Good afternoon, and thank you for the opportunity to speak specifically about the Committee to Advise on Tropical Medicine and Travel, CATMAT, and its role and process in developing medical, scientific, and public health advice relating to tropical disease and health risks associated with international travel.
The committee, more commonly referred to as CATMAT, is an expert advisory body to the Public Health Agency of Canada and is made up of health professionals, all volunteers, in the fields of tropical medicine, travel medicine, travel health, infectious disease, and epidemiology. Also included are liaison members from relevant associations, including the Association of Medical Microbiology and Infectious Disease Canada and the Canadian Paediatric Society. In addition, we have ex officio representatives from Health Canada and the Department of National Defence who participate in the committee's activities.
In developing its guidelines, the committee undertakes a very thorough review of the scientific literature and also reviews recent research and international and national epidemiological data to tailor its recommendations to the Canadian context. Influencing factors in its recommendations include the drugs available for use in Canada, Canadian-specific travel patterns, and related disease epidemiology or patterns of disease.
CATMAT considers the need for protection and weighs that against the potential for adverse effects that could be associated with treatment or prevention therapies and the values and preferences of Canadian travellers and health care providers. CATMAT regularly reviews and updates its guidelines as new information becomes available so that Canadian health care providers have the information they require to provide appropriate guidance to individual travellers.
With respect to the “Canadian Recommendations for the Prevention and Treatment of Malaria”, these were last developed and published by CATMAT in 2014. CATMAT includes in that edition mefloquine along with doxycycline, atovaquone, and proguanil as drugs of choice for the prevention of malaria in travellers to regions that have strains of malaria that are resistant to chloroquine, another drug that is used to treat some strains of malaria.
The current CATMAT guidelines advise that mefloquine is generally well tolerated and that severe reactions are rare. They stipulate that individual risk assessments are required prior to use, and the Public Health Agency of Canada advises travellers who are going to malaria-affected destinations to discuss the benefits of taking antimalarials with their health care professionals, preferably six weeks before departure.
As part of its regular review schedule, CATMAT is currently reviewing the recommendations for the use of antimalarials, including mefloquine. The review of CATMAT's malaria guidelines is expected to be completed in 2017, and at that point, the Public Health Agency of Canada will review its advice to Canadian travellers based on those updated recommendations.
Thank you for your attention, and I return the floor.