Migration and Malaria Infection in Myanmar-Thailand border area of Tanintharyi Region, Myanmar: A Case-Control Study

Abstract

Nowadays, malaria did not exist as a forest-dependent disease and mainly impacted by migration, mostly to border areas. Migrant workers are distributor of Plasmodium species and their patterns of migration affected on malaria transmission. The study aimed to identify migration pattern of border migrant people and the factors associated with malaria infection in Myanmar-Thailand border area especially in Tanintharyi region, Myanmar. An unmatched case-control was conducted among 320 migrant people living in Dawei, Thayetchaung and Palaw Townships, 160 cases and 160 controls. Cases and controls were confirmed by rapid diagnostic test and data collection was done by using structure questionnaires through face to face interview. Bivariate analysis and logistic regression was used to determine the association between migration pattern and also associated factors with malaria infection. More than half of respondents conducted interrural migration and the rests were intermunicipal migration (19.4%) and interregional migration (27.8%). Interregional migration (OR=1.82, 95%CI=1.11-2.99), seasonal migration (OR=2.99, 95%CI=1.44-6.24) and non-contract migration (OR= 2.60, 95%CI=1.30-5.21) were risk factors for malaria at 5% significance level. Moreover, poor protective behavior (AOR=8.85, 95%CI=2.82-27.80), difficult to access malaria health services (AOR=34.28, 95%CI=4.37-268.48) were risk factors for malaria infection in multiple logistic regression at 95% confidence interval. The findings of this study suggest that malaria risk was varied with migration status and was influenced by protective behavior and ability to access malaria health services. Therefore, local health authorities should target high risk migrant people and provide easy available of malaria health services in Myanmar-Thailand border area.