{ "abstract": "Background\n\nTimely treatment of malaria is critical to preventing severe disease and onward transmission. However, treatment-seeking behavior varies across populations and geographic settings. This study examined treatment-seeking time and its determinants among patients with confirmed malaria in Thailand using national surveillance data.Methods\n\nA retrospective analysis was conducted using surveillance data from laboratory-confirmed malaria cases recorded in Thailand's Electronic Malaria Information System (eMIS) from January 2012 to December 2024. The outcome was treatment-seeking time, defined as the number of days between the self-reported date of symptom onset and the date of confirmed malaria diagnosis recorded in the surveillance system. Descriptive statistics summarized treatment-seeking delays, while geographic variation was visualized using choropleth maps. Factors associated with treatment-seeking time were examined using negative binomial regression, with incidence rate ratios (IRRs) and 95% confidence intervals (CIs) reported.Results\n\nA total of 127,242 confirmed malaria cases were analyzed. The majority were male (68.6%) and aged 15 years or older (73.5%), with Plasmodium vivax accounting for 75.0% of infections. The median treatment-seeking time was 2 days (interquartile range [IQR]: 1-3 days). Delays were longer among adults aged 15-34 years (IRR: 1.03; 95% CI 1.01-1.05) and ≥ 35 years (IRR: 1.03; 95% CI 1.01-1.05) compared with children under five years. Longer delays were also observed among long-term migrants (IRR: 1.04; 95% CI 1.03-1.06), short-term migrants (IRR: 1.06; 95% CI 1.04-1.08), and infections due to P. falciparum (IRR: 1.07; 95% CI 1.05-1.08), P. knowlesi (IRR: 1.19; 95% CI 1.12-1.26), and other species (IRR: 1.22; 95% CI 1.16-1.27), relative to P. vivax. Treatment-seeking time was longer in provinces classified as elimination-phase \"clear-up\" zones (IRR: 1.17-1.20) than in active transmission areas, whereas imported cases had shorter treatment-seeking times than indigenous cases (IRR: 0.96-0.98), likely reflecting differences in surveillance and case detection pathways. Western border provinces with historically high malaria burden showed relatively shorter treatment-seeking times.Conclusions\n\nMost individuals with confirmed malaria in Thailand were diagnosed within a relatively short period following symptom onset, although delays persisted among migrants, individuals with non-P. vivax infections, and residents of elimination-phase settings. Targeted interventions to improve access to care and awareness among mobile populations and low-transmission areas could further reduce treatment-seeking delays and support Thailand's malaria elimination goals.", "abstract_shown": true, "affiliations": [ "Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.", "Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.", "Division of Infectious Diseases and International Medicine, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, 3720 Spectrum Boulevard, Suite 304, Tampa, FL, USA.", "Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.", "Department of Global Health and Biobehavioral Sciences; Department of Epidemiology & Biostatistics; Department of Health, Society, & Behavior, University of California, Irvine, CA, USA.", "Center of Excellence for Biomedical and Public Health Informatics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.", "Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. jetsumon.pra@mahidol.ac.th." ], "article_type": "research article", "arxiv": null, "author_total": 11, "authors": [ { "affs": [ 0 ], "name": "Isara Srisaard" }, { "affs": [ 1 ], "name": "Pyae Linn Aung" }, { "affs": [ 1 ], "name": "Khaing Zin Zin Htwe" }, { "affs": [ 0 ], "name": "Prayuth Sudathip" }, { "affs": [ 0 ], "name": "Suravadee Kitchakarn" }, { "affs": [ 2 ], "name": "Liwang Cui" }, { "affs": [ 3 ], "name": "Saranath Lawpoolsri" }, { "affs": [ 4 ], "name": "Daniel M Parker" }, { "affs": [ 5 ], "name": "Amnat Khamsiriwatchara" }, { "affs": [ 3 ], "name": "Jaranit Kaewkungwal" }, { "affs": [ 6 ], "name": "Jetsumon Sattabongkot" } ], "bibtex": "https://research.draconitic.com/paper/6m085pwkb2xxn.bib", "cited_by": 0, "doi": "10.1186/s12936-026-06105-6", "fulltext_url": "https://europepmc.org/articles/PMC13753233", "id": "6m085pwkb2xxn", "issns": [ "1475-2875" ], "landing_url": "https://europepmc.org/article/MED/43009957", "language": "eng", "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Research" ], [ "openalex", "2739|Malaria Research and Control" ] ], "openalex": "W7203476813", "pdf_url": "https://europepmc.org/articles/PMC13753233?pdf=render", "pmcid": "PMC13753233", "pmid": "43009957", "published": "2026-08-14", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/6m085pwkb2xxn.ris", "sources": [ { "first_seen": "2026-11-12T15:22:43Z", "native_id": "MED:43009957", "source": "europepmc", "url": "https://europepmc.org/article/MED/43009957" }, { "first_seen": "2026-11-15T12:22:25Z", "native_id": "PMC13753233", "source": "pmc", "url": "https://doi.org/10.1186/s12936-026-06105-6" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2739|Malaria Research and Control", "subfield": "epidemiology-public-health" } ], "title": "Treatment-seeking time and its determinants among patients with confirmed malaria in Thailand: a national surveillance analysis, 2012-2024.", "title_text": "Treatment-seeking time and its determinants among patients with confirmed malaria in Thailand: a national surveillance analysis, 2012-2024.", "type": "peer-reviewed", "updated_at": "2026-11-15T12:22:25Z", "url": "https://research.draconitic.com/paper/6m085pwkb2xxn", "venue": "Malaria journal", "versions": [] }