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Published in: Malaria Journal 1/2017

Open Access 01-12-2017 | Research

Pre-travel malaria chemoprophylaxis counselling in a public travel medicine clinic in São Paulo, Brazil

Authors: Tânia do Socorro Souza Chaves, Wuelton Marcelo Monteiro, Jessé Reis Alves, Marcus Lacerda, Marta Heloisa Lopes

Published in: Malaria Journal | Issue 1/2017

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Abstract

Background

Malaria is one of the most prevalent parasitic diseases in the world and represents a threat to travellers visiting endemic areas. Chemoprophylaxis is the prevention measure used in travel medicine, avoiding clinical manifestations and protecting against the development of severe disease and death.

Methods

Retrospective and descriptive analysis of malaria prevention data in travellers was recorded from a travel medicine clinic in São Paulo, Brazil, between January 2006 and December 2010. All the medical records of travellers, who had travelled to areas with risk of disease transmission, including Brazil, were analysed. Demographic characteristics of travellers, travel details and recommendations for preventing malaria were also seen.

Results

During the study period, 2836 pre-travel consultations were carried out on 2744 individuals (92 were consulted twice). The most common reasons for travelling were tourism and work. The most common destinations were Africa (24.5%), Europe (21.2%), Asia (16.6%) and locations within Brazil (14.9%). In general prophylaxis against malaria was recommended in 10.3% of all the consultations. African destinations vs Asian, Brazilian and other destinations and length of stay ≤30 days were independently associated with the higher odds of chemoprophylaxis recommendation after the logistic regression.

Conclusion

The prophylaxis against malaria was recommended in 10.3% of the consultations. The authors believe that a coherent measure of malaria prevention in Brazil and for international travellers would be to recommend for all parts of the North Brazil, avoidance of mosquito bites and immediate consultation of a physician in case of fever during or after the journey is recommended.
Literature
1.
go back to reference WHO. Global Malaria Programme. World Malaria Report 2015. Geneva: World Health Organization; 2016. WHO. Global Malaria Programme. World Malaria Report 2015. Geneva: World Health Organization; 2016.
2.
go back to reference Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasil. Malária: Monitoramento do casos no Brasil em 2014. Bol Epidemiol. 2015;46:1–5. Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasil. Malária: Monitoramento do casos no Brasil em 2014. Bol Epidemiol. 2015;46:1–5.
6.
go back to reference Legros F, Danis M. Surveillance of malaria in Europe. Eurosurveillance. 1998;38:45–7. Legros F, Danis M. Surveillance of malaria in Europe. Eurosurveillance. 1998;38:45–7.
7.
go back to reference Phillips-Howard PA, Radalowicz A, Mitchell J, Bradley DJ. Risk of malaria in British residents returning from malarious areas. BMJ. 1990;300:499–503.CrossRefPubMedPubMedCentral Phillips-Howard PA, Radalowicz A, Mitchell J, Bradley DJ. Risk of malaria in British residents returning from malarious areas. BMJ. 1990;300:499–503.CrossRefPubMedPubMedCentral
8.
go back to reference Wetteyn JCFM, Kager PA, van Gool T. The changing pattern of imported malaria in the academic centre, Amsterdam. J Travel Med. 1997;4:171–5.CrossRef Wetteyn JCFM, Kager PA, van Gool T. The changing pattern of imported malaria in the academic centre, Amsterdam. J Travel Med. 1997;4:171–5.CrossRef
9.
go back to reference Kofoed K, Petersen E. The efficacy of chemoprophylaxis against malaria with chloroquine plus proguanil, mefloquine, and atovaquone plus proguanil in travelers from Denmark. J Travel Med. 2003;10:150–4.CrossRefPubMed Kofoed K, Petersen E. The efficacy of chemoprophylaxis against malaria with chloroquine plus proguanil, mefloquine, and atovaquone plus proguanil in travelers from Denmark. J Travel Med. 2003;10:150–4.CrossRefPubMed
10.
go back to reference Stoney RJ, Chen LH, Jentes ES, Wilson ME, Han PV, Benoit CM, et al. Malaria prevention strategies: adherence among Boston area travelers visiting malaria-endemic countries. Am J Trop Med Hyg. 2016;94:136–42.CrossRefPubMedPubMedCentral Stoney RJ, Chen LH, Jentes ES, Wilson ME, Han PV, Benoit CM, et al. Malaria prevention strategies: adherence among Boston area travelers visiting malaria-endemic countries. Am J Trop Med Hyg. 2016;94:136–42.CrossRefPubMedPubMedCentral
11.
go back to reference Chen LH, Wilson ME, Schlagenhauf P. Prevention of malaria in long-term travelers. JAMA. 2006;296:2234–44.CrossRefPubMed Chen LH, Wilson ME, Schlagenhauf P. Prevention of malaria in long-term travelers. JAMA. 2006;296:2234–44.CrossRefPubMed
12.
go back to reference Fernando SD, Dharmawardana P, Semege S, Epasinghe G, Senanayake N, Rodrigo C, et al. The risk of imported malaria in security forces personnel returning from overseas missions in the context of prevention of re-introduction of malaria to Sri Lanka. Malar J. 2016;15:144.CrossRefPubMedPubMedCentral Fernando SD, Dharmawardana P, Semege S, Epasinghe G, Senanayake N, Rodrigo C, et al. The risk of imported malaria in security forces personnel returning from overseas missions in the context of prevention of re-introduction of malaria to Sri Lanka. Malar J. 2016;15:144.CrossRefPubMedPubMedCentral
13.
go back to reference Chen LH, Wilson ME, Schlagenhauf P. Controversies and misconceptions in malaria chemoprophylaxis for travelers. JAMA. 2007;297:2251–63.CrossRefPubMed Chen LH, Wilson ME, Schlagenhauf P. Controversies and misconceptions in malaria chemoprophylaxis for travelers. JAMA. 2007;297:2251–63.CrossRefPubMed
14.
go back to reference Behrens RH, Carroll B, Beran J, Bouchaud O, Hellgren U, Hatz C, et al. The low and declining risk of malaria in travellers to Latin America: is there still an indication for chemoprophylaxis? Malar J. 2007;6:114.CrossRefPubMedPubMedCentral Behrens RH, Carroll B, Beran J, Bouchaud O, Hellgren U, Hatz C, et al. The low and declining risk of malaria in travellers to Latin America: is there still an indication for chemoprophylaxis? Malar J. 2007;6:114.CrossRefPubMedPubMedCentral
17.
go back to reference Chaves TSS, Mascheretti M, Alves JR, Boulos M, Lopes MH. Travel medicine in the state of São Paulo, Brazil. Travel Med Infect Dis. 2012;10:283–4.CrossRef Chaves TSS, Mascheretti M, Alves JR, Boulos M, Lopes MH. Travel medicine in the state of São Paulo, Brazil. Travel Med Infect Dis. 2012;10:283–4.CrossRef
19.
go back to reference Pina-Costa A, Brasil P, Santi SM, Araújo MP, Suárez-Mutis MC, Santelli ACFS, et al. Malaria in Brazil: what happens outside the Amazonian endemic region. Mem Inst Oswaldo Cruz. 2014;109:618–33.CrossRefPubMedPubMedCentral Pina-Costa A, Brasil P, Santi SM, Araújo MP, Suárez-Mutis MC, Santelli ACFS, et al. Malaria in Brazil: what happens outside the Amazonian endemic region. Mem Inst Oswaldo Cruz. 2014;109:618–33.CrossRefPubMedPubMedCentral
20.
go back to reference Boulos M, Amato Neto V, Dutra AP, Santi SM, Shiroma M. Análise da freqüência de recaídas de malária por Plasmodium vivax em região não endêmica. Rev Inst Med Trop Sao Paulo. 1991;33:143–6.CrossRefPubMed Boulos M, Amato Neto V, Dutra AP, Santi SM, Shiroma M. Análise da freqüência de recaídas de malária por Plasmodium vivax em região não endêmica. Rev Inst Med Trop Sao Paulo. 1991;33:143–6.CrossRefPubMed
21.
go back to reference Pedro RS, Guaraldo L, Campos DP, Costa AP, Daniel-Ribeiro CT, Brasil P. Plasmodium vivax malaria relapses at a travel medicine centre in Rio de Janeiro, a non-endemic area in Brazil. Malar J. 2012;11:245.CrossRefPubMedPubMedCentral Pedro RS, Guaraldo L, Campos DP, Costa AP, Daniel-Ribeiro CT, Brasil P. Plasmodium vivax malaria relapses at a travel medicine centre in Rio de Janeiro, a non-endemic area in Brazil. Malar J. 2012;11:245.CrossRefPubMedPubMedCentral
22.
go back to reference Costa AP, Bressan CS, Pedro RS, Souza RV, Silva S, Souza PR, et al. Diagnostico tardio de malária em área endêmica de dengue na extra-Amazônia brasileira: experiência recente de uma unidade sentinela no Estado do Rio de Janeiro. Rev Soc Bras Med Trop. 2010;43:571–4.CrossRef Costa AP, Bressan CS, Pedro RS, Souza RV, Silva S, Souza PR, et al. Diagnostico tardio de malária em área endêmica de dengue na extra-Amazônia brasileira: experiência recente de uma unidade sentinela no Estado do Rio de Janeiro. Rev Soc Bras Med Trop. 2010;43:571–4.CrossRef
25.
go back to reference Mascheretti M, Boulos M, Lopes M, Sartori AM, Garcia C. Health advice in a Brazilian travel service. 9th Conference of the International Society of Travel Medicine. Lisbon: International Society of Travel Medicine; 2005. p. 178. Mascheretti M, Boulos M, Lopes M, Sartori AM, Garcia C. Health advice in a Brazilian travel service. 9th Conference of the International Society of Travel Medicine. Lisbon: International Society of Travel Medicine; 2005. p. 178.
26.
go back to reference Genton B, D’Acremont V. Malaria prevention in travelers. Infect Dis Clin North Am. 2012;26:637–54.CrossRefPubMed Genton B, D’Acremont V. Malaria prevention in travelers. Infect Dis Clin North Am. 2012;26:637–54.CrossRefPubMed
27.
go back to reference Schlagenhauf P, Adamcova M, Regep L, Schaerer MT, Rhein HG. The position of mefloquine as a 21st century malaria chemoprophylaxis. Malar J. 2010;9:357.CrossRefPubMedPubMedCentral Schlagenhauf P, Adamcova M, Regep L, Schaerer MT, Rhein HG. The position of mefloquine as a 21st century malaria chemoprophylaxis. Malar J. 2010;9:357.CrossRefPubMedPubMedCentral
29.
go back to reference Pagès F, Boutin JP, Meynard JB, Keundjian A, Ryfer S, Giurato L, et al. Tolerability of doxycycline monohydrate salt vs. chloroquine–proguanil in malaria chemoprophylaxis. Trop Med Int Health. 2002;7:919–24.CrossRefPubMed Pagès F, Boutin JP, Meynard JB, Keundjian A, Ryfer S, Giurato L, et al. Tolerability of doxycycline monohydrate salt vs. chloroquine–proguanil in malaria chemoprophylaxis. Trop Med Int Health. 2002;7:919–24.CrossRefPubMed
30.
go back to reference Michel R, Bardot S, Queyriaux B, Boutin JP, Touze JE. Doxycycline-chloroquine vs. doxycycline-placebo for malaria prophylaxis in nonimmune soldiers: a double-blind randomized field trial in sub-Saharan Africa. Trans R Soc Trop Med Hyg. 2010;104:290–7.CrossRefPubMed Michel R, Bardot S, Queyriaux B, Boutin JP, Touze JE. Doxycycline-chloroquine vs. doxycycline-placebo for malaria prophylaxis in nonimmune soldiers: a double-blind randomized field trial in sub-Saharan Africa. Trans R Soc Trop Med Hyg. 2010;104:290–7.CrossRefPubMed
31.
go back to reference Barrett PJ, Emmins PD, Clarke PD, Bradley DJ. Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as antimalarial prophylaxis: postal and telephone survey of travellers. BMJ. 1996;313:525–8.CrossRefPubMedPubMedCentral Barrett PJ, Emmins PD, Clarke PD, Bradley DJ. Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as antimalarial prophylaxis: postal and telephone survey of travellers. BMJ. 1996;313:525–8.CrossRefPubMedPubMedCentral
32.
go back to reference Jacquerioz FA, Croft AM. Drugs for preventing malaria in travellers. Cochrane Database Syst Rev. 2009;4:CD006491. Jacquerioz FA, Croft AM. Drugs for preventing malaria in travellers. Cochrane Database Syst Rev. 2009;4:CD006491.
33.
go back to reference Gething PW, Elyazar IR, Moyes CL, Smith DL, Battle KE, Guerra CA, et al. A long neglected world malaria map: Plasmodium vivax endemicity in 2010. PLoS Negl Trop Dis. 2012;6:e1814.CrossRefPubMedPubMedCentral Gething PW, Elyazar IR, Moyes CL, Smith DL, Battle KE, Guerra CA, et al. A long neglected world malaria map: Plasmodium vivax endemicity in 2010. PLoS Negl Trop Dis. 2012;6:e1814.CrossRefPubMedPubMedCentral
34.
go back to reference Behrens RH, Stauffer WM, Barnett ED, Loutan L, Hatz CF, Matteelli A, et al. Travel case scenarios as a demonstration of risk assessment of VFR travelers: introduction to criteria and evidence-based definition and framework. J Travel Med. 2010;7:153–62.CrossRef Behrens RH, Stauffer WM, Barnett ED, Loutan L, Hatz CF, Matteelli A, et al. Travel case scenarios as a demonstration of risk assessment of VFR travelers: introduction to criteria and evidence-based definition and framework. J Travel Med. 2010;7:153–62.CrossRef
35.
go back to reference Mueller I, Galinski MR, Baird JK, Carlton JM, Kochar DK, Alonso PL, et al. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis. 2009;9:555–66.CrossRef Mueller I, Galinski MR, Baird JK, Carlton JM, Kochar DK, Alonso PL, et al. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis. 2009;9:555–66.CrossRef
36.
go back to reference Siqueira AM, Lacerda MV, Magalhães BM, Mourão MP, Melo GC, Alexandre MA, et al. Characterization of Plasmodium vivax-associated admissions to reference hospitals in Brazil and India. BMC Med. 2015;13:57.CrossRefPubMedPubMedCentral Siqueira AM, Lacerda MV, Magalhães BM, Mourão MP, Melo GC, Alexandre MA, et al. Characterization of Plasmodium vivax-associated admissions to reference hospitals in Brazil and India. BMC Med. 2015;13:57.CrossRefPubMedPubMedCentral
37.
go back to reference Center of Diseases Control. CDC Health Information for International Travel. In: Kotton CN, Freedman DO, editors. Advising travelers with specific needs immunocompromised travelers. Atlanta: CDC; 2016. Center of Diseases Control. CDC Health Information for International Travel. In: Kotton CN, Freedman DO, editors. Advising travelers with specific needs immunocompromised travelers. Atlanta: CDC; 2016.
Metadata
Title
Pre-travel malaria chemoprophylaxis counselling in a public travel medicine clinic in São Paulo, Brazil
Authors
Tânia do Socorro Souza Chaves
Wuelton Marcelo Monteiro
Jessé Reis Alves
Marcus Lacerda
Marta Heloisa Lopes
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2017
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-017-1713-3

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