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Journal article

Survey and analysis of chemoprophylaxis policies for domestic travel in malaria-endemic countries

Abstract:
The prevention of malaria in travelers with the use of antimalarials often occurs in connection with international travel to areas of significant risk of infection. Although these travelers sometimes cause outbreaks in their malaria-free home countries, the cardinal objective of prescribed chemoprophylaxis is to protect the traveler from patent malaria during travel. Here we consider the chemoprophylaxis of domestic travelers from malaria-free but -receptive areas within malaria-endemic countries. The main objective in this setting is the protection of those areas from reintroduced malaria transmission. In order to better understand policy and practices in this regard, we surveyed malaria prevention and treatment guidelines of 36 malaria-endemic countries and 2 that have recently eliminated malaria (Sri Lanka, China) for recommendations regarding malaria chemoprophylaxis for domestic travel. Among them, just 8 provided specific and positive recommendations, 1 recommended without specific guidance, and 4 advised against the practice. Most nations (25/38; 66%) did not mention chemoprophylaxis for domestic travel, though many of those did offer guidance for international travel. The few positive recommendations for domestic travel were dominated by the suppressive prophylaxis options of daily doxycycline or atovaquone-proguanil or weekly mefloquine. The incomplete protection afforded by these strategies, along with impractical dosing in connection with the typically brief domestic travel, may in part explain the broad lack of policies and practices across malaria-endemic nations regarding chemoprophylaxis.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3390/tropicalmed7070121

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-2170-300X
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Role:
Author
ORCID:
0000-0002-7469-977X
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Role:
Author
ORCID:
0000-0003-3572-0457


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Funder identifier:
https://ror.org/029chgv08


Publisher:
MDPI
Journal:
Tropical Medicine and Infectious Disease More from this journal
Volume:
7
Issue:
7
Article number:
121
Place of publication:
Switzerland
Publication date:
2022-06-29
Acceptance date:
2022-05-31
DOI:
EISSN:
2414-6366
Pmid:
35878133


Language:
English
Keywords:
Pubs id:
1270263
Local pid:
pubs:1270263
Deposit date:
2025-01-14
ARK identifier:

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