HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by RIDDLE, M. S. Articles by TRIBBLE, D. R. Search for Related Content PubMed PubMed Citation Articles by RIDDLE, M. S. Articles by TRIBBLE, D. R. Related Collections Diarrheal diseases

INCIDENCE, ETIOLOGY, AND IMPACT OF DIARRHEA AMONG LONG-TERM TRAVELERS (US MILITARY AND SIMILAR POPULATIONS): A SYSTEMATIC REVIEW

To determine regional estimates of pathogen-specific prevalence and incidence, as well as, describe morbidity associated with diarrhea among deployed US military and similar populations, a systematic review was conducted for publications between January 1990 to June 2005. Point estimates and confidence intervals of pathogen prevalence and travelers’ diarrhea incidence were combined in a random effects model and assessed for heterogeneity. In total, 262 studies were identified for potential inclusion, of which 52 fulfilled inclusion criteria. Overall, 38% were from the Middle East, 29% from Southeast Asia, 27% from Latin America/Caribbean, and 6% from sub-Saharan Africa. Median duration of travel was 1.5 months (interquartile range, 1–3 months). Enterotoxigenic Escherichia coli (ETEC), Campylobacter, and Shigella were identified as causing 38–45% of diarrhea, with regional and population differences. Incidence based on self-report was higher than studies using passive surveillance or clinic-based methods (29 versus 7 versus 6 episodes per 100 person-months, respectively) without regional differences.

Received September 15, 2005. Accepted for publication December 29, 2005.

^* Address correspondence to Mark S. Riddle, NAMRU 3, PSC 452, Box 105, FPO AE 09835. E-mail: markriddlemd{at}hotmail.com

Authors’ addresses: Mark S. Riddle, NAMRU-3, PSC 452, Box 105, FPO AE 09835, E-mail: markriddlemd{at}hotmail.com. John W. Sanders, Infectious Disease Service, National Naval Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, E-mail: jwsanders{at}bethesda.med.navy.mil. Shannon D. Putnam, U.S. Embassy Jakarta, NAMRU 2, Box 8132, FPO AP 96520, E-mail: sha8299{at}hotmail.com. David R. Tribble, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910-7500, E-mail: tribbled{at}nmrc.med.navy.mil.

This article has been cited by other articles:

				S. Baqar, L. A. Applebee, T. C. Gilliland Jr., L. H. Lee, C. K. Porter, and P. Guerry Immunogenicity and Protective Efficacy of Recombinant Campylobacter jejuni Flagellum-Secreted Proteins in Mice Infect. Immun., July 1, 2008; 76(7): 3170 - 3175. [Abstract] [Full Text] [PDF]

				D. R. Tribble, S. Baqar, L. W. Pang, C. Mason, H.-S. H. Houng, C. Pitarangsi, C. Lebron, A. Armstrong, O. Sethabutr, and J. W. Sanders Diagnostic Approach to Acute Diarrheal Illness in a Military Population on Training Exercises in Thailand, a Region of Campylobacter Hyperendemicity J. Clin. Microbiol., April 1, 2008; 46(4): 1418 - 1425. [Abstract] [Full Text] [PDF]

				M. R. MONTEVILLE, M. S. RIDDLE, U. BAHT, S. D. PUTNAM, R. W. FRENCK, K. BROOKS, M. MOUSTAFA, J. BLAND, and J. W. SANDERS Incidence, etiology, and impact of diarrhea among deployed us military personnel in support of operation iraqi freedom and operation enduring freedom. Am J Trop Med Hyg, October 1, 2006; 75(4): 762 - 767. [Abstract] [Full Text] [PDF]