Assessment of Risks Associated with Short-Term Use of Mefloquine in Canadian Forces Members: A Descriptive Cross-Sectional Study
Bibliographic record
Abstract
Background: Media reports have implicated mefloquine as a contributor to adverse health effects experienced by military members serving in areas where chloroquine-resistant malaria is endemic. A systematic retrospective review has been undertaken to evaluate the health effects seen in members who received mefloquine for chemoprophylaxis against malaria. Methods: Medical records of Regular Canadian Forces (CF) personnel who served in Somalia between 1992 and 1993 were reviewed by trained data extractors. All health effects recorded during treatment with mefloquine were assigned ICD-10-CA codes. Data extractors also noted if the effect has been reported with mefloquine, and rated the severity of the effect. Cohen's kappa was calculated to determine concordance between extractors, and descriptive statistics used to report the health effects seen. Results: The majority of the 1413 subjects identified were male (96%). A total of 5019 adverse health effects were recorded in the medical records, most of which were mild in severity. At least one adverse effect which could potentially have been related to mefloquine was reported in 74.7% ( n = 1056) of subjects. Of the adverse effects recorded, 21 were classified by the data extractors as major (18 cases affecting the nervous system and 3 cardiovascular system effects). These results are consistent with those reported in other populations. Conclusions: The results of this study have been applied to guide development of policies governing the provision of chemoprophylaxis during subsequent military missions. In particular, resources have been allocated to formalize the counselling provided to members regarding antimalarials and prevention of malaria infection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".