Premium
Effectiveness of chemoprophylaxis and other determinants of malaria in travellers to Kenya
Author(s) -
Muehlberger,
Jelínek,
Schlipkoeter,
V. Sonnenburg,
Nothdurft
Publication year - 1998
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1046/j.1365-3156.1998.00235.x
Subject(s) - chemoprophylaxis , malaria , medicine , mefloquine , proguanil , malaria prophylaxis , chloroquine , environmental health , population , logistic regression , tropical medicine , travel medicine , pediatrics , surgery , immunology , psychiatry , pathology
Summaryobjective To investigate the effectiveness of chemoprophylaxis and the determinants of malaria importation from Kenya. method In a population‐based case‐control study, 51 travellers from Bavaria diagnosed with falciparum malaria imported from Kenya (cases) and a sample of 383 healthy Bavarian travellers returning from Kenya (controls) were interviewed. Data were analysed by multiple logistic regression. results Mefloquine (OR = 0.055; 95% Cl 0.019‐0.16) and chloroquine combined with proguanil (OR = 0.128; 95% CI 0.039‐0.419) were highly protective against P. falciparum malaria, whereas other drugs were ineffective (OR = 1.225; 95% CI 0.536‐2.803). Ineffective prophylaxis (10.4%) and non‐prophylaxis (11.2%) were the main reasons for malaria importation. Travelling alone or with friends, male sex, and travel duration over 4 weeks could be identified as additional risk factors. The main reason for inadequate chemoprophylaxis was inappropriate medical advice (87.5%). Prophylaxis refusal occurred frequently despite correct advice (58.1%). Diagnosis was often delayed unnecessarily (27.5%). conclusion Malaria importation from Kenya could be reduced substantially (34%) by eliminating inappropriate medical advice.