Tropical Medicine and International Health Clinic, Division of Infectious Diseases Ottawa Hospital General Campus, University of Ottawa, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
Malar J. 2010 Apr 9;9:92. doi: 10.1186/1475-2875-9-92.
Chemoprophylaxis for travellers' malaria is problematic. Decision modeling may help determine optimal prevention strategies for travellers' malaria. Such models can fully assess effect of drug use and disease on quality of life, and help travellers make informed values based decisions. Such models require utility values reflecting societal preferences over different health states of relevance. To date, there are no published utility values relating to clinical malaria or chemoprophylaxis adverse events.
Utility estimates for health states related to falciparum malaria, sequelae and drug-related adverse events were obtained using a self-administered visual analogue scale in 20 individuals. Utility values for health states related to clinical malaria were obtained from a survey of 11 malaria experts questioned about length of hospital stay or equivalent disability with simple and severe travellers' malaria.
The general public (potential travellers), were more tolerant of taking prophylaxis if associated with no or mild AEs and least tolerant of mild sequelae from malaria and severe drug related events. The rating value reported for taking no prophylaxis was quite variable. Tropical medicine specialists estimated a mean hospital stay 3.23 days (range 0.5-4.5 days) for simple and 6.36 days (range 4.5-7 days) for severe malaria.
This study provides a benchmark for important utility value estimates for modeling malaria and drug-related outcomes in non-immune travellers.
旅行者疟疾的化学预防存在问题。决策模型可能有助于确定旅行者疟疾的最佳预防策略。此类模型可以充分评估药物使用和疾病对生活质量的影响，并帮助旅行者根据自身价值观做出明智的决策。此类模型需要反映出社会对相关健康状况的偏好的效用值。迄今为止，尚无与临床疟疾或化学预防不良事件相关的已发表的效用值。
使用 20 名个体的自我管理视觉模拟量表获得与恶性疟原虫疟疾、后遗症和药物相关不良事件相关的健康状况的效用估计值。通过对 11 名疟疾专家进行的一项调查，获得与临床疟疾相关的健康状况的效用值，该调查询问了简单和严重旅行者疟疾的住院时间或同等残疾的长度。
一般公众（潜在旅行者）如果与无或轻度 AE 相关，更能容忍服用预防药物，而最不能容忍疟疾的轻度后遗症和严重的药物相关事件。报告的不服用预防药物的评分值差异很大。热带医学专家估计，简单疟疾的平均住院时间为 3.23 天（范围为 0.5-4.5 天），严重疟疾的平均住院时间为 6.36 天（范围为 4.5-7 天）。
本研究为非免疫旅行者疟疾和药物相关结局建模提供了重要的效用值基准估计。
