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Compliance with long-term malaria prophylaxis in British expatriates

Cunningham, Jane, Horsley, Jason, Patel, Dipti, Tunbridge, Anne and Lalloo, David ORCID: (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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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.


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.


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.


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):
Depositing User: Lynn Roberts-Maloney
Date Deposited: 03 Jun 2015 09:46
Last Modified: 06 Feb 2018 13:10


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