RESUMO
Because of a high prevalence of hepatitis C virus (HCV) infection (10-20%) among veterans seeking care in Department of Veterans Affairs (VA) hospitals, current US military forces were evaluated for HCV infection. Banked serum samples were randomly selected from military personnel serving in 1997 and were tested for antibody to HCV (anti-HCV). Overall prevalence of anti-HCV among 10,000 active-duty personnel was 0.48% (5/1,000 troops); prevalence increased with age from 0.1% among military recruits and active-duty personnel aged <30 years to 3.0% among troops aged >/=40 years. Prevalence among 2,000 Reservists and active-duty troops was similar. Based on sequential serum samples from 7,368 active-duty personnel (34,020 person-years of observation), annual incidence of infection was 2/10,000. Of 81 HCV RNA-positive troops for whom genotype was determined, genotypes 1a (63%) and 1b (22%) predominated, as in the civilian population. These data indicate that HCV infection risk among current military forces is lower than in VA studies and the general civilian population aged <40 years. The low level of HCV infection may be attributed to infrequent injection drug use in the military due to mandatory testing for illicit drugs prior to induction and throughout military service.
Assuntos
Hepacivirus/patogenicidade , Hepatite C Crônica/epidemiologia , Militares , Adolescente , Adulto , Fatores Etários , Feminino , Hepacivirus/genética , Anticorpos Anti-Hepatite , Humanos , Incidência , Masculino , Medicina Militar , Reação em Cadeia da Polimerase , Prevalência , RNA Viral/genética , Fatores de Risco , Estudos Soroepidemiológicos , Abuso de Substâncias por Via IntravenosaAssuntos
Exposição Ambiental/efeitos adversos , Estresse Psicológico/etiologia , Veteranos , Guerra , Canadá/epidemiologia , Diagnóstico Diferencial , Pessoas com Deficiência , Medo , Humanos , Oriente Médio , Política , Pesquisa , Fatores de Risco , Síndrome , Reino Unido/epidemiologia , Estados Unidos/epidemiologia , United States Department of Veterans Affairs , Veteranos/psicologiaAssuntos
Antraz/prevenção & controle , Vacinas Bacterianas/efeitos adversos , Atenção à Saúde/normas , Medicina Militar/normas , Militares , Medicina Preventiva , Política Pública , Adulto , Idoso , Vacinas Bacterianas/administração & dosagem , Feminino , Nível de Saúde , Humanos , Serviços de Informação , Masculino , Pessoa de Meia-Idade , Síndrome do Golfo Pérsico , Formulação de Políticas , Estados UnidosRESUMO
During a 2-year period (December 1987-December 1989), 165 Department of Defense (DoD) military hospitals world-wide provided 71,800 cases with 83,197 reviews for quality of care evaluations by the Civilian External Peer Review Program (CEPRP). The majority (78,246 of 79,896) of completed peer review determinations (97.9%) generated agreement with care and documentation. It is concluded that health care in military treatment facilities is of high quality, meeting and generally exceeding accepted standards of care. It is also concluded that the DoD CEPRP offers conceptual and practical experience to guide the further evolution and integration of clinical peer review and quality improvement activities.
