Treatment-seeking behaviours of malaria patients versus non-malaria febrile patients along China-Myanmar border

Abstract

Background Appropriate malaria treatment-seeking behavior (MTSB) is critical to timely detect malaria for prompt treatment and prevent onward transmission of the diseases in a community. The aim of this study was to compare treatment-seeking behaviours between malaria patients and non-malaria febrile patients, and analyse factors associated with appropriate MTSB along China-Myanmar border. Methods This case-control study matched one malaria case patient confirmed by microscopy to two controls (non-malaria febrile patients). Factors associated with appropriate MTSB was identified by a matched logistic regression analysis (LRA). Results Among 223 malaria case patients and 446 controls, 129 (57.8%) of the cases sought treatment first in health facilities without laboratory test compared to 163 (36.5%) of the controls (P<0.0001). A total of 85(38.1%) of the malaria case patients sought treatment in health facilities with laboratory test within 48 hours as compared with 278 (62.3%) of the controls (P<0.0001). Multivariate LRA identified that the malaria cases with Chinese nationality were less likely to seek treatment for malaria in health facilities with laboratory testwithin 48 hours compared to malaria cases with other nationalities (adjusted odds ratio [AOR]: 0.21, 95%CI: 0.07-0.68, P=0.0097), and malaria case patients residing in urban areas were more likely to seek treatment in health facilities with laboratory test within 48 hours compared to those living in rural areas (AOR: 2.16, 95%CI: 1.06-4.39, P=0.0337). Conclusions Malaria treatment-seeking behaviors were inappropriate. Chinese citizenship and rural residence are two independent factors associated with inappropriate MTSB. It is continuously necessary to improve appropriate MTSB through effective campaigns of information, education and communication.