Mark S. Riddle ^1*, David R. Tribble ², Shannon D. Putnam ³, Manal Mostafa ⁴, Theodore R. Brown ⁵, Andrew Letizia ⁶, Adam W. Armstrong ⁷, John W. Sanders ⁸

¹ Naval Medical Research Center, Silver Spring, MD
² Uniformed Services University of the Health Sciences, Bethesda, MD
³ US Naval Medical Research Unit No. 2, Jakarta, Indonesia
⁴ US Naval Medical Research Unit No.3, Cairo, Egypt
⁵ Walter Reed Army Institute of Research, Silver Spring, MD
⁶ Branch Medical Clinic Capodichino
⁷ US Naval Medical Research Unit No. 3, Cairo, Egypt
⁸ Naval Medical Research Center Detachment, Lima, Peru

^* To whom correspondence should be addressed. E-mail: markriddlemd{at}hotmail.com.

	Abstract

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.

Key Words: Epidemiology, Infections, Injury/Emergency Care/Violence, Surveillance, Surveys