MSMR最新文献

Uterine fibroids are the most common benign tumors of the uterus among women of reproductive age, disproportionally affecting non-Hispanic Black women compared to other races and ethnicities. This report is an update of a 2011 MSMR report that examined uterine fibroids among female active component service members in the U.S. Armed Forces from 2001 to 2010. Incident uterine fibroids were identified for this report from inpatient and outpatient medical encounter data from 2011 to 2022. Health care burden was estimated utilizing uterine fibroid-related inpatient and outpatient diagnostic and procedure codes. Crude incidence rates and incidence rate ratios were calculated to compare rate differences between subpopulations. A total of 16,046 new uterine fibroid cases were identified, with an incidence rate of 63.5 cases per 10,000 person-years (95% confidence interval: 62.5-64.5). The highest incidence rates were observed among service women 40 years and older, non-Hispanic Black women, and those who served in the Army. Health care burden analysis showed that, even with increases in medical encounters and individuals affected, the numbers of hospital bed days declined over time. The decline in uterine fibroid-related hospital bed days could be attributed to early diagnoses and minimally-invasive treatments. Continued promotion of uterine fibroid awareness can potentially help further reduce uterine fibroid-related impacts on military readiness.

The U.S. military has witnessed rising obesity among active component service members. The Department of Defense authorized coverage of weight loss medications in 2018, but no study has evaluated prescription prevalence within the active component. This descriptive retrospective cohort study analyzed data from active component U.S. military service members from January 2018 through June 2023. The study used data from the Defense Medical Surveillance System to determine prescription period prevalence of weight loss medication. Data on demographics, body mass index, and history of diabetes were considered. The study revealed a 100-fold increase in the prescription period prevalence of weight loss agents in the active component from their initial authorization date. Demographics associated with higher prescription period prevalence were non-Hispanic Black race and ethnicity, female sex, and older age. Service members in the health care occupations and the Navy had higher prevalence compared to other service branches and occupations. The findings indicate a significant rise in the period prevalence of weight loss prescriptions over time. Further research is recommended to assess the effectiveness, safety, and use in austere military environments.

Vector-borne diseases (VBDs) may pose an increased risk for U.S. service members during recurring military training exercises, operations, and response missions, in addition to residence in endemic regions within and outside the continental U.S. Prior MSMR reports address VBD surveillance, described by surveillance data for 23 reportable medical events (RMEs), among active duty and reserve component service members. This report covers a 13-year surveillance period, from January 2010 to December 2022, and provides linear trends of selected VBDs among Armed Forces service and non-service member beneficiaries diagnosed at installations within the Northern Command (NORTHCOM), Africa Command (AFRICOM), Central Command (CENTCOM), European Command (EUCOM), Indo-Pacific Command (INDOPACOM), or Southern Command (SOUTHCOM). Trends of only the 4 mostfrequently reported VBDs were evaluated, as Lyme disease, malaria, Rocky Mountain Spotted Fever (RMSF), and dengue fever comprised 90% (n=5,199) of all 23 VBDs (n=5,750) among Military Health System (MHS) beneficiaries documented as RMEs during the surveillance period.

This report describes ivermectin prescription fill rates among U.S. active component service members (ACSM) over time during the early phases of the COVID-19 pandemic. Information about the unsubstantiated benefits of ivermectin for coronavirus 2019 (COVID-19) prevention and treatment was widely available online early in the COVID-19 pandemic. Ivermectin prescription fill rates increased among ACSM during periods of Alpha and Delta coronavirus variant predominance, but not during the predominance of the Omicron variant. At the peak of the fill rate curve, in August 2021, rates were higher among men compared to women, older compared to younger age groups, senior officers compared to junior officers, senior enlisted compared to junior enlisted service members, and those with a bachelor's or advanced degree compared to those without a bachelor's degree. Ivermectin prescriptions were more likely to have been filled at a retail pharmacy than at a military hospital or clinic. During the COVID-19 pandemic fill rates for ivermectin prescriptions among ACSM increased, including those without a qualifying diagnosis. Rates peaked in August 2021 but subsequently declined. The decrease in ivermectin fill rates was coincident with vigorous efforts to correct previous misinformation and implement pre-authorization requirements for prescriptions. Research on the impact of unproven online claims about clinical and public health interventions has potential to curtail future unnecessary and potentially harmful treatments.

Inpatient and outpatient encounter data retrieved from the Defense Medical Surveillance System (DMSS) were used to establish that there were 1,127 diagnoses of systemic lupus erythematosus (SLE) among active component U.S. service members (ACSM) from 2000 to 2022, with an overall incidence rate of 3.5 cases per 100,000 person-years. Annual incidence remained relatively constant over the 23-year surveillance period, peaking in 2009. Female ACSM accounted for 69.5% of incident cases, with a rate of incidence 12.3 times greater than males, while non-Hispanic Black ACSM accounted for 50.0% of incident cases, with a rate 6.7 times greater than among non-Hispanic Whites. This study further demonstrates greatest SLE incidence among non-Hispanic Black women, in all age groups.