Preventing malaria in international travellers: an evaluation of published English-language guidelines

BMC Public Health

Paul Garner²  David Sinclair²  Kristina Poole¹  Merav Kliner² 

[1] Cheshire and Merseyside Public Health England Centre, 5th Floor, Rail House, Lord Nelson Street, Liverpool L1 1JF, UK;Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK

关键词: Prevention;    Chemoprophylaxis;    Travellers;    Malaria;   

Others  :  1123077
DOI  :  10.1186/1471-2458-14-1129

 received in 2014-06-04, accepted in 2014-10-21,  发布年份 2014

【 摘 要 】

Background

People intending to travel may seek information on malaria prevention from a range of sources. To ensure the best protection, this information needs to be reliable, up-to-date, consistent, and useful to their decision making. This study appraises current international and national guidelines written in English for malaria prevention in travellers, and whether any recommendations conflict.

Methods

We systematically identified national or international English-language guidelines on malaria prevention in travellers to July 2013 using standard and multiple searching methods. We critically appraised guidelines using the AGREE II tool, and report inconsistent recommendations within guidelines.

Results

We identified five sets of English-language guidelines on preventing malaria for travellers. Assessment against AGREE II indicate that all of the guidelines fall short of internationally accepted standards in guideline development: none include a transparent description of methods; only one describes sources of funding or potential conflicts of interest; and only one includes formal presentation of the evidence alongside transparent assessment of the quality of that evidence. There were a number of important discrepancies between guidelines, and some omit information about effectiveness, safety and adverse effects of chemoprophylaxis options.

Conclusions

The methods used for developing guidelines for malaria prevention in travellers lags behind current internationally recognized standards. Healthcare professionals as well as travellers themselves could be better informed if guidelines were more systematic and transparent summaries of the current knowledge on drug interventions in relation to effects, safety, administration and contra-indications.

【 授权许可】

   
2014 Kliner et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Health Protection Agency: Malaria imported into the United Kingdom in 2011: implications for those advising travellers. Health Prot Rep 2012, 6(17):3-6.
• [2]Bazaz R, Green E, Green ST: Quality of malaria information provided on Internet travel operator websites. Travel Med Infect Dis 2010, 8:285-291.
• [3]National Institute for Health and Care Excellence. About clinical guidelineshttp://www.nice.org.uk/aboutnice/whatwedo/aboutclinicalguidelines/about_clinical_guidelines.jsp webcite
• [4]AGREE IIhttp://www.agreetrust.org/ webcite
• [5]World Health Organisation: International travel and health. Geneva: World Health Organisation; 2012.
• [6]Public Health Agency of Canada: Canadian Recommendations for the Prevention and Treatment of Malaria Among International Travellers. CCDR 2008, 34(S3):1-45.
• [7]Centre for Health Protection: Scientific Committee on Vector-borne Diseases: Guidelines on malaria chemoprophylaxis for travellers from Hong Kong. Hong Kong: Department of Health Protection, Department of Health, Hong Kong Special Administrative Region, Hong Kong; 2007.
• [8]Public Health England: Guidelines for malaria prevention in travellers from the UK. Public Health England 2013. Accessed at https://www.gov.uk/government/publications/malaria-prevention-guidelines-for-travellers-from-the-uk webcite on 27/10/14, Published 29/7/14.
• [9]Arguin PM, Tan KR: Malaria. In Yellow Book, Centers for Disease Control and Prevention (CDC). Atlanta: Georgia; 2013.
• [10]BPAC NZ: Providing medical advice to travellers. BPJ 2011, 41:30-39.
• [11]Guyatt GH, Oxman AD, Kunz R, Falck-Ytter Y, Vist GE, Liberati A, Schünemann HJ, GRADE Working Group: Rating quality of evidence and strength of recommendations: Going from evidence to recommendations. BMJ 2008, 336:1049-1051.
• [12]Akhtar S, Mukherjee S: Chloroquine-induced mania. Int J Psychiatry Med 1993, 23:349-356.
• [13]Toovey S: Mefloquine neurotoxicity: a literature review. Travel Med Infect Dis 2009, 7:2-6.
• [14]O’Connor A: Using decision aids to help patients navigate the ‘grey zone’ of medical decision making. CMAJ 2007, 176:1597-1598.
• [15]van der Weijden T, Pieterse AH, Koelewijn-van Loon MS, Knaapen L, Légaré F, Boivin A: How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant study. BMJ Qual Saf 2013, 22:855-863.
• [16]Calleri G, Castelli F, El Hamad I, Gobbi F, Matteelli A, Napoletano G, Romi R, Rossanese A: New Italian guidelines for malaria prophylaxis in travellers to endemic areas. Infection 2014, 42(1):239-250. doi:10.1007/s15010-013-0563-3. Epub 2013 Dec 18