Dengue Virus Infections among Peace Corps Volunteers in Timor-Leste, 2018-2019.

Dengue is an ongoing health risk for Peace Corps Volunteers (PCVs) working in the tropics. On May 2019, the Peace Corps Office of Health Services notified the Centers for Disease Control and Prevention (CDC) of a dengue outbreak among PCVs in Timor-Leste. The purpose of this investigation was to identify the clinical, demographic, and epidemiological characteristics of PCVs with dengue and recommend dengue preventive measures. To identify PCVs with dengue and describe disease severity, the medical records of PCVs reporting fever during September 2018-June 2019 were reviewed. To identify factors associated with dengue virus (DENV) infection, we administered a questionnaire on demographics, travel history, and mosquito avoidance behaviors and collected blood specimens to detect the anti-DENV IgM antibody to diagnose recent infection. Of 35 PCVs in-country, 11 (31%) tested positive for dengue (NS1, IgM, PCR), eight requiring hospitalization and medical evacuation. Among 27 (77%) PCVs who participated in the investigation, all reported having been recently bitten by mosquitoes and 56% reported being bitten most often at home; only 16 (59%) reported having screens on bedroom windows. Nearly all (93%) PCVs reported using a bed net every night; fewer (70%) reported using mosquito repellent at least once a day. No behaviors were significantly associated with DENV infection. Raising awareness of dengue risk among PCVs and continuing to encourage mosquito avoidance behavior to prevent dengue is critical. Access to and use of measures to avoid mosquito bites should be improved or implemented. Peace Corps medical officers should continue to receive an annual refresher training on dengue clinical management.

Mental Health of Chinese Peacekeepers in Liberia

Background and Objectives: As part of UN peacekeeping operations in Liberia, China has sent a dozen of batches of peacekeeping force to Liberia for medical, engineering and transporting purposes from 2003 to 2012. This study aimed to explore the mental health of Chinese peacekeepers under the influence of stressful and traumatic events in Liberia. Methods: A total of 440 Chinese peacekeepers were selected by cluster sampling and surveyed by Chinese Military Mental Health Scale (CMMHS) before, during and after peacekeeping deployment. Results: The total CMMHS score (48.90 ± 21.15), depression factor (7.25 ± 3.43), interpersonal sensitivity (4.20 ± 2.15) of Chinese peacekeepers were significantly higher than the Chinese military norm (23.04 ± 14.70, 2.47 ± 2.46, 3.95 ± 2.97 respectively) (p<0.01). The total score and anxiety, somatization factor score of the transporting group were significantly higher than those of the medical group (P <0.05); All CMMHS factors in the transporting group and the medical group were higher than those of the engineering group (p<0.01). CMMHS factors score of the peacekeepers positively correlated with the age, military service duration, years of eudcation and military rank (r = 0.107 ~ 0.523, p<0.05); stepwise linear regression analysis revealed that years of eudcation was the main influence factor for peacekeepers' mental health (t = 2.288 ~ 4.358, p<0.05 ~ 0.01). Conclusions: The mental health status of Chinese peacekeepers was worse than average Chinese servicemen. Peacekeepers of different mission groups had different degree of mental damage, and the years of education was the main influence factor for peacekeepers' mental health, whereas age, military service duration as well as military rank were the secondary influence factors (AU)

No disponible

Tuberculosis risk in US Peace Corps Volunteers, 1996 to 2005.

BACKGROUND: With the popularity of international travel increasing, more travelers in endemic areas may increase their risk of tuberculosis (TB). We analyzed Peace Corps data to assess the risk of TB in long-term travelers from the United States. METHODS: We analyzed purified protein derivative (PPD) conversion and acute TB case data from the Peace Corps Epidemiological Surveillance System as well as postservice claims data. We calculated the risk of PPD conversion and active TB in all countries with Peace Corps Volunteers between 1996 and 2005 and compared these risks with other published data. RESULTS: The overall incidence rates for positive PPD conversions and active TB cases are 1.283 and 0.057 per 1,000 Volunteer-months, respectively. The Africa region had the highest PPD conversion rate of 1.467 conversions per 1,000 Volunteer-months as well as the highest active TB rate of 0.089 cases per 1,000 Volunteer-months. Per-country incidence rates for PPD conversions and active TB cases ranged widely from 0.000 to 5.514 cases and 0.000 to 2.126 cases per 1,000 Volunteer-months, respectively. In countries identified as "high risk," there were 1.436 cases of PPD conversions and 0.084 cases of active TB per 1,000 Volunteer-months. CONCLUSIONS: Peace Corps Volunteers have significantly higher rates of TB when compared to the average US population but much lower than those reported for travelers to highly endemic countries. Volunteers assigned to highly endemic countries still have a lower risk compared to other travelers to those same countries. Keeping in mind that Peace Corps Volunteers are a unique population, these data may be useful in providing medical advice to long-term travelers.

Fatalities in the Peace Corps: a retrospective study, 1984 to 2003.

BACKGROUND: To determine causes of death for Peace Corps Volunteers (PCV) between 1984 and 2003 and compare them with prior Volunteer death rates and with US death rates. METHODS: We conducted a retrospective cohort study of all PCV between 1984 and 2003 and compared them to published data for prior years and against US death rates. RESULTS: Of the 66 deaths in our study period, the major causes were unintentional injury, homicide, medical illness, and suicide. Comparisons to US mortality data controlled for age, marital status, and educational attainment found equal or lower death rates among Volunteers. When compared to previous study results from 1961 to 1983, the total number of deaths, as well as the death rate per Volunteer-year, decreased. Deaths from unintentional injury, suicide, and medical illness decreased in number and rate; only homicides increased in number during our study period, but this increase did not reach statistical significance. CONCLUSIONS: PCV are exposed to unique risks, but these risks have become significantly less fatal over the past 20 years when compared to prior Peace Corps data and matched US population data.