Prevalence of contraindications to mefloquine use among USA military personnel deployed to Afghanistan.
BACKGROUND
Mefloquine has historically been considered safe and well-tolerated for long-term malaria chemoprophylaxis, but its prescribing requires careful attention to rule out contraindications to its use, including a history of certain psychiatric and neurological disorders. The prevalence of these disorders has not been defined in cohorts of U.S. military personnel deployed to areas where long-term malaria chemoprophylaxis is indicated.


METHODS
Military medical surveillance and pharmacosurveillance databases were utilized to identify contraindications to mefloquine use among a cohort of 11,725 active duty U.S. military personnel recently deployed to Afghanistan.


RESULTS
A total of 9.6% of the cohort had evidence of a contraindication. Females were more than twice as likely as males to have a contraindication (OR = 2.48, P < 0.001).


CONCLUSIONS
These findings underscore the importance of proper systematic screening prior to prescribing and dispensing mefloquine, and the need to provide alternatives to mefloquine suitable for long-term administration among deployed U.S. military personnel.
Nevin
Remington L
RL
Army Medical Surveillance Activity, 2900 Linden Lane, Suite 200, Silver Spring, MD 20910, USA. remington.nevin@us.army.mil
Pietrusiak
Paul P
PP
Caci
Jennifer B
JB
D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D000962:Antimalarials; D000075202:Contraindications; D005260:Female; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine; D008875:Middle Aged; D008889:Military Personnel; D015995:Prevalence; D014481:United States
D000962:Antimalarials; D015767:Mefloquine