Understanding the epidemiology, clinical characteristics, knowledge and barriers to treatment and prevention of malaria among returning international laborers in northern Vietnam: a mixed-methods study

BMC Infectious Diseases

Ekaterina I. Milgotina¹  Rosalie J. Whedbee¹  Trung Vu Nguyen²  Kinh Van Nguyen²  Hoa Mai Tran²  Hoi Thi Le²  Nga Thi Nguyen²  Binh Thi Huong Nguyen³  Tho Huy Tran³  Thang Duc Ngo³  Duong Thanh Tran³  Nicholas J. Martin⁴  Kimberly A. Edgel⁴  Sara Canavati⁵  Long Khanh Tran⁵  Thu Minh Nguyen⁵ 

[1] Global Scientific Solutions for Health;National Hospital for Tropical Diseases;Parasitology and Entomology (NIMPE), National Institute of Malariology;U.S. Naval Medical Research Unit TWO;Vysnova Partners, Inc.;

关键词: Vietnam;    Plasmodium falciparum;    Plasmodium vivax;    Plasmodium ovale;    Plasmodium malariae;    Migration;   

DOI  :  10.1186/s12879-022-07322-5

来源: DOAJ

【 摘 要 】

Abstract Background With the decline in local malaria transmission in Vietnam as a result of the National Malaria Control Program (NMCP) elimination activities, a greater focus on the importation and potential reintroduction of transmission are essential to support malaria elimination objectives. Methods We conducted a multi-method assessment of the demographics, epidemiology, and clinical characteristics of imported malaria among international laborers returning from African or Southeast Asian countries to Vietnam. Firstly, we conducted a retrospective review of hospital records of patients from January 2014 to December 2016. Secondly, we conducted a mixed-methods prospective study for malaria patients admitted to the study sites from January 2017 to May 2018 using a structured survey with blood sample collection for PCR analysis and in-depth interviews. Data triangulation of the qualitative and quantitative data was used during analysis. Results International laborers were young (median age 33.0 years IQR 28.0–39.5 years), predominantly male (92%) adults returning mostly from the African continent (84%) who stayed abroad for prolonged periods (median time 13.5 months; IQR 6.0–331.5 months) and were involved in occupations that exposed them to a higher risk of malaria infection. Epidemiological trends were also similar amongst study strands and included the importation of Plasmodium falciparum primarily from African countries and P. vivax from Southeast Asian countries. Of 11 P. malariae and P. ovale infections across two study strands, 10 were imported from the African continent. Participants in the qualitative arm demonstrated limited knowledge about malaria prior to travelling abroad, but reported knowledge transformation through personal or co-worker’s experience while abroad. Interestingly, those who had a greater understanding of the severity of malaria presented to the hospital for treatment sooner than those who did not; median of 3 days (IQR 2.0–7.0 days) versus 5 days (IQR 4.0–9.5 days) respectively. Conclusion To address the challenges to malaria elimination raised by a growing Vietnamese international labor force, consideration should be given to appropriately targeted interventions and malaria prevention strategies that cover key stages of migration including pre-departure education and awareness, in-country prevention and prophylaxis, and malaria screening upon return.

【 授权许可】

Unknown