title: Compliance with antimalarial chemoprophylaxis recommendations for wounded United States military personnel admitted to a military treatment facility.
abstract: Malaria chemoprophylaxis is used as a preventive measure in military personnel deployed to malaria-endemic countries. However, limited information is available on compliance with chemoprophylaxis among trauma patients during hospitalization and after discharge. Therefore, we assessed antimalarial primary chemoprophylaxis and presumptive antirelapse therapy (primaquine) compliance among wounded United States military personnel after medical evacuation from Afghanistan (June 2009-August 2011) to Landstuhl Regional Medical Center in Landstuhl, Germany, and then to three U.S. military hospitals. Among admissions at Landstuhl Regional Medical Center, 74% of 2,540 patients were prescribed primary chemoprophylaxis and < 1% were prescribed primaquine. After transfer of 1,331 patients to U.S. hospitals, 93% received primary chemoprophylaxis and 33% received primaquine. Of 751 trauma patients with available post-admission data, 42% received primary chemoprophylaxis for four weeks, 33% received primaquine for 14 days, and 17% received both. These antimalarial chemoprophylaxis prescription rates suggest that improved protocols to continue malaria chemoprophylaxis in accordance with force protection guidelines are needed.
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany elizabeth.a.rini.mil@mail.mil.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rini
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Weintrob
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: David R
authors.initials: DR
authors.lastname: Tribble
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Lloyd
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Tyler E
authors.initials: TE
authors.lastname: Warkentien
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Faraz
authors.initials: F
authors.lastname: Shaikh
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Deepak
authors.initials: D
authors.lastname: Aggarwal
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: M Leigh
authors.initials: ML
authors.lastname: Carson
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas; Walter Reed National Military Medical Center, Bethesda, Maryland; Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
mesh_terms: D000328:Adult; D000346:Afghanistan; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006801:Humans; D008288:Malaria / Q000188:drug therapy / Q000517:prevention & control*; D008297:Male; D008889:Military Personnel; D010349:Patient Compliance; D010961:Plasmodium / Q000187:drug effects*; D011159:Population Surveillance; D011319:Primaquine / Q000008:administration & dosage / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries; D055815:Young Adult
chemical_list: D000962:Antimalarials; D011319:Primaquine; D004318:Doxycycline
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