Educating travelers about malaria: dealing with resistance and patient noncompliance.

Abstract

Malaria is a risk to travelers in many parts of the world. Physicians need to tailor chemoprevention strategies to take into account resistance patterns. Patient education is important, especially for those travelers least likely to comply with prevention strategies. Most travelers who contract malaria do not become ill until they return home, so recognition and treatment are crucial. s KEY POINTS Health information should be targeted to travelers who are likely to use suboptimal chemoprophylaxis or may be noncompliant with prophylaxis-men and people traveling alone. Mosquito bed nets, insecticides, insect repellents, and preventive drugs effectively reduce the risk of malaria. Plasmodia have developed resistance to traditional preventive drugs, including chloroquine and sulfadoxinepyrimethamine, in vast areas of the world. Mefloquine (taken weekly), doxycycline (taken daily), and atovaquone-proguanil (taken daily) are the preventive drugs of choice in most areas. Chloroquine is still effective in Haiti, the Dominican Republic, Central America west of the Panama Canal Zone, Egypt, and most countries in the Middle East; in other areas, plasmodia have gained resistance to it. F This paper was funded by an unrestricted grant provided by Hoffmann-La Roche Inc.