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Use of malaria prevention measures by North American and European travelers to East Africa.
J Travel Med. 2001 Jul-Aug; 8(4):167-72.JT

Abstract

BACKGROUND

The use of preventive measures, including effective chemoprophylaxis, is essential for protection against malaria among travelers. However, data have shown that travelers and medical advisors are confused by the lack of uniform recommendations and numerous prophylactic regimens of varying effectiveness that are used.

METHODS

To assess the use and type of preventive measures against malaria, we conducted a cross-sectional study in 1997 among travelers departing from the Nairobi and Mombasa airports in Kenya with European destinations.

RESULTS

Seventy-five percent of the travelers studied were residents of Europe and 25% were residents of North America; all stayed less than 1 year, and visited malarious areas. Most travelers, 97.1%, were aware of the risk and 91.3% sought pretravel medical advice. Although 95.4% used chemoprophylaxis and/or antimosquito measures, only 61.7% used both regular chemoprophylaxis and two or more antimosquito measures. Compliance with chemoprophylaxis was lowest amongst those who used a drug with a daily, as opposed to, a weekly dosing schedule, stayed more than 1 month, attributed an adverse health event to the chemoprophylaxis, and were less than 40 years of age. Among US travelers, 94.6% of those taking chemoprophylaxis were taking an effective regimen, that is, mefloquine or doxycycline. Only 1.9% used a suboptimal drug regimen, such as chloroquine/proguanil. Among European travelers, 69% used mefloquine or doxycycline, and 25% used chloroquine/proguanil. Notably, 45.3% of travelers from the UK used chloroquine/proguanil. Adverse events were noted by 19.7% of mefloquine users and 16.4% of travelers taking chloroquine/proguanil. Neuropsychologic adverse events were reported by 7.8% of users of mefloquine and 1.9% of those taking chloroquine/proguanil. The adverse events, however, had a lesser impact on compliance than frequent dosing schedule.

CONCLUSIONS

Health information should be targeted to travelers who are likely to use suboptimal chemoprophylaxis or may be noncompliant with prophylaxis. Uniform recommendations for effective chemoprophylaxis with simple dosing schedules are necessary to reduce rates of malaria among travelers to Africa.

Authors+Show Affiliations

Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Hwy., Atlanta, GA 30341, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11703900

Citation

Lobel, H O., et al. "Use of Malaria Prevention Measures By North American and European Travelers to East Africa." Journal of Travel Medicine, vol. 8, no. 4, 2001, pp. 167-72.
Lobel HO, Baker MA, Gras FA, et al. Use of malaria prevention measures by North American and European travelers to East Africa. J Travel Med. 2001;8(4):167-72.
Lobel, H. O., Baker, M. A., Gras, F. A., Stennies, G. M., Meerburg, P., Hiemstra, E., Parise, M., Odero, M., & Waiyaki, P. (2001). Use of malaria prevention measures by North American and European travelers to East Africa. Journal of Travel Medicine, 8(4), 167-72.
Lobel HO, et al. Use of Malaria Prevention Measures By North American and European Travelers to East Africa. J Travel Med. 2001 Jul-Aug;8(4):167-72. PubMed PMID: 11703900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of malaria prevention measures by North American and European travelers to East Africa. AU - Lobel,H O, AU - Baker,M A, AU - Gras,F A, AU - Stennies,G M, AU - Meerburg,P, AU - Hiemstra,E, AU - Parise,M, AU - Odero,M, AU - Waiyaki,P, PY - 2001/11/13/pubmed PY - 2002/1/5/medline PY - 2001/11/13/entrez SP - 167 EP - 72 JF - Journal of travel medicine JO - J Travel Med VL - 8 IS - 4 N2 - BACKGROUND: The use of preventive measures, including effective chemoprophylaxis, is essential for protection against malaria among travelers. However, data have shown that travelers and medical advisors are confused by the lack of uniform recommendations and numerous prophylactic regimens of varying effectiveness that are used. METHODS: To assess the use and type of preventive measures against malaria, we conducted a cross-sectional study in 1997 among travelers departing from the Nairobi and Mombasa airports in Kenya with European destinations. RESULTS: Seventy-five percent of the travelers studied were residents of Europe and 25% were residents of North America; all stayed less than 1 year, and visited malarious areas. Most travelers, 97.1%, were aware of the risk and 91.3% sought pretravel medical advice. Although 95.4% used chemoprophylaxis and/or antimosquito measures, only 61.7% used both regular chemoprophylaxis and two or more antimosquito measures. Compliance with chemoprophylaxis was lowest amongst those who used a drug with a daily, as opposed to, a weekly dosing schedule, stayed more than 1 month, attributed an adverse health event to the chemoprophylaxis, and were less than 40 years of age. Among US travelers, 94.6% of those taking chemoprophylaxis were taking an effective regimen, that is, mefloquine or doxycycline. Only 1.9% used a suboptimal drug regimen, such as chloroquine/proguanil. Among European travelers, 69% used mefloquine or doxycycline, and 25% used chloroquine/proguanil. Notably, 45.3% of travelers from the UK used chloroquine/proguanil. Adverse events were noted by 19.7% of mefloquine users and 16.4% of travelers taking chloroquine/proguanil. Neuropsychologic adverse events were reported by 7.8% of users of mefloquine and 1.9% of those taking chloroquine/proguanil. The adverse events, however, had a lesser impact on compliance than frequent dosing schedule. CONCLUSIONS: Health information should be targeted to travelers who are likely to use suboptimal chemoprophylaxis or may be noncompliant with prophylaxis. Uniform recommendations for effective chemoprophylaxis with simple dosing schedules are necessary to reduce rates of malaria among travelers to Africa. SN - 1195-1982 UR - https://www.unboundmedicine.com/medline/citation/11703900/Use_of_malaria_prevention_measures_by_North_American_and_European_travelers_to_East_Africa_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.2310/7060.2001.22206 DB - PRIME DP - Unbound Medicine ER -