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Mefloquine adverse effect — DTM&H MCQ

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ModerateMalariaMefloquine adverse effectDTM&H

A 34-year-old man with a history of severe depression plans travel to the Democratic Republic of Congo. He asks whether weekly mefloquine would be convenient for malaria prevention. What is the most appropriate prophylaxis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Avoid mefloquine and use an alternative regimen

Avoid mefloquine and use an alternative regimen is the single best answer because mefloquine is avoided in people with significant neuropsychiatric history because serious psychiatric adverse effects can occur. Start mefloquine at departure is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that choosing prophylaxis requires destination resistance patterns and patient-specific contraindications.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026