Strategies to prevent acute diarrhea and upper respiratory tract infection among disaster relief workers

Background: Sickness among field relief workers prompted us to develop strategies for preventing manpower loss. Most studies have focused on the preparedness and safety of medical responders in the prepared phase, but those parameters are lacking in the response phase. This study attempted to identify effective ways to prevent medical team members from acquiring acute diarrhea and upper respiratory tract infection (URI) based on our field reports. Methods: This was a retrospective cohort study. The 56 team members were from eight missions in total, including medial disaster relief and international humanitarian assistance, deployed between June 2007 and February 2010. The demographics of the participating members and their actions were examined for association with acute diarrhea and upper respiratory tract infection episodes using a mixed-effect logistic regression model. Results: One member (7.0%) with acute diarrhea and 11 (26.1%) members without acute diarrhea took doxycycline. The relationship between doxycycline and acute diarrhea episodes was not statistically significant. However, while 6 of 14 team members (42.9%) with acute diarrhea used hand sanitizer, 35 of 42 team members (83.3%) without diarrhea used hand sanitizer. Only hand sanitizer use was statistically related to the prevention of acute diarrhea and URI (p value = 0.021, 0.032). Conclusion: Hand sanitizer is suggested to protect medical teams from acute diarrhea and URI in such challenging environments. Chemoprophylaxis for malaria remains dependent on the area of deployment.