@article{ref1,
title="Deaths and parasuicides associated with mefloquine chemoprophylaxis: a systematic review",
journal="Travel medicine and infectious disease",
year="2017",
author="Tickell-Painter, Maya and Saunders, Rachel and Maayan, Nicola and Lutje, Vittoria and Mateo-Urdiales, Alberto and Garner, Paul",
volume="20",
number="",
pages="5-14",
abstract="BACKGROUND: Mefloquine is recommended in international health guidelines for preventing malaria in travellers. Reports of psychosis and suicide are often alluded to but are not clearly established. <br><br>METHODS: We carried out a systematic review to identify and critically appraise any death or parasuicide associated with mefloquine prophylaxis. We developed a comprehensive search that included publications up to 11 July 2017. We included case studies but excluded newspaper reports. Two authors independently appraised each death or parasuicide against a standardised causality assessment tool. The protocol was registered on PROSPERO (CRD42016041988). <br><br>RESULTS: We identified 527 articles that required full-text retrieval; of these 17 were unique publications that reported deaths or parasuicide. Eight unique publications had sufficient detail to be included in causality assessment. We identified 2 deaths with a probable association that appeared to be idiosyncratic drug reactions; we categorised the remaining 8 deaths as &quot;unlikely&quot; to be related to mefloquine, or &quot;unclassifiable&quot;. There was one parasuicide with a possible causal association. There were 9 additional publications that searched spontaneous drug reporting databases; none provided sufficient detail to perform a causality assessment. <br><br>CONCLUSIONS: Overall, the number of deaths that we could reliably attribute to the prophylactic use of mefloquine is very low.<br><br>Copyright © 2017. Published by Elsevier Ltd.<p /> <p>Language: en</p>",
language="en",
issn="1477-8939",
doi="10.1016/j.tmaid.2017.10.011",
url="http://dx.doi.org/10.1016/j.tmaid.2017.10.011"
}