My 2 Cents on Malaria Chemo

Recently, I got an email from a Navy GMO, assigned to the grunts. I tried to respond to his email, but the return address is bad, so here’s my answer to his question(s):

I would wholeheartedly continue to use doxycycline for malaria prophylaxis. I know it’s an ancient drug, and that it has some side effects. I think, however, it will have unintended effects to promote our malaria program. If they have to take a pill every day, then they have to think about malaria (and other bugborne diseases) daily, instead of weekly. It’s good to have daily reinforcement for this sort of thing.

I would get some mefloquine, and reserve it for your G6PD deficient troops (after explaining what fatal hemolysis is, and why they’re getting different meds). You can’t have more than 20 in the whole command, so that’s OK. Also, should your have females in your command, you might consider mefloquine for them to help prevent candidiasis. I was told while I was in that malaria drugs were the main reason the Navy spends all that money screening for G6PD.

It’s nice that your CO has given you some power to enforce the meds, but beware that as a staff officer it’s your role to advise the command. You have no real power (other than a ‘lawful order’) to compel compliance, but every corporal in the Corps will do what the sargent says. Use your power to get the S4 to actually get and bring stuff like nets, permethrin for uniforms (hopefully already done), and fans for quarters. There are some good recommendations in the comments of my prior malaria posts, by many crustier and saltier than me.

Best of luck, and send me a good email address.