Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

doi:10.1186/1475-2875-9-41

Malaria Journal

Volume 9

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Resseguier N
Machault V
Ollivier L
Orlandi-Pradines E
Texier G
Pradines B
Gaudart J
Buguet A
Tourette-Turgis C
Rogier C

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Resseguier N
Machault V
Ollivier L
Orlandi-Pradines E
Texier G
Pradines B
Gaudart J
Buguet A
Tourette-Turgis C
Rogier C
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Research

Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

Noémie Resseguier¹^,2^,3 , Vanessa Machault¹ , Lénaick Ollivier¹ , Eve Orlandi-Pradines¹ , Gaetan Texier¹^,2^,4 , Bruno Pradines¹ , Jean Gaudart²^,3 , Alain Buguet⁵ , Catherine Tourette-Turgis⁶ and Christophe Rogier¹

¹Institute for Biomedical Research of the French Army (IRBA) & URMITE UMR6236, Allée du Médecin Colonel Jamot, Parc du Pharo, BP60109, 13262 Marseille cedex 07, France

²Aix Marseille University, Faculty of Medicine Marseille, Laboratory of Education and Research in Medical Information Processing (LERTIM) EA 3283, Biostatistics Research Unit, Marseille, France

³Assistance Publique - Hôpitaux de Marseille, SSPIM Timone, Marseille, France

⁴Département d'épidémiologie et de santé publique & EA3283, Parc du Pharo, 13262 Marseille cedex 07, France

⁵EA4170 Free Radicals, Energy Substrates and Physiopathology, Claude-Bernard Lyon I University, 8 Avenue Rockefeller, 69373 Lyon cedex 08, France

⁶Institut d'éducation thérapeutique, Fondation partenariale, University Pierre et Marie Curie, Paris 6, and University of Rouen, France

author email corresponding author email

Malaria Journal 2010, 9:41doi:10.1186/1475-2875-9-41


Published:	3 February 2010

Abstract

Background

The effectiveness of malaria chemoprophylaxis is limited by the lack of compliance whose determinants are not well known.

Methods

The compliance with malaria chemoprophylaxis has been estimated and analysed by validated questionnaires administered before and after the short-term missions (about four months) in five tropical African countries of 2,093 French soldiers from 19 military companies involved in a prospective cohort study. "Correct compliance" was defined as "no missed doses" of daily drug intake during the entire mission and was analysed using multiple mixed-effect logistic regression model.

Results

The averaged prevalence rate of correct compliance was 46.2%, ranging from 9.6%to 76.6% according to the companies. Incorrect compliance was significantly associated with eveningness (p = 0.028), a medical history of clinical malaria (p < 0.001) and a perceived mosquito attractiveness inferior or superior to the others (p < 0.007). Correct compliance was significantly associated with the systematic use of protective measures against mosquito bites (p < 0.001), the type of military operations (combat vs. training activities, p < 0.001) and other individual factors (p < 0.05).

Conclusions

The identification of circumstances and profiles of persons at higher risk of lack of compliance would pave the way to specifically targeted strategies aimed to improve compliance with malaria chemoprophylaxis and, therefore, its effectiveness.