TY - JOUR
T1 - Adherence to antimalarial chemoprophylaxis among Israeli travelers visiting malaria-endemic areas
AU - Khoury, Sobhi
AU - Kaplan, Shiran
AU - Zaidenstein, Ronit
AU - Cohen, Erica
AU - Tischler-Aurkin, Dinni
AU - Sheffer, Rivka
AU - Mathew, Lewis
AU - Mor, Zohar
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Background: Travelers are recommended to take antimalarial chemoprophylaxis (AMC) when traveling to endemic areas. Methods: This prospective comparative cohort study included 400 Israeli travelers to malaria-endemic areas, recruited in pre-travel clinics. They were contacted within one month following their return and asked about their actual adherence and the reasons for non-adherence. Results: Of 400 travelers with a mean age of 24.6 [SD = 4] years, 201 (50.2%) were men and 328 (82%) were singles. The majority (N = 185, 46.3%) traveled with friends, and the most common travel destination was southeast Asia (N = 267, 66.8%). Most travelers (N = 340, 85%) did not adhere to the AMC. In the multivariate analysis, non-adherence was found to be significantly associated with traveling solo or with friends, traveling to southeast Asia and longer travel duration. The most common reason for non-adherence among travelers was the perception that the risk of contracting malaria is low (N = 251, 73.8%). Conclusion: In this study, 85% of the Israeli travelers did not adhere to the AMC, especially those traveling solo or with friends, visiting southeast Asia and for a long period. Counselors at the pre-travel clinics should stress the importance of AMC in highly endemic countries and consider alternative treatment strategies, especially in low risk areas or long duration travel, such as short-term schedule or reserve AMC for field trips.
AB - Background: Travelers are recommended to take antimalarial chemoprophylaxis (AMC) when traveling to endemic areas. Methods: This prospective comparative cohort study included 400 Israeli travelers to malaria-endemic areas, recruited in pre-travel clinics. They were contacted within one month following their return and asked about their actual adherence and the reasons for non-adherence. Results: Of 400 travelers with a mean age of 24.6 [SD = 4] years, 201 (50.2%) were men and 328 (82%) were singles. The majority (N = 185, 46.3%) traveled with friends, and the most common travel destination was southeast Asia (N = 267, 66.8%). Most travelers (N = 340, 85%) did not adhere to the AMC. In the multivariate analysis, non-adherence was found to be significantly associated with traveling solo or with friends, traveling to southeast Asia and longer travel duration. The most common reason for non-adherence among travelers was the perception that the risk of contracting malaria is low (N = 251, 73.8%). Conclusion: In this study, 85% of the Israeli travelers did not adhere to the AMC, especially those traveling solo or with friends, visiting southeast Asia and for a long period. Counselors at the pre-travel clinics should stress the importance of AMC in highly endemic countries and consider alternative treatment strategies, especially in low risk areas or long duration travel, such as short-term schedule or reserve AMC for field trips.
KW - Backpacker
KW - Compliance
KW - Endemic
KW - Prevention
KW - Prophylaxis
UR - http://www.scopus.com/inward/record.url?scp=85118334850&partnerID=8YFLogxK
U2 - 10.1016/j.tmaid.2021.102193
DO - 10.1016/j.tmaid.2021.102193
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 34728384
AN - SCOPUS:85118334850
SN - 1477-8939
VL - 44
JO - Travel Medicine and Infectious Disease
JF - Travel Medicine and Infectious Disease
M1 - 102193
ER -