title: Requests for malaria prevention advice to Public Health England, Malaria Reference Laboratory: a retrospective observational study.
abstract: BACKGROUND
  The Malaria Reference Laboratory (MRL) provides a specialist advisory service for complex queries from healthcare professionals. This study was conducted to examine the types of queries that general practitioners and nurses ask around malaria prophylaxis, to identify issues which are not obvious from existing easily available sources.
  
  
  METHODS
  We reviewed all the faxed requests received over a period of 6 months at the MRL.
  
  
  RESULTS
  There were a total of 608 queries (104 concerning children) relating to 450 travellers. 98% of requests were from general practice (GP or practice nurse). The most common enquiries were about travellers to multiple destinations (95/529, 17.96%), prolonged duration of travel (70/529, 13.23%), the immunosuppressed (38/529, 7.18%), potential drug interactions (69/529, 13.04%), pregnancy and conception (36, 6.81%). 79/529 queries related to patients with multiple conditions requiring expert advice from the MRL. 27% of the enquiries could have been answered by consulting the UK malaria prophylaxis guidelines available on the MRL site.
  
  
  CONCLUSIONS
  Most queries where practitioners requested help were not easily answered with existing guidelines. Pregnancy and epilepsy are areas where guidance needs strengthening. Difficulties for practitioners were multifactorial, it would be difficult to address all scenarios in guidelines without making them unwieldy.
authors.affiliation: Public Health England, Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, Keppel St, London, UK. gaurigodbole@doctors.org.uk
authors.forename: Gauri
authors.initials: G
authors.lastname: Godbole
authors.forename: Marie
authors.initials: M
authors.lastname: Blaze
authors.forename: Valerie
authors.initials: V
authors.lastname: Smith
authors.forename: Christopher J M
authors.initials: CJ
authors.lastname: Whitty
authors.forename: Peter L
authors.initials: PL
authors.lastname: Chiodini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D058006:General Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011634:Public Health; D012189:Retrospective Studies; D014195:Travel; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000962:Antimalarials
keywords: Malaria; Prophylaxis; Travellers