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Malaria chemoprophylaxis advice: survey of South African community pharmacists' knowledge and practices.
J Travel Med. 2006 May-Jun; 13(3):161-5.JT

Abstract

BACKGROUND

Over 3 million South African residents travel to malarious areas annually. Given pharmacists' ready accessibility and travel clinics' incapacity to service total potential demand, South African community pharmacists' malaria chemoprophylaxis knowledge and practice were assessed.

METHODS

Covert survey. Pharmacies were approached at random and asked for malaria chemoprophylaxis recommendations. A standard questionnaire indicating a 3-day stay in either Maputo (N= 43; malarious) or Harare (N= 25; non-malarious) was used.

RESULTS

Maputo group: 41/43 (95%) pharmacists correctly identified need for chemoprophylaxis; 3/41 (7%) recommended an ineffective drug. Eight of 41 (20%) enquired about diving, and 6/41 (15%) enquired about epilepsy or mental illness; despite positive responses mefloquine, was nevertheless recommended. Harare group: 12/25 (48%) incorrectly advised chemoprophylaxis was necessary; 4/12 (33%) sought contraindications; all prophylaxis recommended was considered effective. Overall, 54/68 (79%) pharmacists correctly determined whether chemoprophylaxis was required or not; 6/53 (11%) of all recommended chemoprophylaxis included "alternative" antimalarials; 1/68 (1%) consulted external advice before making recommendations; 11/53 (21%) referred travelers to a physician; 1/68 (1%) referred to a travel clinic. Pharmacies were significantly more likely (Fisher exact, p < 0.0001) to recommend unnecessary prophylaxis (12/25; 48%) than to advise against necessary prophylaxis (2/43; 5%).

CONCLUSIONS

Pharmacists are willing to give malaria chemoprophylaxis advice but appear to overprescribe; although unnecessary adverse events may result, this may be the preferred error in a falciparum-dominated region. Pharmacists' knowledge of contraindications, willingness to consult external resources, and knowledge of antimalarials' effectiveness could be improved. Pharmacists appear unwilling to refer to travel clinics. An effective intervention to improve the safety and accuracy of pharmacists' advice might be the provision of a simple aid listing effective antimalarials and their contraindications, illustrated with a malaria risk map. Improving the safety and accuracy of pharmacists' advice would increase significantly travelers' access to reliable travel health information.

Authors+Show Affiliations

SAA-Netcare Travel Clinics. malaria@freesurf.ch

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16706947

Citation

Toovey, Stephen. "Malaria Chemoprophylaxis Advice: Survey of South African Community Pharmacists' Knowledge and Practices." Journal of Travel Medicine, vol. 13, no. 3, 2006, pp. 161-5.
Toovey S. Malaria chemoprophylaxis advice: survey of South African community pharmacists' knowledge and practices. J Travel Med. 2006;13(3):161-5.
Toovey, S. (2006). Malaria chemoprophylaxis advice: survey of South African community pharmacists' knowledge and practices. Journal of Travel Medicine, 13(3), 161-5.
Toovey S. Malaria Chemoprophylaxis Advice: Survey of South African Community Pharmacists' Knowledge and Practices. J Travel Med. 2006 May-Jun;13(3):161-5. PubMed PMID: 16706947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Malaria chemoprophylaxis advice: survey of South African community pharmacists' knowledge and practices. A1 - Toovey,Stephen, PY - 2006/5/19/pubmed PY - 2006/8/3/medline PY - 2006/5/19/entrez SP - 161 EP - 5 JF - Journal of travel medicine JO - J Travel Med VL - 13 IS - 3 N2 - BACKGROUND: Over 3 million South African residents travel to malarious areas annually. Given pharmacists' ready accessibility and travel clinics' incapacity to service total potential demand, South African community pharmacists' malaria chemoprophylaxis knowledge and practice were assessed. METHODS: Covert survey. Pharmacies were approached at random and asked for malaria chemoprophylaxis recommendations. A standard questionnaire indicating a 3-day stay in either Maputo (N= 43; malarious) or Harare (N= 25; non-malarious) was used. RESULTS: Maputo group: 41/43 (95%) pharmacists correctly identified need for chemoprophylaxis; 3/41 (7%) recommended an ineffective drug. Eight of 41 (20%) enquired about diving, and 6/41 (15%) enquired about epilepsy or mental illness; despite positive responses mefloquine, was nevertheless recommended. Harare group: 12/25 (48%) incorrectly advised chemoprophylaxis was necessary; 4/12 (33%) sought contraindications; all prophylaxis recommended was considered effective. Overall, 54/68 (79%) pharmacists correctly determined whether chemoprophylaxis was required or not; 6/53 (11%) of all recommended chemoprophylaxis included "alternative" antimalarials; 1/68 (1%) consulted external advice before making recommendations; 11/53 (21%) referred travelers to a physician; 1/68 (1%) referred to a travel clinic. Pharmacies were significantly more likely (Fisher exact, p < 0.0001) to recommend unnecessary prophylaxis (12/25; 48%) than to advise against necessary prophylaxis (2/43; 5%). CONCLUSIONS: Pharmacists are willing to give malaria chemoprophylaxis advice but appear to overprescribe; although unnecessary adverse events may result, this may be the preferred error in a falciparum-dominated region. Pharmacists' knowledge of contraindications, willingness to consult external resources, and knowledge of antimalarials' effectiveness could be improved. Pharmacists appear unwilling to refer to travel clinics. An effective intervention to improve the safety and accuracy of pharmacists' advice might be the provision of a simple aid listing effective antimalarials and their contraindications, illustrated with a malaria risk map. Improving the safety and accuracy of pharmacists' advice would increase significantly travelers' access to reliable travel health information. SN - 1195-1982 UR - https://www.unboundmedicine.com/medline/citation/16706947/Malaria_chemoprophylaxis_advice:_survey_of_South_African_community_pharmacists'_knowledge_and_practices_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2006.00035.x DB - PRIME DP - Unbound Medicine ER -