Abstract
BackgroundAmong strategies for malaria prevention, stand-by emergency treatment (SBET) is a possible approach, but scarce evidences exists investigating travellers’ adherence and behaviours toward its use; therefore, the presented study aimed to determine travellers’ compliance toward the SBET when prescribed in travel clinics.MethodsA prospective cohort study was performed at the Travel Health Clinic of the Hospital Universitari de Bellvitge, Barcelona, Spain, during 2017. The research was planned on survey-based design, using pre- and post-travel questionnaires.ResultsIn the study period, of 5436 subjects who attended the HUB Travel Medicine Clinic, 145 travellers to malaria-endemic areas were prescribed SBET, and all patients agreed to participate in the study by completing the pre-travel questionnaire. Approximately half the participants were women (n = 75, 51.7%), and the median age of all travellers was 29 years (range 13–57), mainly travelling to South-East Asia (n = 69, 47.6%), with Indonesia and the Philippines as the most popular destinations. The length of travels had a median duration of 29 days (range 10–213). Of the recruited participants, 98 replied to the online post-travel survey, reaching a response rate of 67.6%. A total of 62.2% of travellers to which SBET was prescribed did not buy and carry drugs while travelling abroad. No participants’ baseline or travel characteristic was shown to be significantly associated (p > 0.05) with this behaviour. Four women (4.1%) experienced fever and self-administered SBET, without seeking medical attention. No malaria cases were observed.ConclusionsThis cohort study addressed travellers’ adherence and behaviour toward SBET, highlighting an incorrect use of the emergency treatment in case of presumptive malaria symptoms. This should be taken into account during pre-travel consultation, since the success of this strategy for malaria prevention depends on travellers’ strong adherence to it.
Highlights
Among strategies for malaria prevention, stand-by emergency treatment (SBET) is a possible approach, but scarce evidences exists investigating travellers’ adherence and behaviours toward its use; the presented study aimed to determine travellers’ compliance toward the SBET when prescribed in travel clinics
The SBET prescription associated with mosquito avoidance measures is due to a risk-benefits analysis, since the Ferrara et al Malar J (2018) 17:134 incidence of adverse effects of chemoprophylaxis could outweigh the attack rate of malaria in areas at low risk of transmission [5, 6]
From January to December 2017, 5436 travellers presented to the Hospital Universitari de Bellvitge (HUB) Travel Medicine Clinic, and 1025 intended to travel to malaria-endemic areas, being prescribed SBET in 14.1% of cases (n = 145) as a reliable malaria self-treatment when the traveller planned to stay in remote areas with low risk for disease transmission
Summary
Among strategies for malaria prevention, stand-by emergency treatment (SBET) is a possible approach, but scarce evidences exists investigating travellers’ adherence and behaviours toward its use; the presented study aimed to determine travellers’ compliance toward the SBET when prescribed in travel clinics. The World Health Organization (WHO) provides general guidelines that travellers carrying SBET should observe, such as to consult a physician immediately if fever occurs 1 week or more after entering an endemic area, to start the SBET when medical care is not available within 24 h of the onset of fever and to seek medical care as soon as possible for a complete evaluation and to exclude other illnesses and to use antipyretics to lower fever and reduce vomiting due to anti-malarial drugs [5]. Regarding the topic of travellers’ adherence to SBET, very little has been published [11,12,13,14]; the aim of this study was to determine travellers’ compliance with prescribed SBET
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
