MALARIA PROPHYLAXIS PRESCRIBED FOR TRAVELERS FROM NEW-ZEALAND

Aim. To investigate advice given by general practitioners on the use o f chemoprophylaxis and other preventive measures against malaria. Meth od. Four hundred general practitioners were randomly selected from the register of the New Zealand Medical Council and sent self-administere d questionnaires. Results. Three hundred and thirty two (83%) general practitioners responded. Advice concerning malaria (310/ 310, 100%) an d insect avoidance (287/299, 96%) was commonly given. The most commonl y prescribed regimes for malaria chemoprophylaxis were chloroquine (93 /305, 30.5%), chloroquine plus either quinine or mefloquine as a stand by (63/305, 21%), mefloquine (45/305, 15%), chloroquine/Maloprim((R)) (pyrimethamine/dapsone) (41/305, 13%), doxycycline (26/305, 8%), and c hloroquine plus doxycycline (24/305, 8%). Chloroquine plus Maloprim((R )) was used significantly more by general practitioners in older age g roups, ie 45 years and over (p < 0.05). Conclusions. This cross sectio nal study has shown variability in the patterns of antimalarials used. Issues of concern include continued use of chloroquine alone, given w idespread global resistance, and the use of Maloprim.((R)) Although Ma loprim((R)) use has not been recommended since 1992, it is still being used by a substantial minority of general practitioners. This issue, which needs to be addressed nationally, is of concern given the advers e events associated with the use of Maloprim.((R)) New methods for the effective dissemination of information regarding appropriate chemopro phylaxis need to be developed.