Pathogens were identified in 40% of samples; enteric viruses were predominant (28.1%). Three determinants were associated with diarrhea

by multivariate analysis: diarrhea in the close circle [OR: 3.8 (2.0–7.0)]; always eating at the military mess [OR: 0.2 (0.1–0.5)]; or staying in a temporary encampment [OR: 0.3 (0.1–0.8)]. Conclusions. This study found a high frequency of enteric viruses and a high risk of person-to-person transmission associated with diarrhea. Eating at the military mess or staying in a temporary encampment conferred a protective effect. In addition to food-borne disease prevention, stringent hygiene measures are required to break transmission of diarrhea during military deployments. Acute diarrhea is one of the most common illnesses in travelers.1 Travelers’ diarrhea (TD) is usually defined as the passage of three or more unformed UK-371804 order stools in p38 MAPK activation a person traveling from an industrialized country to a developing country.2 Acute diarrhea among French forces during overseas deployments has been under epidemiological surveillance for the last 10 years. It appears to be the primary cause of morbidity among the 62 diseases under surveillance.3 Since the beginning of diarrhea surveillance among French forces, the cumulative incidence rates have appeared to be higher in Chad than in other African countries where French troops are permanently deployed (Republic of Djibouti, Gabon,

Senegal, Ivory Coast, Cameroon, and Central African Republic).4 In 2007, the incidence rate was 1,423/1,000 person-years in Chad, corresponding to a relative risk (RR) of diarrhea of 6.9 95% CI (6.5–7.4) compared

to other African countries.5 However, surveillance to date has not provided any reliable data on the etiologies of pathogens and risk factors for diarrhea in Chad. The objective of this O-methylated flavonoid study was to assess, for the first time, incidence, etiology, and determinants associated with TD among French forces deployed to Chad. This observational study was conducted at the French military medical center in the French forces camp in N’Djamena, Chad, between September 22, 2007 and February 26, 2008 (corresponding to the duration of the deployment of Army battalions). In this camp, the members of the French service were permanently housed in permanent buildings and drank only bottled water. For meals, military personnel had a military mess in the camp, but could eat at local restaurants when off-duty. All French military personnel including Air Force, Army, and Medical Department personnel deployed to N’Djamena were eligible for the study. Diarrhea was defined as three or more loose stools in a 24-hour period or at least two loose stools within the last 8 hours. Each episode of acute diarrhea was taken into account as a new case unless the diarrhea lasted for more than 10 days (considered chronic for this study). After clinical evaluation by a physician, an anonymous physician-administered questionnaire was filled out.