Development of Surveillance of Disease Occurrence for Measles in Migrant Workers in Sung Noen Subdistrict, Sung Noen District, Nakhon Ratchasima Province

Abstract

This action research aimed to study the situation of epidemiological surveillance, disease reporting, disease prevention and control of measles outbreak, and development of measles surveillance in migrant workers in Sung Noen district, Nakhon Ratchasima province. The study was divided into 3 phases of data collections. Key informants in phase 1 were persons who were involved in measles surveillance including 24 hospital personnel, 6 persons from a factory, 10 migrant workers from Myanmar who came to the hospital and did not have measles, and information retrieved form medical records. Key informants in phase 2 were persons involved in measles surveillance including 30 hospital personnel and 15 persons working in the factory. Persons participated in phase 3 included 200 migrant workers from Myanmar who completed questionnaires that assessed knowledge on measles prevention. This phase also included satisfactions on services collected from 300 participants. The study was conducted during January-September 2019, using quantitative (surveys) and qualitative data collection methods (in-depth interviews, focus group discussions, and non-participant observations). Data were cross-checked using triangulation techniques. Quantitative data were analyzed using descriptive statistics while qualitative data were analyzed using content analysis.

The study found that, in phase 1, migrant workers from Myanmar were at risks of contracting measles because of unknown history of measles vaccines among migrant workers, living environments not meeting sanitary standards, crowded and poorly ventilated living environments, sharing personal items and lack of understanding in surveillance procedures and case report according to Measles Eradication Project under the international commitment. In phase 2, guidelines for measles surveillance in Myanmar migrant workers in Sung Noen subdistrict were developed, including surveillance approach from history taking, screening, searching for risk groups, and medical referral communications. Myanmar migrant worker volunteers for measles prevention were trained in prevention measures, sanitation of living environments, and vaccination. In phase 3, Myanmar migrant workers showed increases in knowledge scores (37.18%) and purchasing of health insurance package and receiving of measles vaccine (36.14%). Satisfactions with the health examination services were at 86.8 percent and overall coverage of measles vaccination passed the criteria of 95 percent.

It was recommended that history of the measles vaccination for Myanmar migrant workers must be screened. Measles vaccines should be included in health insurance package and Myanmar migrant worker volunteers should be trained to keep the continuous monitoring and surveillance of measles according the Sung Noen district contexts.