Mefloquine and doxycycline malaria prophylaxis in Australian soldiers in East Timor.
OBJECTIVE
To describe the tolerability of mefloquine in Australian soldiers for malaria prophylaxis, including a comparison with doxycycline.


METHODS
Open-label, prospective study and cross-sectional questionnaire and interview.


METHODS
Two contingents of Australian soldiers, each deployed to East Timor for peacekeeping duties over a 6-month period (April 2001-October 2001 and October 2001-May 2002).


METHODS
Withdrawals during the study; adverse events relating to mefloquine prophylaxis; willingness to use mefloquine again on deployment.


RESULTS
Of 1157 soldiers starting on mefloquine, 75 (6.5%) withdrew because of adverse responses to the drug. There were three serious adverse events of a neuropsychiatric nature, possibly relating to mefloquine. Fifty-seven per cent of soldiers using mefloquine prophylaxis reported at least one adverse event, compared with 56% using doxycycline. The most commonly reported adverse effects of both drugs were sleep disturbance, headache, tiredness and nausea. Of the 968 soldiers still taking mefloquine at the end of their deployments, 94% indicated they would use mefloquine again. Of 388 soldiers taking doxycycline prophylaxis who were deployed with the first mefloquine study contingent, 89% indicated they would use doxycycline again.


CONCLUSIONS
Mefloquine was generally well tolerated by Australian soldiers and should continue to be used for those intolerant of doxycycline.
Kitchener
Scott J
SJ
Centre for Military and Veterans' Health, Mayne Medical School, Herston, QLD. s.kitchener@uq.edu.au
Nasveld
Peter E
PE
Gregory
Robin M
RM
Edstein
Michael D
MD
D000962:Antimalarials / Q000009:adverse effects*; D001315:Australia; D003430:Cross-Sectional Studies; D004318:Doxycycline / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000009:adverse effects*; D008889:Military Personnel; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D049648:Timor-Leste; D016312:Treatment Refusal
D000962:Antimalarials; D004318:Doxycycline; D015767:Mefloquine