Ethnicity was a significant factor associated with a high
rate of patient delay in seeking treatment. The delay
was significantly higher in people of hill tribe ethnicity
compared to other ethnic categories. The majority of hill
tribe people in this study were Karen (62.5%). Previous
studies have suggested that their diverse languages and
beliefs in supernatural causes during an illness, resulting
from current or past misdeeds of traditional healing, can
be barriers to understanding modern western ideas and
practices that might be related to a delay [24,25]. Interestingly,
the research presented here suggests that had only
1.5% of respondents had visited a traditional healer, whilst
the majority had initially attempted self-treatment. The
Table 1 Factors associated with delay in seeking treatment by bivariate analysis (n = 456) (Continued)
Visiting sub-district health promotion hospital/malaria post
No 380 295 (77.6) 1.00
Yes 76 67 (88.2) 2.15 (1.03-4.48) 0.042*
Accessibility of health services
Distance (km)
≤3 181 139 (76.8) 1.00
>3 275 223 (81.1) 1.30 (0.82-2.05) 0.268
Transport
Private transport 322 250 (76.1) 1.00
Bicycle/walking 58 47 (81.0) 1.23 (0.61-2.25) 0.565
Hired transport 76 65 (85.5) 1.70 (0.85-3.40) 0.131
Travel time (minutes)
≤30 384 300 (78.1) 1.00
>30 72 62 (86.1) 1.74 (0.85-3.53) 0.128
Cost of visit (Baht)
≤60 229 175 (76.4) 1.00
>60 227 187 (82.4) 1.44 (0.91-2.28) 0.117
Social support
High 243 178 (73.3) 1.00
Medium 114 96 (84.2) 1.95 (1.09-3.47) 0.024*
Low 99 88 (88.9) 2.92 (1.47-5.81) 0.002*
Receiving mass media messages about malaria
Yes 401 315 (78.6) 1.00 0.239
No 55 47 (85.5) 1.60 (0.73-3.52)
*The statistically significant identification at p-value < 0.05.
majority of participants reported having suffered previous
malaria illnesses, and this may have made them feel
confident in initially attempting to manage the illness
themselves.