor families, accounting for33.7%;117people in ordinary families, accounting for33.4%;115 people in wealthy families, accounting for32.9%.(2)KAP(knowledge, attitude, practice) showed that the knowledge section scored6.6±1.2in average, the attitude scored5.2±1.0in average, action scored4.3±0.8in average, total KAP scored16.09±1.92in total.(3)Regarding the survey of accessibility of medical services, The distance from home to medical clinic were divided into three categories, which were less than500m,500-1000m,1000m and more. The data in response to the three types were57cases, accounting for16.3%;117cases, accounting for33.4%;176cases, accounting for50.3%. The time they spent in walking to medical clinic from their home were also divided into three types, including less than half an hour, half an hour and more than one hour beyond, data in response to the three types were208cases, accounting for59.4%;117cases, accounting for33.4%;25cases, accounting for7.2%. Publicity covered317cases, accounting for90.6%,33cases were not covered by publicity, accounting for9.4%.(4)Medical-seeking behavior showed,98.6%of respondents took action such as going to hospital, including52.6%,46.0%went to pharmacy, only1.4%of respondents did nothing. Among184cases in hospital admissions,77cases chose to go to village clinic, accounting for41.9%,102cases chose to go to rural hospitals, accounting for55.5%,4cases chose to go to hospitals out of county, accounting for2.1%. Among184people in hospital,15.1%of them thought that health care was too expensive,40%of them thought that they can afford,44.9%thought it’s cheap.(5)Myanmar residents comparative analysis:Only different age, ethnicity, education level and family economic income showed significant differences (P<0.05), while the malaria patients seeking behavior was not statistically significant between Chinese and Myanmar.(6)Seeking behavior influencing factors analysis:whether to medical institutions for treatment as the dependent variable, univariate analysis showed that only the head of household or by the influence of gender on medical treatment, the use of non-conditional logistic regression seeking behavior analysis of the factors affecting The results showed that nationality, community outreach, economic indicators also seeking behavior affected.Conclusions and recommendations:There were170cases who have primary school education background (accounting for48.6%) and112cases aged from35-44(accounting for32.0%) in the hotspot of malaria in border areas Myanmar. Seeking ways in different sexes have shadow (4.159, P<0.05), However, there’s no statistical differences among nationality, age, occupation, ethnicity, marital status, education level, health insurance, KAP and other factors. Logistic regression model analysis showed that nationality, community publicity, economic indicators are the positive factors in the process of medical-seeking; The possibility of medical-seeking behavior in Myanmar patients were less than that in China, as well as the patients with worse economic situation. People tended to seek medical service while they were covered by plenty of community publicity, and vice versa. The result strongly recommended that we should strengthen the publicity of malaria knowledge, and provide effective health care services to increase people’s awareness of malaria, in order to motivate local resident to take protective measures. |
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