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CAPT Elizabeth Ledbetter, MC, USN
Navy Environmental & Preventive Medicine Unit No. 5 San Diego, Calif

Sue Shallow
San Diego State University San Diego, Calif

Kevin R. Hanson, MD
First Marine Expeditionary Force Camp Pendleton, Calif

JAMA. 1995;273(10):774-775.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In the article assessing malaria in US Marines returning from Somalia by Dr Newton and colleagues,¹ important issues regarding prevention may be obscured by their finding that 50% of patients were administered suboptimal chemoprophylaxis.

The Navy Environmental and Preventive Medicine Unit No. 5 identified 132 cases of Somalia-related malaria in 128 marines. Ninety-seven individuals were interviewed. Plasmodium vivax accounted for 82 (65.1%) of 126 diagnoses, 34 (27.0%) were Plasmodium falciparum, eight (6.3%) were mixed, and two (1.6%) were unspeciated.

Malaria exposure had been anticipated² and preparations made. Appropriate prescribing is published in the widely distributed Navy Medical Department Guide to Malaria Prevention and Control.³ For doxycycline, 89 (89.9%) of 99 prescriptions were appropriate, as were 81 (92.0%) of 88 primaquine prescriptions. For mefloquine, 59 (71.1%) of 83 were appropriate. The other 24 (28.9%) included many that failed to overlap doxycycline and mefloquine by 1 . . . [Full Text PDF of this Article]

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