COMPLIANCE AND TOLERANCE OF MEFLOQUINE AN D CHLOROQUINE PLUS PROGUANIL CHEMOPROPHYLAXIS IN FRENCH SHORT-TERM TRAVELERS TO AFRICA

To determine if mild adverse events attributed to mefloquine (MQ) and chloroquine + proguanil (CQ-PRO) were experienced with the same freque ncy we carried out a study in two groups of French native adult short- term visitors to Africa originating from Amiens. CQ (100 mg daily) + P RO (200 mg daily) prophylaxis was prescribed for all patients travelli ng to Senegal and those for Kenya when MQ was contraindicated, includi ng all the patients with an history of any neuropsychiatric events, ev en mild (group I). MQ (250 mg weekly) was prescribed for the others su bjects (group 2). The self-reported questionnaire has been sent by mai l to 534 travellers between one to three months after the end of their travels for obtaining information about travel conditions and health problems, mainly those attributed to anti-malarial drugs taken for che moprophylaxis. We have received 377 available responses (71 %): 183 in group I and 194 in group 2. There are no significant differences for age, sex, exposition and measures of protection against mosquito bites , concomitant drug use, mean duration of chemoprophylaxis. The complia nce during the travel is excellent in each group. CP was interrupted p rematurely (< 15 days after returning) in 13.8 % of the case with MQ a gainst 4.2 % only with CQ-PRO (OR = 3.7, CI 95 % = 1.5-9.1). The rates of overall side effects attributed to malaria chemoprophylaxis are re spectively : 15.8 % for MQ against 12.4 % for CQ-PRO (difference not s ignificant). However non-serious neuropsychiatric adverse events (dizz iness, headache, mood change and sleep disturbance) are more frequent with MQ :11.5 % against 2.1 % with CQ-PRO (OR = 6,2; CI 95 % = 2.2-17, 2). Although all side effects were transient and judged to be mild to moderate by the subjects themselves, these results back up the fact th at mefloquine should be used with caution.