@article{fdi:010090030,
  title = {{F}ever and health-seeking behaviour among migrants living along the {T}hai-{M}yanmar border : a mixed-methods study},
  author = {{K}hirikoekkong, {N}. and {A}sarath, {S}. {A}. and {M}unruchaitrakun, {M}. and {B}lay, {N}. and {W}aithira, {N}. and {C}heah, {P}. {Y}. and {N}osten, {F}. and {L}ubell, {Y}. and {L}andier, {J}ordi and {A}lthaus, {T}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground{F}ever is a common reason to seek healthcare in {S}outheast {A}sia, and the decline of malaria has complexified how is perceived, and what actions are taken towards it. {W}e investigated the concept of fever and the determinants influencing health-seeking behaviours among migrants on the {T}hai-{M}yanmar border, where rapid economic development collides with precarious political and socio-economic conditions.{M}ethods{W}e implemented a mixed-methods study between {A}ugust to {D}ecember 2019. {P}hase {I} used a qualitative approach, with in-depth interviews and focus group discussions. {P}hase {II} used a quantitative approach with a close-ended questionnaire based on {P}hase {I} findings. {A} conditional inference tree ({CIT}) model first identified geographic and socio-demographic determinants, which were then tested using a logistic regression model.{R}esults{F}ever corresponded to a high diversity of conceptions, symptoms and believed causes. {S}elf-medication was the commonest behaviour at fever onset. {I}f fever persisted, migrants primarily sought care in humanitarian cost-free clinics (45.5%, 92/202), followed by private clinics (43.1%, 87/202), health posts (36.1%, 73/202), public hospitals (33.7%, 68/202) and primary care units (30, 14.9%). {T}he qualitative analysis identified distance and legal status as key barriers for accessing health care. {T}he quantitative analysis further investigated determinants influencing health-seeking behaviour: living near a town where a cost-free clinic operated was inversely associated with seeking care at health posts (adjusted odds ratio [a{OR}], 0.40, 95% confidence interval [95% {CI}] [0.19-0.86]), and public hospital attendance (a{OR} 0.31, 95% {CI} [0.14-0.67]). {L}iving further away from the nearest town was associated with health posts attendance (a{OR} 1.05, 95% {CI} [1.00-1.10] per 1 km). {H}aving legal status was inversely associated with cost-free clinics attendance (a{OR} 0.27, 95% {CI} [0.10-0.71]), and positively associated with private clinic and public hospital attendance (a{OR} 2.56, 95% {CI} [1.00-6.54] and 5.15, 95% {CI} [1.80-14.71], respectively).{C}onclusions{F}ever conception and believed causes are context-specific and should be investigated prior to any intervention. {D}istance to care and legal status were key determinants influencing health-seeking behaviour. {C}urrent economic upheavals are accelerating the unregulated flow of undocumented migrants from {M}yanmar to {T}hailand, warranting further inclusiveness and investments in the public health system.},
  keywords = {{H}ealth-seeking behaviour ; {F}ever conception ; {F}ebrile illness ; {M}igrants ; {T}hai-{M}yanmar border ; {H}umanitarian-based ; {NGO} clinics ; {H}ealthcare service ; {P}ublic health system ; {M}igration health ; {THAILANDE} ; {MYANMAR}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {23},
  numero = {1},
  pages = {501 [15 p.]},
  year = {2023},
  DOI = {10.1186/s12879-023-08482-8},
  URL = {https://www.documentation.ird.fr/hor/fdi:010090030},
}