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Self-Reported Adverse Events Associated With Antimalarial Chemoprophylaxis in Peace Corps Volunteers

      Objectives

      To determine adverse events associated with the use of antimalarial chemoprophylaxis in Peace Corps volunteers who have served in malaria-endemic countries 6 months or longer.

      Methods

      Survey of Peace Corps volunteers’ adverse events associated with the use of antimalarial chemoprophylaxis between August 1, 2005 and July 31, 2006. Analyses were conducted in fall 2006.

      Results

      Two thousand seven hundred and one surveys were received (43% response rate) from volunteers in malaria-endemic countries, with 1,731 (64%) in country for 6 months or longer (average 19 months). Nearly two thirds (62%) reported at least one adverse event. Those on mefloquine reported the most neuropsychologic adverse events; those on doxycycline reported the most gastrointestinal as well as skin and vaginal adverse events. Nearly one quarter of respondents (23%) changed their chemoprophylaxis regimen due to adverse events. Severe adverse events were reported by 9% of respondents, and 1% reported being hospitalized.

      Conclusions

      Adverse events were frequently reported among volunteers using antimalarial medications for more than 6 months, but very few were severe or required hospitalization. In light of the large number of adverse events, having multiple drug regimens available for the long-term traveler may be one method of maintaining adherence to antimalarial chemoprophylaxis.
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      References

      1. Centers for Disease Control and Prevention. Frequently Asked Questions About Malaria. August 13, 2004. Available at http://www.cdc.gov/malaria/faq.htm. Accessed February 26, 2007.

      2. World Tourism Organisation. ”Another Record Year for Tourism.” Press Release. January 29, 2007. Available at http://www.world-tourism.org/newsroom/Releases/2007/january/recordyear.htm. Accessed February 26, 2007.

        • Chen L.H.
        • Wilson M.E.
        • Schlagenhauf P.
        Prevention of malaria in long-term travelers.
        JAMA. 2006; 296: 2234-2244
        • Cave W.
        • Pandey P.
        • Osrin D.
        • et al.
        Chemoprophylaxis use and the risk of malaria in travelers to Nepal.
        J Trav Med. 2003; 10: 100-105
        • Hoebe C.
        • de Munter J.
        • Thijs C.
        Adverse effects and compliance with mefloquine or proguanil antimalarial chemoprophylaxis.
        Euro J Clin Pharm. 1997; 52: 269-275
        • Petersen E.
        • Ronne T.
        • Ronn A.
        • et al.
        Reported side effects to chloroquine, chloroquine plus proguanil, and mefloquine as chemoprophylaxis against malaria in Danish travelers.
        J Trav Med. 2000; 7: 79-84
        • Carme B.
        • Peguet C.
        • Nevez G.
        Compliance with and tolerance of mefloquine and chloroquine + proguanil malaria chemoprophylaxis in French short-term travellers to sub-Saharan Africa.
        Trop Med Int Hlth. 1997; 2: 953-956
        • Schlagenhauf P.
        • Tschop A.
        • Johnson R.
        • et al.
        Tolerability of malaria chemoprophylaxis in non-immune travelers to sub-Saharan Africa: multicentre, randomized, double blind, four-arm study.
        BMJ. 2003; 327: 1078-1083
        • Wells T.S.
        • Smith T.C.
        • Smith B.
        • et al.
        Mefloquine use and hospitalizations among US service members, 2002–2004.
        Am J Trop Med Hyg. 2006; 74: 744-749
        • Hopperus Buma A.P.
        • van Thiel P.P.
        • Lobel H.O.
        • et al.
        Long-term malaria chemoprophylaxis with mefloquine in Dutch marines in Cambodia.
        J Infect Dis. 1996; 173: 1506-1509
        • Lobel H.O.
        • Miani M.
        • Eng T.
        • Bernard K.W.
        • Hightower A.W.
        • Campbell C.C.
        Long-term malaria prophylaxis with weekly mefloquine.
        Lancet. 1993; 341: 848-851
        • Centers for Disease Control and Prevention
        Health Information for International Travel 2005–2006.
        U.S. Department of Health and Human Services, Public Health Service, Atlanta2005
        • Barrett P.J.
        • Emmins P.D.
        • Clarke P.D.
        • Bradley D.J.
        Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as antimalarial prophylaxis: postal and telephone survey of travellers.
        BMJ. 1996; 313: 525-528
        • Bernard K.W.
        • Graitcer P.L.
        • van der Vlugt T.
        • et al.
        Epidemiological surveillance in Peace Corps volunteers: a model for monitoring health in temporary residents of developing countries.
        Int J Epidemiol. 1989; 18: 220-226