Recommendations for malaria prevention in moderate to low risk areas: travellers’ choice and risk perception

Malaria Journal

Research

Delphine Berthod¹  Clotilde Rambaud-Althaus²  Rachel Voumard³  Blaise Genton⁴  Valérie D’Acremont⁵ 

[1] Infectious Diseases Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland;Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland;Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland;Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland;Infectious Diseases Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland;Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland;Travel Clinic, Department of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, 1011, Lausanne, Switzerland;Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland;

关键词: Malaria;    Adverse Drug Reaction;    Risk Perception;    Rapid Diagnostic Test;    Malaria Prevention;   

DOI  :  10.1186/s12936-015-0654-y

 received in 2015-01-07, accepted in 2015-03-15,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe considerable malaria decline in several countries challenges the strategy of chemoprophylaxis for travellers visiting moderate- to low-risk areas. An international consensus on the best strategy is lacking. It is essential to include travellers’ opinions in the decision process. The preference of travellers regarding malaria prevention for moderate- to low-risk areas, related to their risk perception, as well as the reasons for their choices were investigated.MethodsPrior to pre-travel consultation in the Travel Clinic, a self-administered questionnaire was given to travellers visiting moderate- to low-risk malaria areas. Four preventive options were proposed to the traveller, i.e., bite prevention only, chemoprophylaxis, stand-by emergency treatment alone, and stand-by emergency treatment with rapid diagnostic test. The information was accompanied by a risk scale for incidence of malaria, anti-malarial adverse drug reactions and other travel-related risks, inspired by Paling palettes from the Risk Communication Institute.ResultsA total of 391 travellers were included from December 2012 to December 2013. Fifty-nine (15%) opted for chemoprophylaxis, 116 (30%) for stand-by emergency treatment, 112 (29%) for stand-by emergency treatment with rapid diagnostic test, 100 (26%) for bite prevention only, and four (1%) for other choices. Travellers choosing chemoprophylaxis justified their choice for security reasons (42%), better preventive action (29%), higher efficacy (15%) and easiness (15%). The reasons for choosing stand-by treatment or bite prevention only were less medication consumed (29%), less adverse drug reactions (23%) and lower price (9%). Those who chose chemoprophylaxis were more likely to have used it in the past (OR = 3.0 (CI 1.7-5.44)), but were not different in terms of demographic, travel characteristics or risk behaviour.ConclusionsWhen travelling to moderate- to low-risk malaria areas, 85% of interviewees chose not to take chemoprophylaxis as malaria prevention, although most guidelines recommend it. They had coherent reasons for their choice. New recommendations should include shared decision-making to take into account travellers’ preferences.

【 授权许可】

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© Voumard et al.; licensee BioMed Central. 2015. 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 credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.