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Choice of and adherence to prophylactic antimalarials
Larry Goodyer1, Leanne Rice, Alan Martin
1Leicester School of Pharmacy, Faculty ofHealth and Life Sciences,De Montfort University, The Gateway, Leicester, UK. LGoodyer@dmu.ac.uk
Journal of Travel Medicine
|July 5, 2011
Summary
Travelers showed better adherence to atovaquone plus proguanil compared to doxycycline for malaria prevention. Shorter post-travel regimens significantly impact adherence, with perceived risk influencing traveler behavior.
Area of Science:
- Travel Medicine
- Infectious Diseases
- Pharmacology
Background:
- Imported malaria cases in the UK, primarily from chloroquine-resistant Plasmodium falciparum, highlight adherence challenges.
- Poor adherence to antimalarial regimens is a significant factor in malaria cases and fatalities.
Purpose of the Study:
- To assess adherence behavior and perceptions of UK travelers regarding antimalarial medications.
- To investigate factors influencing the choice of antimalarial prophylaxis from both traveler and prescriber perspectives.
Main Methods:
- Observational study using pre- and post-travel questionnaires.
- Assessed adherence to atovaquone plus proguanil, doxycycline, and mefloquine for P. falciparum prevention.
- Examined traveler and prescriber reasons for antimalarial selection.
Main Results:
- Higher self-reported adherence observed with atovaquone plus proguanil compared to doxycycline.
- Adherence to mefloquine was comparable to or better than doxycycline and atovaquone plus proguanil.
- Effectiveness, side effects, prior experience, and convenience were key determinants in medication choice.
Conclusions:
- Shorter post-travel antimalarial regimens significantly improve adherence.
- Travelers' reassessment of malaria risk upon returning home contributes to poor adherence.
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