PMID- 17617844
OWN - NLM
STAT- MEDLINE
DCOM- 20070921
LR  - 20151119
IS  - 1195-1982 (Print)
IS  - 1195-1982 (Linking)
VI  - 14
IP  - 4
DP  - 2007 Jul-Aug
TI  - Malaria and mefloquine prophylaxis use among Japan Ground Self-Defense Force 
      personnel deployed in East Timor.
PG  - 226-32
AB  - BACKGROUND: Malaria poses a significant threat to military personnel stationed in 
      endemic areas; therefore, it is important to examine the risks of military 
      operations, particularly in areas where malaria-related data are scarce. The 
      recent deployment of Japan Ground Self-Defense Force (JGSDF) for a peacekeeping 
      operation in East Timor provided an opportunity to investigate these risks. The 
      results of these studies may be translated into chemoprophylactic strategies for 
      travelers. METHODS: A total of 1,876 members were deployed between April 2002 and 
      September 2003. They consisted of three battalions; each remained for 6 months 
      and was put on mefloquine prophylaxis. Malaria infection was investigated, 
      including exposure to Plasmodium falciparum sporozoites, assessed by 
      seroconversion for anticircumsporozoite (anti-CS) protein antibodies. Adherence 
      to and adverse events (AEs) of mefloquine were studied via questionnaires. 
      RESULTS: Four members were evacuated: one each with optic neuritis, lung cancer 
      with brain metastasis, IgA nephropathy, and psychotic reactions that may have 
      been precipitated by mefloquine. Six clinical episodes of Plasmodium vivax 
      occurred, including one relapse, but there were no clinical cases of P 
      falciparum, yielding a crude malaria attack rate of 0.32% for the 6-month period. 
      Overall, 3.1% of the study population seroconverted for the anti-CS protein 
      antibodies, with some regional differences noted. About 24% of questionnaire 
      respondents, reported AEs; however, none of the AEs was severe. The AEs tended to 
      emerge during the initial doses of chemoprophylaxis. CONCLUSIONS: The 
      implementation of mefloquine prophylaxis among JGSDF personnel in East Timor, 
      where P falciparum constitutes a moderate risk, appears to have been a success. 
      Mefloquine prophylaxis was generally safe for Japanese unless predisposed to 
      neuropsychiatric illness. However, given that mefloquine is the only 
      chemoprophylactic agent available, a risk-benefit analysis tailored to the 
      traveler is required for visits to countries such as East Timor.
FAU - Fujii, Tatsuya
AU  - Fujii T
AD  - Department of Internal Medicine, Japan Self-Defense Forces Central Hospital, 
      Tokyo, Japan. t-fujii@mishuku.gr.jp
FAU - Kaku, Koki
AU  - Kaku K
FAU - Jelinek, Tomas
AU  - Jelinek T
FAU - Kimura, Mikio
AU  - Kimura M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Travel Med
JT  - Journal of travel medicine
JID - 9434456
RN  - 0 (Antimalarials)
RN  - TML814419R (Mefloquine)
SB  - IM
MH  - Adult
MH  - Animals
MH  - Antimalarials/*therapeutic use
MH  - Cross-Sectional Studies
MH  - Drug Utilization
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Japan/epidemiology
MH  - Malaria, Falciparum/*epidemiology/parasitology
MH  - Malaria, Vivax/*epidemiology/parasitology
MH  - Male
MH  - Mefloquine/*therapeutic use
MH  - Military Personnel/*statistics & numerical data
MH  - Plasmodium falciparum/growth & development
MH  - Plasmodium vivax/growth & development
MH  - Surveys and Questionnaires
MH  - Timor-Leste/epidemiology
EDAT- 2007/07/10 09:00
MHDA- 2007/09/22 09:00
CRDT- 2007/07/10 09:00
PHST- 2007/07/10 09:00 [pubmed]
PHST- 2007/09/22 09:00 [medline]
PHST- 2007/07/10 09:00 [entrez]
AID - JTM122 [pii]
AID - 10.1111/j.1708-8305.2007.00122.x [doi]
PST - ppublish
SO  - J Travel Med. 2007 Jul-Aug;14(4):226-32. doi: 10.1111/j.1708-8305.2007.00122.x.