Efficacy of antimalarial chemoprophylaxis among French residents travelling to Africa.
Controversy exists about which antimalarial chemoprophylaxis regimen should be used among travellers to Africa: the WHO and other experts recommend the use of mefloquine throughout sub-Saharan Africa, whereas French experts still support the combination of chloroquine and proguanil in most of West Africa (the so-called zone 2 countries). In this case-control study based at a travel clinic, we examined the compliance with antimalarial chemoprophylaxis and its efficacy among travellers to tropical areas. Cases were patients with Plasmodium falciparum malaria (n = 131). Controls were patients who had a negative malaria film (n = 158). Of all controls, only 36 (22.8%) were adequately protected (i.e. compliant with an adapted regimen of chemoprophylaxis). In zone 2 countries, the efficacy of the combined chloroquine and proguanil was 58% (95% CI 22-78%) for all users, but increased to 100% (95% CI 89-100%) for compliant users. In zone 3 countries, the efficacy of mefloquine was 90% (95% CI 51-98%) and 100% (95% CI 58-100%) for all users and compliant users, respectively.
Fontanet
Arnaud L
AL
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, 28, rue du Docteur Roux, Paris 75015, France.
Houzé
Sandrine
S
Keundjian
Annick
A
Schiemann
Ricarda
R
Ralaimazava
Pascal
P
Durand
Rémy
R
Cha
Olivier
O
Coulaud
Jean-Pierre
JP
Le Bras
Jacques
J
Bouchaud
Olivier
O
D000328:Adult; D017954:Africa South of the Sahara; D000354:Africa, Western; D000962:Antimalarials / Q000627:therapeutic use*; D016022:Case-Control Studies; D002738:Chloroquine / Q000097:blood / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000208:ethnology; D006801:Humans; D016778:Malaria, Falciparum / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000097:blood / Q000627:therapeutic use; D008875:Middle Aged; D010349:Patient Compliance; D002727:Proguanil / Q000097:blood / Q000627:therapeutic use; D014195:Travel; D016896:Treatment Outcome
D000962:Antimalarials; D002738:Chloroquine; D002727:Proguanil; D015767:Mefloquine