Mefloquine versus doxycycline for malaria prophylaxis in intermittent exposure of Israeli Air Force aircrew in Rwanda.
BACKGROUND
The issue of the best chemoprophylaxis agent for aircrew to use against malaria is still not settled.


METHODS
We studied the patterns of use of both doxycycline and mefloquine in aviators and other aircrew for 2 mo during biweekly flights from Israel to Rwanda with a few hours' visits. Some 28 aviators and 15 non-aviator aircrew were treated with doxycycline and mefloquine, respectively, less than 12 h before the first flight and up to 4 wk after the last return.


RESULTS
No case of malaria occurred within or after the operational period. Compliance was better for mefloquine than for doxycyline for the full period of the operation (100% vs. 75%, respectively). The rate of side effects, mostly gastrointestinal, was higher for doxycycline (39% vs. 13%, respectively) and was related mainly to the frequency of administration (daily vs. weekly).


CONCLUSIONS
In situations involving frequent intermittent short-term visits to areas with substantial risk of acquiring malaria, we conclude that aircrew can safely take weekly mefloquine as prophylaxis.
Shamiss
A
A
Israeli Air Force Aeromedical Center, Tel Hashomer, Israel.
Atar
E
E
Zohar
L
L
Cain
Y
Y
D000337:Aerospace Medicine; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000962:Antimalarials / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007557:Israel / Q000208:ethnology; D008288:Malaria / Q000517:prevention & control*; D015767:Mefloquine / Q000627:therapeutic use*; D008889:Military Personnel; D016273:Occupational Exposure; D010349:Patient Compliance; D012432:Rwanda; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D000962:Antimalarials; D004318:Doxycycline; D015767:Mefloquine