Diarrhea remains a leading cause of acute morbidity among civilian and military members alike, negatively impacting the health and functionality of both populations. U.S. military personnel often are deployed into developing regions in which enteric pathogens associated with diarrheal disease are prevalent. Documented studies from previous exercises in Thailand demonstrated that U.S. Soldiers suffer consistent diarrhea attack rates during their first few weeks in-country. Acute diarrhea in deployed military personnel increases health care service utilization, contributes to a major loss of work-hours and adversely impacts operational readiness. While a number of strategies have been used to mitigate this threat to military personnel, diarrhea, and the associated increases in antimicrobial resistance of enteric bacterial pathogens, remains a primary concern for force health protection.
AFRIMS tracks the causes of diarrhea in both host nation and traveler populations in Thailand, Nepal, Cambodia and the Philippines, including at sites maintained in collaboration with the Royal Thai Army. Bacterial isolates are analyzed to understand the phenotypic and genotypic characterization of antibiotic-resistant bacteria, antimicrobial susceptibility profiles and identify antimicrobial resistance and virulence genes. Risk factors associated with enteric infections are also evaluated via microbiome studies conducted in collaboration with host nation travel clinics. This surveillance information informs the development of more effective prevention strategies and treatments for both host nation partners and the U.S. military.