Quality assessment in a travel clinic:: A study of travelers' knowledge about malaria

Background. Quality in health care delivery is considered essential and should be expected for all who deliver health care. We were not able to identify in Portugal any previous studies that assessed the quality of travel medicine consultations. The aims of this study was to assess the impact of travel health advice on travelers' knowledge and the quality of the outcome of the travel consultations at the Institute of Hygiene and Tropical Medicine, Portugal. Method. We selected the quasi-experimental model "separate-sample pretest-posttest design." Two random samples were obtained (control and experimental groups). An anonymous self-administered questionnaire was applied during the second half of 2002, until we had received about 200 questionnaires for each group. The questions assessed travelers' knowledge of malaria, its transmission, prevention, and clinical features. Results. There was a significant improvement of travelers' knowledge in the postconsultation group, with 98.5% of individuals understanding that malaria is transmitted by mosquito bite (p = 0.005), 91.5% that malaria may be prevented by appropriate prophylactic medication (p = 0.007), and 93% knowing that malaria is prevented by avoiding mosquito bites (p = 0.003). However, almost half of the postconsultation group did not realize that there was no vaccine available for preventing malaria (p < 0.001) or that avoiding unsafe food and drink did not prevent malaria (p = 0.006). About 53% gave correct answers about malaria incubation periods (p < 0.001), and 91.1% were able to identify the initial symptoms of malaria (p < 0.001). Conclusions. Travel medicine consultations increase the knowledge base of travelers but do not achieve 100% correct answers. Our results suggest that during a travel health consultation, critical information is assimilated about the prevention of malaria, but myths and misunderstandings that are held by travelers are not completely dispelled.