Evaluation of Knowledge, Attitudes and Practices of Malaria Among Forest-Goer Communities in Mukdahan Province, Northeastern Thailand

Abstract

Background: Malaria remains a major public health challenge in Thailand. In Thailand, the transmission now progressively clusters in hotspots along international borders and among high-risk groups, including forest-goers. Therefore, continuous assessment and understanding of the behavioral and perceptions related to malaria exposure in the high-risk group are necessary to achieve the elimination goal. This study aimed to investigate knowledge, attitudes and practices (KAP) related to malaria in rural communities living close to a forested area in the northeastern part of Thailand.Methods: A community-based cross-sectional survey was conducted in three forest-goer communities (i.e. Ban Khok, Ban Koh and Dong Yang) in Khamcha-i district, Mukdahan Province from July and August 2019. Community members aged 18 years and above were interviewed. Demographic, socio-economic information and KAP data were collected using a structured questionnaire. Data were analyzed using descriptive statistics.Results: Overall, 346 individuals were interviewed. Although the household indoor residual spraying (IRS) coverage was 100%, ownership of mosquito bed net was 24.3% and only reported in Ban Khok. Nevertheless, almost all of the respondents were aware that malaria is transmitted by mosquitoes (97.7%) and bed nets were used to prevent malaria (94.5%). Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the nearby clinic (58.1%), followed by self-healing (38.7%) and self-purchase of medication from a local shop (3.2%). Concerning attitude towards malaria transmission, 69.1% and 24.3% of the respondents reported entering nearby forests and spending the night in the forest within the last six months, respectively. Conclusion: This study found that most respondents living in the villages have an acceptable level of knowledge and awareness about malaria. Nevertheless, the positive attitudes and practices concerning malaria prevention measures against malaria require marked improvement. Therefore, new approaches to improving malaria KAP evidently need in this community.

Choice of health providers and health-seeking behaviour among forest goer population in Myanmar: findings from a cross-sectional household survey

“…Similar findings were found in this study that forest goers and their family members' choice of providers were determined by socio-economic status and having more providers in their village [15,16,30,31,41,42,[48][49][50]. In cases of knowledge of malaria prevention and transmission, almost all of the forest goers in a Thailand study were aware that malaria was transmitted by mosquitoes and bed nets were used to prevent malaria [32]. Similarly, it was found that forest-goers in GMS countries often had knowledge of malaria transmission [20].…”

“…In addition, their socio-economic status seemed to influence their health-seeking behaviour from providers. Self-medication and home treatment were found to be common in these populations [30][31][32]. Age was found to be a predictor for providers' choice and the association was mixed for different occasions.…”

“…There was a negative association of correct knowledge on malaria transmission and prevention with choice of providers was found in our study. It indicated that the knowledge did not seem to translate into practice in this particular population because malaria has been popular among them and they already had knowledge related to transmission [32]. Studies from Laos [34], Cambodia [35][36][37] and Bangladesh [38] show that economic constraints influenced health-seeking behaviour for malaria significantly, causing health service underutilization and delay in malaria treatment seeking in people with lower income.…”

Forest malaria and prospects for anti-malarial chemoprophylaxis among forest goers: findings from a qualitative study in Thailand

“…Many respondents considered VMWs or MPWs as essential primary care providers for malaria. Like elsewhere in the GMS (Cambodia [ 27 , 42 – 45 ], Lao PDR [ 46 ], Myanmar [ 47 ], and Vietnam [ 48 ]), village residents in Thailand are likely to seek testing and treatment from local health workers [ 49 , 50 ]. Nevertheless, their decision to seek treatment at a malaria clinic or hospital in the district depended less on its distance from home than in other countries, likely because of better access to care compared to other communities in mountainous and remote areas, particularly in the rainy season, or the perceived cost of treatment elsewhere [ 51 ].…”