Malaria standby emergency treatment (SBET) for travellers visiting malaria endemic areas: a systematic review and meta-analysis.

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Version: Author's accepted manuscript
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Serval ID
serval:BIB_F9EDE4B557E4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Malaria standby emergency treatment (SBET) for travellers visiting malaria endemic areas: a systematic review and meta-analysis.
Journal
Journal of travel medicine
Author(s)
Tan R., Elmers J., Genton B.
ISSN
1708-8305 (Electronic)
ISSN-L
1195-1982
Publication state
Published
Issued date
01/06/2019
Peer-reviewed
Oui
Volume
26
Number
4
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Systematic Review
Publication Status: ppublish
Abstract
Malaria prevention methods for travellers to low or moderate malaria risk areas vary and remain controversial. Standby emergency treatment (SBET) for malaria is one possible strategy increasingly recommended since 1988 with little evidence on its effectiveness or how it is truly being used.
A systematic review and meta-analysis were performed based on a structured search in Embase, Medline, PubMed, Cochrane and Web of Science on 7 September 2018. The primary outcome was the overall prevalence of SBET use in travellers, and secondary outcomes were the proportion carrying SBET, the response to fever [use of SBET, health facility attendance and use of malaria rapid diagnostic test (mRDT)], adverse events to SBET and the proportion using SBET incorrectly (incorrect dosage/duration). The pooled SBET use prevalence was analysed using a random effects model. A descriptive summary was done to present secondary outcomes. The study protocol was registered with PROSPERO CRD42018103703.
A total of 11 studies were eligible for inclusion among the 1027 titles identified by our search. The studies included 7/11 prospective cohort studies that recruited pre-travel clinic attendees in Europe and 4/11 cross-sectional studies, of which 3 recruited travellers at airports before their return home from Southeast Asia and Africa and 1 from an employee registry including long-term travellers. The overall pooled prevalence of SBET use among the 26 403 travellers was 2.5% (95% confidence interval, 1.1-4.3%; range, 0.4-10.8%). There was significant variation in the proportion of travellers carrying SBET medication (40-100%), the proportion of travellers with appropriate response to fever (23-100%), adverse events (0-33%) and incorrect dosage/duration of SBET (0-100%).
Adherence to the proposed recommendations for SBET use, notably the response to fever, was poor. If the use of SBET is to be pursued, modifications to the current SBET strategy should be considered, such as better selection of travellers at higher risk for malaria and the potential addition of mRDTs.
Keywords
Antimalarials/adverse effects, Antimalarials/therapeutic use, Emergency Treatment, Humans, Malaria/prevention & control, Medication Adherence/statistics & numerical data, Travel, Malaria, SBET, mRDT, meta-analysis, standby emergency treatment, systematic review, traveller
Pubmed
Web of science
Open Access
Yes
Create date
28/04/2019 15:08
Last modification date
23/06/2020 6:21
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