Malaria prevention behaviour and risk awareness in French adult travellers

Pistone, Thierry; Ezzedine, Khaled; Gaudin, Anne-Françoise; Hercberg, Serge; Nachbaur, Gaëlle; Malvy, Denis

doi:10.1016/j.tmaid.2009.10.005

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Volume 8, Issue 1 , Pages 13-21, January 2010

Malaria prevention behaviour and risk awareness in French adult travellers

Thierry Pistone
- Service de Médecine Interne et des Maladies Tropicales, Hôpital St-André, CHU Bordeaux, Bordeaux, France
- The first two authors contributed equally to the study and to the preparation of the manuscript.
Khaled Ezzedine
- Service de Médecine Interne et des Maladies Tropicales, Hôpital St-André, CHU Bordeaux, Bordeaux, France
- UMR U557 INSERM, University of Paris XIII, Bobigny, France
- Corresponding author at: Service de Dermatologie, Hôpital Saint André, CHU Bordeaux, 1, rue Jean Burguet, 33075 Bordeaux, France. Tel.: +33 5 56 79 49 65; fax: +33 5 56 79 58 80.
- The first two authors contributed equally to the study and to the preparation of the manuscript.
Anne-Françoise Gaudin
- Laboratoire GlaxoSmithKline, Marly-le-Roi, France
Serge Hercberg
- UMR U557 INSERM, University of Paris XIII, Bobigny, France
Gaëlle Nachbaur
- Laboratoire GlaxoSmithKline, Marly-le-Roi, France
Denis Malvy
- Service de Médecine Interne et des Maladies Tropicales, Hôpital St-André, CHU Bordeaux, Bordeaux, France

Received 23 June 2009; received in revised form 22 October 2009; accepted 27 October 2009. published online 27 November 2009.

Summary

Travellers from Europe to tropical areas risk acquiring malaria against which they have no immunity. The objective of this study was to assess malaria protection measures in European travellers as a function of the risk of infection with malaria.

This questionnaire-based, retrospective study evaluated 13,017 French adults. 3066 travellers to malaria-endemic countries were identified and data collected on duration and purpose of stay, knowledge of malaria, use of mechanical protection measures and chemoprophylaxis.

Complete data on protection measures were available for 2225 travellers to malaria risk countries. Mechanical protection was used by 1735/2225 of travellers (94.9% of travellers to high-risk areas and 80.4% of travellers to low-risk areas). Appropriate chemoprophylaxis use rates were 47.6% for high-risk areas versus 9.5% for low-risk areas. Chemoprophylaxis compliance was low, even in the case of travellers to high risk areas (18.2%). Many travellers (38%) were unaware that malaria was potentially fatal. The only variables significantly associated with compliant use of appropriate chemoprophylaxis were awareness that malaria was serious (odds-ratio: 2.03; p=0.033) and receiving malaria information from a physician (odds-ratio: 3.01; p=0.042).

Use of malaria chemoprophylaxis is very inadequate. Education campaigns are needed to improve the use of chemoprophylaxis and thus minimise the risk of acquiring malaria.

Keywords: Malaria, Travel, Chemoprophylaxis, Behaviour, Prophylaxis, Risk