Paul Brisson1, Michael Woll, Michael Brisson. 1. Department of Surgery, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA. paul.brisson@us.army.mil
Abstract
OBJECTIVE: Historically, compliance with malaria chemoprophylaxis by military service members (MSM) has been notoriously low, ranging from 30 to 56%. Since 2002, 28 to 85 cases per year of malaria have occurred in MSM deployed to Afghanistan. During their deployment to Afghanistan, the authors identified a low compliance rate with malaria chemoprophylaxis. A performance improvement project was developed to improve compliance. METHODS: In July 2011, a performance improvement plan was developed to improve malaria chemoprophylaxis compliance in MSM arriving on a remote base in western Afghanistan. The plan included a 15-minute briefing and a medical consultation for MSM who had discontinued their chemoprophylaxis because of side effects. At the conclusion of their deployment, the MSM were surveyed on their compliance. RESULTS: Ninety-four MSM attended the briefings. Eighty (85%) MSM completed the survey in October 2011. Ninety-eight percent were taking doxycycline (n = 78). Ninety percent (n = 72) reported that they were compliant with their chemoprophylaxis. One entire unit (n = 29) was identified to be critically short of doxycycline, which initiated an emergency order for medication. Two noncompliant soldiers requested a consultation concerning side effects and were able to continue their chemoprophylaxis. CONCLUSION: Personalized in-theater briefings and consultations by knowledgeable providers may improve compliance with malaria chemoprophylaxis in MSM in Afghanistan.
OBJECTIVE: Historically, compliance with malaria chemoprophylaxis by military service members (MSM) has been notoriously low, ranging from 30 to 56%. Since 2002, 28 to 85 cases per year of malaria have occurred in MSM deployed to Afghanistan. During their deployment to Afghanistan, the authors identified a low compliance rate with malaria chemoprophylaxis. A performance improvement project was developed to improve compliance. METHODS: In July 2011, a performance improvement plan was developed to improve malaria chemoprophylaxis compliance in MSM arriving on a remote base in western Afghanistan. The plan included a 15-minute briefing and a medical consultation for MSM who had discontinued their chemoprophylaxis because of side effects. At the conclusion of their deployment, the MSM were surveyed on their compliance. RESULTS: Ninety-four MSM attended the briefings. Eighty (85%) MSM completed the survey in October 2011. Ninety-eight percent were taking doxycycline (n = 78). Ninety percent (n = 72) reported that they were compliant with their chemoprophylaxis. One entire unit (n = 29) was identified to be critically short of doxycycline, which initiated an emergency order for medication. Two noncompliant soldiers requested a consultation concerning side effects and were able to continue their chemoprophylaxis. CONCLUSION: Personalized in-theater briefings and consultations by knowledgeable providers may improve compliance with malaria chemoprophylaxis in MSM in Afghanistan.
Authors: Patrick W Hickey; Indrani Mitra; Jamie Fraser; David Brett-Major; Mark S Riddle; David R Tribble Journal: Am J Trop Med Hyg Date: 2020-04-23 Impact factor: 2.345
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