ADF and Malaria

Defence has had a long running battle with some of its soldiers in regard to how malaria risk is taken care of while on deployments.

Today's effort from the ABC is only a continuation of the concerns.

You can see a running history here.

Including this August rebuke  by Defence of an article in The Australian.

And this statement in November highlighting the recent leadership view on the situation.

I couldn't imagine the suffering that happens to people afflicted by this. It is not a majority percentage but if it affects you personally...

Here are some results published in 2005 in regard to the East Timor deployments in 2001-2002.

Abstract

Objectives: To describe the tolerability of mefloquine in Australian soldiers for malaria prophylaxis, including a comparison with doxycycline.

Design:

Open-label, prospective study and cross-sectional questionnaire and interview.

Setting and participants: Two contingents of Australian soldiers, each deployed to East Timor for peacekeeping duties over a 6-month period (April 2001–October 2001 and October 2001–May 2002).

Outcome measures:

Withdrawals during the study; adverse events relating to mefloquine prophylaxis; willingness to use mefloquine again on deployment.

Results: Of 1157 soldiers starting on mefloquine, 75 (6.5%) withdrew because of adverse responses to the drug. There were three serious adverse events of a neuropsychiatric nature, possibly relating to mefloquine. Fifty-seven per cent of soldiers using mefloquine prophylaxis reported at least one adverse event, compared with 56% using doxycycline. The most commonly reported adverse effects of both drugs were sleep disturbance, headache, tiredness and nausea. Of the 968 soldiers still taking mefloquine at the end of their deployments, 94% indicated they would use mefloquine again. Of 388 soldiers taking doxycycline prophylaxis who were deployed with the first mefloquine study contingent, 89% indicated they would use doxycycline again.

Conclusions: Mefloquine was generally well tolerated by Australian soldiers and should continue to be used for those intolerant of doxycycline.

It appears that Defence may be willing to accept a 6-7 percent adverse response rate in order to fulfill the mission. The crass aspect is it beats the rest getting malaria.

How did the ADF do in the last real intense conflict known as the Vietnam War? Of the 60,000 sent, 1000 suffered some kind of affect from malaria. Then, a anti-malaria drug known as Dapsone, had been linked to digestive and circulatory disorders.

The bigger picture shows  74.7% that went to the Vietnam War are classified by the Department of Veterans Affairs as suffering from some form of war related health impact (PDF).

What we do know is that this latest anti-malaria drug issue probably won't be administratively resolved for decades, if ever. It is just another one of many major health risks that have to do with wearing the uniform. Additional difficulty can be found because of the weak leadership state of the current entrenched defence bureaucracy.

I hope those affected get the treatment they deserve.