Symptoms of illness during travel and risk factors for non-adherence to malaria prophylaxis-a cross-sectional study in travellers from Germany.

Abstract

BACKGROUND:

Perceived adverse effects of antimalarial chemoprophylaxis can be difficult to distinguish from travel-related illness and are often cited as important reasons for non-adherence or refusal of antimalarial chemoprophylaxis. We aimed to investigate the occurrence of symptoms of illness in travellers with and without chemoprophylaxis in a cross-sectional study after travel and to identify risk factors for non-adherence to prophylaxis.

METHODS:

We enrolled 458 travellers to Africa and South America during their pre-travel medical consultation at the travel clinic of the University Medical Centre Hamburg-Eppendorf and conducted post-travel interviews on symptoms of illness and intake of malaria prophylaxis.

RESULTS:

Eleven percent (49/437) of the participants reported symptoms of illness during travel. In total, 36% (160/448) of the participants reported prescription of chemoprophylaxis, the vast majority of these travelled to Africa (98%) and received atovaquone/proguanil (93%). Frequency of symptoms did not differ significantly between participants without prophylaxis and those taking atovaquone/proguanil. Non-adherence to prophylaxis was frequent (20%), but only 3% (4/149) of the participants stopped the medication early because of perceived side effects. Risk factors associated with non-adherence to prophylaxis included age under 30 years, travel to West or Central Africa and travel duration greater than 14 days.

CONCLUSIONS:

Symptoms of illness during travel occurred at similar frequencies irrespective of intake of chemoprophylaxis. Travellers should be informed about chemoprophylaxis in a balanced way, without raising fear of side effects, especially among groups at higher risk for incorrect use of prophylaxis.

• Authors: Friederike Reinsberg, Mary W Moehlmann, Ralf Krumkamp, Lena Landsmann, Christian Heitkamp, Johannes Jochum, Marylyn Addo, Michael Ramharter, Christiane Radt, Camilla Rothe, Christof Vinnemeier, Benno Kreuels
• Journal: Journal of travel medicine (J Travel Med) Vol. 30 Issue 3 (05 18 2023) ISSN: 1708-8305 [Electronic] England
• PMID: 37098163 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © International Society of Travel Medicine 2023. Published by Oxford University Press.

Chemical References

• Antimalarials
• Proguanil
• Atovaquone

Topics

• Humans
• Adult
• Antimalarials (adverse effects)
• Proguanil (therapeutic use)
• Atovaquone (adverse effects)
• Travel
• Malaria (drug therapy)
• Cross-Sectional Studies
• Travel-Related Illness
• Risk Factors
• Prescriptions
• Drug-Related Side Effects and Adverse Reactions (drug therapy)
• Germany