User Acceptability Patterns for Mefloquine and Doxycycline Malaria Chemoprophylaxis

Area of Science:

• Travel Medicine
• Pharmacology
• Infectious Diseases

Background:

• Mefloquine (250 mg weekly) and doxycycline (100 mg daily) are recommended malaria chemoprophylaxis for chloroquine-resistant areas.
• User acceptability, including adverse effects and compliance, is crucial for effective malaria prevention strategies.
• Understanding differences in tolerability between these regimens is essential for optimizing traveler health.

Purpose of the Study:

• To profile user acceptability of mefloquine and doxycycline for malaria chemoprophylaxis.
• To compare self-reported adverse effects and compliance patterns between the two antimalarial drugs.
• To identify factors influencing the choice and adherence to malaria chemoprophylactic regimens.

Main Methods:

• Prospective study involving travelers prescribed mefloquine or doxycycline.
• Enrollment at pretravel consultations with detailed discussions on drug regimens.
• Post-travel questionnaires assessed self-reported morbidity and compliance levels.

Main Results:

• Mefloquine users (n=285) reported higher overall illness (51.2%) and drug-attributed symptoms (37.9%) compared to doxycycline users (n=383) (36.8% illness, 21.4% adverse effects).
• Females reported more adverse events with mefloquine (14.6%) than males (6.1%), and higher rates of stopping due to side effects (8.8% vs 2.6%).
• Doxycycline showed better compliance (68.1%) than mefloquine (78.2%), with fewer participants stopping due to adverse effects (5.7% vs 6.3%).

Conclusions:

• Drug morbidity is a significant consideration in prescribing antimalarial chemoprophylaxis.
• Females reported a greater number of adverse events, particularly with mefloquine, warranting further investigation.
• Tolerability and side effect profiles influence compliance and necessitate personalized prescribing approaches.