It has to be noted that 3.1% of the patients stopped malaria prophylaxis because they did not see any mosquitoes in the area they stayed in. By contrast, 25.9% of the travelers developed and had to be treated for diarrhea during their trip, which is similar to rates observed in other larger studies (22.2% of cases of diarrhea among 17,353 travelers in the study of Freedman and colleagues[7] and 19.1% of cases of diarrhea among 622 French travelers[8]).

The risk scale for the different diseases[9] as well as their potential severity has to be detailed and explained in order to improve compliance with preventive measures. This study suffers from several limitations. First of all, it included only three quarters of all the patients who attended the ITMS during the study period. It is possible that compliance with recommendations in the missing quarter, Ferroptosis inhibitor and in travelers who did not attend an ITMS consultation could be different, since it cannot be established if their profile or the characteristics of their trips differed from those in travelers who agreed to participate. Moreover, since nearly all of the travelers

included came to the ITMS to be vaccinated against yellow fever (which could be either mandatory or simply recommended Raf tumor depending on the travel destination), and even though they did not necessarily seek advice for other recommendations, the patients who participated were at least minimally aware of the interest of prevention. It can thus be speculated that compliance in the travelers of this study was no worse than that in the

whole population of travelers to at-risk destinations. The same remark may also be relevant regarding the assessment of compliance. Indeed, compliance was self-reported and it cannot be ascertained that it corresponded to reality. It could be suggested, in such cases, that compliance would tend to be overestimated, which Neratinib order would thus reinforce the main message of the study, ie, the strikingly low rate of compliance. More specifically, some travelers may not have used mosquito nets because there were screens in front of the windows in the hotels or houses where they stayed during their trip. Nevertheless, this could not explain the low rate of compliance with malaria chemoprophylaxis and vaccine recommendations. In conclusion, clear information tailored to each traveler, with a focus on key messages that take into account the main determinants of compliance may contribute to improving it. The purpose is to motivate travelers to adopt an active care process, not by worrying them with threats and aggressive measures, but instead by encouraging them to prepare a pleasant trip. Closer cooperation with GPs may be helpful to reach this goal. The authors state that they have no conflicts of interest. “
“Background. Globally, more than 1.