MALARIA PROPHYLAXIS - IDENTIFYING RISK GROUPS FOR NONCOMPLIANCE

To investigate behaviour in the use of drug prophylaxis against malari a and the risk factors for noncompliance, 507 European or North Americ an travellers returning from endemic areas were studied retrospectivel y at Berlin in a ii-year period from 1980 to 1990. Compliance was sign ificantly correlated with shorter travel duration: the group with good compliance stayed 37.2+/-38.5 days (mean +/- SD) in contrast to 69.8/-93.5 days in the group of patients with no compliance (p=0.00001). O lder patients were significantly more compliant than patients aged <55 years (20/27 compliant at >54 years vs. 175/476 at <55 years; p=0.000 1). Compliance was significantly affected by travel destination (South ern and East African regions; p=0.0054), age (less than or equal to 15 and greater than or equal to 55 years, respectively; p=0.0001), and r eason of travel (package tours; p=0.0001). CART analysis confirmed log istic regression analysis with respect to age and travel type, and rev ealed that patients using only one information source were significant ly more compliant than those using two or more information sources. Tr avel agencies were nearly as well informed as Institutes of Tropical M edicine, but family doctors had a significant incidence of giving wron g advice. This study should enable medical personnel dealing with prop hylactic advice against malaria to identify patients at high risk for noncompliance, and to educate them more carefully than other traveller s regarding antimalarial drug prophylaxis.