569. Urinary Tract Infections among Deployed, Female US Soldiers, 2006-2011
Session: Oral Abstract Session: Clinical Epidemiology in Action
Thursday, October 3, 2013: 3:15 PM
Room: The Moscone Center: 300
Background: Urinary tract infections (UTIs) are the third most common medical complaint among women during their reproductive years, causing dysuria, increased urinary frequency and urgency. Infections often occur repeatedly, and may be particularly problematic among women living in austere environments with limited sanitary and medical resources.  Women in the US Army are routinely deployed to such environments in support of overseas contingency operations (OCO).  Deployment settings may not afford adequate sanitation facilities, privacy or time for restroom breaks. This may lead to poor feminine hygiene, holding urine for long periods or decreased water intake to prevent urination, all risk factors for UTIs.  Although UTIs are a frequent complaint among deployed women, the burden of infection has not been well documented.

Methods: Electronic medical encounter records (outpatient, inpatient, and medical evacuation) from OCO deployments to Iraq and Afghanistan were reviewed from January 1, 2006 through December 31, 2011 for incident UTI diagnoses. Follow-up encounters within 14 days of the initial visit were excluded from analysis for all UTIs except pyelonephritis, for which all encounters within 30 days of the initial visit were excluded.

Results: A total of 9,399 female soldiers were diagnosed with a UTI; 11,668 incident infections and 12,960 UTI encounters were identified.  Although more than 99% of all UTIs were treated during an outpatient visit, 74 infections warranted hospitalization and 18 required medical evacuation. Approximately 14% of female soldier ambulatory patients were seen for a UTI related event, and 25% of female soldiers with UTIs had repeat infections. 

Conclusion: UTIs in the deployed setting are common. They can cause pain and discomfort and if left untreated may lead to serious complications, which can interfere with mission duties, reduce work time and impact overall well-being at a time when focus and concentration are critical. Emphasis should be placed on educating female soldiers and their commanders on feminine hygiene issues and behaviors that may modify the risk for a UTI in the deployed setting.   Interventional studies, such as those examining the efficacy of the Female Urination Diversion Device (FUDD) and its impact on UTIs in an operational environment, are also needed.

Nakia Clemmons, MPH, Epidemiology and Disease Surveillance Portfolio, US Army Public Health Command, Edgewood, MD, Nikki Jordan, MPH, Epidemiology and Disease Surveillance, US Army Public Health Command, Edgewood, MD and Joel Gaydos, MD, MPH, Armed Forces Health Surveillance Center, Silver Spring, MD

Disclosures:

N. Clemmons, None

N. Jordan, None

J. Gaydos, None

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