Research

Prevalence of contraindications to mefloquine use among USA military personnel deployed to Afghanistan

Remington L Nevin¹ , Paul P Pietrusiak² and Jennifer B Caci³

¹Army Medical Surveillance Activity, 2900 Linden Lane, Suite 200, Silver Spring, MD 20910, USA

²US Army Center for Health Promotion and Preventive Medicine, APG, MD 21010, USA

³Headquarters, 82^nd Airborne Division, Ft. Bragg, NC 28310, USA

author email corresponding author email

Malaria Journal 2008, 7:30doi:10.1186/1475-2875-7-30

Published:	11 February 2008

Abstract

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).

Conclusion

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.