Jane Cunningham1, Jason Horsley2, Dipti Patel3, Anne Tunbridge4, David G Lalloo5. 1. Sheffield Teaching Hospital NHS Foundation Trust, UK. Electronic address: Jane.cunningham@sth.nhs.uk. 2. University of Sheffield, School of Health and Related Research, UK. 3. 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. 4. Sheffield Teaching Hospital NHS Foundation Trust, UK. 5. Liverpool School of Tropical Medicine, UK.
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.
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: Lin H Chen; Karin Leder; Kira A Barbre; Patricia Schlagenhauf; Michael Libman; Jay Keystone; Marc Mendelson; Philippe Gautret; Eli Schwartz; Marc Shaw; Sue MacDonald; Anne McCarthy; Bradley A Connor; Douglas H Esposito; Davidson Hamer; Mary E Wilson Journal: J Travel Med Date: 2018-01-01 Impact factor: 8.490