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Non-adherence to malaria prophylaxis: The influence of travel-related and psychosocial factors.
J Infect Public Health. 2020 Apr; 13(4):532-537.JI

Abstract

BACKGROUND

The effectiveness of malaria chemoprophylaxis is limited by a lack of compliance in travellers. This study assesses the demographic, travel-related, and psychosocial determinants of non-compliance with chemoprophylaxis.

METHODS

715 adults, who received a pre-travel malaria prophylaxis prescription, were invited to complete a post-travel digital questionnaire on non-compliance, demographics, travel-related and psychosocial variables.

RESULTS

330 travellers (53% response) reported 32% non-compliance with malaria chemoprophylaxis. Logistic regression analyses revealed that 3/11 assessed psychosocial variables uniquely predicted non-compliance: 'negative attitude towards chemoprophylaxis' (β=0.694, OR 2.0, p<0.01), 'low perceived severity of malaria' (β=0.277, p=0.04) and 'fatigue during travel' (β=2.225, OR 9.3, p<0.01). Furthermore, the age and education of the traveller were uniquely predictive of non-compliance (β=-0.023 (p=0.02) and β=0.684 (p=0.04)). None of the travel-related variables predicted non-compliance.

CONCLUSIONS

About one-third of the travellers in our study were non-compliant with malaria prophylaxis, especially young travellers and highly educated travellers. Fatigue during travel seems to lead to non-compliance. Further research should focus on addressing the psychosocial factors in pre-travel consultation, since these appear to be better predictors for intention to comply than travel-related variables.

Authors+Show Affiliations

Regional Public Health Service 'GGD Gelderland-Zuid', PO Box 1120, 6501BC, Nijmegen, the Netherlands. Electronic address: jhoefnagel@ggdgelderlandzuid.nl.Work & Social Psychology, Maastricht University, PO Box 616, 6200MD, Maastricht, the Netherlands. Electronic address: karlijn.massar@maastrichtuniversity.nl.Regional Public Health Service 'GGD Gelderland-Zuid', PO Box 1120, 6501BC, Nijmegen, the Netherlands; Department of Primary and Community Care, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands. Electronic address: jhautvast@ggdgelderlandzuid.nl.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31704047

Citation

Hoefnagel, Jolanda G M., et al. "Non-adherence to Malaria Prophylaxis: the Influence of Travel-related and Psychosocial Factors." Journal of Infection and Public Health, vol. 13, no. 4, 2020, pp. 532-537.
Hoefnagel JGM, Massar K, Hautvast JLA. Non-adherence to malaria prophylaxis: The influence of travel-related and psychosocial factors. J Infect Public Health. 2020;13(4):532-537.
Hoefnagel, J. G. M., Massar, K., & Hautvast, J. L. A. (2020). Non-adherence to malaria prophylaxis: The influence of travel-related and psychosocial factors. Journal of Infection and Public Health, 13(4), 532-537. https://doi.org/10.1016/j.jiph.2019.10.004
Hoefnagel JGM, Massar K, Hautvast JLA. Non-adherence to Malaria Prophylaxis: the Influence of Travel-related and Psychosocial Factors. J Infect Public Health. 2020;13(4):532-537. PubMed PMID: 31704047.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-adherence to malaria prophylaxis: The influence of travel-related and psychosocial factors. AU - Hoefnagel,Jolanda G M, AU - Massar,Karlijn, AU - Hautvast,Jeannine L A, Y1 - 2019/11/06/ PY - 2018/04/10/received PY - 2019/07/05/revised PY - 2019/10/15/accepted PY - 2019/11/11/pubmed PY - 2020/4/17/medline PY - 2019/11/10/entrez KW - Antimalarials KW - Atovaquone KW - Health behaviour KW - Health knowledge attitudes practice KW - Medication adherence KW - Patient compliance KW - Proguanil SP - 532 EP - 537 JF - Journal of infection and public health JO - J Infect Public Health VL - 13 IS - 4 N2 - BACKGROUND: The effectiveness of malaria chemoprophylaxis is limited by a lack of compliance in travellers. This study assesses the demographic, travel-related, and psychosocial determinants of non-compliance with chemoprophylaxis. METHODS: 715 adults, who received a pre-travel malaria prophylaxis prescription, were invited to complete a post-travel digital questionnaire on non-compliance, demographics, travel-related and psychosocial variables. RESULTS: 330 travellers (53% response) reported 32% non-compliance with malaria chemoprophylaxis. Logistic regression analyses revealed that 3/11 assessed psychosocial variables uniquely predicted non-compliance: 'negative attitude towards chemoprophylaxis' (β=0.694, OR 2.0, p<0.01), 'low perceived severity of malaria' (β=0.277, p=0.04) and 'fatigue during travel' (β=2.225, OR 9.3, p<0.01). Furthermore, the age and education of the traveller were uniquely predictive of non-compliance (β=-0.023 (p=0.02) and β=0.684 (p=0.04)). None of the travel-related variables predicted non-compliance. CONCLUSIONS: About one-third of the travellers in our study were non-compliant with malaria prophylaxis, especially young travellers and highly educated travellers. Fatigue during travel seems to lead to non-compliance. Further research should focus on addressing the psychosocial factors in pre-travel consultation, since these appear to be better predictors for intention to comply than travel-related variables. SN - 1876-035X UR - https://www.unboundmedicine.com/medline/citation/31704047/Non_adherence_to_malaria_prophylaxis:_The_influence_of_travel_related_and_psychosocial_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1876-0341(19)30319-3 DB - PRIME DP - Unbound Medicine ER -