Clinical Research
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 1, 2004; 10(1): 127-131
Published online Jan 1, 2004. doi: 10.3748/wjg.v10.i1.127
Acute diarrhea during army field exercise in southern China
Yang Bai, Ying-Chun Dai, Jian-Dong Li, Jun Nie, Qing Chen, Hong Wang, Yong-Yu Rui, Ya-Li Zhang, Shou-Yi Yu
Yang Bai, Ya-Li Zhang, Nan Fang Hospital, The First Military Medical University, Guangzhou 510515, Guangdong Province, China
Ying-Chun Dai, Jian-Dong Li, Jun Nie, Qing Chen, Hong Wang, Yong-Yu Rui, Shou-Yi Yu, Department of Epidemiology, The First Military Medical University, Guangzhou 510515, Guangdong Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Key Program of Military Medical Science and Technique Foundation during the 9th-Five Year Plan Period
Correspondence to: Yang Bai, Department of Digestive Diseases, Nan Fang Hospital, The First Military Medical University, Guangzhou 510515, Guangdong Province, China. baiyang1030@hotmail.com
Telephone: +86-20-61641531
Received: March 5, 2003
Revised: May 20, 2003
Accepted: June 2, 2003
Published online: January 1, 2004
Abstract

AIM: During emergency period, infectious diseases can be a major threat to military forces. During field training in southern China, diarrhea is the main cause of nonbattle injury. To evaluate the causes of and risk factors for diarrhea in emergency period, we collected clinical and epidemiological data from the People’s Liberation Army (PLA) during field training in southern China.

METHODS: From September 25 to October 2 1997, 2636 military personnel were investigated. Fecal sample cultures for lapactic pathogens were obtained from 103 military personnel with diarrhea. In addition, a questionnaire was administered to 103 cases and 206 controls to evaluate the association between illness and potential risk factors. At the same time, another questionnaire of 1:4 case-case control was administered to 22 severe cases (each severe case paired 4 mild cases).

RESULTS: The training troop’s diarrhea incidence rate was significantly higher than that of garrison. The diarrhea incidence rate of officers was significantly lower than that of soldiers. A lapactic pathogen was identified in 63.1% (65/103) of the troops with diarrhea. Enterotoxigenic Escherichia coli (35.0%) and plesiomona shigelloides (16.5%) were the most common bacterial pathogens. All bacterial isolates were sensitive to norfloxacin and ceftazidine. However, almost all of them were resistant to sulfamethoxazole, trimethoprim-sulfamethoxazole, oxytetracycline, doxycycline, furazolidone, ampicillin and cloromycetin to a different degree. Risk factors associated with diarrhea included drinking raw water, eating outside, contacting diarrhea patients, lacking sanitation, depression, lacking sleep, which were established by multiple-factor logistic regression analysis. In addition, the unit incidence rate was associated with the density of flies and the average daily boiled water available by regression and discriminate analysis.

CONCLUSION: A series of risk factors are associated with the incidence rate of diarrhea. Our results may provide a useful basis for prevention and cure of diarrhea in emergency period of PLA.

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