Contributions
Abstract: PB2396
Type: Publication Only
Background
Thalassemia is an inherited disorder characterized by reduced α and/or β globin chains, leading to severe anemia, ineffective erythropoiesis, and other complications. Although originally prevalent in the malaria belt region, thalassemia has become a global problem due to population migration, including in Europe and North America. Thailand has one of the highest burdens of thalassemia in the world, and in response, has developed a national thalassemia prevention and control program. Using public education, genetic counseling, and prenatal screening and diagnosis, the program has achieved moderate success in lowering the incidence of new severe thalassemia cases. However, it excludes nearly 4 million largely low-skilled migrant workers from neighboring Myanmar, Cambodia, and Laos, where thalassemia is also prevalent. Thus, increasing migration may worsen the burden of severe thalassemia in Thailand, as well as in other regions of the world. It is of global interest, therefore, to identify strategies for thalassemia prevention and control in migrants. Nevertheless, few studies have explored barriers to thalassemia screening among Southeast Asian migrants. Both quantitative and qualitative methods are needed to investigate how migrants’ knowledge, attitudes, beliefs, and behaviors may affect the success of interventions targeted to this population. We have designed and are currently conducting a mixed-methods study of barriers to thalassemia screening in Myanmar and Cambodian migrant workers in the industrial region of Laem Chabang, Chonburi, Thailand.
Aims
To compare levels of awareness and knowledge of thalassemia in migrants and Thai citizens; to characterize migrant attitudes and beliefs surrounding thalassemia screening; and to determine the feasibility of large-scale thalassemia screening in migrant communities in Thailand.
Methods
Written informed consent is being obtained from 200 Myanmar or Cambodian migrants and 200 Thai citizens (age 18-49 years) residing in Chonburi. Subjects are sampled for demographic and KAP (knowledge, attitudes, and practices) surveys on thalassemia. Myanmar or Cambodian subjects fluent in Thai, Burmese, or Khmer, presenting for routine health registration, and Thai subjects presenting for outpatient visits are included. Pregnant women and their partners are excluded. Descriptive statistics, tabulations and Chi-Square analysis will be used to compare socio-demographic variables and levels of thalassemia awareness between migrant and Thai subjects. Thai-speaking migrants will also be sampled purposively for in-depth interviews (IDI) and focus group discussions (FGD) to explore beliefs underlying migrant attitudes, as well as sensitive topics such as prenatal screening, termination of pregnancy, stigma, and access to healthcare. FGD will be stratified by gender and country of origin. Qualitative data will be coded and inductive thematic analysis used to identify relevant recurrent themes. Finally, as a feasibility study, migrants will be offered comprehensive thalassemia testing (Figure 1), providing preliminary estimates of thalassemia prevalence and screening uptake among migrants.
Results
This mixed-methods study will evaluate knowledge of thalassemia and identify key barriers to implementing thalassemia screening in migrant populations.
Conclusion
Novel insights gained may inform future thalassemia education and screening efforts for migrants in Thailand and have broader implications for the screening and care of migrants with thalassemia. This is an emerging issue that requires a global solution.
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Migration, Screening, Thalassemia
Abstract: PB2396
Type: Publication Only
Background
Thalassemia is an inherited disorder characterized by reduced α and/or β globin chains, leading to severe anemia, ineffective erythropoiesis, and other complications. Although originally prevalent in the malaria belt region, thalassemia has become a global problem due to population migration, including in Europe and North America. Thailand has one of the highest burdens of thalassemia in the world, and in response, has developed a national thalassemia prevention and control program. Using public education, genetic counseling, and prenatal screening and diagnosis, the program has achieved moderate success in lowering the incidence of new severe thalassemia cases. However, it excludes nearly 4 million largely low-skilled migrant workers from neighboring Myanmar, Cambodia, and Laos, where thalassemia is also prevalent. Thus, increasing migration may worsen the burden of severe thalassemia in Thailand, as well as in other regions of the world. It is of global interest, therefore, to identify strategies for thalassemia prevention and control in migrants. Nevertheless, few studies have explored barriers to thalassemia screening among Southeast Asian migrants. Both quantitative and qualitative methods are needed to investigate how migrants’ knowledge, attitudes, beliefs, and behaviors may affect the success of interventions targeted to this population. We have designed and are currently conducting a mixed-methods study of barriers to thalassemia screening in Myanmar and Cambodian migrant workers in the industrial region of Laem Chabang, Chonburi, Thailand.
Aims
To compare levels of awareness and knowledge of thalassemia in migrants and Thai citizens; to characterize migrant attitudes and beliefs surrounding thalassemia screening; and to determine the feasibility of large-scale thalassemia screening in migrant communities in Thailand.
Methods
Written informed consent is being obtained from 200 Myanmar or Cambodian migrants and 200 Thai citizens (age 18-49 years) residing in Chonburi. Subjects are sampled for demographic and KAP (knowledge, attitudes, and practices) surveys on thalassemia. Myanmar or Cambodian subjects fluent in Thai, Burmese, or Khmer, presenting for routine health registration, and Thai subjects presenting for outpatient visits are included. Pregnant women and their partners are excluded. Descriptive statistics, tabulations and Chi-Square analysis will be used to compare socio-demographic variables and levels of thalassemia awareness between migrant and Thai subjects. Thai-speaking migrants will also be sampled purposively for in-depth interviews (IDI) and focus group discussions (FGD) to explore beliefs underlying migrant attitudes, as well as sensitive topics such as prenatal screening, termination of pregnancy, stigma, and access to healthcare. FGD will be stratified by gender and country of origin. Qualitative data will be coded and inductive thematic analysis used to identify relevant recurrent themes. Finally, as a feasibility study, migrants will be offered comprehensive thalassemia testing (Figure 1), providing preliminary estimates of thalassemia prevalence and screening uptake among migrants.
Results
This mixed-methods study will evaluate knowledge of thalassemia and identify key barriers to implementing thalassemia screening in migrant populations.
Conclusion
Novel insights gained may inform future thalassemia education and screening efforts for migrants in Thailand and have broader implications for the screening and care of migrants with thalassemia. This is an emerging issue that requires a global solution.
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Migration, Screening, Thalassemia