The Defense Medical Surveillance System and the Department of Defense Serum Repository: Glimpses of the Future of Public Health Surveillance

Rubertone, Mark V.; Brundage, John F.

doi:10.2105/ajph.92.12.1900

Cited by 283 publications

(212 citation statements)

References 28 publications

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“…DMSS is the central repository of medical surveillance data for the U.S. Armed Forces and is maintained by the Armed Forces Health Surveillance Branch. 18 DMSS contains longitudinal data on medical encounters (in both military treatment facilities [MTFs] and civilian facilities if paid for by the Military Health System), demographics, service, deployment, and immunizations for service members. TMDS contains medical encounter and pharmacy data from deployed locations.…”

Section: Methodsmentioning

confidence: 99%

Neuropsychiatric Outcomes After Mefloquine Exposure Among U.S. Military Service Members

Eick-Cost

Rohrbeck

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. Mefloquine was widely prescribed to U.S. military service members until 2009 when use was limited to personnel with contraindications to doxycycline and no contraindications to mefloquine. The need to estimate the occurrence of neuropsychiatric outcomes (NPOs) in service members prescribed mefloquine warranted a comprehensive evaluation of this issue. Active component service members filling a prescription for mefloquine, doxycycline, or atovaquone/proguanil (A/P) between January 1, 2008 and June 30, 2013, were included in the analysis. The risk of developing incident NPOs and the risk of subsequent NPOs among subjects with a history of the condition were assessed. A total of 367,840 individuals were evaluated (36,538 received mefloquine, 318,421 received doxycycline, and 12,881 received A/P). Among deployed individuals prescribed mefloquine, an increased risk of incident anxiety was seen when compared with doxycycline recipients (incidence rate ratio [IRR] = 1.12 [1.01-1.24]). Among nondeployed mefloquine recipients, an increased risk of posttraumatic stress disorder (PTSD) was seen when compared with A/P recipients (IRR = 1.83 [1. 07-3.14]). An increased risk of tinnitus was seen for both deployed and nondeployed mefloquine recipients compared with A/P recipients (IRR = 1.81 [1.18-2.79]), 1.51 (1.13-2.03), respectively). Six percent of the mefloquine cohort had an NPO in the year before receiving mefloquine. When comparing individuals with a prior neuropsychiatric history to those without, the ratio of relative risks for adjustment disorder, anxiety, insomnia, and PTSD were higher (not statistically significant) for mefloquine compared with doxycycline. These findings emphasize the continued need for physicians prescribing mefloquine to conduct contraindication screening.

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Section: Methodsmentioning

confidence: 99%

Neuropsychiatric Outcomes After Mefloquine Exposure Among U.S. Military Service Members

Eick-Cost

Rohrbeck

et al. 2017

The American Society of Tropical Medicine and Hygiene

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“…The longest interval was 10 years and the shortest was <12 months. Procedures were in accordance with Department of Defense Directive 6490.2 and Instruction 6490.3 [11]. The samples were frozen in 0.5-ml portions and stored in the Department of Defense Serum Repository.…”

Section: Methodsmentioning

confidence: 99%

“…The samples were frozen in 0.5-ml portions and stored in the Department of Defense Serum Repository. All data were stored in the Defense Medical Surveillance System [11]. This was an exempt protocol of anonymised data, so informed consent was not required.…”

Section: Methodsmentioning

confidence: 99%

Lower prediagnostic serum 25-hydroxyvitamin D concentration is associated with higher risk of insulin-requiring diabetes: a nested case–control study

et al. 2012

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Aims/hypothesis Low serum 25-hydroxyvitamin D [25 (OH)D] concentration may increase risk of insulinrequiring diabetes.Methods A nested case-control study was performed using serum collected during 2002-2008 from military service members. One thousand subjects subsequently developed insulin-requiring diabetes. A healthy control was individually matched to each case on blood-draw date (±2 days), age (±3 months), length of service (±30 days) and sex. The median elapsed time between serum collection and first diagnosis of diabetes was 1 year (range 1 month to 10 years). Statistical analysis used matched pairs and conditional logistic regression. Results ORs for insulin-requiring diabetes by quintile of serum 25(OH)D, from lowest to highest, were 3.5 (95% CI 2.0, 6.0), 2.5 (1.5, 4.2), 0.8 (0.4, 1.4), 1.1 (0.6, 2.8) and 1.0 (reference) (p trend <0.001). The quintiles (based on fifths using serum 25(OH)D concentration in the controls) of serum 25(OH)D in nmol/l, were <43 (median 28), 43-59 (median 52), 60-77 (median 70), 78-99 (median 88) and ≥100 (median 128). Conclusions/interpretation Individuals with lower serum 25(OH)D concentrations had higher risk of insulinrequiring diabetes than those with higher concentrations. A 3.5-fold lower risk was associated with a serum 25 (OH)D concentration ≥60 nmol/l.

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“…The majority of these samples are the remainder of sera drawn for mandated HIV-1 testing. Stored sera are labeled with a unique identifier and are included in DMSS along with testing dates, personnel information, medical events, deployment data, inpatient and outpatient records, and immunization data [15].…”

Section: Data Sourcesmentioning

confidence: 99%

Serum IgG antibody response to the protective antigen (PA) of Bacillus anthracis induced by anthrax vaccine adsorbed (AVA) among U.S. military personnel

Singer

Schneerson

Bautista

et al. 2008

Vaccine

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The seroconversion rates and geometric mean concentrations (GMC) of IgG anti-PA for stored sera from U.S. military personnel immunized 3, 4, and 6 times with the U.S. licensed anthrax vaccine adsorbed were studied. Anti-PA IgG concentrations were measured by ELISA. All 246 vaccinees had low but detectable pre-immunization anti-PA IgG (GMC 1.83μg/mL). Three doses elicited a GMC of 60 μg/mL and a seroconversion rate of 85.3%, four doses elicited a GMC of 157 μg/mL and 67.9% and the sixth of 277 μg/mL and 45.5% respectively. The forth dose elicited 100% seroconversion compared to the pre-immunization level. These results should facilitate comparison between different immunization schedules and new vaccines.

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The Defense Medical Surveillance System and the Department of Defense Serum Repository: Glimpses of the Future of Public Health Surveillance

Cited by 283 publications

References 28 publications

Neuropsychiatric Outcomes After Mefloquine Exposure Among U.S. Military Service Members

Neuropsychiatric Outcomes After Mefloquine Exposure Among U.S. Military Service Members

Lower prediagnostic serum 25-hydroxyvitamin D concentration is associated with higher risk of insulin-requiring diabetes: a nested case–control study

Serum IgG antibody response to the protective antigen (PA) of Bacillus anthracis induced by anthrax vaccine adsorbed (AVA) among U.S. military personnel

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