The Behavior of Jhum Cultivators Living in Chittagong Hill Tracts and Its Relation to Malaria in Bangladesh

Abstract

Aims: Malaria is caused by invasion of hepatocytes and subsequent red blood cell infection by protozoan parasites of the genus Plasmodium. It is one of the focal disease where children under five years are most vulnerable and susceptible to malaria. Concurrently, malaria is still occupational disease in Bangladesh especially among Jhum cultivators who depends mostly on the slash and burn activities during the rainy season mostly at hill districts. This study unveils the behavior of Jhum cultivators and its relation to malaria infection in Bangladesh.  Study Design and Methodology: Both quantitative and qualitative methods were used for this study. A survey was done in 10 sub-districts of Chittagong Hill Tracts resulting 480 sample sizes considering high nonresponse rate in Chittagong Hill Tracts. A Focus Group Discussion was held in each sub-district to get in-depth view of Jhum cultivators related to malaria. Results: In this study, total 386 (80.4%) people were Jhum cultivators followed by non- Jhum cultivators 94(19.6%). Jhum cultivators were 2.5 times of risk of malaria infection than other occupations (P-value = 0.046, CI =1.018-6.156). During their stay at Jhum sites, 54% of Jhum cultivators hang net in the evening and 44% of people did it during sleeping time. The most biting time at Jhum sites was 19.00-20.00 h (P-value = 0.011). The exposure of malaria was high when they came back home (70%) from Jhum sites than malaria being exposed at Jhum sites (27.4%). In logistic regression, distance (OR=1.20, P-value =0.000, CI=1.093-1.316) is most important factor while using of Long Lasing Insecticidal Nets at Jhum sites (OR=0.265, P-value =0.000, CI=0.162-0.431) the other notable factor behind infection of malaria in Bangladesh. Conclusion: Malaria is still occupational disease especially among Jhum cultivators and needs to be taken a comprehensive awareness programme for using of LLIN at Jhum sites especially in19.00-20.00 hours.