Screening the asymptomatic soldiers after a stay in sub-Saharan Africa. A retrospective observational study

Vanbrabant, Peter; Damanet, Benjamin; Maussen, Chris; Esbroeck, Marjan Van; Soentjens, Patrick

doi:10.1016/j.tmaid.2020.101941

Travel Medicine and Infectious Disease

2021

DOI: 10.1016/j.tmaid.2020.101941

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Screening the asymptomatic soldiers after a stay in sub-Saharan Africa. A retrospective observational study

Peter Vanbrabant

Benjamin Damanet

Chris Maussen

et al.

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“…A definite or probable diagnosis of helminth infection was ultimately made in 105 of the total 153 soldiers (69%), with 6 of them having Strongyloides in stool samples [ 9 ]. A 2018 study of 949 Belgian military personnel returning from deployment in a tropical region (median duration 35 days; interquartile range, 14–90) showed a Strongyloides seroprevalence rate of 1.1% [ 10 ]. The present study is meant to examine the recent burden, risk factors, and clinical course of Strongyloides infections within the US Military Health System.…”

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Strongyloides stercoralisin the US Military Health System

Taheri

Kuo

Hockenbury

et al. 2023

Open Forum Infectious Diseases

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Background Strongyloides stercoralis is an intestinal nematode most commonly found in subtropical and tropical locations. Military service members are believed to be at increased risk of exposure due to their unique occupational exposures in endemic regions. Methods Burden, clinical course, and risk factors associated with all Strongyloides infections within the U.S. Military Health System (MHS) from fiscal years 2012-2019 were assessed by manual chart review of records with ICD-9/10 codes for Strongyloides infection. Infection risk in demographic subgroups based on region of birth, military occupation, and age was quantified with univariate analysis and multivariate logistic regression. Results We reviewed 243 charts based on diagnosis coding, yielding 210 confirmed diagnoses (86.4%). Immigrant patients born in Latin America/Caribbean, Sub-Saharan Africa, and East Asia/Pacific regions had statistically significant increased risk ratios of infection at 34.4, 32.0, and 22.4, respectively, when compared to patients born in Europe and North America. In univariate analysis, active duty members in the healthcare occupational category had a statistically significant increased risk ratio of infection at 2.31 compared to those outside this occupation. Multivariate logistic regression analysis demonstrated that occupational categories of healthcare, admininstrative/support, warfighter/combat specialist, and engineering/repair/maintenance occupations, being an immigrant patient, and age >= 65 were all associated with statistically significant increased odds ratios for infection. Conclusions In the Military Health System, occupational exposures, region of birth, and age serve as risk factors for Strongyloides infection. As infections may be chronic, the impact of targeted screening programs to complement routine medical care should be considered.

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confidence: 99%

Strongyloides stercoralisin the US Military Health System

Taheri

Kuo

Hockenbury

et al. 2023

Open Forum Infectious Diseases

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Schistosomiasis in the Military—A Narrative Review

Costescu Strachinaru,

Nyandwaro,

Stoefs

et al. 2024

TropicalMed

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Schistosomiasis is a parasitosis caused by trematodes of the genus Schistosoma. Humans are infected when coming into contact with freshwater containing the parasites’ infective stages, which are amplified through freshwater-dwelling snails acting as intermediate hosts. Schistosomiasis has posed significant problems for troops exposed to freshwater in endemic regions ever since the Napoleonic wars. Schistosomiasis has substantial differences in clinical presentation, depending on the type of parasite, intensity of infection and reinfection, clinical form, and disease stage. It can remain undiagnosed for long periods of time, with well-known long-term morbidity and mortality risks. The diagnosis of schistosomiasis depends on its stage and relays on several tests, all with limitations in sensitivity and specificity. The diagnostic gold standard is the detection of eggs in urine, feces, or tissue biopsies, but this can raise problems in patients such as military personnel, in which the worm burden is usually low. Praziquantel is the drug of choice for schistosomiasis. Currently, there is no available commercial vaccine against any Schistosoma parasite. Avoiding freshwater exposure is the best prevention. Herein, we review the clinical presentation, diagnosis, treatment, and prevention of schistosomiasis in the military. This information may decrease the impact of schistosomiasis on this particular professional group.

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Screening the asymptomatic soldiers after a stay in sub-Saharan Africa. A retrospective observational study

Cited by 2 publications

References 16 publications

Strongyloides stercoralisin the US Military Health System

Strongyloides stercoralisin the US Military Health System

Schistosomiasis in the Military—A Narrative Review

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