Compliance with Atovaquone-Proguanil against Malaria of Korean Travelers Abroad

Nak Hyun Kwon; Tae Soo Park; Hyo Sung Kang; Sung Hoon Kim; Lae Seok Hwang; Hye Jin Noh; Ji Hwan Bang; Jae Yoon Kim; Hyoung Shik Shin

doi:10.3947/ic.2008.40.5.255

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Kwon, Park, Kang, Kim, Hwang, Noh, Bang, Kim, and Shin: Compliance with Atovaquone-Proguanil against Malaria of Korean Travelers Abroad

Original Article

Infection and Chemotherapy

Infection and Chemotherapy 2008; 40(5): 255-258.

Published online: 25 October 2008

DOI: https://doi.org/10.3947/ic.2008.40.5.255

Compliance with Atovaquone-Proguanil against Malaria of Korean Travelers Abroad

Nak Hyun Kwon, M.D.¹, Tae Soo Park, M.D.², Hyo Sung Kang, M.D.¹, Sung Hoon Kim, M.D.¹, Lae Seok Hwang, M.D.¹, Hye Jin Noh, M.D.^1,^*, Ji Hwan Bang, M.D.^1,³, Jae Yoon Kim, M.D.^2,³, Hyoung Shik Shin, M.D.^1,³

¹Department of Internal Medicine, National Medical Center, Seoul, Korea.

²Department of Pediatrics, National Medical Center, Seoul, Korea.

³International Travelers' Clinic, National Medical Center, Seoul, Korea.

Correspondence: Hyoung Shik Shin, M.D. Department of Internal Medicine, National Medical Center, 18-79 Euljiro 6-ga, Jung-gu, Seoul 100-799, Korea. Tel: +82-2-2260-7131, Fax: +82-2-2260-7111, bangmd@medimail.co.kr

Current address:

*Current Affiliation: Cardiac & Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.

Received 29 August 2008 Accepted 6 October 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Recently, many Korean people travel abroad where malaria is prevalent. However, in Korea, relatively little is known about compliance of chemoprophylaxis against malaria. This study was performed to determine the factors influencing compliance of chemoprophylaxis against malaria in Korean travelers.

Materials and Methods

Face to face interview, telephone interview and e-mail correspondence were performed to 241 people who were prescribed with atovaquone-proguanil at the international travelers' clinic of National Medical Center between February 2007 and October 2007.

Results

Total of 55 people out of 235 reported one or more events of adverse reactions after chemoprophylaxis (total 76 events). However, in 38 adverse events the link between chemoprophylaxis and adverse events were very weak. Compliance of malaria chemoprophylaxis with atovaquone-proguanil was 53.9% in the study group. The predictive factors for non-compliance were package tour, travel of business affair and young age group.

Conclusions

Compliance of malaria chemoprophylaxis in Korea travelers was low compared with Dutch and French studies. More efforts to increase compliance are needed, especially in travelers on package tour, business travel and people under age 40.

Keywords: Travel, Malaria, Chemoprophylaxis, Compliance, Atovaquone-proguanil

Figures and Tables

Table 1

Uni-and Multivariate Analyses of Risk Factors for Non-compliance with a Atovaquone-proguanil Chemoprophylaxis among 241 Korean Travelers to Endemic areas of Falciparum malaria

Hosmer-Lemeshow goodness-of-fit χ²=2.307 (df=8) P=0.9701

^*Continous variable expressed as mean ± std

^†P-values based on linear trend test or Chi-squared test

^‡Unadjusted odds ratio(OR) with 95% confidence intervals(CI) based on univariate logistic regression

^§Adjusted ORs with 95% CIs after controlling for all other variables in the model by multiple logistic regression

^‖P-value=0.0052 based on linear trend test

Table 2

Adverse Reactions of Atovaquone-proguanil Chemoprophylaxis

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