Malaria risk perception, knowledge and prophylaxis practices among travellers of African ethnicity living in Paris and visiting their country of origin in sub-Saharan Africa

Pistone, Thierry; Guibert, Philippe; Malvy, Denis; Ezzedine, Khaled; Receveur, M.-C.; Siriwardana, M.G.; Larouzé, Bernard; Bouchaud, Olivier

doi:10.1016/j.trstmh.2007.05.009

Cited by 68 publications

(74 citation statements)

References 11 publications

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“…21,22 VFR travelers in our study were not less adherent to chemoprophylaxis compared with others; however, previous research has shown that VFR travelers who attend a pre-travel health consultation at a travel health clinic adhere more to chemoprophylaxis than those who do not attend a consultation. 23 Therefore, VFRs in our study may not be representative of all VFR travelers. Participants may have underreported how many pills were missed.…”

Section: Discussionmentioning

confidence: 92%

Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries

Stoney¹,

Chen²,

Jentes³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. We conducted a prospective cohort study to assess adherence to malaria chemoprophylaxis, reasons for nonadherence, and use of other personal protective measures against malaria. We included adults traveling to malariaendemic countries who were prescribed malaria chemoprophylaxis during a pre-travel consultation at three travel clinics in the Boston area and who completed three or more surveys: pre-travel, at least one weekly during travel, and post-travel (2-4 weeks after return). Of 370 participants, 335 (91%) took malaria chemoprophylaxis at least once and reported any missed doses; 265 (79%) reported completing all doses during travel. Adherence was not affected by weekly versus daily chemoprophylaxis, travel purpose, or duration of travel. Reasons for nonadherence included forgetfulness, side effects, and not seeing mosquitoes. Main reasons for declining to take prescribed chemoprophylaxis were peer advice, low perceived risk, and not seeing mosquitoes. Of 368 travelers, 79% used insect repellent, 46% used a bed net, and 61% slept in air conditioning at least once. Because travelers may be persuaded to stop taking medication by peer pressure, not seeing mosquitoes, and adverse reactions to medications, clinicians should be prepared to address these barriers and to empower travelers with strategies to manage common side effects of antimalarial medications.

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Section: Discussionmentioning

confidence: 92%

Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries

Stoney¹,

Chen²,

Jentes³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…La CQ seule a été cinq fois moins utilisée en CPAP par les patients de Bordeaux qu'au niveau national, probablement en raison d'une sous-représentation des VFR à Bordeaux. Les VFR semblent effectivement avoir une plus grande propension à recourir à une CPAP par CQ, vraisemblablement en raison de son faible coût et de sa popularité malheureusement encore grande en Afrique subsaharienne, à Madagascar et aux Comores [21,22]. La prépondérance du recours à CP chez les patients pourrait être liée à l'association de plusieurs facteurs.…”

Section: Discussionunclassified

“…Cette différence notable pourrait être liée à un biais de sous-déclaration du recours à la moustiquaire à l'échelle nationale. Une autre explication plausible de cette différence serait que les patients de notre série, majoritairement des « non-VFR », pourraient avoir une perception des risques liés aux piqûres de moustiques globalement plus élevée que les patients recensés par le CNRP, ces derniers étant majoritairement des VFR croyant à l'hypothé-tique pérennité de leur semi-immunité palustre et annonçant à tort, l'inutilité de la prévention [1,14,16,18,20,21,25]. Ces croyances erronées peuvent même parfois influencer les médecins prescripteurs de mesures préventives [4].…”

Section: Discussionunclassified

“…Cette tendance à une décroissance du nombre de cas incidents ne doit cependant pas rassurer les intervenants en santé publique. En effet, les données nationales et celles de notre série de patients rendent compte de l'augmentation continue de la proportion des patients VFR [13], faiblement sensibilisés à la prévention vis-à-vis du paludisme et économiquement limités pour l'accès aux chimioprophylaxies antipaludiques [2,21,22,26]. Dans ce contexte, le paludisme d'importation tue chaque année de 10 à 30 voyageurs en France [13,22].…”

Section: Conclusion Et Perspectivesunclassified

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Le paludisme d’importation au CHU de Bordeaux de 2000 à 2007: épidémiologie, prise en charge et comparaison avec les données nationales

Pistone

Diallo

Receveur

et al. 2010

Bull. Soc. Pathol. Exot.

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In Western countries, France accounts for the most concerned by imported malaria. The objective of the present study was to describe the epidemiological and clinical features of imported malaria in adults attending the University Hospital Center (UHC) ofBordeaux and to compare these findings with the French national epidemiological data. A retrospective analysis of all patients aged over 15 years with parasitologically confirmed malaria in patients recruited between January 1, 2000 and December 31, 2007 has been performed. A total of 526 cases fitted the inclusion criteria with two-thirds of males and a mean age of 37 years. Patients were less frequently native from sub-Saharan Africa (SA), Madagascar, and Comoros than those from the French national data register (29 versus 72%). Hence, SA was the main destination (2/3 travelling to Western Africa and 1/3 to Central Africa). The recourse to an adequate chemoprophylaxis (CPL) for stays in areas of chemoresistance had been reported in about one-third of the patients. From these, two thirds were noncompliant. The recourse to chloroquine less frequent (6 versus 24%) among patients from Bordeaux compared to those from the national data register whereas the recourse to mosquito net use more frequent in patients from Bordeaux (36 versus 3%). Plasmodium falciparum was the main infective species.Malaria was more frequently associated with hospitalization (89 versus 71%) and with severe disease (9 versus 4%) in Bordeaux than in national data register. Two deaths were declared. Atovaquone-proguanil (AP) combination therapy wasmore frequently used in Bordeaux compared to the national data (64 versus 20%). This AP combination treatment was the most frequently prescribed for uncomplicated malaria, whereas intravenous quinine was mainly used for complicated malaria and for patients with vomiting. The lack of CPL, the diagnosis or therapeutic delay, and the lethality of malaria among travellers infected by malaria imported from SA argue for the implementation of continuing medical training and health education targeted at travellers from France to high malaria-endemic areas such as SA, Madagascar, and Comoros.

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“…Approximately 40-50% [9][10][11] of the travellers to Africa are ethnic Africans living in industrialized countries visiting friends and relatives (VFR) to their home countries. VFR often belong to a social class with limited income, especially in France [12] and so have low recourse to MC [8,13].…”

Section: Introductionmentioning

confidence: 99%

Reimbursement of malaria chemoprophylaxis for travellers from Europe to Sub-Saharan Africa: Cost-effectiveness analysis from the perspective of the French national health insurance system

et al. 2008

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Malaria risk perception, knowledge and prophylaxis practices among travellers of African ethnicity living in Paris and visiting their country of origin in sub-Saharan Africa

Cited by 68 publications

References 11 publications

Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries

Malaria Prevention Strategies: Adherence Among Boston Area Travelers Visiting Malaria-Endemic Countries

Le paludisme d’importation au CHU de Bordeaux de 2000 à 2007: épidémiologie, prise en charge et comparaison avec les données nationales

Reimbursement of malaria chemoprophylaxis for travellers from Europe to Sub-Saharan Africa: Cost-effectiveness analysis from the perspective of the French national health insurance system

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