Background: The population structure of the causative agents of human malaria, Plasmodium sp., including the most serious agent Plasmodium falciparum, depends on the local epidemiological and demographic situations, such as the incidence of infected people, the vector transmission intensity and migration of inhabitants (i.e. exchange between sites). Analysing the structure of P. falciparum populations at a large scale, such as continents, or with markers that are subject to non-neutral selection, can lead to a masking and misunderstanding of the effective process of transmission. Thus, knowledge of the genetic structure and organization of P. falciparum populations in a particular area with neutral genetic markers is needed to understand which epidemiological factors should be targeted for disease control. Limited reports are available on the population genetic diversity and structure of P. falciparum in Thailand, and this is of particular concern at the Thai-Myanmar and Thai-Cambodian borders, where there is a reported high resistance to anti-malarial drugs, for example mefloquine, with little understanding of its potential gene flow. Methods: The diversity and genetic differentiation of P. falciparum populations were analysed using 12 polymorphic apparently neutral microsatellite loci distributed on eight of the 14 different chromosomes. Samples were collected from seven provinces in the western, eastern and southern parts of Thailand. Results: A strong difference in the nuclear genetic structure was observed between most of the assayed populations. The genetic diversity was comparable to the intermediate level observed in low P. falciparum transmission areas (average H _S = 0.65 ± 0.17), where the lowest is observed in South America and the highest in Africa. However, uniquely the Yala province, had only a single multilocus genotype present in all samples, leading to a strong geographic differentiation when compared to the other Thai populations during this study. Comparison of the genetic structure of P. falciparum populations in Thailand with those in the French Guyana, Congo and Cameroon revealed a significant genetic differentiation between all of them, except the two African countries, whilst the genetic variability of P. falciparum amongst countries showed overlapping distributions. Conclusion: Plasmodium falciparum shows genetically structured populations across local areas of Thailand. Although Thailand is considered to be a low transmission area, a relatively high level of genetic diversity and no linkage disequilibrium was found in five of the studied areas, the exception being the Yala province (Southern peninsular Thailand), where a clonal population structure was revealed and in Kanchanaburi province (Western Thailand). This finding is particularly relevant in the context of malaria control, because it could help in understanding the special dynamics of parasite populations in areas with different histories of, and exposure to, drug regimens.

Background: Interventions to raise community awareness about malaria prevention and treatment have used various approaches with little evidence on their efficacy. This study aimed to determine the effectiveness of loudspeaker announcements regarding malaria care and prevention practices among people living in the malaria endemic villages of Banmauk Township, Sagaing Region, Myanmar.Methods: Four villages among the most malaria-burdened areas were randomly selected: two villages were assigned as the intervention group, and two as the control. Prior to the peak transmission season of malaria in June 2018, a baseline questionnaire was administered to 270 participants from randomly selected households in the control and intervention villages. The loudspeaker announcements broadcasted health messages on malaria care and prevention practices regularly at 7:00 pm every other day. The same questionnaire was administered at 6-month post intervention to both groups. Descriptive statistics, Chi-square, and the t-test were utilized to assess differences between and within groups.Results: Participants across the control and intervention groups showed similar socio-economic characteristics; the baseline knowledge, attitude and practice mean scores were not significantly different between the groups. Six months after the intervention, improvements in scores were observed atp-value < 0.001 in both groups, however; the increase was greater among the intervention group. The declining trend of malaria was also noticed during the study period. In addition, more than 75% of people expressed positive opinions of the intervention.Conclusions: The loudspeaker intervention was found to be feasible and effective, as shown by the significant improvement in scores related to prevention and care-seeking practices for malaria as well as reduced malaria morbidity. Expanding the intervention to a larger population in this endemic region and evaluating its long-term effectiveness are essential in addition to replicating this in other low-resource malaria endemic regions.

Purpose: Malaria still remains a significant public health problem in Myanmar and it has a complex epidemiology. Evidence-based community awareness raising interventions are also particularly needed. This cross-sectional study was organized to explore the basic characteristics associated with knowledge, attitude and practice (KAP) regarding malaria among people living in the most malaria-endemic villages of the Banmauk Township, Sagaing Region, Myanmar. The paper aims to discuss these issues.Design/methodology/approach: The Banmauk, one of the most malaria-endemic townships, was selected purposively in order to represent the survey results for people living in malaria hotspots. During the peak malaria season (July 2018), 250 household leaders were invited to be interviewed with structured questionnaires. In addition to descriptive data, the associations were determined byχ²-test and correlation.Findings: Overall KAP indicated considerably low percentages of good levels, especially in practice, only 21.6 percent showed good practice, 38.4 percent had good knowledge and 56.8 percent had good attitude. Age (p=0.022) and annual family income (p<0.001) were significantly associated with the knowledge level, whereas having fever attacks among family members in the last two weeks (p=0.023) showed statistical association with attitude at ap-value <0.05. Surprisingly, there were no associated variables with malaria practice. In addition, there were negative correlations between knowledge with attitude and knowledge with practice; however, the results were not significant.Originality/value: The overall KAP regarding malaria was at relatively poor levels among people living in malaria transmission areas. Therefore, new approaches to improve malaria KAP are promptly needed in this community.

Purpose: Gombe state in northeast Nigeria records a high prevalence of home deliveries with very low facility deliveries despite the efforts of government and international non-governmental organizations in supporting maternal health services. The purpose of this paper is to assess the factors influencing the decision to choose a birth center by pregnant women in Gombe, Nigeria. Design/methodology/approach: The design was a cross-sectional study of women from a baseline survey conducted in August 2016 in Gombe state, Nigeria. Data on women groups’ utilization of maternal services with a focus on antenatal care, delivery and postnatal care were collected using a structured questionnaire used for household survey conducted in the state. Data for 157 pregnant women from the sample of 750 women (15–49 years) were selected for the purpose of this analysis. Descriptive statistics, bivariate and multivariate analyses were used to determine the factors associated with choice of birth center. Findings: Religion (AOR=12.117, 95% CI 1.774–82.741), paid work (AOR=3.633, 95% CI 1.243–10.615) and identification and knowledge of pregnancy complications (AOR=4.281, 95% CI 1.054–17.387) were the factors found to be significantly associated with choice of birth center by pregnant women. Age, education, closeness to a facility and decision by husband or woman were not found to be statistically significant. Originality/value: The significance of disseminating knowledge about pregnancy complications, role of religious leaders and encouraging savings from women earnings need attention of the government to improve facility-based delivery.

Purpose: The aim of this study was to determine whether there is an associated effect between sociodemographic characteristics and sexual risk behaviors with health literacy in preventing unintended pregnancy among university students in Chon Buri province, Thailand. Participants and methods: A cross-sectional study design was used. The data were collected between February and May, 2017. A self-administered questionnaire was developed by the Ministry of Public Health and supported by the evolving concept of health literacy of Nutbeam. This questionnaire was then applied to collect data from 418 university students. Descriptive statistical and binary logistic regression methods were used for data analysis in this study. Results: Half the students exhibited inappropriate behaviors to prevent unintended pregnancies. However, half the respondents had been educated to prevent unintended pregnancies. Nearly one-third of the students had experienced sexual intercourse. Binary logistic regression was used to analyze an association between the behavior for unintended-pregnancy prevention with sociodemographic characteristics and the health literacy of university students. The factors assessed were current residence type (the adjusted odds ratio [aOR]=1.897, 95% CI=1.123–3.205), previous sexual intercourse (aOR=3.263, 95% CI=1.735–6.139), cognitive health to prevent unintended pregnancy (aOR=1.095, 95% CI=1.019–1.176), decision skills in choosing appropriate practices to prevent unintended pregnancy (aOR=1.289, 95% CI=1.182–1.405), and self-management to prevent unintended pregnancy (aOR=1.113, 95% CI=1.005–1.232). Conclusion: This study indicated that university students who had experienced sexual intercourse and had low health literacy were more likely to exhibit inappropriate behaviors concerning the lack of prevention of unintended pregnancies. The results will provide health professionals with information to develop more effective prevention and intervention programs.

Cyber sexual harassment has been increasing and has become a major public health problem among youths. Therefore, this study primarily aimed to evaluate the effects of a blended learning program on knowledge, attitudes, intention to cope with cyber sexual harassment, behavioral coping strategies, and cyber sexual harassment among female high-school students in Bangkok, Thailand. A quasi-experimental study with a two-group design was conducted from May 2021 to October 2021. A total of 112 students were recruited into either an intervention (n = 56) or a control (n = 56) group. The intervention group participated in a blended learning program for 12 weeks. A self-administered questionnaire was completed by both groups at pre-intervention, post-intervention, and follow-up. Chi-square test, Fisher’s exact test, and repeated measures analysis of variance (ANOVA) were used for data analysis. The mean score of the intervention group in knowledge, attitude, intention to cope with cyber sexual harassment, behavioral coping strategies, and cyber sexual harassment after completing the program and follow-up were significantly different from baseline and the control group (p < 0.05). A positive effect of the blended learning program was observed among female students. Therefore, this program can be useful for victims, supporting their self-confidence with decreased frequency of cyber sexual harassment experiences.