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

Malar J. 2008 Feb 11:7:30. doi: 10.1186/1475-2875-7-30.


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.

MeSH terms

  • Adolescent
  • Adult
  • Afghanistan
  • Antimalarials*
  • Contraindications
  • Female
  • Humans
  • Malaria / prevention & control*
  • Male
  • Mefloquine*
  • Middle Aged
  • Military Personnel
  • Prevalence
  • United States


  • Antimalarials
  • Mefloquine