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Performance of self-diagnosis and standby treatment of malaria in international oilfield service employees in the field.

Abstract：

BACKGROUND:Falciparum malaria remains a major occupational illness that accounts for several deaths per year and numerous lost working days among the expatriate population, working or living in high-risk malarious areas. Compliance to preventive strategies is poor in travellers, especially business travellers, expatriates and long-term travellers. METHODS:In this cross-sectional, web-based study the adherence to and outcome of a preventive malaria programme on knowledge, attitudes and practices, including the practice of self-diagnosis and standby treatment (curative malaria kit, CMK) was evaluated in 2,350 non-immune expatriates, who had been working in highly malaria endemic areas. RESULTS:One-third (N = 648) of these expatriates visited a doctor for malaria symptoms and almost half (29 of 68) of all hospitalizations were due to malaria. The mandatory malaria training for non-immunes was completed by 92% of those who visited or worked in a high risk malaria country; 70% of the respondents at risk also received the CMK. The malaria awareness training and CMK significantly increased malaria knowledge [relative risk (RR) of 1.5, 95%CI 1.2-2.1], attitudes and practices, including compliance to chemoprophylaxis [RR = 2.2, 95%CI 1.6-3.2]. Hospitalization for malaria tended to be reduced by the programme [RR = 0.4, 95%CI 0.1-1.1], albeit not significantly. Respondents who did not receive instructions on the rapid diagnostic test were two times [RR = 2.3, 95%CI 1.6-3.3] more likely to have difficulties. Those who did receive instructions adhered poorly to the timing of repeating the test. Moreover, 6% (31 of 513) of those with a negative test result were diagnosed with malaria by a local doctor. 77% (N = 393) of the respondents with a negative test result did not take curative medication. 57% (252 of 441) of the respondents who took the curative medication that was included in the kit did not have a positive self-test or clinical malaria diagnosis made by a doctor. CONCLUSION:This survey demonstrated that a comprehensive programme targeting malaria prevention in expatriates can be effectively implemented and that it significantly increased malaria awareness.

journal_name

Malar J

journal_title

Malaria journal

authors

Roukens AH,Berg J,Barbey A,Visser LG

doi

10.1186/1475-2875-7-128

subject

Has Abstract

pub_date

2008-07-14 00:00:00

pages

128

issn

1475-2875

pii

1475-2875-7-128

journal_volume

pub_type

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Performance of self-diagnosis and standby treatment of malaria in international oilfield service employees in the field.