title: Compliance and tolerability of mefloquine and chloroquine plus proguanil for long-term malaria chemoprophylaxis in groups at particular risk (the military).
abstract: An historical prospective study was performed on 5120 Italian soldiers deployed in Somalia and Mozambique in 1992-94, to determine compliance and tolerability of long-term malaria chemoprophylaxis with chloroquine plus proguanil (C + P) and with mefloquine. Compliance with C + P among 3734 soldiers on duty in Somalia for 3.8 +/- 1.8 months and with mefloquine among 1386 soldiers on duty in Mozambique for 3.4 +/- 1.5 months was 90.3% and 95.7%, respectively (P < 0.01). Chemoprophylaxis curtailment rate due to side-effects was 1.5% among C + P users and 0.9% among mefloquine users (P = NS). Compliance with chemoprophylaxis and medication curtailment rate due to side-effects did not change significantly for either C + P or mefloquine, even after 3 months of continuous prophylaxis. Chemoprophylaxis curtailment rate was significantly lower in subjects aged < or = 25 years than in older subjects (1.3% vs. 2.5% for C + P [P < 0.05] and 0.4% vs. 3.3% for mefloquine [P < 0.01]). These results further support the evidence that both C + P and mefloquine regimens may be safely used in long-term malaria chemoprophylaxis. Moreover, weekly mefloquine seems easier to perform than C + P and not to increase prophylaxis discontinuation due to side-effects. Mefloquine regimen should therefore be considered the elective chemoprophylaxis for groups at particular risk of chloroquine-resistant Plasmodium falciparum malaria and especially for young male subjects.
authors.affiliation: Ospedale Militare, Chieti, Italy.
authors.forename: M S
authors.initials: MS
authors.lastname: Peragallo
authors.forename: G
authors.initials: G
authors.lastname: Sabatinelli
authors.forename: G
authors.initials: G
authors.lastname: Sarnicola
mesh_terms: D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D002738:Chloroquine / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006801:Humans; D007558:Italy; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D008889:Military Personnel; D010349:Patient Compliance; D002727:Proguanil / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000962:Antimalarials; D002738:Chloroquine; D002727:Proguanil; D015767:Mefloquine