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Compliance with long-term malaria prophylaxis in British expatriates.
Travel Med Infect Dis. 2014 Jul-Aug; 12(4):341-8.TM

Abstract

BACKGROUND

There were 219 million cases of malaria with 600,000 deaths in 2010. Current UK guidance recommends malaria chemoprophylaxis for travellers to malaria endemic areas. Despite proven efficacy, compliance amongst long-term travellers with prophylaxis and personal protective strategies is sub-optimal. This survey assesses compliance rates amongst Foreign and Commonwealth Office employees on placement in malaria endemic areas and establishes the rationale for their decisions.

METHODS

A Survey Monkey questionnaire was circulated to Foreign and Commonwealth Office employees on long-term placement in endemic areas. This ascertained background knowledge of malaria, compliance with prevention strategies and the rationale for decisions made.

RESULTS

The response rate was 56.5% (327 of 579); responses showed a good knowledge of malaria. 59% of respondents continued their prophylaxis for 0-3 months only. No pregnant women reported compliance of greater than 95%. More than half of the individuals with a compliance of <25% cited concerns about long term safety. 39.5% of respondents reported significant side-effects to chemoprophylaxis. 12.8% reported contracting malaria.

CONCLUSION

Despite being well informed, poor adherence was reported, especially amongst pregnant respondents. The majority of individuals ceased medication within three months. Concern regarding the safety of long-term medication was the major barrier. Suggestions are made regarding optimisation of compliance or alternative strategies.

Authors+Show Affiliations

Sheffield Teaching Hospital NHS Foundation Trust, UK. Electronic address: Jane.cunningham@sth.nhs.uk.University of Sheffield, School of Health and Related Research, UK.Foreign and Commonwealth Office, London, UK; The National Travel Health Network and Centre, London, UK; Centre for Occupational and Environmental Health, Manchester University, Manchester, UK.Sheffield Teaching Hospital NHS Foundation Trust, UK.Liverpool School of Tropical Medicine, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24485647

Citation

Cunningham, Jane, et al. "Compliance With Long-term Malaria Prophylaxis in British Expatriates." Travel Medicine and Infectious Disease, vol. 12, no. 4, 2014, pp. 341-8.
Cunningham J, Horsley J, Patel D, et al. Compliance with long-term malaria prophylaxis in British expatriates. Travel Med Infect Dis. 2014;12(4):341-8.
Cunningham, J., Horsley, J., Patel, D., Tunbridge, A., & Lalloo, D. G. (2014). Compliance with long-term malaria prophylaxis in British expatriates. Travel Medicine and Infectious Disease, 12(4), 341-8. https://doi.org/10.1016/j.tmaid.2013.12.006
Cunningham J, et al. Compliance With Long-term Malaria Prophylaxis in British Expatriates. Travel Med Infect Dis. 2014;12(4):341-8. PubMed PMID: 24485647.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Compliance with long-term malaria prophylaxis in British expatriates. AU - Cunningham,Jane, AU - Horsley,Jason, AU - Patel,Dipti, AU - Tunbridge,Anne, AU - Lalloo,David G, Y1 - 2014/01/14/ PY - 2013/10/29/received PY - 2013/12/23/revised PY - 2013/12/24/accepted PY - 2014/2/4/entrez PY - 2014/2/4/pubmed PY - 2015/4/1/medline KW - Expatriate KW - Long-term travellers KW - Malaria prophylaxis SP - 341 EP - 8 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 12 IS - 4 N2 - BACKGROUND: There were 219 million cases of malaria with 600,000 deaths in 2010. Current UK guidance recommends malaria chemoprophylaxis for travellers to malaria endemic areas. Despite proven efficacy, compliance amongst long-term travellers with prophylaxis and personal protective strategies is sub-optimal. This survey assesses compliance rates amongst Foreign and Commonwealth Office employees on placement in malaria endemic areas and establishes the rationale for their decisions. METHODS: A Survey Monkey questionnaire was circulated to Foreign and Commonwealth Office employees on long-term placement in endemic areas. This ascertained background knowledge of malaria, compliance with prevention strategies and the rationale for decisions made. RESULTS: The response rate was 56.5% (327 of 579); responses showed a good knowledge of malaria. 59% of respondents continued their prophylaxis for 0-3 months only. No pregnant women reported compliance of greater than 95%. More than half of the individuals with a compliance of <25% cited concerns about long term safety. 39.5% of respondents reported significant side-effects to chemoprophylaxis. 12.8% reported contracting malaria. CONCLUSION: Despite being well informed, poor adherence was reported, especially amongst pregnant respondents. The majority of individuals ceased medication within three months. Concern regarding the safety of long-term medication was the major barrier. Suggestions are made regarding optimisation of compliance or alternative strategies. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/24485647/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(14)00002-7 DB - PRIME DP - Unbound Medicine ER -