Malaria prophylaxis prescribed for travellers from New Zealand

Aim. To investigate advice given by general practitioners on the use of chemoprophylaxis and other preventive measures against malaria. Method. Four hundred general practitioners were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Results. Three hundred and thirty two (83%) general practitioners responded. Advice concerning malaria (310/ 310, 100%) and insect avoidance (287/299, 96%) was commonly given. The most commonly prescribed regimes for malaria chemoprophylaxis were chloroquine (93/305, 30.5%), chloroquine plus either quinine or mefloquine as a standby (63/305, 21%), mefloquine (45/305, 15%), chloroquine/Maloprim((R)) (pyrimethamine/dapsone) (41/305, 13%), doxycycline (26/305, 8%), and chloroquine plus doxycycline (24/305, 8%). Chloroquine plus Maloprim((R)) was used significantly more by general practitioners in older age groups, ie 45 years and over (p < 0.05). Conclusions. This cross sectional study has shown variability in the patterns of antimalarials used. Issues of concern include continued use of chloroquine alone, given widespread global resistance, and the use of Maloprim.((R)) Although Maloprim((R)) use has not been recommended since 1992, it is still being used by a substantial minority of general practitioners. This issue, which needs to be addressed nationally, is of concern given the adverse events associated with the use of Maloprim.((R)) New methods for the effective dissemination of information regarding appropriate chemoprophylaxis need to be developed.