MSMR最新文献

{"title":"Number of tuberculosis tests and diagnoses of latent tuberculosis infection among U.S. army active component service members, January 2014-December 2023.","authors":"Ralph A Stidham, Rachel G Tyler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a force health protection threat to the U.S. military, particularly in crucial populations at increased risk of exposure or re-activation. This analysis examined TB testing trends and the prevalence of latent tuberculosis infection (LTBI) among U.S. Army active component soldiers from 2014 through 2023, the first decade following a major policy shift to targeted testing. Defense Medical Surveillance System data indicate that a total of 339,465 TB tests were administered, primarily (81.0%) tuberculin skin tests. Of those tests, 22,762 (6.7%) were positive, leading to the identification of 18,018 (5.3%) LTBI diagnoses. Asian/Pacific Islander soldiers demonstrated the highest LTBI diagnosis proportion (10.2%), followed by non-Hispanic Black (8.6%), Hispanic (5.6%), and Non-Hispanic White (2.9%) soldiers; the data also include 'other' (6.8%) and 'unknown/missing' (3.6%) categories. Recruits exhibited a significantly higher LTBI diagnosis proportion (11.0%) than non-recruits (3.6%), highlighting a high prevalence of LTBI among incoming personnel at time of accession. A marked decline in testing volume-a 72% decrease from 2014 to 2023 in the annual numbers of tests administered-followed the 2013 U.S. Army Medical Command policy shift. The substantially higher average proportion (6.7%) of positive tests from 2014 to 2023 compared to the average from the pre-policy era (1.3%) of universal screening demonstrates the successful concentration of testing resources on those most at risk, thereby improving diagnostic yield within a low-prevalence military force. This analysis's findings describe the epidemiological outcomes of the Army's targeted testing policy and underscore the importance of ongoing, targeted surveillance to mitigate TB risks in military settings. The 2013 policy that successfully transitioned the U.S. Army from universal tuberculosis screening to a targeted, risk-based strategy reduced testing volume by 72% over the next decade. The decline in tuberculosis testing volume coincided with a substantial increase in diagnostic yield, with the overall positivity proportion rising from 1.3% in the pre-policy era to 6.7% in 2023. The 2013 policy revision to a targeted, risk-based tuberculosis testing strategy succeeded in focusing valuable public health resources on high-risk groups. The high prevalence (14.0%) of latent tuberculosis infection that has been identified in recruits confirms that accession is the most critical juncture for tuberculosis control within the Army. Slight but notable differences in testing type positivity suggests opportunity for further policy refinement.</p>","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 2","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHAMPS: the Career History Archival Medical and Personnel System-a summary of career and medical records of the U.S. Armed Forces, 1980-2023.","authors":"Yohannes G Haile, Adam T Biggs, James F Bonkowski, Zeina G Khodr, Jennifer McAnany, Christa R Lausted, Nathan C Carnes","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 2","pages":"13-17"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to disease and injury standardized surveillance categories in two U.S. Africa Command exercises, 2024.","authors":"Zachary J Rupert, Dianne N Frankel, Michelle A Dressner, David R Sayers","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 2","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-infection symptoms in U.S. soldiers with malaria during the Second World War: major limitation to return to duty.","authors":"G Dennis Shanks","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 2","pages":"8-10"},"PeriodicalIF":0.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13075966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An atypical Ross River virus infection in an Australian Army service member.","authors":"Melissa Graham, Brian Vesely, Cielo Pasay, Wenjun Liu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 1","pages":"22-25"},"PeriodicalIF":0.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying distinct approaches to racial and ethnic classification to the surveillance of obstetric and neonatal outcomes in the U.S. military, 2010-2021.","authors":"Celeste J Romano, Clinton Hall, Monica Burrell, Anna T Bukowinski, Jackielyn Lanning, Sandra Maduforo, Sandra Michelle Magallon, Zeina G Khodr, Gia R Gumbs, Ava Marie S Conlin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traditional, mutually exclusive approaches to racial and ethnic classification obscure important differences within major demographic groups and among multiracial populations. This study offers a novel examination of obstetric and neonatal outcomes among pregnant U.S. military service members, by applying multiple approaches to racial and ethnic classification and presenting disaggregated data. Overall, 235,608 births were identified among pregnant service members from 2010 through 2021. Inclusion of service members who identified with each racial group, whether alone or in combination with any other group, increased the American Indian or Alaska Native and Native Hawaiian or Pacific Islander birth populations by 209.7% and 94.0%, respectively, when compared to mutually exclusive classifications. Prevalences of obstetric outcomes such as cesarean delivery varied among racial and ethnic groups, particularly Asian and Latino populations, for example, Asian Indian, 36.7%; Filipino, 32.3%; Chinese, 26.5%; Puerto Rican, 30.2%; Mexican, 23.2%; and between distinct multiracial populations. Disaggregated estimates ultimately increased visibility of multiracial and Native service members and elucidated patterns indiscernible in aggregated data. Wider adoption of disaggregated racial and ethnic data methods is needed to improve understanding of health outcomes in the Military Health System. Reporting of non-mutually exclusive racial and ethnic groups as well as disaggregated Asian, Hispanic or Latino, and multiracial populations elucidates important differences in obstetric and neonatal outcomes.</p>","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 1","pages":"12-21"},"PeriodicalIF":0.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chikungunya in Military Health System Beneficiaries, 2020-2024.","authors":"Shauna L Stahlman, Kiara D Scatliffe-Carrion, Charles E McCannon","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 1","pages":"26-27"},"PeriodicalIF":0.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guillain-Barré syndrome clinical characteristics and outcomes among U.S. active component service members, 2014-2022.","authors":"Emily J Elliott, Shauna L Stahlman, Nora Watson, Cole Denkensohn, Kaye Sedarsky","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An examination of Guillain-Barré Syndrome (GBS) cases among U.S. active component service members from 2014 through 2022 revealed an incidence rate of 1.6 cases per 100,000 person-years. Individuals younger than age 20 years and those in basic training exhibited higher incidence. The type of antecedent event, either illness or immunization, was not associated with higher disability ratings at long-term follow-up. The analysis also quantified morbidity among service members with GBS, finding that 28.0% of cases had a subsequent chronic pain diagnosis, and 28.7% of cases were referred to the medical evaluation board. The need for neuropathic pain medication during the acute phase predicted poorer long-term functional outcomes. Furthermore, electrodiagnostic evidence of axonal or mixed nerve damage correlated with greater disability after 1 year. Although basic trainees had higher incidence, their long-term morbidity was comparable to other groups. These findings underscore the considerable impact that GBS can have on affected military personnel and identify factors associated with long-term complications. There were 1.6 cases of Guillain-Barré syndrome per 100,000 person years among active component U.S. service members from 2014 through 2022. There was no association between persistent disability and associated antecedent event (e.g., infection or immunization). Many patients experienced incomplete recovery, with 28.7% resulting in medical board referrals. Persistent disability was independently associated with chronic pain diagnosis.</p>","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 1","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold weather injuries among the active and reserve components of the U.S. Armed Forces, July 2020-June 2025.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>From July 2024 through June 2025, a total of 806 members of the active (n=702) and reserve (n=104) components of the U.S. Armed Forces had at least 1 cold weather injury. Compared to the 2023-2024 cold season, the cold weather injury rates during the 2024-2025 cold season increased by 41.8% (from 38.6 to 54.7 per 100,000 person-years) and 45.8% (from 8.5 to 12.4 per 100,000 person-years) in the active and reserve components, respectively. The Army, Navy, and Marine Corps recorded their highest cold weather injury rates during the 2024-2025 season of the 5-year surveillance period. Frostbite was the most common cold weather injury in the Army, Navy, and Marine Corps, with the Marine Corps experiencing the largest surge in frostbite rates. Over the entire surveillance period, U.S. active component service member cold weather injury rates were generally higher among male service members, non-Hispanic Black individuals, and those under age 20 years. The incidence rate of cold weather injuries among active component service members increased by over 40% between the 2023-2024 and 2024-2025 cold seasons, resulting in a 5-year rate of 41.5 per 100,000 person-years. This increase was primarily attributable to higher rates in the Army, Navy, and Marine Corps. The Marine Corps evinced the largest incidence rate increase (77.4%) during the 2024-2025 cold season. This year's update expanded cold injury surveillance to include \"other specified and unspecified effects of reduced temperature,\" to provide a more comprehensive assessment of cold weather injuries.</p>","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"32 12","pages":"3-16"},"PeriodicalIF":0.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnoses of mental health disorders among U.S. active component service members, 2020-2024.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mental health disorders have long been recognized as a problem in a wide range of domains, including the military, resulting in significant impacts on general morbidity, health care provision, disability, and military discharges. From 2020 through 2024, a total of 560,035 U.S. active component service members were diagnosed with at least 1 mental health disorder. Annual incidence rates of mental health disorder increased steadily from 2020 until 2022, but adjustment disorder decreased since then, anxiety gradually increased, and the remaining conditions remained relatively unchanged. Most mental health disorder diagnoses were attributable to adjustment disorders, anxiety disorders, depressive disorders, post-traumatic stress disorder, alcohol-related disorder, and other mental health disorders. Historically, mental health disorders have often been misunderstood and stigmatized, leading to under-reporting, delayed treatment, and poor prognoses. Reflecting the unique stressors and cultural stigmas of military life, ongoing efforts to raise awareness, encourage help-seeking, and improve treatment options are essential to supporting the mental and emotional well-being of service members. While the incidence of U.S. service members who were diagnosed with at least 1 mental health disorder remained stable from 2023 to 2024, the annual incidence rate of anxiety disorders demonstrated a continual increase from 2020 to 2024.</p>","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"32 12","pages":"25-35"},"PeriodicalIF":0.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}