Factors associated with malaria chemoprophylaxis compliance among French service members deployed in Central African Republic

Malaria Journal

Research

Guillaume Velut¹  Marie-Aude Créach¹  Rémy Michel²  Aurélie Mayet³  Catherine Marimoutou³  Franck de Laval³  Jean-Baptiste Meynard⁴  Xavier Deparis⁴  Sébastien Briolant⁵  Luc Aigle⁶  Fabrice Simon⁷  Bruno Pradines⁸ 

[1] French Armed Forces Centre for Epidemiology and Public Health (CESPA), GSBdD, Marseille Aubagne-111, Avenue de la Corse-P 40026, 13568, Marseille cedex 02, France;French Armed Forces Centre for Epidemiology and Public Health (CESPA), GSBdD, Marseille Aubagne-111, Avenue de la Corse-P 40026, 13568, Marseille cedex 02, France;Department of Infectious and Tropical Diseases, Laveran Armed Forces Teaching Hospital, Marseille, France;French Armed Forces Centre for Epidemiology and Public Health (CESPA), GSBdD, Marseille Aubagne-111, Avenue de la Corse-P 40026, 13568, Marseille cedex 02, France;INSERM, UMR912 (SESSTIM), 13006, Marseille, France;French Armed Forces Centre for Epidemiology and Public Health (CESPA), GSBdD, Marseille Aubagne-111, Avenue de la Corse-P 40026, 13568, Marseille cedex 02, France;INSERM, UMR912 (SESSTIM), 13006, Marseille, France;Ecole du Val-de-Grâce, Paris, France;Inter-Army Health Service Directorate, Cayenne, French Guiana, France;Parasitology Laboratory, Institut Pasteur of French Guiana, Cayenne, French Guiana, France;Research Unit on Emerging Infectious and Tropical Diseases, Aix Marseille University, UM 63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France;Operation Sangaris, Bangui, Central African Republic;Parasitology and Entomology Unit, Department of Infectious Diseases, Armed Forces Biomedical Research Institute, Brétigny sur Orge, France;Department of Infectious and Tropical Diseases, Laveran Armed Forces Teaching Hospital, Marseille, France;Ecole du Val-de-Grâce, Paris, France;Research Unit on Emerging Infectious and Tropical Diseases, Aix Marseille University, UM 63, CNRS 7278, IRD 198, Inserm 1095, Marseille, France;Parasitology and Entomology Unit, Department of Infectious Diseases, Armed Forces Biomedical Research Institute, Brétigny sur Orge, France;National Reference Centre for Malaria, Marseille, France;

关键词: Armed forces;    Malaria;    Chemoprophylaxis;    Compliance;    Health education;    Peer-to-peer reinforcement;   

DOI  :  10.1186/s12936-016-1219-4

 received in 2015-09-05, accepted in 2016-03-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundMalaria is a public health concern in the French armed forces, with 400–800 cases reported every year and three deaths in the past 2 years. However, lack of chemoprophylaxis (CP) compliance is often reported among service members. The aim of this study was to explore factors associated with CP compliance.MethodsA retrospective study (1296 service members) was carried out among troops deployed in Central African Republic. Determinants of CP were collected by self-questionnaire. Socio-demographic variables, behavioural characteristics, belief variables, operational determinants such as troops in contact (TIC) and number of nights worked per week and peer-to-peer reinforcement were studied. Relationships between covariates and compliance were explored using logistic regressions (outcome: compliance as a dummy variable).ResultsChemoprophylaxis compliance was associated with other individual preventive measures against mosquito bites (bed net use, OR (odds ratio) = 1.41 (95 % CI [1.08–1.84]), and insecticide on clothing, OR = 1.90 ([1.43–2.51]) and malaria-related behaviours (taking chemoprophylaxis at the same time every day, OR = 2.37 ([1.17–4.78]) and taking chemoprophylaxis with food, OR = 1.45 ([1.11–1.89])). High perceived risk of contracting malaria, OR = 1.59 ([1.02–2.50]), positive perception of CP effectiveness, OR = 1.62 ([1.09–2.40]) and the practice of peer-to-peer reinforcement, OR = 1.38 ([1.05–1.82]) were also associated with better compliance. No association was found with TIC and number of nights worked.ConclusionsThis study, which shows a positive relationship between peer-to-peer reinforcement and CP compliance, also suggests the existence of two main personality profiles among service members: those who seek risks and those who are health-conscious. Health education should be expanded beyond knowledge, know-how and motivational factors by using a comprehensive approach based on identification of health determinants, development of psychosocial skills and peer-to-peer reinforcement.

【 授权许可】

CC BY   
© Créach et al. 2016