Epidemiology and etiology of diarrhea in UK military personnel serving on the United Nations Mission in South Sudan in 2017: A prospective cohort study

A Multisite Network Assessment of the Epidemiology and Etiology of Acquired Diarrhea among U.S. Military and Western Travelers (Global Travelers’ Diarrhea Study): A Principal Role of Norovirus among Travelers with Gastrointestinal Illness

“…This higher percentage of EAEC found in the African region differs from Shah et al, 16 who found EAEC to be infrequently detected in Africa (3/165, 2%), but is in agreement with later findings of ETEC, EPEC, and EAEC frequently detected among Western military personnel in South Sudan, and NoV detected less frequently. 32 Despite these differences in most common pathogens detected, the distribution of single-, multiple-, and no pathogen-detected results showed similar patterns when comparing the SA with the primary analysis, although these differed from the work of Biswas et al 32 who found that nearly 80% of those enrolled in their study had two or more pathogens detected. However, this group used the BioFire Film Array GI panel, which included a wider scope of pathogens than the GTD study, and so may have contributed to the higher proportion of reported coinfections.…”

Undifferentiated febrile illnesses in South Sudan: a case series from Operation TRENTON from June to August 2017

“…Where a potential focus was suspected (eg, URT symptoms) results from the FilmArray were not conclusive for diagnosis. This is in contrast to testing diarrhoea samples, for example, where FilmArray provided real-time results which affected clinical management 11. It should therefore be noted by providers that qualitative PCR (especially without appropriate interpretation) is not a solution to every testing conundrum.…”

Clinical activity at the UK military level 2 hospital near Bentiu, South Sudan during Op TRENTON from June 2017 to October 2018

“…These figures are probably due to the large number of acute gastroenteritis (AGE) cases that occurred in UK military staff during the first 3 months, because these usually required admission for isolation until their symptoms resolved and were then able to return to their units without any need for medical evacuation. 2 Despite a marked decrease in AGE cases, the proportion of patients requiring definitive care from medicine specialists (general physicians) remained high (44% to 47%). Most of the remaining patients received definitive care from the emergency medicine team (41% to 31%), which highlights their important role in supporting the primary healthcare teams dealing with a range of minor illnesses and injuries.…”

“…AGE outbreaks remain a problem during the initial stages of UK military deployments, but can be brought under control. 2 Future deployments to similar environments (eg. Mali) are likely to see similar clinical activity and so operational planning should take account of these findings.…”