Regional Public Health Service 'GGD Gelderland-Zuid', PO Box 1120, 6501BC, Nijmegen, the Netherlands.
Work & Social Psychology, Maastricht University, PO Box 616, 6200MD, Maastricht, the Netherlands.
J Infect Public Health. 2020 Apr;13(4):532-537. doi: 10.1016/j.jiph.2019.10.004. Epub 2019 Nov 6.
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.
由于旅行者依从性差，疟疾化学预防的效果受到限制。本研究评估了旅行者不遵守化学预防的人口统计学、旅行相关和社会心理决定因素。
715 名接受旅行前疟疾预防处方的成年人被邀请填写一份关于不遵守、人口统计学、旅行相关和社会心理变量的旅行后数字问卷。
330 名旅行者（53%的回复率）报告了 32%的抗疟化学预防不依从。逻辑回归分析显示，11 个评估的社会心理变量中有 3 个可单独预测不依从：“对化学预防的消极态度”（β=0.694，OR 2.0，p<0.01）、“对疟疾严重程度的低感知”（β=0.277，p=0.04）和“旅行期间疲劳”（β=2.225，OR 9.3，p<0.01）。此外，旅行者的年龄和教育程度是不依从的唯一预测因素（β=-0.023（p=0.02）和β=0.684（p=0.04））。没有一个旅行相关变量可以预测不依从。
在我们的研究中，约三分之一的旅行者不遵守疟疾预防措施，尤其是年轻旅行者和高学历旅行者。旅行期间疲劳似乎会导致不依从。进一步的研究应集中在解决旅行前咨询中的社会心理因素上，因为这些因素似乎比旅行相关因素更能预测依从意向。
