Factors determining use of pre-travel preventive health services by West African immigrants in the Netherlands

Objective: To determine for what reasons West African immigrants, who contribute the largest single group of malaria cases in the Netherlands, visit pre-travel preventive health services and whether use of such services is likely to improve use of preventive measures. Methods: Semi-structured interviews with eligible participants recruited through West African churches and societies and at a large festival. Results: A total of 70% of the total non-random sample of 292 participants said that they always use pre-travel preventive health services before travelling. Being from Ghana (OR = 2.5), having legal residency status (OR = 2.5), visiting friends and relatives rather than going for business or funeral (OR = 6.7), and living in Amsterdam (OR = 5.1) were all independently associated with using pre-travel preventive health services, as were taking general preventive measures (OR = 3.0), and self-reported use of malaria prophylaxis. Higher use of pre-travel preventive health services was not associated with better knowledge of malaria as such. Conclusions: West Africans, in particular non-Ghanaians, illegal immigrants and West African immigrants leaving at short notice should be encouraged to use pre-travel preventive health services. Adequate methods to reach these groups need to be developed, including health education on the importance of prevention in general.

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