Well-tolerated chemoprophylaxis uniformly prevented Swedish soldiers from Plasmodium falciparum malaria in Liberia, 2004-2006.
BACKGROUND
Between 2004 and 2006, 1,170 Swedish soldiers were deployed to Liberia. They were prescribed mefloquine or atovaquone/proguanil as malaria chemoprophylaxis. Our study aims were to estimate the chemoprophylaxis effectiveness and adverse events.


METHODS
Cases of malaria were routinely reported during and after the mission. After return to Sweden, the soldiers filled in a questionnaire concerning type of accommodation, use of prophylaxis, and adverse events.


RESULTS
No cases of Plasmodium falciparum malaria were recorded during a total of approximately 7,000 person-months. Adverse events (AE) were reported by 57% in the mefloquine group and 34% in the atovaquone/proguanil group. In the mefloquine group, the soldiers reported more neuropsychological AE.


CONCLUSIONS
Both drugs were safe and 100% effective as long-term prophylaxis for prevention of P. falciparum malaria. Atovaquone/ proguanil was better tolerated with respect to self-reported AE.
Andersson
Håkan
H
Swedish Armed Forces, Livgardet, Kungsängen, Stockholm, Sweden.
Askling
Helena H
HH
Falck
Björn
B
Rombo
Lars
L
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D053626:Atovaquone / Q000627:therapeutic use; D018890:Chemoprevention; D005260:Female; D006801:Humans; D007988:Liberia / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use; D008887:Military Medicine; D008889:Military Personnel; D010963:Plasmodium falciparum / Q000187:drug effects*; D002727:Proguanil / Q000627:therapeutic use; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013548:Sweden
D000962:Antimalarials; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone