Safety, Tolerability, and Compliance with Long-Term Antimalarial Chemoprophylaxis in American Soldiers in Afghanistan

Details

• Personal Author:
  Bennett K ; Garges E ; Kosmowski AJ ; Magill AJ ; Manning JE ; Saunders DL ; Schaffer S
• Description:
  Long-term antimalarial chemoprophylaxis is currently used by deployed U.S. military personnel. Previous small, short-term efficacy studies have shown variable rates of side effects among patients taking various forms of chemoprophylaxis, though reliable safety and tolerability data on long-term use are limited. We conducted a survey of troops returning to Fort Drum, NY following a 12-month deployment to Operation Enduring Freedom, Afghanistan from 2006 to 2007. Of the 2,351 respondents, 95% reported taking at least one form of prophylaxis during their deployment, and 90% were deployed for > 10 months. Compliance with daily doxycycline was poor (60%) compared with 80% with weekly mefloquine (MQ). Adverse events (AEs) were reported by approximately 30% with both MQ and doxycycline, with 10% discontinuing doxycycline compared with 4% of MQ users. Only 6% and 31% of soldiers reported use of bed nets and skin repellents, respectively. Compliance with long-term malaria prophylaxis was poor, and there were substantial tolerability issues based on these anonymous survey results, though fewer with MQ than doxycycline. Given few long-term antimalarial chemoprophylaxis options, there is an unmet medical need for new antimalarials safe for long-term use. [Description provided by NIOSH]
• Subjects:
  Aging Demography Men Occupational Health Personal Protective Equipment Safety Women
• Keywords:
  Age Groups Antimalarial Drugs Demographic Characteristics Disease Prevention Diseases Health Effects Humans Medicinal Chemicals Military Personnel Personal Protection Physical Reactions Statistical Analysis

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• ISSN:
  0002-9637
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; New York ; Ohio ; OSHA Region 10 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  93
• Issue:
  3
• NIOSHTIC Number:
  nn:20049944
• Citation:
  Am J Trop Med Hyg 2015 Sep; 93(3):584-590
• Contact Point Address:
  David L. Saunders, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok 10400, Thailand
• Email:
  david.saunders@afrims.org
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of Cincinnati
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  The American Journal of Tropical Medicine and Hygiene
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4b0eefe8052b4cee4bf51bed5ef1d7bc5cd94e787f56a98ad54164bc4b7faceb715f4564c32622487cc96c8a199fc365bc18459fab57ea899749fae35d3c8cda
• Download URL:
  https://stacks.cdc.gov/view/cdc/210530/cdc_210530_DS1.pdf
• File Type:
  [PDF - 472.34 KB ]