• Rim Boubaker, Annie Hérard Fossati, Pierrette Meige, Catherine Mialet, Chantal Ngarambe Buffat, Jacynthe Rochat, Manisinh Souvannaraj-Blanchant, Mediatrice Uwanyiligira, Francine Widmer, Sylvie Payot, Laurence Rochat, Serge de Vallière, Valérie D'Acremont, and Blaise Genton.
• Travel Clinic, Department of Ambulatory Care and Community Medicine, University Hospital, Lausanne, Switzerland.
• J Travel Med. 2017 Sep 1; 24 (5).

BackgroundThere are several possible malaria prevention strategies for travellers. In Switzerland, chemoprophylaxis (CP) is recommended for persons visiting areas highly endemic for malaria and stand-by emergency treatment (SBET) for areas with moderate to low risk.ObjectiveTo describe the type of malaria prevention prescribed to travel clinic attendees with a specific focus on changes over time following adaptation of recommendations.MethodsAll pre-travel first consultation data recorded between November 2002 and December 2012 were included. Country-specific malaria preventive recommendations provided and medicines prescribed over time were analysed.ResultsIn total, 64 858 client-trips were recorded. 91% of travellers planned to visit a malaria endemic country. Among those clients, 42% were prescribed an antimalarial medicine as CP only, 36% as SBET only, and 3% both. Between 2002 and 2012, there was a 16% drop of CP prescription ( P  < 0.001) and a 21% increase of SBET prescription ( P  < 0.001). Among travellers receiving CP, the proportion of those prescribed mefloquine dropped from 82% in 2002 to 46% in 2012 while those prescribed atovaquone-proguanil (AP) increased from 7% to 39%. For those prescribed SBET, the proportion dropped from 46% to 30% for AP and increased from 2% to 61% for artemether-lumefantrine. CP prescription for travellers to India fell from 62% to 5% and SBET prescription increased from 40% to 88% after the change of recommendation from CP to SBET in 2005 for this country. Comparatively, CP prescription for travellers to Senegal, for which no change of recommendation occurred, remained relatively stable between 88% in 2002 and 89% in 2012.ConclusionThis study shows the considerable decline of antimalarial prescription for chemoprophylaxis that occurred over the 10-year period in favour of SBET.© International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

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