title: Malaria chemoprophylaxis recommendations for immigrants to Europe, visiting relatives and friends--a Delphi method study.
abstract: BACKGROUND
  Numbers of travellers visiting friends and relatives (VFRs) from Europe to malaria endemic countries are increasing and include long-term and second generation immigrants, who represent the major burden of malaria cases imported back into Europe. Most recommendations for malaria chemoprophylaxis lack a solid evidence base, and often fail to address the cultural, social and economic needs of VFRs.
  
  
  METHODS
  European travel medicine experts, who are members of TropNetEurop, completed a sequential series of questionnaires according to the Delphi method. This technique aims at evaluating and developing a consensus through repeated iterations of questionnaires. The questionnaires in this study included questions about professional experience with VFRs, controversial issues in malaria prophylaxis, and 16 scenarios exploring indications for prescribing and choice of chemoprophylaxis.
  
  
  RESULTS
  The experience of participants was rather diverse as was their selection of chemoprophylaxis regimen. A significant consensus was observed in only seven of 16 scenarios. The analysis revealed a wide variation in prescribing choices with preferences grouped by region of practice and increased prescribing seen in Northern Europe compared to Central Europe.
  
  
  CONCLUSIONS
  Improving the evidence base on efficacy, adherence to chemoprophylaxis and risk of malaria and encouraging discussion among experts, using techniques such as the Delphi method, may reduce the variability in prescription in European travel clinics.
authors: Amedeo di Savoia Hospital, Department of Infectious Diseases, Travel Medicine Unit, Corso Svizzera 164, 10149-Torino, Italy. calleri@aslto2.it
authors: Guido
authors: G
authors: Calleri
authors: Ron H
authors: RH
authors: Behrens
authors: Matthias L
authors: ML
authors: Schmid
authors: Federico
authors: F
authors: Gobbi
authors: Martin P
authors: MP
authors: Grobusch
authors: Francesco
authors: F
authors: Castelli
authors: Joaquim
authors: J
authors: Gascon
authors: Zeno
authors: Z
authors: Bisoffi
authors: Tomas
authors: T
authors: Jelinek
authors: Pietro
authors: P
authors: Caramello
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