Background and rationale
Methods
Study area and population
Respondent driven sampling and recruitment
Ethical considerations
Data management and oversight
Statistical analysis
Results
Recruitment
Demographics
Variables | Cambodian | Myanmar | ||
---|---|---|---|---|
M1* n = 350 % (95% CI) | M2 ** n = 475 % (95% CI) | M1 * n = 871 % (95% CI) | M2 ** n = 19 % (95% CI) | |
Total
| 28.3% (25.5-33.3) | 71.7% (66.7-74.5) | 97.3% (95.8-98.6) | 2.7% (1.4-4.2) |
Age
| ||||
≤ 25 years | 38.8% (31.6-46.5) | 50.1% (45.7-54.6) | 48.8% (45.4-53.1) | 60.1% (39.4-90.1) |
26 - 35 years | 31.6% (25.4-38.1) | 27.1% (23.2-31.1) | 29.8% (26.0-32.8) | 16.0% (0.0-35.4) |
36 - 45 years | 18.8% (14.2-24.5) | 19.0% (15.4-22.9) | 15.2% (13.2-17.9) | 2.9% (0.0-5.3) |
>45 years | 10.8% (7.0-14.4) | 3.8% (2.0-6.2) | 6.2% (4.4-7.7) | 21.0% (0.0-39.5) |
Gender
| ||||
Male | 51.5% (45.7-60.9) | 64.6% (60.9-69.5) | 56.5% (52.7-60.3) | 38.1% (9.9-67.0) |
Female | 48.5% (39.1-54.3) | 35.4% (30.5-39.1) | 43.5% (39.7-47.3) | 61.9% (33.1-90.2) |
Marital Status
| ||||
Single | 30.9% (22.5-37.4) | 38.0% (33.1-42.2) | 32.5% (28.6-36.3) | 53.0% (27.7-83.4) |
Married | 61.7% (55.9-70.4) | 58.1% (53.3-63.1) | 65.8% (62.1-69.8) | 45.7% (16.6-72.4) |
Married, not living together | 2.0% (0.4-4.0) | 1.2% (0.3-2.7) | 0.6% (0.3-0.9) | --- |
Divorced | 1.0% (0.0-1.9) | 1.2% (0.2-2.0) | 0.4% (0.0-0.8) | --- |
Widowed | 4.4% (2.1-6.7) | 1.5% (0.5-2.8) | 0.7% (0.3-1.2) | --- |
Education level
| ||||
No education | 22.3% (17.7-27.5) | 34.7% (30.3-39.5) | 33.1% (29.4-36.8) | 39.8% (12.3-62.5) |
≤Primary School | 58.1% (52.4-65.3) | 52.2% (48.1-56.5) | 62.5% (58.9-66.3) | 60.2% (37.6-87.7) |
>Primary School | 19.6% (14.3-23.6) | 20.5% (16.8-24.9) | 4.3% (2.9-5.9) | --- |
Ethnic Group
| ||||
Karen | --- | --- | 1.3% (0.3-2.5) | --- |
Mon | --- | --- | 86.7% (83.6-89.7) | 100% |
Burmese | --- | --- | 11.8% (.1-14.8) | --- |
Other | --- | --- | 0.2 (0.0-0.5) | --- |
Languages spoken
| ||||
Thai | 55.7% (48.9-63.0) | 17.5% (14.1-20.4) | 76.9% (74.2-80.0) | 15.8% (4.0-36.3) |
Khmer | 99.6% (99.2-100) | 99.7% (99.3-100) | 0.3% (0.0-0.5) | --- |
Burmese | --- | --- | 54.5% (51.0-58.5) | 69.2% (42.1-93.1) |
Mon | --- | --- | 93.8% (81.6-95.9) | 76.9% (49.2-100) |
Karen | --- | --- | 1.6% (0.6-3.0) | --- |
Languages read
| ||||
Thai | 13.5% (9.4-17.9) | 2.3% (0.9-3.9) | 4.7% (3.1-6.2) | --- |
Khmer | 75.9% (70.6-80.9) | 64.0% (59.5-69.1) | --- | --- |
Burmese | --- | --- | 45.1% (41.3-49.4) | 47.9% (24.6-81.0) |
Mon | --- | --- | 31.9% (28.2-35.6) | 21.0% (7.6-43.5) |
Karen | --- | --- | 0.3% (0.0-0.8) | --- |
Duration of residence and work history in Thailand
Variables | Cambodian | Myanmar | ||
---|---|---|---|---|
M1* n = 350% (95% CI) | M2 ** n = 475% (95% CI) | M1 * n = 871% (95% CI) | M2 ** n = 19% (95% CI) | |
Purpose of being in Thailand
| ||||
Came for work | 95.4% (93.0-97.8) | 98.5% (97.8-99.9) | 93.1% (90.5-95.3) | 100% |
Came with family member | 2.5% (1.1-3.5) | 1.6% (1.1-2.8) | 6.2% (4.0-8.6) | --- |
Came with friends | 1.6% (1.1-2.8) | --- | 0.8% (0.2-1.5) | ---- |
Duration of stay in Thailand (months)
| ||||
Mean | 61.5 | 2.6 | 86.8 | 4.5 |
Median(IQR) | 23(12-60) | 2(1-3) | 72(33-113) | 4 (3-5) |
Min-Max | 7-724 | 1-6 | 7-564 | 2-6 |
Own home in Thailand
| 5.3% (3.0-8.7) | 0.5% (0.0-1.3) | 35.0% (31.0-40.0) | 26.0% (3.8-51.5) |
Location of family members
| ||||
With them in Thailand | 59.8% (50.2-67.3) | 57.0% (52.0-62.3) | 77.7% (74.2-81.0) | 63.6% (32.6-88.5) |
Elsewhere in Thailand | 0.4% (0.0-0.8) | ---- | 2.9% (2.0-4.1) | --- |
In Cambodia | 39.9% (32.3-47.1) | 38.3% (33.0-42.5) | --- | --- |
In Myanmar | --- | --- | 2.0% (1.2-2.9) | --- |
Other country | --- | --- | 12.9% (10.0-15.8) | 29.1% (5.5-55.1) |
Size of family/relatives in Thailand
| ||||
Mean | 2.3 | 1.5 | 2.4 | 1.4 |
Median(IQR) | 2(0-4) | 1(0-2) | 2(1-3) | 1(0-3) |
Reasons for not working in home country
| ||||
Grew up in Thailand | --- | --- | 11.3% (8.4-14.2) | --- |
No jobs in home country | 76.5% (71.9-83.1) | 76.9% (73.5-81.9) | 84.9% (81.6-87.7) | 94.4% (82.5-100) |
Jobs were irregular | 40.7% (34.5-48.4) | 51.4% (45.1-56.2) | 50.3% (45.9-54.0) | 63.5% (38.8-92.9) |
Work seasonal jobs in both | 3.5% (1.4-5.6) | 1.4% (0.6-2.0) | --- | --- |
To be with family | 3.5% (1.7-5.1) | --- | 5.6% (4.2-7.2) | 3.3% (0.0-10.9) |
Job/work at initial entry
| ||||
Agriculture | 54.4% (43.7-64.6) | 91.9% (89.0-94.5) | 2.1% (1.2-3.1) | --- |
Rubber tapping | 4.2% (1.8-6.5) | 0.9% (0.2-1.8) | 88.6% (86.1-91.0) | 83.0% (61.4-100) |
Domestic | 7.5% (4.3-10.6) | 0.4% (0.0-0.9) | 1.5% (0.6-2.7) | 3.4% (0.0-11.4) |
Construction | 6.6% (3.8-9.0) | 0.6% (0.0-1.0) | 5.6% (3.8-7.7) | --- |
Fishing | 12.1% (8.4-15.5) | 0.9% (0.4-1.4) | 2.3% (1.3-3.4) | --- |
Mining | --- | --- | 0.9% (0.5-1.4) | --- |
Forestry | 0.3% (0.1-0.7) | --- | --- | --- |
Restaurant/shop | 5.1% (2.5-8.8) | 2.5% (0.9-4.0) | 0.8% (0.3-1.4) | --- |
Factory | 5.7% (3.1-7.7) | --- | 3.4% (2.3-4.6) | 8.9% (0.0-21.3) |
Benefits received from employer
| ||||
Health insurance | 0.2% (0.0-0.6) | 1.1% (0.0-2.0) | 8.2% (6.4-10.6) | 9.2% (0.0-25.4) |
Salary | 12.1% (7.9-17.5) | 10.8% (7.1-14.2) | --- | --- |
Food | 6.8% (3.0-10.7) | 4.4% (2.3-7.3) | --- | --- |
Water | 7.1% (3.5-11.6) | 8.1% (5.0-10.8) | --- | --- |
Housing | 8.0% (4.3-12.7) | 9.1% (5.5-11.9) | 0.4% (0.1-0.8) | --- |
Duration of being in this job/work(Years)
| ||||
Mean | 3.2 | *** | 5.5 | 0.4 |
Median(IQR) | 2(1-3) | 0.2(0.1-0.3) | 5(2-7) | 0.4(0.2-0.5) |
Plan to continue in this job
| ||||
Until the job ends | 20.2% (14.3-24.8) | 31.4% (27.1-35.5) | 13.7% (11.2-16.3) | 8.6% (0.0-20.1) |
Don't know/no plans to leave | 68.5% (62.1-75.3) | 45.9% (42.1-51.2) | 83.9% (81.7-87.1) | 73.8% (59.6-100) |
Health care-seeking behaviour and health messages
Variables | Cambodian | Myanmar | ||
---|---|---|---|---|
M1* n = 350 (95% CI) | M2** n = 475 (95% CI) | M1* n = 871 (95% CI) | M2** n = 19 (95% CI) | |
Has Thai health insurance
| 14.7% (10.9-19.3) | 3.4% (1.4-5.4) | 98.7% (97.3-99.7) | 100% |
Treatment place of last sickness episode
| ||||
No treatment sought | 15.2% (10.3-19.6) | 27.3% (23.9-32.3) | 30.9% (26.8-34.2) | 52.1% (5.0-71.6) |
To government clinic | 42.3% (37.1-51.1) | 45.1% (40.5-49.6) | 62.6% (59.7-67.3) | 47.9% (28.7-95.2) |
To private clinic | 10.2% (6.3-15.1) | 4.0% (2.2-5.6) | 1.6% (0.9-2.5) | --- |
Pharmacy | 18.0% (12.3-22.3) | 10.1% (7.0-12.7) | 1.1% (0.1-2.1) | --- |
HCW at work | --- | --- | 3.5% (2.1-5.2) | --- |
Self-treat | 7.0% (3.0-10.5) | 11.3% (8.6-14.3) | 0.2% (0.0-0.4) | --- |
Of those who sought treatment,% returned to home country
| ||||
Government clinic | 19.1% (10.7-27.6) | 72.4% (65.3-79.5) | --- | --- |
Private clinic | 46.5% (19.6-73.5) | 94.3% (85.7-100) | --- | --- |
Pharmacy | 47.7% (40.0-61.4) | 87.0% (77.0-97.0) | --- | --- |
Reasons for choosing the treatment site
| ||||
Close | 57.2% (49.7-64.2) | 42.9% (38.5-47.6) | 41.7% (37.6-45.4) | 25.1% (4.5-52.7) |
Cheap | 20.2% (14.9-24.6) | 10.3% (7.9-13.1) | 22.2% (19.2-25.1) | 19.1% (1.5-42.1) |
Familiarity | 10.8% (6.9-14.7) | 3.2% (1.4-5.7) | 2.3% (1.4-3.5) | 5.1% (0.0-16.2) |
Insurance works there | 1.6% (0.3-3.2) | 1.7% (0.6-2.9) | --- | --- |
Translator present | 1.9% (0.6-3.2) | --- | --- | --- |
Other | 11.3% (4.6-19.2) | 6.6% (4.0-8.9) | 3.6% (2.4-5.2) | --- |
Why did you not seek treatment?
| ||||
Too far | 4.8% (2.7-7.1) | 1.6% (0.4-3.0) | 0.3% (0.0-0.6) | 3.9% (0.0-10.1) |
Expensive | 10.9% (5.1-19.3) | 3.5% (1.9-5.2) | 0.6% (0.1-1.2) | --- |
Worried about deportation | 5.9% (3.7-7.6) | 0.9% (0.3-1.5) | 0.3% (0.0-0.7) | --- |
Had to work | 2.3% (0.7-4.8) | 2.5% (1.0-4.2) | 1.8% (0.9-2.8) | --- |
Didn't know where | 3.0% (1.2-5.3) | 9.2% (6.3-11.5) | --- | --- |
Preferred self-treatment | 25.1% (17.7-28.1) | 27.9% (24.0-32.3) | 6.1% (4.5-7.7) | 3.9% (0.0-10.4) |
It was a minor illness | 19.4% (14.1-24.4) | 13.3% (9.8-16.6) | 31.7% (28.5-35.2) | 35.4% (15.7-67.8) |
Too far | 4.8% (2.7-7.1) | 1.6% (0.4-3.0) | 0.3% (0.0-0.6) | 3.9% (0.0-10.1) |
Received health messages in past 3 month
| 42.8% (36.0-51.3) | 13.3% (9.6-16.5) | 77.4% (73.7-80.5) | 24.4% (6.6-49.6) |
Primary channels
| ||||
Family/friends | 3.9% (1.9-6.3) | 0.5% (0.0-1.2) | 6.8% (5.4-8.3) | --- |
Health care worker | 16.8% (11.3-25.1) | 8.0% (5.5-12.8) | 50.1% (46.0-54.1) | 8.8% (0.0-21.5) |
Billboard | 2.3% (0.8-4.2) | 0.3% (0.0-0.7) | 21.2% (17.9-24.9) | 20.0% (0.0-43.9) |
Radio | 8.4% (5.3-11.3) | 3.2% (1.7-4.7) | 1.1% (0.4-1.9) | --- |
TV | 28.0% (21.3-32.8) | 6.4% (4.0-8.6) | 30.7% (26.9-36.7) | 10.6% (0.0-26.6) |
Brochures | --- | --- | 10.3% (8.5-14.6) | 5.0% (0.0-15.3) |
Other | 5.4% (2.5-8.3) | 4.05 (1.8-6.2) | 0.8% (0.2-1.5) | |
Primary locations
| ||||
Home | 30.5% (23.2-35.5) | 8.1% (5.5-11.0) | 70.2% (66.4-74.2) | 17.7% (5.5-37.9) |
Market | 3.1% (1.7-4.3) | 0.1% (0.0-0.3) | --- | --- |
Work place | 5.3% (2.8-7.8) | 2.4% (0.8-4.0) | 2.1% (1.1-3.3) | |
Clinic | 7.5% (2.7-15.3) | 1.2% (0.5-2.0) | 14.1% (10.9-17.3) | 6.2% (0.0-20.5) |
Border crossing | 1.0% (0.0-2.5) | 0.3% (0.0-1.1) | --- | --- |
Knowledge, perception, and practice regarding malaria
Variables | Cambodian | Myanmar | ||
---|---|---|---|---|
M1 * (n = 350) (%) | M2** (n = 475) (%) | M1 * (n = 871) (%) | M2 ** (n = 19) (%) | |
Heard of malaria
| 75.0% (69.4-81.7) | 54.7% (49.8-59.3) | 80.0% (76.6-83.3) | 48.4% (21.9-75.7) |
Self or family member has had malaria
| 35.3% (29.9-42.6) | 30.4% (25.3-33.6) | 29.9% (26.3-34.8) | 11.4% (0.0-37.5) |
Treated for malaria in the past 3 months
| 3.2% (1.1-5.6) | 7.4% (4.7-9.9) | 0.6% (0.2-1.1) | 5.3% (0.0-23.1) |
Owns one or more bed nets
| 97.8% (95.8-99.7) | 98.4% (96.7-99) | 92.0% (89.8-93.8) | 84.4% (62.2-100) |
Slept under a bed net the previous night
| 94.6% (91.1-98.2) | 97.2% (95.0-99.5) | 90.4% (87.9-92.8) | 86.6% (68.4-100) |
How malaria is transmitted
| ||||
Mosquitoes | 76.0% (70.4-82.2) | 63.4% (58.6-68.2) | 83.9% (81.0-87.0) | 52.2% (26.3-82.6) |
Water | 4.8% (2.3-7.3) | 2.0% (0.8-3.3) | --- | --- |
Work in forests | 8.5% (5.6-12.0) | 3.9% (2.4-5.3) | 0.3% (0.0-0.8) | --- |
Don't know | 19.6% (13.9-25.0) | 33.2% (28.6-37.8) | 15.2% (12.0-18.2) | 37.0% (9.2-64.7) |
Malaria symptoms
| ||||
Fever | 64.4% (57.8-71.3) | 40.9% (35.8-46.0) | 56.7% (52.9-60.8) | 28.4% (8.0-55.3) |
Sweats | 11.8% (9.1-16.7) | 17.6% (14.2-21.1) | 22.3% (18.0-24.3) | 1.6% (0.0-3.9) |
Body aches | 12.1% (9.0-16.1) | 7.1% (5.3-9.7) | 29.7% (26.5-33.3) | 20.1% (3.6-46.5) |
Headache | 72.2% (66.6-78.2) | 50.3% (45.5-55.2) | 75.9% (72.5-79.3) | 37.9% (15.2-65.6) |
Anorexia | 3.6% (1.9-5.5) | 3.8% (2.2-5.8) | 11.4% (7.5-12.7) | 1.7% (0.0-4.8) |
Diarrhoea | 2.5% (1.0-4.9) | 0.5% (0.1-1.0) | 0.1% (0.0-0.3) | --- |
Convulsions | 1.3% (0.5-2.3) | --- | 0.2% (0.0-0.5) | --- |
Dizziness | 10.8% (7.5-14.1) | 4.05 (2.3-6.0) | 16.6% (13.8-19.7) | 11.9% (0.0-32.1) |
Chills | 68.2% (62.7-74.7) | 57.9% (53.1-62.6) | 57.7% (54.1-61.4) | 25.6% (5.9-50.9) |
Other | 10.7% (6.7-15.2) | 12.8% (9.9-16.6) | 13.7% (10.6-17.0) | 35.4% (0.0-62.0) |
Don't know | 11.1% (6.1-15.0) | 31.0% (26.2-35.9) | 6.6% (5.1-8.4) | 11.8% (2.5-28.3) |
Malaria prevention
| ||||
Mosquito net | 85.6% (80.7-90.6) | 65.5% (60.5-70.7) | 87.2% (84.6-89.9) | 56.2% (30.0-89.1) |
Prophylactic medicine | 2.6% (0.8-5.5) | 4.3% (2.6-5.6) | 0.2% (0.1-0.4) | --- |
Spray repellant | 29.9% (24.8-37.6) | 14.6% (12.1-18.4) | 76.2% (72.6-79.4) | 46.7% (24.0-83.4) |
Mosquito coils | 23.4% (17.7-29.4) | 5.8% (3.8-8.4) | 41.1% (37.6-45.3) | 1.5% (0.0-4.1) |
Keep house clean | 3.2% (1.7-5.0) | 7.5% (5.1-11.0) | --- | --- |
Cover water tanks | 3.1% (1.6-4.6%) | 1.5% (0.7-2.6) | 0.1% (0.0-0.3) | --- |
Close windows/door | 1.9% (0.4-3.0) | 3.8% (1.7-5.7) | --- | --- |
Other | 6.1% (3.0-8.8) | 3.4% (1.9-5.2) | 7.6% (5.6-10.0) | 19.1% (0.0-36.5) |
Don't know | 13.7% (8.7-18.6) | 32.0% (27.6-36.5) | 9.4% (7.0-11.9) | 30.0% (0.7-58.6) |
Malaria treatment
| ||||
Medicine from health worker | 63.3% (55.5-70.7) | 40.9% (36.2-45.3) | 53.3% (46.6-60.3) | 22.1% (5.6-53.2) |
Herbal medicine | 4.5% (2.4-7.1) | 3.5% (1.7-5.0) | 0.1% (0.0-0.2) | --- |
Prayer/meditation | --- | --- | --- | --- |
Other | 3.3% (1.2-5.7) | 5.7% (3.2-8.9) | 34.5% (28.6-43.0) | 32.7% (5.2-68.3) |
Don't know | 25.8% (18.0-33.5) | 50.1% (45.5-55.2) | 5.8% (3.9-7.9) | 33.6% (5.0-60.9) |