Back to Top Skip to main content Skip to sub-navigation

DHA recognizes 25 years of AFHSB's health surveillance journal

Medical technicians wearing masks and entering information on a computer Georgia Army National Guardsman Pfc. Loran Jones, a combat medic with the Marietta-based 248th Medical Company, 265th Chemical Battalion, updates patient medical records at Wellstar Atlanta Medical Center in Atlanta, Ga. In May, the Georgia National Guard strategically deployed medical support teams to hospitals to augment medical staff. (Photo by Spc. Isaiah Matthews.)

Recommended Content:

Armed Forces Health Surveillance Division | Medical Surveillance Monthly Report

This year, the Armed Forces Health Surveillance Branch (AFHSB) celebrated the 25th anniversary of its peer-reviewed journal, the Medical Surveillance Monthly Report (MSMR). The MSMR offers readers evidence-based estimates of the health-related conditions and trends prevalent among U.S. military members and their associated populations.

“MSMR surveillance information and the published explanations of such information facilitate military leaders’ understanding of the public health measures that help to preserve the health and readiness of our armed forces,” said Dr. Francis O’Donnell, MSMR editor. Established in 1995, the MSMR was created as a flagship publication and public health authority within the Army Medical Surveillance Activity (AMSA), the forerunner of the AFHSB, a part of the Public Health Directorate at the Defense Health Agency.

“The 25 years of reports in the MSMR have dealt with a myriad of illnesses, injuries, and health threats that have challenged our military members. The rich historical record preserved in MSMR archives helps in assessments of the military importance of current health threats and in the development of policies to prevent or mitigate their medical and military operational impacts,” said Dr. John Brundage former editor and co-founder of the report.

Many studies in the MSMR are based on summaries of medical administrative data that are routinely provided to AFHSB and integrated into the Defense Medical Surveillance System (DMSS) for health surveillance purposes. The DMSS is an active database of health-related information on service members who have served in the military since 1990. It contains billions of records including medical encounters such as hospitalizations, outpatient visits, immunizations, reportable medical events, health risk appraisals, and deployment health assessments; demographic characteristics; and military experiences like deployments, assignments, and casualty information.

According to Brundage, Dr. Mark Rubertone, chief of AFHSB’s Data Management & Technical Support section, played an essential role in the production of the MSMR from its inception. Rubertone led the collection and assembly of military health surveillance-related data (initially, in the AMSA and then the Defense Medical Surveillance System) in the 1990s that allowed for a new method of statistical and epidemiologic analyses by military health surveillance professionals. “There would not have been a MSMR without the vision, dedication, and relentless efforts of Doctor Mark Rubertone,” credits Brundage.

“It has been a real pleasure witnessing the MSMR’s evolution to a peer-reviewed journal.  My association with the MSMR remains one of the efforts I am most proud of during my service in the DoD," stated Rubertone, as he expressed congratulations to the current and past MSMR staff on 25 years of tireless, comprehensive health surveillance reporting. This point-of-view was strongly supported by Dr. Jose “Toti” Sanchez, deputy chief, AFHSB, who since his early days at the Walter Reed Army Institute of Research in the early 1990’s saw the potential and relevance of this publication in providing a unique military-relevant perspective to the major public health problems faced by the U.S. military.

The MSMR is published on a monthly basis and is available online only in a downloadable PDF format. To subscribe to the MSMR, visit https://health.mil/msmr.

You also may be interested in...

Incidence, Timing, and Seasonal Patterns of Heat Illnesses During U.S. Army Basic Combat Training, 2014–2018

Article
4/1/2019
U.S. Marines participate in morning physical training during a field exercise at Marine Corps Base Camp Pendleton, California. (Photo Courtesy: U.S. Marine Corps)

Risk factors for heat illnesses (HIs) among new soldiers include exercise intensity, environmental conditions at the time of exercise, a high body mass index, and conducting initial entry training during hot and humid weather when recruits are not yet acclimated to physical exertion in heat. This study used data from the Defense Health Agency’s–Weather-Related Injury Repository to calculate rates and to describe the incidence, timing, and geographic distribution of HIs among soldiers during U.S. Army basic combat training (BCT). From 2014 through 2018, HI events occurred in 1,210 trainees during BCT, resulting in an overall rate of 3.6 per 10,000 BCT person-weeks (p-wks) (95% CI: 3.4–3.8). HI rates (cases per 10,000 BCT p-wks) varied among the 4 Army BCT sites: Fort Benning, GA (6.8); Fort Jackson, SC (4.4); Fort Sill, OK (1.8); and Fort Leonard Wood, MO (1.7). Although the highest rates ofHIs occurred at Fort Benning, recruits in all geographic areas were at risk. The highest rates of HI occurred during the peak training months of June through September, and over half of all HI cases affected soldiers during the first 3 weeks of BCT. Prevention of HI among BCT soldiers requires relevant training of both recruits and cadre as well as the implementation of effective preventive measures.

Recommended Content:

Medical Surveillance Monthly Report

Testosterone Replacement Therapy

Infographic
3/20/2019
Testosterone Replacement Therapy

With the increasing number of testosterone deficiency diagnoses and potential health risks associated with initiation of TRT, it is important to understand the epidemiology of which U.S. service men are receiving TRT and whether these individuals have an indication for receiving treatment.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Division | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Sexually Transmitted Infections

Infographic
3/20/2019
Sexually Transmitted Infections

This report summarizes incidence rates of the 5 most common sexually transmitted infections (STIs) among active component service members of the U.S. Armed Forces during 2010–2018.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Division | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Vasectomy

Infographic
3/20/2019
Vasectomy

There are few published studies of vasectomy and vasectomy reversal among the U.S. military population. To address these gaps, the current analysis describes the overall and annual incidence rates of vasectomy among active component service men during 2000–2017 by demographic and military characteristics and by type of surgical vas isolation procedure used. In addition, the median age at incident vasectomy and the time between incident vasectomy and first vasectomy reversal are described.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Male Infertility

Infographic
3/20/2019
Male Infertility

The current report updates and expands on the findings of the previous MSMR analysis of infertility among active component service men. Specifically, the current report summarizes the frequencies, rates, temporal trends, types of infertility, and demographic and military characteristics of infertility among active component service men during 2013–2017.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Division | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Adenovirus

Infographic
3/1/2019
Adenovirus

During August–September 2016, U.S. Naval Academy clinical staff noted an increase in students presenting with acute respiratory illness (ARI). An investigation was conducted to determine the extent and cause of the outbreak.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Glaucoma

Infographic
3/1/2019
Glaucoma

This report describes an analysis using the Defense Medical Surveillance System to identify all active component service members with an incident diagnosis of glaucoma during the period between 2013 and 2017.

Recommended Content:

Health Readiness | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Malaria

Infographic
3/1/2019
Malaria

Since 1999, the Medical Surveillance Monthly Report has published regular updates on the incidence of malaria among U.S. service members. The MSMR’s focus on malaria reflects both historical lessons learned about this mosquito-borne disease and the continuing threat that it poses to military operations and service members’ health.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Division | Epidemiology and Analysis | Medical Surveillance Monthly Report | Public Health

Brief Report: Male Infertility, Active Component, U.S. Armed Forces, 2013–2017

Article
3/1/2019
Sperm is the male reproductive cell  Photo: iStock

Infertility, defined as the inability to achieve a successful pregnancy after 1 year or more of unprotected sexual intercourse or therapeutic donor insemination, affects approximately 15% of all couples. Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male. A male factor contributes in part or whole to about 50% of cases of infertility. However, determining the true prevalence of male infertility remains elusive, as most estimates are derived from couples seeking assistive reproductive technology in tertiary care or referral centers, population-based surveys, or high-risk occupational cohorts, all of which are likely to underestimate the prevalence of the condition in the general U.S. population.

Recommended Content:

Medical Surveillance Monthly Report

Sexually Transmitted Infections, Active Component, U.S. Armed Forces, 2010–2018

Article
3/1/2019
Anopheles merus

This report summarizes incidence rates of the 5 most common sexually transmitted infections (STIs) among active component service members of the U.S. Armed Forces during 2010–2018. Infections with chlamydia were the most common, followed in decreasing order of frequency by infections with genital human papillomavirus (HPV), gonorrhea, genital herpes simplex virus (HSV), and syphilis. Compared to men, women had higher rates of all STIs except for syphilis. In general, compared to their respective counterparts, younger service members, non-Hispanic blacks, soldiers, and enlisted members had higher incidence rates of STIs. During the latter half of the surveillance period, the incidence of chlamydia and gonorrhea increased among both male and female service members. Rates of syphilis increased for male service members but remained relatively stable among female service members. In contrast, the incidence of genital HPV and HSV decreased among both male and female service members. Similarities to and differences from the findings of the last MSMR update on STIs are discussed.

Recommended Content:

Medical Surveillance Monthly Report

Vasectomy and Vasectomy Reversals, Active Component, U.S. Armed Forces, 2000–2017

Article
3/1/2019
Sperm is the male reproductive cell  Photo: iStock

During 2000–2017, a total of 170,878 active component service members underwent a first-occurring vasectomy, for a crude overall incidence rate of 8.6 cases per 1,000 person-years (p-yrs). Among the men who underwent incident vasectomy, 2.2% had another vasectomy performed during the surveillance period. Compared to their respective counterparts, the overall rates of vasectomy were highest among service men aged 30–39 years, non-Hispanic whites, married men, and those in pilot/air crew occupations. Male Air Force members had the highest overall incidence of vasectomy and men in the Marine Corps, the lowest. Crude annual vasectomy rates among service men increased slightly between 2000 and 2017. The largest increases in rates over the 18-year period occurred among service men aged 35–49 years and among men working as pilots/air crew. Among those who underwent vasectomy, 1.8% also had at least 1 vasectomy reversal during the surveillance period. The likelihood of vasectomy reversal decreased with advancing age. Non-Hispanic black and Hispanic service men were more likely than those of other race/ethnicity groups to undergo vasectomy reversals.

Recommended Content:

Medical Surveillance Monthly Report

Testosterone Replacement Therapy Use Among Active Component Service Men, 2017

Article
3/1/2019
Image of Marines carrying a wooden log for physical fitness. Click to open a larger version of the image.

This analysis summarizes the prevalence of testosterone replacement therapy (TRT) during 2017 among active component service men by demographic and military characteristics. This analysis also determines the percentage of those receiving TRT in 2017 who had an indication for receiving TRT using the 2018 American Urological Association (AUA) clinical practice guidelines. In 2017, 5,093 of 1,076,633 active component service men filled a prescription for TRT, for a period prevalence of 4.7 per 1,000 male service members. After adjustment for covariates, the prevalence of TRT use remained highest among Army members, senior enlisted members, warrant officers, non-Hispanic whites, American Indians/Alaska Natives, those in combat arms occupations, healthcare workers, those who were married, and those with other/unknown marital status. Among active component male service members who received TRT in 2017, only 44.5% met the 2018 AUA clinical practice guidelines for receiving TRT.

Recommended Content:

Medical Surveillance Monthly Report

Outbreak of Acute Respiratory Illness Associated with Adenovirus Type 4 at the U.S. Naval Academy, 2016

Article
2/1/2019
Malaria case definition

Human adenoviruses (HAdVs) are known to cause respiratory illness outbreaks at basic military training (BMT) sites. HAdV type-4 and -7 vaccines are routinely administered at enlisted BMT sites, but not at military academies. During August–September 2016, U.S. Naval Academy clinical staff noted an increase in students presenting with acute respiratory illness (ARI). An investigation was conducted to determine the extent and cause of the outbreak. During 22 August–11 September 2016, 652 clinic visits for ARI were identified using electronic health records. HAdV-4 was confirmed by real-time polymerase chain reaction assay in 18 out of 33 patient specimens collected and 1 additional HAdV case was detected from hospital records. Two HAdV-4 positive patients were treated for pneumonia including 1 hospitalized patient. Molecular analysis of 4 HAdV-4 isolates identified genome type 4a1, which is considered vaccine-preventable. Understanding the impact of HAdV in congregate settings other than enlisted BMT sites is necessary to inform discussions regarding future HAdV vaccine strategy.

Recommended Content:

Medical Surveillance Monthly Report

Update: Malaria, U.S. Armed Forces, 2018

Article
2/1/2019
Anopheles merus

Malaria infection remains an important health threat to U.S. service mem­bers who are located in endemic areas because of long-term duty assign­ments, participation in shorter-term contingency operations, or personal travel. In 2018, a total of 58 service members were diagnosed with or reported to have malaria. This represents a 65.7% increase from the 35 cases identi­fied in 2017. The relatively low numbers of cases during 2012–2018 mainly reflect decreases in cases acquired in Afghanistan, a reduction due largely to the progressive withdrawal of U.S. forces from that country. The percentage of cases of malaria caused by unspecified agents (63.8%; n=37) in 2018 was the highest during any given year of the surveillance period. The percent­age of cases identified as having been caused by Plasmodium vivax (10.3%; n=6) in 2018 was the lowest observed during the 10-year surveillance period. The percentage of malaria cases attributed to P. falciparum (25.9 %) in 2018 was similar to that observed in 2017 (25.7%), although the number of cases increased. Malaria was diagnosed at or reported from 31 different medical facilities in the U.S., Afghanistan, Italy, Germany, Djibouti, and Korea. Pro­viders of medical care to military members should be knowledgeable of and vigilant for clinical manifestations of malaria outside of endemic areas.

Recommended Content:

Medical Surveillance Monthly Report

Update: Incidence of Glaucoma Diagnoses, Active Component, U.S. Armed Forces, 2013–2017

Article
2/1/2019
Glaucoma

Glaucoma is an eye disease that involves progressive optic nerve damage and vision loss, leading to blindness if undetected or untreated. This report describes an analysis using the Defense Medical Surveillance System to identify all active component service members with an incident diagnosis of glaucoma during the period between 2013 and 2017. The analysis identified 37,718 incident cases of glaucoma and an overall incidence rate of 5.9 cases per 1,000 person-years (p-yrs). The majority of cases (97.6%) were diagnosed at an early stage as borderline glaucoma; of these borderline cases, 2.2% progressed to open-angle glaucoma during the study period. No incident cases of absolute glaucoma, or total blindness, were identified. Rates of glaucoma were higher among non-Hispanic black (11.0 per 1,000 p-yrs), Asian/Pacific Islander (9.5), and Hispanic (6.9) service members, compared with non-Hispanic white (4.0) service members. Rates among female service members (6.6 per 1,000 p-yrs) were higher than those among male service members (5.8). Between 2013 and 2017, incidence rates of glaucoma diagnoses increased by 75.4% among all service members.

Recommended Content:

Medical Surveillance Monthly Report
<< < ... 11 12 13 14 15  ... > >> 
Showing results 181 - 195 Page 13 of 22

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.