Perceived risk of watery diarrhea and dysentery and intended compliance with chemoprophylaxis among a deployed military population.

Chad K Porter,Mark S Riddle,David R Tribble,Kristen Felicione,Adam W Armstrong,Manal Mostafa

doi:10.1186/s40794-015-0009-2

Abstract

BackgroundInfectious diseases are a leading cause of morbidity among travelers to resource-limited regions and primary prevention is a cornerstone to risk reduction. Chemoprophylaxis has been successfully utilized for specific diseases.MethodsWe assessed self-reported compliance to daily chemoprophylaxis among deployed US military personnel. A 21 item self-completed questionnaire was completed by military personnel during mid-deployment.ResultsThe perception of high disease risk was associated with an increased likelihood of compliance with daily chemoprophylaxis. However, 60 % of respondents stated they would not comply with a daily regimen.ConclusionsThese data highlight the complexity of perceived risk and the difficulties with prophylactic interventions.

Highlights

Infectious diseases are a leading cause of morbidity among travelers to resource-limited regions and primary prevention is a cornerstone to risk reduction
Vaccination has a clear history of reducing disease risk for many diseases of military importance; for several vaccines remain unavailable
A significant proportion of subjects identified themselves as being at no risk for dysentery (46.7), watery diarrhea (45.8), or malaria (48.6) regardless of the country to which the subject was predominately deployed, while approximately 30 % did not know their risk for these infectious diseases (Table 1)

Summary

Background

Infectious diseases have been and remain a leading cause of morbidity in travelers, including the deployed military. Disease prevention has emphasized preparation, education, personal protective measures, vaccines, and chemoprophylaxis [1]. The effectiveness of these measures is often dependent on the disease in question, though understanding the perceptions and attitudes towards primary prevention strategies may enable the development of more targeted interventions with higher success rates. Vaccination has a clear history of reducing disease risk for many diseases of military importance; for several (malaria, travelers’ diarrhea, dengue fever, skin infections, etc.) vaccines remain unavailable. In their absence, increased use of personal protection, vector control, and chemoprophylaxis has reduced malaria incidence in endemic regions [2]. Chemoprophylaxis is not currently recommended for travelers’ diarrhea (TD), and utilization of standard public health practices to minimize disease risks has yielded little impact on TD incidence,

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Discussion

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