Outcomes of diarrhea management in operations Iraqi Freedom and Enduring Freedom

Summary Introduction Among deployed U.S. military personnel, a sub-population of international travelers, acute infectious diarrhea continues to be a leading cause of morbidity and a potential threat to military effectiveness. Methods To assess outcomes and satisfaction of diarrhea management in the...

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Bibliographic Details
Published in:Travel medicine and infectious disease 2009-11, Vol.7 (6), p.337-343
Main Authors: Brown, Jamey A, Riddle, Mark S, Putnam, Shannon D, Schlett, Carey D, Armstrong, Adam W, Jones, James J, Tribble, David R, Sanders, John W
Format: Article
Language:English
Subjects:
Adult
Afghanistan - epidemiology
Antibiotics
Armed forces
Diarrhea - diagnosis
Diarrhea - epidemiology
Diarrhea - therapy
Empiric therapy
Female
Health sciences
Humans
Illnesses
Infectious Disease
Iraq - epidemiology
Logistic Models
Male
Middle East
Military
Military personnel
Military Personnel - statistics & numerical data
Patient Acceptance of Health Care - statistics & numerical data
Questionnaires
Severity of Illness Index
Studies
Surveys and Questionnaires
Travel
Travel medicine
Travelers' diarrhea
Treatment Outcome
U.S. military
United States
Warfare
Young Adult
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Summary:Summary Introduction Among deployed U.S. military personnel, a sub-population of international travelers, acute infectious diarrhea continues to be a leading cause of morbidity and a potential threat to military effectiveness. Methods To assess outcomes and satisfaction of diarrhea management in the field, a systematic survey was given to military personnel during mid- or post-deployment from Iraq or Afghanistan, from January through August 2004. Results Sixty-three percent of those surveyed reported at least one episode of diarrhea, while less than half sought care for their symptoms. Overall, trends of decreased post-treatment duration were noted as traveler's diarrhea therapy modalities grew more complex, controlling for severity of illness at presentation. Among those reporting diarrhea, the greatest level of satisfaction was seen in treatment with IV fluids (59%) followed by antibiotics (46%) and loperamide (40%). The greatest amount of dissatisfaction was seen in treatments with oral fluids only. Conclusion While current standard of care is self-treatment of diarrhea in civilian travelers, the U.S. military lacks standards outlining self-treatment of personnel at the individual level. Further research is needed to develop treatment guidelines on diarrhea management during military deployment.
ISSN:1477-8939
1873-0442
DOI:10.1016/j.tmaid.2009.09.001