Romeo Toriro, B Tabberer, S I Davis, N L Reece, S D Woolley, M K O'Shea, T E Fletcher, D S Burns, N J Beeching
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引用次数: 0
摘要
背景：胃肠道疾病是军事训练和作战部署期间的常见病。我们比较了英国军人（SP）最近在肯尼亚和阿曼训练期间报告的旅行者腹泻（TD）的发病率和负担：2018年在肯尼亚和2018-2019年在阿曼进行为期6周的训练演习后，英国军人填写了一份经过验证的匿名问卷，内容涉及任何腹泻疾病的临床特征、相关风险因素以及对工作能力的影响。结果：共收到肯尼亚 388 名（32%）和阿曼 627 名（52%）SP 的调查问卷。肯尼亚 6 周内报告的腹泻累计发生率为 14.2%（95% CI 8.02%至 22.61%），而阿曼为 3.9%（95% CI 1.10%至 9.91%）（OR 3.56，95% CI 2.18 至 5.8；p 结论：肯尼亚的结核病流行病学、风险因素和负担与之前的描述相似，总体发病率持续下降。阿曼的发病率和负担明显较低，均大大低于历史描述。肯尼亚和阿曼的发病高峰时间和相关风险因素各不相同。继续记录和审查不同地理位置训练演习期间的 TD 至关重要，可让指挥系统了解行动效果面临的风险。
Epidemiology and impact of travellers' diarrhoea differs during UK military training exercises in Kenya and Oman.
Background: Gastrointestinal illnesses are common during military training and operational deployments. We compared the incidence and burden of travellers' diarrhoea (TD) reported by British service personnel (SP) during recent training exercises in Kenya and Oman.
Methods: SP completed a validated anonymous questionnaire regarding clinical features of any diarrhoeal illness, associated risk factors and impact on work capability after 6-week training exercises in 2018 in Kenya and 2018-2019 in Oman. Responses were tabulated for descriptive comparisons.
Results: Questionnaires were received from 388 (32%) SP in Kenya and 627 (52%) in Oman. The cumulative incidence of reported diarrhoea over 6-weeks was 14.2% (95% CI 8.02% to 22.61%) in Kenya compared with 3.9% (95% CI 1.10% to 9.91%) in Oman (OR 3.56, 95% CI 2.18 to 5.8; p<0.0001). Attack rates were 9.45 SP/100 exposure-months in Kenya and 2.66/100 in Oman. The number of workdays lost was greater in Kenya (6.26 per 1000 days) compared with Oman (4.13 per 1000 days) (p<0.01). In Kenya, 52.3% of those experiencing diarrhoea became ill during the first 14 days of deployment, but in Oman, 50% were ill in the last deployment week. The strongest risk factor associated with TD at both locations was contact with a colleague experiencing diarrhoea, followed in Kenya by eating locally sourced food and swimming in local water, which had weaker protective associations in Oman.
Conclusions: The epidemiology, risk factors and burden of TD in Kenya were similar to previous descriptions, where overall incidence continues to decline. Incidence and burden were significantly lower in Oman, where both were much lower than historical descriptions. Peak timing of illness and associated risk factors differed between Kenya and Oman. Continued documentation and review of TD during training exercises at different geographical locations is essential to inform the chain of command about risks to operational effectiveness.
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