Travelers are given safety recommendations about food-borne illness, water precautions, altitude illness, and environmental risks. About 50% of travelers visiting the center require malaria prophylaxis and many are prescribed once daily atovaquone-proguanil. The recommended dosing regimen is one pill by mouth daily starting 2 days before, each day during, and 7 days after travel to malarious areas. The purpose of our study was to assess
adherence to this regimen and identify any factors that may alter adherence. This was a prospective, non-blinded study from July 2008 through December 2008 to evaluate atovaquone-proguanil adherence. All travelers aged 18 years and older who visited our Selleck ABT-199 travel clinic and selected atovaquone-proguanil as chemoprophylaxis were eligible for enrollment. Those who were pregnant or reported prior adverse effects to atovaquone-proguanil or any one of
its components were excluded. Prior to enrollment, all travelers received pre-travel consultation, which included a discussion of protective measures for mosquito prevention in accordance with IDSA guidelines.7 They were instructed on the use of DEET-containing products as well as their options for FGFR inhibitor appropriate chemoprophylaxis and adverse effects associated with each agent. Within 3 weeks of returning home from the malarious area, one of the investigators contacted the traveler by telephone to determine atovaquone-proguanil adherence. The telephone conversation consisted of seven Oxymatrine questions regarding completion of the medication course. If the traveler reported that the medication course was not completed, follow-up questions were asked about the factors which may have contributed to non-adherence. They were also asked if the medication was taken as directed (ie, with food) and how many doses, if any, were missed. In addition to the questions asked via telephone, demographic data including age, sex, race, country of origin, occupation, previous malarious
travel, and previous malaria chemoprophylaxis were recorded. All responses were entered into a database and analyzed using SAS (SAS Institute, Cary, NC, USA). The study was approved by the Institutional Review Board of the North Shore/Long Island Jewish Health System. Between July 21, 2008, and December 12, 2008, 124 individuals from our Travel and Immunization Center were enrolled. One hundred and four were contacted via telephone and completed the questionnaire (83.9%) by the study’s conclusion. Of the 20 travelers for whom data were not obtained, 8 never went on their trip to the malarious region (6.5%), 11 were not able to be contacted (8.9%), and 1 was still traveling at the time the data were analyzed (0.8%). The mean age was 55.5 years with males accounting for 47%. The mean duration of the trips was 12 days; 18.3% reported previous travel to a malarious region, and 68.4% of those had taken atovaquone-proguanil prophylaxis.