title: Factors associated with the use of protective measures against vector-borne diseases among troops deployed to Iraq and Afghanistan.
abstract: METHODS
  Vector-borne diseases are known threats to deployed troops. We performed a cross-sectional study of troops deployed to Southwest Asia between January 2005 and February 2007 to evaluate practices of personal protective measures and their relationship to self-report of Old World cutaneous leishmaniasis (CL), a marker of vector-borne disease threat.
  
  
  RESULTS
  Regular or always N, N-diethyl-m-toluamide (DEET) use was low (2-5%). Associations for DEET use were command emphasis, branch of service, uniform treatment with permethrin, and duty station. Uniform treatment with permethrin was associated with branch of service, command emphasis, and use of DEET. We identified 22 cases of CL (incidence density of 1.8-3.7 per 100 person-years) with increased risk among Reserve/National Guard components, Air Force and Marine personnel.
  
  
  CONCLUSIONS
  Commanders can influence the use of the military insect repellent system. Unit-based treatment of uniforms improves prevalence. CL incidence may be higher than previously reported.
authors.affiliation: Preventive Medicine and Biometrics Department, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room A1040A, Bethesda, MD 20824-4799, USA. jvickery@usuhs.mil
authors.forename: John P
authors.initials: JP
authors.lastname: Vickery
authors.forename: David R
authors.initials: DR
authors.lastname: Tribble
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Putnam
authors.forename: Timothy
authors.initials: T
authors.lastname: McGraw
authors.forename: John W
authors.initials: JW
authors.lastname: Sanders
authors.forename: Adam W
authors.initials: AW
authors.lastname: Armstrong
authors.forename: Mark S
authors.initials: MS
authors.lastname: Riddle
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D000818:Animals; D015415:Biomarkers; D003430:Cross-Sectional Studies; D003671:DEET / Q000627:therapeutic use*; D004199:Disease Vectors; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D007299:Insect Bites and Stings; D007302:Insect Repellents / Q000627:therapeutic use*; D007306:Insecticides / Q000627:therapeutic use*; D007493:Iraq; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care; D026023:Permethrin / Q000627:therapeutic use*; D015995:Prevalence; D012309:Risk-Taking; D012449:Safety; D014481:United States; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007302:Insect Repellents; D007306:Insecticides; D003671:DEET; D026023:Permethrin