Brisson Paul, Woll Michael, Brisson Michael
Department of Surgery, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA.
Mil Med. 2012 Dec;177(12):1539-42. doi: 10.7205/milmed-d-12-00215.
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.
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.
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.
Personalized in-theater briefings and consultations by knowledgeable providers may improve compliance with malaria chemoprophylaxis in MSM in Afghanistan.
从历史上看，军人对疟疾化学预防的依从性一直很低，在30%至56%之间。自2002年以来，部署到阿富汗的军人每年有28至85例疟疾发生。在他们部署到阿富汗期间，作者发现疟疾化学预防的依从率很低。于是开展了一个绩效改进项目来提高依从性。
2011年7月，制定了一项绩效改进计划，以提高抵达阿富汗西部一个偏远基地的军人对疟疾化学预防的依从性。该计划包括为因副作用而停止化学预防的军人提供15分钟的简报和一次医疗咨询。在他们部署结束时，对军人的依从情况进行了调查。
94名军人参加了简报会。80名（85%）军人在2011年10月完成了调查。98%的人服用强力霉素（n = 78）。90%（n = 72）的人报告说他们遵守了化学预防措施。发现有一个完整的单位（n = 29）强力霉素严重短缺，这引发了紧急药品订购。两名不遵守规定的士兵就副作用问题请求咨询，并能够继续进行化学预防。
由知识渊博的提供者进行个性化的战区简报和咨询可能会提高阿富汗军人对疟疾化学预防的依从性。
