Implementation of pretravel advice: good for malaria, bad for diarrhoea.
Pretravel immunizations and health advice can substantially reduce the incidence of travel-related diseases. The aim of this study was to evaluate the implementation of pretravel advice among a homogenous group of students, who received similar written information on vaccination requirements and health advice. They were referred to the travel clinic (50%) or a general practitioner (50%) for vaccination, counselling and prescriptions. Eighty-four out of 110 students (76%) returned the questionnaire. Insect repellent was used by all and only 10 used the repellent for less than 75% of the time spent in malaria endemic areas. Malaria chemoprophylaxis was taken by all but one: chloroquine plus proquanil by 12 and mefloquine by 71. Reported compliance with the dosing regimen was optimal in 64 students, 9 missed one dose and 10 stopped too early. Side effects due to antimalarials were reported by 25 (30%). Diarrhoea during travel occurred in 43 students (51%). Loperamide was used by 34 students with diarrhoea (79%), but only 2 out of 27 students with moderate to severe diarrhoea used the recommended self-treatment with a fluoroquinolone antibiotic. In conclusion, the recommendations of malaria prophylaxis were well implemented by most travellers despite a high incidence of self-reported side effects to antimalarials. The incidence of traveller's diarrhoea was high and the recommendation for early self-treatment of moderate to severe diarrhoea with a fluoroquinolone antibiotic in combination with loperamide was not put into practice.
Peetermans
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Department of Internal Medicine, University Hospital Leuven, Leuven, Belgium. willy.peetermans@uz.kuleuven.ac.be
Van Wijngaerden
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D000328:Adult; D001530:Belgium; D003967:Diarrhea / Q000517:prevention & control*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007114:Immunization / Q000592:standards* / Q000639:trends; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D011322:Primary Prevention / Q000592:standards*; D013019:South Africa; D011795:Surveys and Questionnaires; D014195:Travel