Success of malaria chemoprophylaxis for outbound civil and military travellers in prevention of reintroduction of malaria in Sri Lanka

Abstract

Background: Sri Lanka was certified as malaria-free in September 2016. However, the continuous presence of the malaria vector poses serious risks of reintroduction of the disease. Chemoprophylaxis and advice on malaria preventive behaviour for international travellers is a key strategy adopted to reduce the risk of imported malaria. Methods: We conducted an efficiency study of malaria chemoprophylaxis for civilian and military travellers who requested travel advice from the Anti Malaria Campaign (AMC) prior to departure. The AMC is the only agency that can issue malaria chemoprophylaxis to travellers and hence this sample is representative of all such individuals seeking travel advice in Sri Lanka. Results: A total of 544 (400 civilians and 144 military) travellers were interviewed prior to departure and after return. The majority travelled to African destinations (516/544 [94.8%]) and were prescribed mefloquine (517/544 [95%]). Chemoprophylaxis was well tolerated and discontinuation due to adverse events was minimal. Regular chemoprophylaxis was reported by 505 (92.8%) participants while overseas. The protective efficacy of chemoprophylaxis was 100% among those who complied with the full course. Conclusions: The compliance with chemoprophylaxis and its protective efficacy were satisfactory in this study. It is an effective tool in preventing imported malaria to post-elimination Sri Lanka.