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To the Editor: As members of the public health authority that issues recommendations for malaria chemoprophylaxis for the Canadian Forces members, we were interested in the Research Letter by Dr Croft and colleagues¹ regarding the differences in the approach to malaria prevention among armed forces deployed to Afghanistan. However, the data reported for Canada are inaccurate in that, after a reassessment of risk, the Canadian Forces discontinued the use of malaria chemoprophylaxis for members in Kabul in April 2005 and at Kandahar Air Field (from where the Canadian Forces primarily operates) in May 2006. Malaria chemoprophylaxis is still recommended outside these locations during the malaria season. Although mefloquine may be the drug most often selected, Canadian Forces members have the option of using either mefloquine weekly or doxycycline daily, with atovaquone/proguanil preferred when protection of short duration is needed.

The authors do not address the use of terminal prophylaxis with . . . [Full Text of this Article]

Martin Tepper, MD, MHSc, FRCPC
tepper.ml@forces.gc.ca

Steve Schofield, PhD; James Anderson, MD, MTM&H
Directorate of Force Health Protection
Canadian Forces Health Services Group Headquarters
Department of National Defence
Ottawa, Ontario, Canada

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RELATED LETTER

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JAMA. 2007;298(11):1275-1276.
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