HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.131680v1 98/12/2199    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Riddle, M. S. Articles by Sanders, J. W. Search for Related Content PubMed PubMed Citation Articles by Riddle, M. S. Articles by Sanders, J. W. Related Collections Epidemiology Other Infections Injury/Emergency Care/Violence Occupational Health Prevention Surveillance Surveys Other Respiratory Health

Mark S. Riddle, MD, DrPH, David R. Tribble, MD, DrPH, Shannon D. Putnam, PhD, Manal Mostafa, MPhil, Theodore R. Brown, DO, MPH, Andrew Letizia, MD, Adam W. Armstrong, DO, MSPH and John W. Sanders, MD, MPH&TM

Mark S. Riddle is with the Naval Medical Research Center, Silver Spring, MD. David R. Tribble is with the Uniformed Services University of the Health Sciences, Bethesda, MD. Shannon D. Putnam is with the US Naval Medical Research Unit No. 2, Jakarta, Indonesia. Manal Mostafa and Adam W. Armstrong are with the US Naval Medical Research Unit No. 3, Cairo, Egypt. Theodore R. Brown is with the Walter Reed Army Institute of Research, Silver Spring. Andrew Letizia is with the Branch Medical Clinic, Capodichino, Italy. John W. Sanders is with the Naval Medical Research Center Detachment, Lima, Peru.

Correspondence: Request for reprints should be sent to Mark S. Riddle, Enteric Diseases Department, Naval Medical Research Center, 503 Robert Grant Ave, Silver Spring, MD 20910 (e-mail: markriddlemd{at}hotmail.com).

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.