Tracking Epidemiological Profiles of Military Personnel Deployed to Remote Terrorist Threat Conditions Areas (threatcons) Using Electronic Surveillance

Background: Military operations often require the deployment of personnel to remote areas to respond to terrorist threat conditions. In Peru, the Apurimac – Ene River Valley (VRAE) has been under this condition for approximately one year due to narco-terrorist organizations. It is characterized by harsh terrain with high mountains and deep valleys, poorly developed villages with small local populations, and incomplete knowledge of the locally endemic diseases. Military personnel deployed there use Alerta, an electronic surveillance system, for regular reporting of medical conditions. Objective: To assess the ability of an electronic reporting system, ALERTA, to describe the epidemiological profile of units from the Peruvian Army and Navy when deployed to the VRAE. Methods: This is a descriptive study. We analyzed the reports of infectious diseases from ALERTA for personnel (Army and Navy) deployed to the VRAE during 2008. Reports were received weekly by either phone or Internet, depending on access and convenience. Diseases were grouped into two categories: specific diagnosis or symptomatic syndrome (such as acute respiratory infections (ARI) and acute diarrheal disease (ADD). Results: Of the units deployed to the VRAE (n=18), 50% reported on time to the Alerta system. During 2008, there were 1699 reports from units describing 7707 separate cases. The most common diagnoses in Army units and Navy units were ARI (70.39% vs 77.39%, p=0.1023), ADD (26.01% vs 17.39%, p=0.0362), and Malaria (Plasmodium Vivax )(2.00% vs 3.48%, p=0.2631). Conclusions: Electronic surveillance systems can be useful tools for near real-time disease reporting from remote and/or THREATCON areas, allowing medical planners to track the epidemiology of disease in deployed troops and make rapid responses for their treatment or prevention, thus maintaining the fighting force. Due to half of reports were made on time, further work on improving reporting options and access, especially from these regions should be explored.