Non-adherence to malaria prophylaxis: The influence of travel-related and psychosocial factors.
Adult
Age Factors
Antimalarials
/ therapeutic use
Attitude to Health
Chemoprevention
/ psychology
Cross-Sectional Studies
Educational Status
Female
Humans
Logistic Models
Malaria
/ prevention & control
Male
Medication Adherence
/ psychology
Middle Aged
Netherlands
/ epidemiology
Psychology
Travel
/ psychology
Antimalarials
Atovaquone
Health behaviour
Health knowledge attitudes practice
Medication adherence
Patient compliance
Proguanil
Journal
Journal of infection and public health
ISSN: 1876-035X
Titre abrégé: J Infect Public Health
Pays: England
ID NLM: 101487384
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
10
04
2018
revised:
05
07
2019
accepted:
15
10
2019
pubmed:
11
11
2019
medline:
17
4
2020
entrez:
10
11
2019
Statut:
ppublish
Résumé
The effectiveness of malaria chemoprophylaxis is limited by a lack of compliance in travellers. This study assesses the demographic, travel-related, and psychosocial determinants of non-compliance with chemoprophylaxis. 715 adults, who received a pre-travel malaria prophylaxis prescription, were invited to complete a post-travel digital questionnaire on non-compliance, demographics, travel-related and psychosocial variables. 330 travellers (53% response) reported 32% non-compliance with malaria chemoprophylaxis. Logistic regression analyses revealed that 3/11 assessed psychosocial variables uniquely predicted non-compliance: 'negative attitude towards chemoprophylaxis' (β=0.694, OR 2.0, p<0.01), 'low perceived severity of malaria' (β=0.277, p=0.04) and 'fatigue during travel' (β=2.225, OR 9.3, p<0.01). Furthermore, the age and education of the traveller were uniquely predictive of non-compliance (β=-0.023 (p=0.02) and β=0.684 (p=0.04)). None of the travel-related variables predicted non-compliance. About one-third of the travellers in our study were non-compliant with malaria prophylaxis, especially young travellers and highly educated travellers. Fatigue during travel seems to lead to non-compliance. Further research should focus on addressing the psychosocial factors in pre-travel consultation, since these appear to be better predictors for intention to comply than travel-related variables.
Sections du résumé
BACKGROUND
BACKGROUND
The effectiveness of malaria chemoprophylaxis is limited by a lack of compliance in travellers. This study assesses the demographic, travel-related, and psychosocial determinants of non-compliance with chemoprophylaxis.
METHODS
METHODS
715 adults, who received a pre-travel malaria prophylaxis prescription, were invited to complete a post-travel digital questionnaire on non-compliance, demographics, travel-related and psychosocial variables.
RESULTS
RESULTS
330 travellers (53% response) reported 32% non-compliance with malaria chemoprophylaxis. Logistic regression analyses revealed that 3/11 assessed psychosocial variables uniquely predicted non-compliance: 'negative attitude towards chemoprophylaxis' (β=0.694, OR 2.0, p<0.01), 'low perceived severity of malaria' (β=0.277, p=0.04) and 'fatigue during travel' (β=2.225, OR 9.3, p<0.01). Furthermore, the age and education of the traveller were uniquely predictive of non-compliance (β=-0.023 (p=0.02) and β=0.684 (p=0.04)). None of the travel-related variables predicted non-compliance.
CONCLUSIONS
CONCLUSIONS
About one-third of the travellers in our study were non-compliant with malaria prophylaxis, especially young travellers and highly educated travellers. Fatigue during travel seems to lead to non-compliance. Further research should focus on addressing the psychosocial factors in pre-travel consultation, since these appear to be better predictors for intention to comply than travel-related variables.
Identifiants
pubmed: 31704047
pii: S1876-0341(19)30319-3
doi: 10.1016/j.jiph.2019.10.004
pii:
doi:
Substances chimiques
Antimalarials
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
532-537Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.