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Publications


Medical research is usually subject to peer review, where independent qualified and experienced medical professionals review the quality and suitability of a proposed article prior to publication in a medical journal. Most medical journals are subject to copyright provisions that limit the ability to provide copies directly. If you are experiencing difficulties accessing articles from the link, a copy can be requested through ADF.malaria@defence.gov.au

Peer reviewed articles

Long term health outcomes among Returned Peace Corps Volunteers after malaria prophylaxis, 1995–2014

This study examined latent effects of malaria chemoprophylaxis among Returned Peace Corps Volunteers (RPCVs) who served during 1995-2014. Using an internet-based survey of volunteers, this is one of the first studies to look at latent adverse effects of using anti-malarials for prophylaxis over an extended period of time.
*abstract only

Adverse effects of mefloquine for the treatment of uncomplicated malaria in Thailand: A pooled analysis of 19, 850 individual patients)

In this study, 19,850 malaria patients each received one of seven different treatment regimens, each containing mefloquine in different doses or dosing schedules. The analysis focused on predominantly gastrointestinal and neuropsychiatric effects.

Neuropsychiatric outcomes after mefloquine exposure among U.S. military service members

This article is a very large retrospective review of US military service members prescribed mefloquine, doxycycline or malarone and neuropsychiatric outcomes between 2008 and 2013.

Randomized, double-blind study of the safety, tolerability, and efficacy of tafenoquine versus mefloquine for malaria prophylaxis in non-immune subjects

This article describes the outcomes of the 2000-2001 study conducted by the Army Malaria Institute in Timor Leste involving the 1st Battalion Royal Australian Regiment Battalion Group.

Mefloquine and doxycycline malaria prophylaxis in Australian soldiers in East Timor

This article describes the outcomes of the studies conducted in 2001-2002 by the Army Malaria Institute in Timor Leste involving the 2nd Battalion and 4th Battalion, Royal Australian Regiment Battalion Groups.

The efficacy and tolerability of three different regimens of tafenoquine verses primaquine for post-exposure prophylaxis of Plasmodium vivax malaria in the Southwest Pacific

This article describes the outcomes of studies conducted in 1998-99 by the Army Malaria Institute in Bougainville involving the Peace Monitoring group (PMG).

Doxycycline for malaria prophylaxis in Australian soldiers deployed to United Nations missions in Somalia and Cambodia

This article describes, in retrospect the ADF experience of using doxycycline as its primary anti-malarial agent on two overseas deployments between 1992 and 1993.
*abstract only

Mefloquine use and hospitalizations among US service members, 2002-2004

This article describes the outcomes of a large study comparing hospitalisation of US service members who had taken mefloquine with those that had not.

Tafenoquine for the treatment of recurrent Plasmodium vivax malaria

This article outlines the outcomes from using tafenoquine to treat 31 ADF personnel suffering from recurrent malaria when previous treatments with chloroquine and primaquine failed.

Tafenoquine plus chloroquine for the treatment and relapse prevention of Plasmodium vivax malaria

This study assessed the dose response, safety, and tolerability of single-dose tafenoquine plus 3-day chloroquine for P vivax malaria radical cure.

Tafenoquine for preventing relapse in people with vivax malaria

This article describes the effect of the drug tafenoquine on clearing the dormant P vivax parasites in infected patients to prevent a relapse.

Army Malaria Institute – its evolution and achievements – Third decade (1st half): 1985-1990

This article documents the work done from 1985-1990 at the then Army Malaria Research Unit (to become the Army Malaria Institute) as an internationally recognised as a centre of excellence for malaria research.

Army Malaria Institute – its evolution and achievements – Third decade (2nd half): 1990-1995

This article documents the work done from 1990-1995 at then Army Malaria Research Unit (to become the Army Malaria Institute) as an internationally recognised centre of excellence for malaria research.

Army Malaria Institute - its evolution and achievements. Fourth decade (1st half) 1995-2000

This article documents the work done from 1995-2000 at the Army Malaria Institute as an internationally recognised as a centre of excellence for malaria research.

Army Malaria Institute - its evolution and achievements. Fourth decade (2nd half) 2000-2005

This article documents the work done from 2000-2005 at the Army Malaria Institute as an internationally recognised as a centre of excellence for malaria research.

Army Malaria Institute - its evolution and achievements. Fifth decade 2nd 2006-2015

This article documents the work done from 2006-2015 at the Army Malaria Institute as an internationally recognised centre of excellence for malaria research.

Recent military experience with malaria chemoprophylaxis

This article discusses the value of various drug regimens for malaria prophylaxis under circumstances where Maloprim and chloroquine, followed by the 14-day primaquine eradication course, were no longer effective in protecting military personnel.

Plasmodium vivax resistance to chloroquine?

This article describes two cases of vivax malaria in Australian soldiers that were acquired in Papua New Guinea while taking adequate doses of chloroquine.
*abstract only

Malaria in US Marines returning from Somalia

This article describes the study of compliance with malaria prophylaxis in a group of US Marines who were diagnosed with malaria after returning from Somalia in 1993. It discusses non-compliance with personal protective measures and chemoprophylaxis as a significant contributing factor to the malaria outbreak.

Tolerability of prophylactic Lariam™ regimens

This study compared the tolerability of weekly mefloquine, weekly mefloquine following a loading dose, and weekly chloroquine in 359 US Marines over a 12 week period. It concluded that mefloquine prophylaxis with a loading dose should be considered for short term adult travellers or military personnel going to malarious areas where there is chloroquine resistance.

Long-term malaria chemoprophylaxis with mefloquine in Dutch marines in Cambodia

This study looked at the compliance, adverse events and effectiveness of mefloquine malaria prophylaxis for Dutch marines deployed to Cambodia for six months. One of the three battalions involved took a loading dose of mefloquine. The group that took a loading dose did not report any more adverse effects that the other groups.

Tolerance of mefloquine chemoprophylaxis in Dutch military personnel

This study involved a group of Dutch marines stationed in Cambodia during 1993. Mefloquine was given as a loading dose followed by weekly doses for four months. The main aim of the study was to look at heart effects, although other effects were also monitored. Overall, the study concluded that mefloquine was safe and well tolerated in this group of people.

Tolerance of mefloquine by SwissAir trainee pilots

At the time this study was done, mefloquine prophylaxis was not recommended for people needing fine coordination and spatial discrimination, like pilots. This study looked at the effect of mefloquine on flying performance, psychomotor function, sleep and mood.

Case Studies

Prolonged neuropsychiatric symptoms in a military service member exposed to mefloquine

This case study describes the experience of an American soldier who developed persistent symptoms after taking mefloquine for malaria prophylaxis. This is a useful resource for medical officers as it demonstrates the complexity of assessing persistent neuropsychiatric symptoms in the context of mefloquine and deployment.

Editorials

Malaria chemoprophylaxis: in war and peace

This editorial in the Medical Journal of Australia discusses the use of mefloquine in both a military and civilian context.

Mefloquine for malarial prophylaxis in military personnel – Not the first choice

This editorial in the British Medical Journal discusses the use of mefloquine in a UK military context.
*requires users to sign up for trial subscription to access the full article

Mefloquine or doxycycline prophylaxis in US troops in Somalia

This letter to the editor describes the findings of an investigation into the comparison of the use of doxycycline and mefloquine as malaria prophylaxis in US troops in Somalia in 1992-93.

Failure of dapsone/pyrimethamine plus chloroquine against falciparum malaria in Papua New Guinea

This letter to the editor describes a case of falciparum malaria in an Australian serviceman acquired in Papua New Guinea while taking the recommended Maloprim (dapsone/pyrimethamine) and chloroquine prophylaxis regimen.

Other

A review article by Major Stuart McCarthy which represents an alternative view on the use of mefloquine in the ADF is available at:

http://www.hindawi.com/journals/jpr/2015/287651/

Defence does not endorse the views expressed in the article but believe it is important to include in the interests of transparency.