Rural and urban disparities in health-seeking for fever in Myanmar: Findings from a probability-based household survey

Background: The World Health Organization (WHO) recognizes Myanmar as having the highest burden of malaria in the Greater Mekong Sub-region (GMS). Early diagnosis and proper treatment are critical in containing malaria. The objective of this study was to assess determinants of seeking treatment for fever from trained providers across rural and urban areas in Eastern Myanmar. Methods: A cross-sectional survey was conducted during the high malaria seasons in the eastern part Myanmar between August and September 2014. Multi-staged cluster sampling was used to sample households. A series of questions related to treatment-seeking for fever were asked. Bivariate and multivariate logistic regressions were conducted to identify independent correlates of seeking treatment for fever from trained providers. Results: The analysis was restricted to 637 participants who reported either themselves or their family members having had fever 2 weeks prior to the interview. In the multivariate analysis, rural residents were less likely to have sought treatment from trained providers (AOR = 0.60, 95 % CI 0.42-0.88; p = 0.01) while residents who had fever patients between the ages of 5 and 14 years (AOR = 1.60, 95 % CI 0.90-2.53; p = 0.05); and those who knew that sleeping under bed nets can prevent malaria (AOR = 2.08, 95 % CI 1.00-4.30; p = 0.05); were borderline more likely to have sought treatment. Conclusion: This study suggests that rural populations need improved access to trained providers. Additionally, future programmes should focus on increasing knowledge around malaria prevention and treatment.