Malaria in US military forces: A description of deployment exposures from 2003 through 2005
Malaria in US military forces: A description of deployment exposures from 2003 through 2005
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DOI：
10.4269/ajtmh.2007.76.275
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发表时间：
2007-02-01
影响因子：
3.3
通讯作者：
Brundage, John
中科院分区：
文献类型：
--
作者：
Ciminera, Paul;Brundage, John
美国军人经常被派往疟疾流行地区。预防措施在减少疾病风险和对使命绩效的不利影响方面发挥着重要作用。目前。在东南亚和西南亚的疟疾流行地区部署了一支庞大的美国部队。本研究的目的是描述疟疾病例报告的三个服务报告的医疗事件系统的曝光（部署历史）和感染的潜伏期。我们对疾病监测常规收集的人群健康数据进行了回顾性分析。对2006年1月3日之前进入国防医学监测系统的所有疟疾报告，发病日期在2000年1月1日至2005年12月31日之间，其中诊断的个体是与人员和部署数据相关的现役或预备役军事部分的成员，进行分析以确定分配和部署历史。主要结局指标是按发病日期和暴露天数列出的疟疾（间日疟原虫、恶性疟原虫、卵形疟原虫、疟疾疟原虫和未指明的疟疾）的ICD 9-CM诊断。研究期间共报告了423例疟疾病例。陆军（n - 325）和海军陆战队（n 46）报告的病例数最多。间日疟原虫（n = 242）和恶性疟原虫（n = 92）引起了所有报告病例的近五分之四。在2003年至2005年期间，34%的部署病例暴露于一个以上的疟疾流行地区。大韩民国有74例病例，所有病例都是在高风险传播期间出现在韩国的。78例病例记录了在阿富汗服役的情况;只有4例有淡季暴露，没有其他记录的暴露。有60个病例记录了在“伊拉克自由行动”期间的接触情况。只有6个季节性接触和6个非季节性接触的OIF病例没有其他记录的接触。50%的韩国病例是在暴露季节诊断的，只有3%的阿富汗病例是在暴露季节诊断的。今天的军队要求士兵在确诊前接触一个以上的疟疾流行地区。这给疾病监测和预防政策的制定带来了新的复杂性。
U.S. service members are often deployed to regions endemic for malaria. Preventive measures play an important role in mitigating the risk of disease and adverse effects on mission performance. Currently. a large contingent of U.S. forces is deployed ill malarious regions in southeast and southwest Asia. The purpose of this study was to describe malaria cases reported by the tri-service reportable medical events system in terms of exposure (deployment history) and latency of infection. We conducted a retrospective analysis of population health data routinely collected for disease surveillance. All malaria reports received into the Defense Medical Surveillance System by January 3, 2006 with a date of onset between January 1, 2000 and December 31, 2005 in which the individual diagnosed is a member of the active or reserve military components linked to personnel and deployment data were analyzed to determine assignment and deployment history. The main outcome measure was the ICD9-CM diagnosis of malaria (Plasmodium vivax, P. falciparum, P. ovale, P. malaria, and unspecified malaria) by date of onset and days from exposure. A total of 423 cases of malaria were reported during the study period. The Army (n - 325) and the Marine Corps (n 46) had the highest number of reported cases. Plasmodium vivax (n = 242) and P. falciparum (n = 92) caused nearly four-fifths of all reported cases. During the period front 2003 through 2005, 34% of deployed cases were exposed to more than one malaria-endemic region. Seventy-four cases had been assigned in the Republic of Korea, and all were present in Korea during the high risk transmission period. Seventy-eight cases had documented service in Afghanistan; only 4 had off-season exposure and no other documented exposures. Sixty cases had documented exposure during Operation Iraqi Freedom (OIF). Only six seasonally exposed and six off seasonally exposed OIF cases had no other documented exposure. Fifty percent of Korean cases were diagnosed during an exposure season, and only 3% of Afghan cases were diagnosed during an exposure season. Soldiers in today's military call be exposed to more than one malaria-endemic region prior to diagnosis. This presents new complexities for disease monitoring and prevention policy development.