title: The knowledge, attitudes and practices of wintersun vacationers to the Gambia toward prevention of malaria: is it really that bad?
abstract: BACKGROUND
  Each year clusters of imported malaria cases are observed in Dutch wintersun vacationers returning from The Gambia. To gain more insight in the travel health preparation and awareness of these travellers, the knowledge, attitudes and practices (KAP) of this travel group was studied by analysing the data of the Continuous Dutch Schiphol Airport Survey.
  
  
  METHODS
  In the years 2002 to 2009 a questionnaire-based survey was conducted at the Dutch Schiphol Airport with the aim to study the KAP, i.e. accuracy of risk perception ("knowledge"), intended risk-avoiding behaviour ("attitude") and use of personal protective measures and malaria chemoprophylaxis ("practice") toward prevention malaria in travellers to The Gambia. Travellers to other high-risk destinations served as controls.
  
  
  RESULTS
  The KAP of travellers to The Gambia toward prevention of malaria was significantly better than that observed in other travellers. Trend analyses indicated that attitude improved over time in both groups but knowledge did not change. Only in travellers to high-risk countries other than The Gambia significant increases in protection rates were observed over time.
  
  
  CONCLUSIONS
  The KAP of travellers to The Gambia toward prevention of malaria was better than that observed in travellers to destinations other than The Gambia. Trend analyses revealed a significant improvement of intended risk avoiding behaviour but not in protection rates or risk perception.
authors.affiliation: Institute for Tropical Diseases, Havenziekenhuis, Haringvliet 72, 3011 TG Rotterdam, The Netherlands. p.van.genderen@havenziekenhuis.nl.
authors.forename: Perry J J
authors.initials: PJ
authors.lastname: van Genderen
authors.forename: Paul G H
authors.initials: PG
authors.lastname: Mulder
authors.forename: David
authors.initials: D
authors.lastname: Overbosch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005714:Gambia / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014195:Travel; D055815:Young Adult