Study Of Malaria Cases Among Seafarers In Croatia And The Causes Of Ineffective Chemoprophylaxis Among Them

Introduction: Malaria in Croatia was endemic until 1954, when the last autochthonous cases were reported. Now we have imported cases and the disease still most commonly affects seafarers and workers temporarily employed in malaria endemic countries. The aim of this study was to investigate ineffective malaria chemoprophylaxis among Croatian seafarers. Materials and methods: This study used the data collected by questionnaires that followed every imported case of malaria in Croatia. In addition, a survey was conducted among the seafarers attending the Special education program at the Faculty of Maritime Studies in Split, regarding their attitudes / reasons for not using chemoprophylaxis using a short questionnaire. Results: From the 1st January 2007 to 31st December 2019 there was a total of 108 imported malaria cases in Croatia, of which 22 (20.37%) referred to seafarers. In situations reporting the information whether the infected seafarers used chemoprophylaxis, twenty seafarers (91% of the overall infected) responded that they had not used chemoprophylaxis, while two of them (9.0%) responded that they had used it incorrectly. Conclusion: It appears that the main reason for avoiding chemoprophylaxis is the fear of side-effects. Some of the respondents, particularly the young ones, stated that they were not vaccinated – which is a proof of ignorance, as the vaccine does not exist. How to familiarise and motivate maritime students and seafarers to participate actively in protection against malaria – this is an issue that is important not only in Croatia but, presumably, in other countries as well.