Abstract
BackgroundAlthough mobile and migrant populations are considered an important group in malaria elimination settings, there is currently a lack of understanding about foreign migrant workers in the Lao People’s Democratic Republic (Lao PDR). The present study aimed to document the migration characteristics, positive rate of malaria infection, and preventive and treatment-seeking behavior for malaria among foreign migrant workers in the malaria-endemic districts of Savannakhet province, Lao PDR.MethodsA community-based survey was undertaken in four districts of Savannakhet province between February and June, 2015. Questionnaire-based interviews and blood examinations, including rapid diagnostic tests and PCR assays, were conducted with 391 migrant workers who were registered at local police departments.ResultsMost of the study participants were men (75.7%) and Vietnamese (92.6%). The median age (interquartile range) was 31 (25 to 41) years old. Most common occupation was factory worker (47.6%), followed by trader/shopkeeper (21.5%) and plantation worker/farmer (16.4%). The median length of stay (interquartile range) in the districts was 405 (183 to 1207) days. The majority of the participants (85.9%) had not worked in a province other than the study province, nor had the majority (92.6%) worked in a foreign country other than the Lao PDR. Although most of the participants (62.7%) reportedly used a bed net daily, these nets were mostly conventional untreated ones. No one tested positive for malaria. However, 10.0% of the participants reported a malaria-like illness episode that had occurred in the Lao PDR. The most common measure taken for the episode was to visit a hospital/health center in the Lao PDR, followed by conducting self-medication alone. Forty-one participants reported an experience of working in the forest while living in the Lao PDR.ConclusionsForeign migrant workers who are registered at local police departments are unlikely to play a major role in maintaining local transmissions and spreading drug-resistant malaria in the study province. However, some of them were involved in forest-related activities, suggesting that these workers are potentially at risk of malaria. The Lao National Malaria Control Program should educate foreign migrant workers about the risk of malaria when living in Lao PDR.
Highlights
Mobile and migrant populations are considered an important group in malaria elimination settings, there is currently a lack of understanding about foreign migrant workers in the Lao People’s Democratic Republic (Lao PDR)
The most common measure taken for the episode was to visit a hospital/health center in the Lao PDR (n = 23, 59.0%), followed by conducting self-medication alone (n = 6, 15.4%) and taking a rest alone
In the present study involving 391 foreign migrant workers from Thapangthong, Xepon, Nong, and Phin districts in 2015, no participants tested positive for malaria, even though a number of studies that were conducted with the general Laotian population in these districts between 2013 and 2015 reported substantial positive rates of Plasmodium infections
Summary
Mobile and migrant populations are considered an important group in malaria elimination settings, there is currently a lack of understanding about foreign migrant workers in the Lao People’s Democratic Republic (Lao PDR). The burdens of malaria have decreased in the Lao People’s Democratic Republic (Lao PDR) in recent years: estimated malaria cases dropped from 51,000 in 2010 to 27,390 in 2016 [1]. In 2015, the countries in the Greater Mekong Sub-region (GMS) such as Cambodia, China ( Yunnan Province and Guangxi Zhuang Autonomous Region), Lao PDR, Myanmar, Thailand, and Vietnam adopted the malaria elimination strategy that was proposed by the World Health Organization because Plasmodium falciparum resistance to antimalarial medicines had reached alarming levels in certain areas of the GMS, and the only solution is to eliminate P. falciparum from the GMS. Hydropower dam projects in Attapeau province involved an estimated 4000 to 5000 workers at the peak of the construction phase in 2012, the majority of whom were Vietnamese and Chinese [5]
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