Table 1 Recent Accomplishments of DoD Laboratory Partners in Enteric Disease Surveillance Under AFHSC-GEIS

AFRIMS

• Pediatric case-control study

• Enteric surveillance in troops deploying to Cobra Gold 2009 (Thailand) and Balaktan 2009 (Philippines)

• Defining etiology of AGE and antimicrobial resistance among indigenous populations in South Asia and Southeast Asia

• Sites in Nepal and Thailand have enrolled more than 2500 cases and controls during the past year

• High rates of fluroquinolone and TMP-SMX resistance among pediatric and travel-associated Campylobacter isolates.

• Most Shigella species are TMP-SMX resistant

NAMRU-3

• Birth cohort research and epidemiology

• Severe diarrhea study at Cairo University

• Case-control study of modifiable risk behaviors

• Molecular biology and cholera/rotavirus microbiology reference center for the Middle East and Africa

• Training workshops and courses for laboratorians from Afghanistan, Djibouti, Ghana, Iraq, Jordan, Libya, Morocco, Sudan

• Biennial enteric disease surveillance in Operation Bright Star (Egypt)

• 2223 children enrolled to describe pathogen distribution (2000 to 2005)

• 117 cases and 1:1 age-matched controls assessed for risk behaviors including food and water sources

• 303 V. cholerae isolates archived and characterized—2 serotypes with widespread antimicrobial resistance

• 937 stool samples processed from eight countries to date this year in capacity as WHO Rotavirus Reference Laboratory

• Norovirus outbreak response support, Incirlik Air Base, Turkey

NMRCD-Peru

• Cohort study among basic combat trainees

• Antimicrobial surveillance testing in Lima and five departments of Peru

• Received 2159 specimens for antimicrobial surveillance and confirmed bacterial pathogens in 83 percent of them.

• The cohort study enrolled 381 participants with 84 diarrheal cases with bacterial pathogens confirmed in 42 (50 percent).

NAMRU-2

• 12,000 specimens from Indonesian pediatric diarrhea

• Surveillance project covered six cities on five islands and identified rotavirus as the leading causative agent

• Advanced characterization of Campylobacter spp. and Shigella spp.

USAMRU-K

• Movement of Enteric Microbiology Laboratory from Nairobi to Kericho includes all ages case-control protocol at Kericho District Hospital and two additional district hospitals in Kisumu

• Detected and identified bacterial pathogens in 28 percent of diarrheal stool specimens

• Renovated infrastructure to enable facility relocation to the new Microbiology Hub in Kericho (MHK)

• Five-year surveillance protocol uses case-control approach, broadens testing spectrum, and includes antibiotic susceptibility testing

• Clinical and (FDA-approved) molecular epidemiology of diarrheal illnesses

NEPMU-2

• Establishing diagnostic capability for Norovirus VGE collection kits with thermal shipping boxes deployed to 30 ships

• Expected to start processing kits in early 2010