title: Problems in prescribing malaria chemoprophylaxis for travelers.
abstract: To offer effective malaria chemoprophylaxis for travelers in a country, the physician must know the precise status of malaria there (frequency, resistance), determine the degree of exposure to mosquito bites, evaluate the precise clinical condition of the traveler, and improve the traveler's compliance with treatment by providing good information on potential side-effects. These side-effects, sometimes overemphasized in the media, lead to poor compliance, particularly after returning home, and, consequently, increase the risk of acquiring malaria. The recently approved Malarone could overcome these drawbacks. But its cost is high and its wide use could also lead to the emergence of resistant strains. Therefore, training professionals in travel medicine is important in malaria prevention and decrease the prescription of abusive or inaccurate prophylaxis (e.g., most tourists traveling in organized tours in Asia, with no stay in remote malaria endemic areas, do not need any prophylaxis). In addition, prevention of mosquito bites with repellents, impregnated bed nets, and indoor insecticide-dispensing devices is still an important tool for controlling malaria in travelers.
authors.affiliation: Centre de Vaccinations Internationales, Hôpital Cochin, Assistance Publique/Hôpitaux de Paris, 27, rue du Faubourg Saint Jacques - 75014 Paris, France. jean.dupouy-camet@cch.ap-hop-paris.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Dupouy-Camet
authors.forename: Hélène
authors.initials: H
authors.lastname: Yera
authors.forename: Claudine
authors.initials: C
authors.lastname: Tourte-Schaeffer
mesh_terms: D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D053626:Atovaquone; D002648:Child; D004334:Drug Administration Schedule; D004338:Drug Combinations; D018432:Drug Resistance, Multiple; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007299:Insect Bites and Stings / Q000517:prevention & control; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods; D009285:Naphthoquinones / Q000627:therapeutic use; D010349:Patient Compliance; D011247:Pregnancy; D002727:Proguanil / Q000627:therapeutic use; D014195:Travel
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D009285:Naphthoquinones; C109496:atovaquone, proguanil drug combination; D002727:Proguanil; D053626:Atovaquone