标题：Past Trends and Current Status of Self-Reported Incidence and Impact of Disease and Nonbattle Injury in Military Operations in Southwest Asia and the Middle East
摘要：Objectives. To evaluate the evolutional changes in disease and nonbattle injury in a long-term deployment setting, we investigated trends of selected disease and nonbattle injury (NBI) incidence among US military personnel deployed in ongoing military operations in Southwest Asia and the Middle East. Methods. Participants completed an anonymous questionnaire concerning diarrhea, acute respiratory illness (ARI), and NBIs. We compared incidence, morbidity, and risk associations of disease and NBI incidence with historical data. We analyzed a clinic screening form to describe trends in diarrhea incidence over a 3-year period. Results. Between April 2006 and March 2007, 3374 troops completed deployment questionnaires. Incidence of diarrhea was higher than that of ARI and NBI (12.1, 7.1, and 2.5 episodes per 100 person-months, respectively), but ARI and NBI resulted in more-frequent health system utilization (both P < .001) and decreased work performance ( P < .001 and P = .05, respectively) than did diarrhea. Compared with historical disease and NBI incidence rates, diarrhea and NBI incidence declined over a 4-year period, whereas ARI remained relatively constant. Conclusions. Diarrhea, ARI, and NBI are important health concerns among deployed military personnel. Public health and preventive measures are needed to mitigate this burden. Diarrhea, acute respiratory illness (ARI), and nonbattle injuries (NBIs) may reduce the operational readiness of deployed military personnel by causing loss of person-days and increase in medical visits and medical evacuations. 1 , 2 Acute diarrhea is usually the most common illness incurred by US military personnel deployed overseas. This was true in World War II, during which a million man-days were lost because of amebiasis 3 ; in Vietnam, where diarrhea accounted for 4 times as many admissions as did malaria 4 ; and in the Gulf War, during which 57% of troops reported at least 1 episode and 1 out of 5 were temporarily unable to perform their duties. 5 , 6 Most recently, the self-reported prevalence of diarrhea during Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan) was 76.8% in Iraq and 54.4% in Afghanistan. 2 Although not as common as diarrhea, ARI and NBIs can also have a profound effect on operational readiness for deployed personnel. 7 – 9 ARI for operations Iraqi Freedom and Enduring Freedom have been reported in 69% of deployed personnel, with 17% of them seeking medical care. 2 The same study found 34% of the troops reporting nonbattle injuries, with 77% reporting seeking care multiple times. 2 Taking into account the evolving nature of military personnel, infrastructure, and operations, we describe results from ongoing surveillance to provide an update on trends in the incidence, impact, and factors associated with the differential risk of these common causes of disease and nonbattle injury (DNBI) incidence among troops across primary countries of deployment in the Southwest Asia and Middle East regions.
