Survey of use of malaria prevention measures by Canadians visiting India

Background: Imported malaria is an increasing problem, particularly among n ew immigrant populations. The objective of this study was to determine the malaria prevention measures used by Canadians originating from a malaria-en demic area when returning to visit their country of origin. Methods: A 35-item English-language questionnaire was administered by inter view to travellers at a departure lounge at Pearson International Airport, Toronto, between January and lune 1995. Information was collected on subjec t characteristics, travel itinerary, perceptions about malaria, and pretrav el health advice and malaria chemoprophylaxis and barriers to their use. Results: A total of 324 travellers departing on flights to India were appro ached, of whom 307 (95%) agreed to participate in the study. Participants w ere Canadian residents of south Asian origin with a mean duration of reside nce in Canada of 12.8 years. Most of the respondents were returning to visi t relatives for a mean visit duration of 6.8 weeks. Although 69% of the res pondents thought malaria was a moderate to severe illness and 54% had sough t advice before travelling, only 31% intended to use any chemoprophylaxis, and less than 10% were using measures to prevent mosquito bites. Only 7% ha d been prescribed a recommended drug regimen. Family practitioners were the primary source of information for travellers and were more likely to presc ribe an inappropriate chemoprophylactic regimen than were travel clinics or public health centres (76% v. 36%) (p = 0.003). Respondents who had lived in Canada longest and those with a family history of malaria were more like ly to use chemoprophylaxis (p < 0.01). Interpretation: Few travellers were using appropriate chemoprophylaxis and mosquito prevention measures. Misconceptions about malaria risk and appropr iate prevention measures were the main barriers identified.