Determinants of compliance with anti-vectorial protective measures among non-immune travellers during missions to tropical Africa

Malaria Journal

Research

Remy Michel¹  Alain Buguet²  Noémie Resseguier³  Eve Orlandi-Pradines³  Vanessa Machault³  Frédéric Pages³  Bruno Pradines³  Sébastien Briolant³  Gaetan Texier⁴  Lénaïck Ollivier⁴  Emmanuel Sagui⁵  Christophe Rogier⁶  Catherine Tourette-Turgis⁷ 

[1] Département d'épidémiologie et de santé publique & EA3283, Parc du Pharo, 13262, Marseille Cedex 07, France;EA4170 Free Radicals, Energy Substrates and Physiopathology, Claude-Bernard Lyon I University, 8 Avenue Rockefeller, 69373, Lyon Cedex 08, France;Field Infectiology Department, Institute for Biomedical Research of the French Armed Forces (IRBA) & URMITE UMR6236, Allée du Médecin Colonel Jamot, BP60109, Parc du Pharo, 13262, Marseille Cedex 07, France;Field Infectiology Department, Institute for Biomedical Research of the French Armed Forces (IRBA) & URMITE UMR6236, Allée du Médecin Colonel Jamot, BP60109, Parc du Pharo, 13262, Marseille Cedex 07, France;Département d'épidémiologie et de santé publique & EA3283, Parc du Pharo, 13262, Marseille Cedex 07, France;Field Infectiology Department, Institute for Biomedical Research of the French Armed Forces (IRBA) & URMITE UMR6236, Allée du Médecin Colonel Jamot, BP60109, Parc du Pharo, 13262, Marseille Cedex 07, France;Hôpital d'Instruction des Armées Laveran, BP 60149, 13384, Marseille Cedex 13, France;Field Infectiology Department, Institute for Biomedical Research of the French Armed Forces (IRBA) & URMITE UMR6236, Allée du Médecin Colonel Jamot, BP60109, Parc du Pharo, 13262, Marseille Cedex 07, France;Institut Pasteur de Madagascar, B.P. 1274, 101 Antananarivo, Madagascar;Institut d'éducation thérapeutique, Fondation partenariale, University Pierre et Marie Curie, University of Rouen, 6, Paris, France;

关键词: Malaria;    Generalize Estimate Equation;    Health Belief Model;    Ivory Coast;    Clinical Malaria;   

DOI  :  10.1186/1475-2875-10-232

 received in 2011-02-06, accepted in 2011-08-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe effectiveness of anti-vectorial malaria protective measures in travellers and expatriates is hampered by incorrect compliance. The objective of the present study was to identify the determinants of compliance with anti-vectorial protective measures (AVPMs) in this population that is particularly at risk because of their lack of immunity.MethodsCompliance with wearing long clothing, sleeping under insecticide-impregnated bed nets (IIBNs) and using insect repellent was estimated and analysed by questionnaires administered to 2,205 French military travellers from 20 groups before and after short-term missions (approximately four months) in six tropical African countries (Senegal, Ivory Coast, Chad, Central African Republic, Gabon and Djibouti). For each AVPM, the association of "correct compliance" with individual and collective variables was investigated using random-effect mixed logistic regression models to take into account the clustered design of the study.ResultsThe correct compliance rates were 48.6%, 50.6% and 18.5% for wearing long clothing, sleeping under bed nets and using repellents, respectively. Depending on the AVPM, correct compliance was significantly associated with the following factors: country, older than 24 years of age, management responsibilities, the perception of a personal malaria risk greater than that of other travellers, the occurrence of life events, early bedtime (i.e., before midnight), the type of stay (field operation compared to training), the absence of medical history of malaria, the absence of previous travel in malaria-endemic areas and the absence of tobacco consumption.There was no competition between compliance with the different AVPMs or between compliance with any AVPM and malaria chemoprophylaxis.ConclusionInterventions aimed at improving compliance with AVPMs should target young people without management responsibilities who are scheduled for non-operational activities in countries with high risk of clinical malaria. Weak associations between compliance and history of clinical malaria or variables that pertain to threat perception suggest that cognition-based interventions referencing a "bad experience" with clinical malaria could have only a slight impact on the improvement of compliance. Further studies should focus on the cognitive and behavioural predictors of compliance with AVPMs.

【 授权许可】

Unknown   
© Sagui et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.