International Journal of Epidemiology, Vol 28, 312-318, Copyright © 1999 by International Epidemiological Association
JM Gambel, JJ Drabick and L Martinez-Lopez
BACKGROUND: Multinational peacekeepers, both military and civilian, often
deploy to areas of the world where significant health threats are endemic
and host country public health systems are inadequate. Medical surveillance
of deployed personnel enables leaders to better direct health care
resources to prevent and treat casualties. Over a 5-month period, June to
October 1995, a medical surveillance system (MSS) was implemented in
support of the United Nations Mission in Haiti (UNMIH). Information
obtained from this system as well as lessons learned from its
implementation and management may help decrease casualty rates during
future multinational missions. METHODS: Over 90% of UNMIH personnel (80%
military from over 11 countries and 20% civilian from over 70 countries)
stationed throughout Haiti participated in the MSS. A weekly standardized
reporting form included the number of new outpatient visits by disease and
non-battle injury (DNBI) category and number of personnel supported by each
participating UN medical treatment facility (MTF). Previously, medical
reporting consisted of simple counts of patient visits without
distinguishing between new and follow-up visits. Weekly incidence rates
were determined and trends compared within and among reporting sites. The
diagnoses and numbers of inpatient cases per week were only monitored at
the 86th Combat Support Hospital, the facility with the most sophisticated
level of health care available to UN personnel. RESULTS: The overall
outpatient DNBI incidence rate ranged from 9.2% to 13% of supported UN
personnel/week. Of the 14 outpatient diagnostic categories, the three
categories consistently with the highest rates included orthopaedic/injury
(1.6- 2.5%), dermatology (1.3-2.2%), and respiratory (0.9-2.2%) of
supported UN personnel/week. The most common inpatient discharge diagnoses
included suspected dengue fever (22.3%), gastro-enteritis (15%), and other
febrile illness (13.5%). Of the 249 patients who presented with a febrile
illness, 79 (32%) had serological evidence of recent dengue infection.
Surveillance results helped lead to interventions that addressed issues
related to field sanitation, potable water, food preparation and vector
control. CONCLUSIONS: Despite hurdles associated with distance, language,
and communications, the MSS was a practical and effective tool for UNMIH
force protection. UN requirements for standardized medical surveillance
during deployments should be developed and implemented. Furthermore,
planners should recognize that if ongoing medical surveillance and related
responses are to be effective, personnel should be trained prior to
deployment and resources dedicated to a sustained effort in theatre.
ARTICLES
Medical surveillance of multinational peacekeepers deployed in support of the United Nations Mission in Haiti, June-October 1995
Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100, USA.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Patel, C. Easmon, P. Seed, C. Dow, and D. Snashall Morbidity in expatriates--a prospective cohort study Occup. Med., August 1, 2006; 56(5): 345 - 352. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. RIDDLE, J. W. SANDERS, S. D. PUTNAM, and D. R. TRIBBLE Incidence, etiology, and impact of diarrhea among long-term travelers (us military and similar populations): a systematic review. Am J Trop Med Hyg, May 1, 2006; 74(5): 891 - 900. [Abstract] [Full Text] [PDF]
|
|