Compliance with long-term malaria prophylaxis in British expatriates

Cunningham, Jane, Horsley, Jason, Patel, Dipti, Tunbridge, Anne and Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200 (2014) 'Compliance with long-term malaria prophylaxis in British expatriates'. Travel Medicine and Infectious Disease, Vol 12, Issue 4, pp. 341-348.

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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.

Item Type:	Article
Subjects:	W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 85 Patients. Attitude and compliance WA Public Health > Preventive Medicine > WA 108 Preventive health services. Preventive medicine. Travel Medicine. WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.tmaid.2013.12.006
Depositing User:	Lynn Roberts-Maloney
Date Deposited:	03 Jun 2015 09:46
Last Modified:	06 Feb 2018 13:10
URI:	https://archive.lstmed.ac.uk/id/eprint/5184

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