Malaria prevention: the general practitioners experience on the Reunion Island.

: Malaria has been officially eradicated from the Reunion Island since 1979. However, a potentially active vector of the disease - Anopheles arabiensis - persists on the island. The risk of resurgence is quite significant. More than 90%of the patients presenting a malarial infection in Reunion Island after a stay in Madagascar or in the Comoros had followed a chemoprophylaxis that was not in accordance with the guidelines. A survey, that included 100 general practitioners, wasconducted in the Reunion Island regarding their practices concerning the malaria prevention. The upshot of all this is that these doctors themselves do not follow the optimal malaria prevention practices during journeys, and neglect their protection against mosquito bites. Travelers' consultations with the doctors before a journey represent only a modest part of their activity. However, the general practitioner is considered to be the interlocutor of choice for these patients. During these consultations, they do not refer enough to the national references which, according to a number of practitioners, are difficult to obtain. On the contrary, they refer too much to the information delivered by the pharmaceutical industry. With regard to the prescriptions of prophylactic treatments, only 40% of the doctors respect the official recommendations. This gap in the recommendations is sometimes deliberate and justified by the very high cost of a number of treatments. However, a lack of up-to-date knowledge cannot be excluded. Finally, the promotion of the protection against mosquito bites remains very poor. According to these data, it seems important to promote networking between the doctors and the reference centers, which would enhance optimal practices concerning chemoprophylaxis and protection against mosquito bites, especially targeting the "at risk" patients.