Table 3 Main implications for implementation of malaria prophylaxis among forest goers

Prophylaxis as a part of malaria intervention

Prophylaxis should be implemented in combination with existing malaria services including use of ITNs, distribution of forest packages, and prompt testing and treatment

Targeting forest goers should consider their travel patterns and seasonality to ensure coverage of and access to the intervention, particularly among mobile population groups

Choice of regimen

Choice of regimen needs to consider frequency, dosing, and especially potential side effects of the drug to encourage uptake and minimize non-adherence

Delivery of prophylaxis and provider

Delivery of prophylaxis should be from a local, trusted, and trained provider with support from an equipped healthcare facility

Prophylaxis should be prescribed with a package of high-fat food (a pack of biscuits was used in this trial) to maximize lumefantrine absorption; the package should be easily portable and convenient for travelling and consumption in forest settings where meal preparation may be difficult

Messages about prophylaxis

Messages about prophylaxis should be clear and comprehensible (verbally and/or visually) in local language(s) with considerations for illiterate individuals and ethnic groups

Information about the cause of malaria infection, how prophylaxis works as a prevention, and why some malaria patients are asymptomatic can create a better understanding of prophylaxis and encourage its uptake

Emphasize the importance of continuing other modes of prevention to protect from mosquito bites (i.e. use of other measures) together with prophylaxis (i.e. preventive medicine)

Convey that side effects are rare and mild, and short-lived for those who may experience them