Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
Más filtros











Base de datos
Intervalo de año de publicación
1.
Int J Epidemiol ; 28(2): 312-8, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10342697

RESUMEN

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.


Asunto(s)
Estado de Salud , Personal Militar/estadística & datos numéricos , Morbilidad/tendencias , Naciones Unidas , Femenino , Haití/epidemiología , Humanos , Cooperación Internacional , Masculino , Vigilancia de la Población , Misiones Religiosas
2.
Mil Med ; 164(4): 300-2, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10226460

RESUMEN

The incidence of dengue infections has been increasing in the Caribbean, and cases have been identified among successive deployments of multinational peacekeepers to Haiti (1994-1997). In the absence of an effective vaccine or chemoprophylaxis to prevent dengue fever, vector-control operations and use of personal protection measures to prevent arthropod bites are the most effective means of limiting disease transmission. During our 5-month deployment as part of the United Nations Mission in Haiti, 79 cases of recent dengue fever were identified among 249 patients (32%) presenting with febrile illness to the 86th Combat Support Hospital. Further investigation revealed low unit readiness to perform standard vector-control activities and poor individual adherence to measures to prevent arthropod bites. Command enforcement of existing field preventive medicine doctrine is essential to prevent casualties caused by dengue, other arthropod-borne infections, and nuisance arthropod bites during military deployments.


Asunto(s)
Dengue/diagnóstico , Dengue/prevención & control , Medicina Militar/métodos , Personal Militar/estadística & datos numéricos , Prevención Primaria/métodos , Dengue/sangre , Dengue/etiología , Haití , Humanos , Evaluación de Necesidades , Factores de Riesgo , Encuestas y Cuestionarios , Estados Unidos
3.
Am J Trop Med Hyg ; 59(2): 275-8, 1998 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-9715946

RESUMEN

We evaluated laboratory methods to confirm a clinical diagnosis of dengue. Acute sera were collected from personnel (n = 414) supporting the United Nations Mission in Haiti and presenting with febrile illness consistent with dengue fever or no apparent underlying cause. Dengue virus was recovered from 161 of 379 acute sera by inoculation into C6/36 cell culture. While 93 of 414 acute sera had detectable IgM antibodies, the IgM capture ELISA (MAC ELISA) had a sensitivity of only 13% compared with the virus isolation gold standard. If presumptive dengue fever cases were identified by both virus isolation and the presence of IgM, virus isolation and the MAC ELISA had clinical sensitivities of 69% and 40%, respectively. This study suggests that a combination of laboratory methods that target virus or subviral components as well as anti-viral IgM antibodies may be necessary for sensitive laboratory diagnosis with acute sera.


Asunto(s)
Anticuerpos Antivirales/sangre , Virus del Dengue/inmunología , Virus del Dengue/aislamiento & purificación , Dengue/diagnóstico , Personal Militar , Enfermedad Aguda , Aedes , Animales , Línea Celular , Dengue/epidemiología , Ensayo de Inmunoadsorción Enzimática , Haití/epidemiología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Cinética , Factores de Riesgo , Sensibilidad y Especificidad , Naciones Unidas , Estados Unidos , Viremia/virología
4.
Am J Trop Med Hyg ; 58(6): 731-6, 1998 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9660454

RESUMEN

Information about the prevalence of hepatitis E virus (HEV) infection is sparse in many countries. Following the identification of four cases of acute HEV infection among Bangladeshi soldiers, a serologic survey was conducted to determine the prevalence of HEV infection among other peacekeepers from the United Nations Mission in Haiti (UNMIH) and Haitian civilians. Of the 981 participants in the survey, 876 were soldiers from eight UNMIH-participating countries representing Asia, Africa, and the Americas, and 105 were Haitian civilians. The prevalence of HEV infection by country (from highest to lowest) included Pakistan (62%), India (37%), Nepal (37%), Bangladesh (27%), Djibouti (13%), Honduras (6%), Guatemala (5%), Haiti (3%), and the United States (2%). More than 90% of those surveyed from Guatemala, Haiti, and Honduras, where prevalence data has been scarce, appeared susceptible to HEV infection. Future multinational missions like the UNMIH might also present unique opportunities to study health threats of widespread interest.


Asunto(s)
Anticuerpos Antihepatitis/sangre , Virus de la Hepatitis E/inmunología , Hepatitis E/epidemiología , Personal Militar , Adulto , Asia , América Central , Estudios Transversales , Djibouti , Femenino , Haití/epidemiología , Humanos , Inmunoglobulinas/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Encuestas y Cuestionarios , Naciones Unidas , Estados Unidos
5.
Am J Trop Med Hyg ; 57(4): 449-54, 1997 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-9347962

RESUMEN

In the fall of 1995, within a month of deployment to Haiti for peacekeeping duty, four Bangladeshi soldiers developed acute icteric hepatitis in rapid succession. Hepatitis E virus (HEV) was found to be the etiology by demonstrating HEV genomic sequences in serum samples by the polymerase chain reaction (PCR) and serologically by the detection of elevated IgM titers to HEV. No case had serologic evidence of acute hepatitis A or C infection. The soldiers had probably acquired their infection while living in a cantonment area outside Dhaka, Bangladesh for one month prior to deployment. Cloning and sequencing of amplified PCR products demonstrated a single strain suggestive of a common source of infection. Furthermore, high genomic identity with Asian strains of HEV and dissimilarity with the Mexican strain was demonstrated, verifying that the strain had indeed been imported. Human waste management from the Bangladesh camp in Haiti was strictly controlled and no secondary cases were observed. A convenience sample of 105 (12%) soldiers from the Bangladesh battalion (850 men) revealed anicteric or asymptomatic HEV infection in seven (7%) of 105. This report contains the first demonstration of acute hepatitis E in natives of Bangladesh and demonstrates the power of the PCR in the rapid diagnosis and epidemiologic analysis of HEV infection. More importantly, this cluster demonstrates the importation of an important infectious disease by multinational peacekeepers to a potentially susceptible host country.


Asunto(s)
Hepatitis E/epidemiología , Personal Militar , Enfermedad Aguda , Bangladesh/etnología , Haití/epidemiología , Hepatitis E/genética , Hepatitis E/inmunología , Virus de la Hepatitis E/genética , Virus de la Hepatitis E/inmunología , Humanos , Masculino , ARN Viral/genética , Agrupamiento Espacio-Temporal , Viaje
6.
Mil Med ; 162(6): 380-3, 1997 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-9183157

RESUMEN

Prostatodynia is a clinical entity associated with voiding symptoms and pelvic pain suggestive of prostatitis but with a normal prostate examination and without evidence of inflammation or infection in expressed prostatic secretions. The problem tends to be chronic and is vexing in its management. Although thought to be a common condition, prevalence data are generally lacking. From June to October 1995, the U.S. Army's 86th Combat Support Hospital provided medical support to a multinational United Nations peacekeeping force in Haiti. Patients diagnosed with prostatodynia were more common (13 cases) than men with other urologic problems (urolithiasis, 6 cases; urinary tract infection, 6 cases; scrotal abscess/mass, 2 cases; epididymitis, 1 case). Patients tended to be young (mean age 29.8), had multiple visits, failed to respond to multiple courses of antibiotics for presumed "prostatitis," and denied recent sexual relations. Some patients reported having had similar symptoms on prolonged separation from their spouses in the past that resolved with resumption of normal intercourse. Masturbation, however, had no impact on symptoms and was painful in some individuals. Terazosin, an alpha-antagonist, and stress-reduction therapy led to improvement in some patients' symptoms. A discussion of these retrospective findings in light of what is known about the possible etiologies and treatment of prostatodynia is presented. Prostatodynia appears to be a common problem in deployed troops and can lead to frequent use of medical services. Physicians supporting long deployments need to be aware of this entity.


Asunto(s)
Personal Militar , Dolor Pélvico/diagnóstico , Enfermedades de la Próstata/diagnóstico , Naciones Unidas , Absceso/diagnóstico , Antagonistas Adrenérgicos alfa/uso terapéutico , Adulto , Factores de Edad , Antibacterianos/uso terapéutico , Enfermedad Crónica , Coito , Diagnóstico Diferencial , Epididimitis/diagnóstico , Enfermedades de los Genitales Masculinos/diagnóstico , Enfermedades de los Genitales Masculinos/microbiología , Haití , Humanos , Masculino , Masturbación/fisiopatología , Persona de Mediana Edad , Dolor Pélvico/prevención & control , Prazosina/análogos & derivados , Prazosina/uso terapéutico , Prevalencia , Enfermedades de la Próstata/prevención & control , Prostatitis/diagnóstico , Prostatitis/tratamiento farmacológico , Estudios Retrospectivos , Escroto/microbiología , Estrés Fisiológico/prevención & control , Cálculos Urinarios/diagnóstico , Infecciones Urinarias/diagnóstico , Trastornos Urinarios/diagnóstico
7.
Bull World Health Organ ; 75(2): 109-15, 1997.
Artículo en Inglés | MEDLINE | ID: mdl-9185362

RESUMEN

From June to October 1995, the U.S. Army's 86th Combat Support Hospital was deployed in Haiti in support of the United Nations peacekeeping mission. The hospital's mission was to provide comprehensive health care to United Nations military and civilian personnel in Haiti. The hospital's laboratory, with microbiological and parasitological capability, was a critical asset in light of the infectious disease threats in Haiti. A total of 356 microbiological (5.4%) and 887 parasitological (13.4%) tests were performed, out of a total of 6628 laboratory tests. One finding was the discovery of antibiotic-resistant urinary isolates of Escherichia coli. These were from community-acquired infections and included strains resistant to ampicillin (6/15), trimethoprim+sulfamethoxazole (6/15), and ciprofloxacin (2/15). Ampicillin (8/15) and trimethoprim+sulfamethoxazole (3/15) resistance was also noted in Shigella spp. However, no chloroquine-resistant strains of malaria were encountered. Dengue virus, also mosquito borne, was a major pathogen. Antimicrobial-resistant nosocomial pathogens were also encountered. Deployed laboratories should be able to determine antimicrobial susceptibility and perform microbial identification to guide clinical management, conduct medical surveillance, and detect emerging resistance.


Asunto(s)
Enfermedades Transmisibles/diagnóstico , Laboratorios de Hospital , Medicina Militar , Haití , Humanos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA