title: The respect of recommendations provided in an international travelers' medical service: far from the cup to the lips.
abstract: BACKGROUND
  It is not clearly known how frequently the recommendations given to travelers are followed, and what factors could encourage compliance with these recommended measures.
  
  
  METHODS
  Adults consulting at a Medical Department for International Travelers (International Travelers' Medical Services, ITMS) in October and November 2010 were asked to answer a questionnaire before their journey. They were also contacted for a post-travel telephone interview to determine whether they had followed the recommendations regarding vaccinations and malaria prevention, and the reasons for poor or noncompliance with these recommendations.
  
  
  RESULTS
  A total of 353 travelers were included, with post-travel data available for 321 of them. Complete compliance with all the recommendations (vaccinations and malaria chemoprophylaxis) was observed in 186/321 (57.9%) of the travelers. Only 55.6% (233/419) of the prescribed vaccinations were given, with huge variability according to the type of vaccine. Only 57.3% (184/321) of the patients used a mosquito net. Among the 287 prescriptions for antimalarial drugs, 219 (76.3%) were taken correctly, 37 (12.9%) were taken incorrectly (noncompliance with the duration and/or dosage), and 31 (10.8%) were not taken at all. Traveling to areas of mass tourism (Kenya/Senegal), consulting their general practitioner (GP), and being retired were significantly and independently associated with better overall compliance in univariate and multivariate analyses.
  
  
  CONCLUSIONS
  Compliance could be improved by focusing on factors associated with poor compliance to improve the advice given to less compliant travelers, by providing clear information tailored to each traveler, with a focus on key messages, and by improving coordination between ITMS and GPs.
authors: Infectious Diseases Department, University-Hospital-CHU, Dijon, France.
authors: Jean Michel
authors: JM
authors: Muller
authors: Anne Laure
authors: AL
authors: Simonet
authors: Raphaelle
authors: R
authors: Binois
authors: Elisabeth
authors: E
authors: Muggeo
authors: Pierre
authors: P
authors: Bugnon
authors: Jérome
authors: J
authors: Liet
authors: Michel
authors: M
authors: Duong
authors: Pascal
authors: P
authors: Chavanet
authors: Lionel
authors: L
authors: Piroth
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000627:therapeutic use*; D018890:Chemoprevention / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005602:France; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control; D008875:Middle Aged; D057147:Mosquito Nets / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014195:Travel / Q000145:classification / Q000523:psychology / Q000706:statistics & numerical data; D057236:Travel Medicine / Q000379:methods; D014611:Vaccination / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D000962:Antimalarials