BACKGROUND The aim of this systematic review was to identify predictors of actual or intended adherence with malaria chemoprophylaxis amongst travellers from non-endemic countries visiting endemic countries. METHODS A systematic review of the literature was conducted using MEDLINE, Embase, PsycINFO and Global Health databases for studies published up to April 2019. Studies were included if they assessed reasons for adherence among people travelling from a country where malaria was not endemic to a country where it was. RESULTS Thirty-two studies were included. Predictors of adherence were categorized as relating to either the nature of the travel or the traveller themselves. The three main predictors associated with nature of travel included: destination (e.g. country visited, urban vs rural areas), length of travel and type of travel (e.g. package vs backpacking holiday). The four main traveller-associated predictors were: age, reason for travel (e.g. business, leisure or visiting friends and relatives), perceived risk of catching malaria and experienced or expected medication effects. CONCLUSIONS In order to improve adherence, clinicians should focus on travellers who are least likely to exhibit adherent behaviour. This includes travellers visiting destinations known to have lower adherence figures (such as rural areas), backpackers, business travellers, younger travellers and those travelling for longer periods of time. They should also check to ensure travellers' perceptions of the risks of malaria are realistic. Where appropriate, misperceptions (such as believing that curing malaria is easier than taking prophylaxis or that travellers visiting relatives have some level of innate immunity) should be corrected. All travellers should be informed of the potential side-effects of medication and given guidance on why it is nonetheless beneficial to continue to take prophylaxis. Further research is required to test interventions to improve adherence.

中文翻译：

---

对来自非流行国家的旅行者中遵守疟疾化学预防措施的因素进行了系统评价。

背景技术该系统综述的目的是在访问流行国家的非流行国家的旅行者中确定实际或预期的疟疾化学预防依从性的预测因子。方法使用MEDLINE，Embase，PsycINFO和Global Health数据库对截至2019年4月发表的研究进行系统的文献综述。如果研究评估了疟疾不在一个国家流行的国家旅行的人们依从性的原因，则纳入研究。它在哪里。结果共纳入32项研究。依从性的预测因素归类为与旅行的性质或旅行者本身有关。与旅行性质相关的三个主要预测因素包括：目的地（例如访问的国家，城市与农村地区），旅行时间和旅行类型（例如 包与背包度假）。与旅行者相关的四个主要预测因素是：年龄，旅行原因（例如，商务，休闲或来访的亲戚），感知到的感染疟疾的风险以及经验或预期的用药效果。结论为了改善依从性，临床医生应关注那些最不可能表现出依从性行为的旅行者。这包括前往依从性较低的目的地（例如农村地区），背包客，商务旅行者，年轻旅行者和时间较长的旅行者。他们还应检查以确保旅行者对疟疾风险的认识是切合实际的。在适当情况下，误解（例如认为治愈疟疾比预防疟疾容易，或者来访亲戚的旅行者具有一定水平的先天免疫力）应予以纠正。应告知所有旅行者药物的潜在副作用，并就继续采取预防措施为何有益的方法提供指导。需要进一步的研究来测试干预措施以提高依从性。