Investigating factors associated with reporting concerns towards malaria prophylaxis, and the content of concerns amongst UK Service Personnel deployed to the Iraq conflict between 2003-2006: a mixed methods study.

BACKGROUND There was a significant risk of malaria in the area to which military personnel were deployed during the Iraq War. In this paper we investigated attitudes towards anti malarial tablets, health and the reporting of military hazards during deployment. METHODS A cross sectional study of military personnel deployed to Iraq between 2003 and 2006 was performed. A mixed methods model of analysis, with quantitative analysis of reported concerns regarding anti-malarial tablets, health and environmental exposures was undertaken with a qualitative analysis of responses to a free text question inviting comments on concerns regarding the prophylaxis. RESULTS Individuals who reported concerns were more likely to report multiple physical symptoms, common mental health problems, side effects to NAPS tablets and anthrax vaccination and exposures during deployment to military hazards (odds ratios: 1.17-3.10). The majority did not voice concerns regarding malarial prophylaxis, in those that did however, strong themes of unease regarding safety and trust emerged. DISCUSSION We found evidence of a link between reporting concerns about anti malarial tablets and reporting worse health and increased exposure to military hazards. We hypothesise that this relationship is mediated by negative affect.