Socioeconomic and behavioural determinants of malaria among the migrants in gold mining,rubber and oil palm plantation areas in Myanmar

Background:Malaria is a major public health problem in Myanmar.Migrant populations are at high risk of contracting malaria and its control is more difficult than for settled population.Studies on malaria and migration are rare in Myanmar.This study was undertaken with the main objective of identifying socioeconomic and behavioural determinants of malaria among the migrant workers involved in gold mining,rubber and oil palm plantations.Methods:A cross-sectional analytic study was conducted using pretested interview-administered questionnaires among internal migrants(n=406)in the malaria endemic townships of Shwegyin,Bago Region,Thanbyuzayat,Mon State and Kawthaung,Taninthayi Region from August to November,2015.Data were collected by well-trained Basic Health Staff members in study areas,and then analysed by SPSS version 16.0 using Chi-square tests with significant level at 0.05.Results:Majority of participants were male,Bahmar nationals,married and with primary basic education level and below.The mean duration of migratory work was 4.51 years.43.1%of them gave definite previous history of malaria within last two years during migration.92.9%(377/406)of them always used bed nets.Malaria determinants found were male gender(OR=1.84,95%CI:1.22-2.77;P=0.0040),habit of going out at dawn(OR=2.36,95%CI:1.58-3.52;P<0.001),usual sleeping indoors(OR=2.14,95%CI:1.04-4.42;P=0.036),torn bed net or net with large hole(s)(OR=2.0,95%CI:1.21-3.3;P=0.006),habit of not always sleeping under a bed net at night(OR=2.02,95%CI:1.15-3.52;P=0.014),alcohol drinking(OR=2.71,95%CI:1.73-4.26;P<0.001)and failure to attend malaria health talk(OR=1.78,95%CI:1.2-2.65;P=0.004).Conclusions:The present study highlighted that it is warranted to launch an effective health education programme for malaria,and to encourage the proper use of insecticide-treated bed nets,blankets and/or mufflers and mosquito repellents to reduce the occurrence of malaria among the migrants.

Mapping and modelling the impact of mass drug adminstration on filariasis prevalence in Myanmar

Background:Lymphatic filariasis(LF)is endemic in Myanmar and targeted for elimination.To highlight the National Programme to Eliminate Lymphatic Filariasis(NPELF)progress between 2000 and 2014,this paper describes the geographical distribution of LF,the scale-up and impact of mass drug administration(MDA)implementation,and the first evidence of the decline in transmission in five districts.Methods:The LF distribution was determined by mapping historical and baseline prevalence data collected by NPELF.Data on the MDA implementation,reported coverage rates and sentinel site surveillance were summarized.A statistical model was developed from the available prevalence data to predict prevalence at township level by year of measurement.Transmission assessment survey(TAS)methods,measuring antigenemia(Ag)prevalence in children,were used to determine whether prevalence was below a level where recrudescence is unlikely to occur.Results:The highest baseline LF prevalence was found in the Central Valley region.The MDA implementation activities scaled up to cover 45 districts,representing the majority of the endemic population,with drug coverage rates ranging from 60.0%to 98.5%.Challenges related to drug supply and local conflict were reported,and interrupted MDA in some districts.Overall,significant reductions in LF prevalence were found,especially after the first 2 to 3 rounds of MDA,which was supported by the corresponding model.The TAS activities in five districts found only two Ag positive children,resulting in all districts passing the critical threshold.Conclusion:Overall,the Myanmar NPELF has made positive steps forward in the elimination of LF despite several challenges,however,it needs to maintain momentum,drawing on international stakeholder support,to aim towards the national and global goals of elimination.