Treatment seeking behavior and associated factors of suspected dengue fever among Shan people in eastern Shan special region IV, Myanmar: a cross-sectional study

Abstract

Background: Dengue fever (DF) is a rapidly spreading mosquito-borne disease along the China-Myanmar border. Understanding treatment-seeking behaviors (TSBs) and associated factors of suspected DF patients in local communities helps to improve health services via promoting prompt treatment, improving patients' prognosis, finding DF information and timely response to DF foci. Methods: A combination of qualitative semi-structured in-depth interview (SDIs) included 18 key-informants, and quantitative household questionnaire survey (HHSs) involved 259 households was carried out to investigate TSBs and associated factors of suspected DF patients in the Eastern Shan Special Region IV (ESSR4), Myanmar. Results: The key informants mentioned that most of their fellow villagers did not seek treatment in public health facilities first. The HHS questionnaires were distributed to household heads, and 241 of the 259 HHS respondents were valid after data auditing. Only 102 (43.2%) household heads reported that their family sought treatment for suspected DF at a public health facility immediately; 111 (46.1%) respondents said that they chose self-medication first. The adjusted odds ratio of multivariate logistic analysis (MLA) predicting household heads' first seeking healthcare at a public hospital were 1.91 (95%CI: 1.03-3.53) for those who knew DF and 5.11 (95%CI: 2.08-12.58) for those who regarded DF as a deadly disease, indicating that families who knew DF and regarded DF as a deadly disease were more likely to seek treatment for suspected DF at a public health facility immediately. Conclusion: The inappropriateness of treatment-seeking behaviors for suspected DF hinders the improvement of the patient prognosis and dengue control in ESSR4, Myanmar. People's awareness of the potential seriousness of DF is a factor influencing appropriate healthcare-seeking behavior among Shan People.

Different Domains of Dengue Research in Malaysia: A Systematic Review and Meta-Analysis of Questionnaire-Based Studies

“…Despite the importance of immediate treatment-seeking behaviour upon dengue infection, only a few studies have been conducted in Malaysia. Similar patterns of treatment-seeking behaviour have been demonstrated in Myanmar [ 101 ] and Venezuela [ 102 ], reflecting a lack of awareness of the need for immediate medical attention for dengue. This situation could be caused by several factors, including: (i) misconception that dengue is easily curable without progression to further complications, and this intention is worrying; (ii) poor transportation amongst rural populations in certain states of Malaysia, such as Sabah and Sarawak; (iii) poor healthcare services, such as poor ambulance response time in case of emergency, lack of facilities, and low skills of health care providers, that lead to lack of confidence among community residents [ 103 , 104 , 105 ] could partly explain the reason for a delay in treatment-seeking behaviour among Malaysian population; and (iv) dependency to symptom-relief-based supporting therapy, especially over-the-counter medication like paracetamol [ 106 ].…”

The health perceptions, dengue knowledge and control willingness among Dai ethnic minority in Yunnan Province, China

“…Community involvement is one of effective strategies to manage the habitats of Aedes sp mosquitoes [ 11 , 12 ]. Early diagnosis is very important for effectively clinical management to improve patient prognosis and to reduce transmission of dengue virus [ 13 , 14 ]. In China, laboratory test for dengue fever is only available in public health facilities, thus that suspected dengue fever patients seek appropriate treatment first from public health facilities is helpful to detection of dengue fever [ 6 ].…”

“…Local people’s health beliefs and knowledge of dengue fever may likely influence their willingness to participate in dengue fever control and then further influence transmission of dengue virus [ 14 , 15 ]. The health beliefs are generally shaped by people’s expectancies about the environmental cues that are about how events are connected - about what leads to what, the consequences of their own actions that are about how individual behaviors are likely to influence outcomes, and their own competence to perform the behavior needed to influence outcomes.…”

The health beliefs, dengue knowledge and control behaviors among internally displaced persons versus local residents in Kachin Special Region II, Myanmar

“…As lacking effective antiviral therapies for DF [28], early diagnosis and timely treatment benefit the prognosis of DF patients. In contrast, delay in proper treatment could lead to complications or to severe dengue, and also further transmission [29,30]. In the context that people were unable to pay for medication by themselves, the free public health facilities were their sole option.…”