BACKGROUND: The indications for prescribing malaria chemoprophylaxis lack a solid evidence base that results in subjectivity and wide variation of practice across countries and among professionals. METHODS: European experts in travel medicine, who are members of TropNetEurop, participated in a survey conducted using the Delphi method. This technique aims at evaluating and developing a consensus through iterations of questionnaires, controlled feedback, and statistical group responses. RESULTS: A first questionnaire, including questions about controversial issues in prescribing malaria prophylaxis, required responses on a visual scale between 1 and 10. The questionnaire included issues on problematic prescribing, characteristics of drugs, relevance of geography, and importance of insect bite prevention. The repeat questionnaire with the group response from the first round revealed an increasing consensus on most issues. A second survey considered 14 practical scenarios (including two internal standards) and investigated preferred choice of prophylaxis. A significant consensus was noted in 8 of 14 scenarios, which did not increase after a second round. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice, and a greater willingness to prescribe in northern and southern Europe than in central Europe. The second round showed a 9.5% change of opinion. CONCLUSIONS: The study shows that improving the evidence base on efficacy and tolerability and risk of malaria for prescribing chemoprophylaxis is needed as is further discussion across Europe to achieve harmonization of prescribing practice.
BACKGROUND: The indications for prescribing malaria chemoprophylaxis lack a solid evidence base that results in subjectivity and wide variation of practice across countries and among professionals. METHODS: European experts in travel medicine, who are members of TropNetEurop, participated in a survey conducted using the Delphi method. This technique aims at evaluating and developing a consensus through iterations of questionnaires, controlled feedback, and statistical group responses. RESULTS: A first questionnaire, including questions about controversial issues in prescribing malaria prophylaxis, required responses on a visual scale between 1 and 10. The questionnaire included issues on problematic prescribing, characteristics of drugs, relevance of geography, and importance of insect bite prevention. The repeat questionnaire with the group response from the first round revealed an increasing consensus on most issues. A second survey considered 14 practical scenarios (including two internal standards) and investigated preferred choice of prophylaxis. A significant consensus was noted in 8 of 14 scenarios, which did not increase after a second round. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice, and a greater willingness to prescribe in northern and southern Europe than in central Europe. The second round showed a 9.5% change of opinion. CONCLUSIONS: The study shows that improving the evidence base on efficacy and tolerability and risk of malaria for prescribing chemoprophylaxis is needed as is further discussion across Europe to achieve harmonization of prescribing practice.
Authors: Guido Calleri; Ron H Behrens; Matthias L Schmid; Federico Gobbi; Martin P Grobusch; Francesco Castelli; Joaquim Gascon; Zeno Bisoffi; Tomas Jelinek; Pietro Caramello Journal: Malar J Date: 2011-05-20 Impact factor: 2.979
Authors: G Calleri; F Castelli; I El Hamad; F Gobbi; A Matteelli; G Napoletano; R Romi; A Rossanese Journal: Infection Date: 2013-12-18 Impact factor: 3.553
Authors: Vanessa Field; Philippe Gautret; Patricia Schlagenhauf; Gerd-Dieter Burchard; Eric Caumes; Mogens Jensenius; Francesco Castelli; Effrossyni Gkrania-Klotsas; Leisa Weld; Rogelio Lopez-Velez; Peter de Vries; Frank von Sonnenburg; Louis Loutan; Philippe Parola Journal: BMC Infect Dis Date: 2010-11-17 Impact factor: 3.090