Peace Corps The Health of The Volunteer 2010 Annual Report of Volunteer Health

The Health
of the
Volunteer
2010
Peace Corps Ofce of Medical Services
_____________________________________________________________________________
The Health of the Volunteer

2010
Annual Report of Volunteer Health
_____________________________________________________________________________
Table of Contents
Contributors
Introduction ....................................................... 2
Peace Corps Medical Officers

Worldwide
Data Methods ..................................................... 2

Data Sources
Data Analysis
Data Limitations
2010 Changes
2
2
2
3
Feedback ............................................................ 3
2010 Highlights .................................................. 4
Notable
2010 Results ....................................................... 5

Volunteer demographics
5
Most common conditions
5
Conditions with significant rate differences
5
Infectious Conditions
6
Noninfectious conditions
13
Severe outcomes
18
Pre- and Post-service
19
Appendix B: Peace Corps Volunteers by Countries
and Regions, 2010
21
Appendix D: Tables
23
Dick Banks
Surveillance and Tracking Coordinator
Myrna Charles, DO, MBA, MPH
Chief, Epidemiology and Surveillance Unit
Janet Ladd, RN
Pre-Service Unit Manager
Karol Duffy, RN, MS
Field Support Manager
Diana Johnson, RN, MSN
Post-Service Manager
Timothy Lawler, PhD, MPH
Director, Counseling and Outreach Unit
Common Acronyms and Definitions ............. 38

Subject Index ................................................... 39
Peace Corps Office of Medical Services, Epidemiology and Surveillance Unit, 1111 20th St NW, Washington DC, 20526
cases of disease in a year by the VT year count and

then multiplying by 100.
Introduction
The Health of the Volunteer is an annual report
produced by the Epidemiology and Surveillance Unit
of Peace Corps Office of Medical Services (OMS).
This report provides information on health conditions
experienced by Peace Corps Volunteers, Peace Corps
Response Volunteers, and trainees during the calendar
year and is intended for use by Peace Corps medical
officers (PCMOs), Volunteers, and agency staff.
Rate in =
VT years
Number of new cases of disease

( Time each Volunteer )
served in years
x 100
Volunteer Years
Volunteer years (VT years) take into account both the
number of Volunteers and the length of time each
Volunteer served. Since Volunteers may serve less
than a full calendar year, counting VT years is more
accurate than counting individual Volunteers.
The Health of the Volunteer 2010 reflects OMS

mission to monitor and evaluate trends in global and
regional health conditions among Peace Corps
Volunteers and trainees. This volume includes 2010
highlights, along with details reflecting each reported
condition and event. Appendices have extended
figures, tables, and country-specific data.
Female Volunteer Years

Rates for pregnancy, gynecological infections, and
colposcopies are given per 100 female VT years.
Since these conditions affect only females, male
Volunteers have been excluded from the denominator
in these calculations.
The report is designed to facilitate the education and

training of Volunteers and staff and to help enhance
prevention efforts. This volume, additional tables, and
previous reports may be accessed via the Peace Corps
Intranet on the Epidemiology page.
Malaria Volunteer Years
Data Methods
Rates for malaria (by type), malaria (by prophylaxis),

and average monthly antimalaria chemoprophylaxis
are given per 100 malaria VT years. Since these
conditions only affect Volunteers in countries with
endemic malaria, Volunteers serving in nonmalarial
countries have been excluded from the denominator in
these calculations.
Data Sources
Information used to prepare this report came from
PCMOs through monthly Epidemiologic Surveillance
System (ESS) reports (Appendix A). Accommodation
data were collected by the OMS Pre-Service Unit.
Post-service claims data were provided through the
OMS Post-Service Unit. Information on mental
health consultations was collected by the Counseling
and Outreach Unit (COU) in the Office of Volunteer
Support (OVS).
Trend Lines
Figures that show incidence rates over time display
trend lines to emphasize tendencies in data direction.
Commencing in 2007, trend lines were tested for joins
or places where the data trends show a significant
direction change.
Throughout this document the term Volunteer

includes Peace Corps Volunteers and trainees, as well
as Peace Corps Response Volunteers.
Trendlines were created using Joinpoint, a program

freely available from the National Cancer Institute.
Information on this method is available at
http://srab.cancer.gov/joinpoint.
Data Analysis
Incidence Rates
Data Limitations
Incidence is the number of new cases of a disease or

condition. Incidence rate is the proportion of new
cases within the population at risk.
There are several limitations to the information

presented in this report. If Volunteers do not seek
health care from the PCMO, the number of reported
cases may not reflect the actual burden of disease.
In The Health of the Volunteer, incidence rates are

expressed per 100 Volunteer years (VT years). These
rates are calculated by dividing the number of new
The Health of the Volunteer 2010

service by the Medical Placement Coordinator. This
process may include consultation between the OMS,
the Office of Volunteer Recruitment and Selection
and Peace Corps post staff.
Not all conditions can be precisely confirmed, so

some reported cases may be misclassified.
Incidence rates based on small numbers of cases (20
or less) should be interpreted with caution since a
change of a few cases can produce a large change in
rate. Most country-specific rates fall into this
category. In the figures provided, counts are given
instead of rates when the number of cases in one or
more categories is less than 20.
Feedback
Comments on the content of this report and
suggestions to enhance its usefulness, especially as a
training tool for Volunteers, are encouraged. Please
direct feedback to Dr. Myrna Charles in the
Epidemiology and Surveillance Unit at
mcharles@peacecorps.gov or 202.692.1517.
2010 Changes
Changes to Peace Corps Countries
Peace Corps served in 69 posts in 2010 (Appendix B).
During the year, three posts were opened: Indonesia in
April, Sierra Leone in July, and Colombia in October.
One post (Guinea) was re-opened in September.
Programs that close during the calendar year provide
data only for the months during which they were
operational. Incidence data for these posts should be
interpreted cautiously.
Changes to Peace Corps Units
The Office of Special Services was officially renamed
the Counseling and Outreach Unit to better reflect the
range of services provided by staff in the Unit.
Changes to The Health of the Volunteer Report
Commencing with The Health of the Volunteer 2010
report, information on the number of pre-service
accommodations by country has been included in
Appendix D.
Pre-Service Accommodations
The Medical Accommodation Program within OMS is
designed to facilitate the decision-making process
regarding applicants with special medical or site
placement needs. The Pre-Service Unit and/or the
Medical Placement Coordinator review all applicants
who need special medical and/or site placement.
Applicants with conditions that require special
medical monitoring (i.e., beyond routine care), are
cleared by the Screening Team for countrywide
service in countries that can support such monitoring.
Applicants with conditions that require a specific
geographic location or require proximity to an urgent
care medical facility are cleared for site-specific
2010 Highlights
Increase in In-Country Hospitalizations (page 19)
Notable
In 2010, the rate of in-country hospitalizations for

Volunteers was 4.8 hospitalizations per 100 VT years.
The EMA region reported an increase in the rate of incountry hospitalizations since 2009, from 2.4 to 4.0
hospitalized cases per 100 VT years (51 to 93 cases)
in 2010.
Increase in Dengue Rates (Page 6)

Reported cases of dengue in 2010 were greater than
the average number of cases per year reported during
2001-2009 (mean: 96 cases). One hundred and thirtyeight cases of dengue were reported in 2010 for a rate
of 1.8 cases per 100 VT years. This represents a 29
percent rise in dengue infections from the previous
year.
Changes in asthma rates in IAP and Africa (Page 14)
From 2009 to 2010, the asthma rate among Volunteers
in the IAP region increased by 40 percent, from 2.5 to
3.5 per 100 VT years (60 to 90 cases). Costa Rica,
Honduras, Nicaragua, and Paraguay reported
significant increases in the number of Volunteers
treated for asthma.
From 2009 to 2010, the Africa region reported a 50
percent decrease in the asthma rate among Volunteers,
from 2.0 to 1.0 per 100 VT years (56 to 29 cases).
EMA had no change in cases.
Increase in Mental Health Issues (Page 17)
The rate of mental health issues in 2010 was 18.1
mental health issues per 100 VT years. This represents
an increase since 2009 (15.8 cases per 100 VT years).
The highest incidence of mental health issues occurred
in the EMA region (20.3 cases per 100 VT years),
followed by Africa (18.8) and IAP (15.3).
Increase in Malaria rates in Africa (Page 10)
From 2009 to 2010, reports of malaria cases increased
by 26 percent, from a rate of 5.4 to 6.8 cases per 100
VT years (145 to 189 reported cases.) Six countries in
Africa accounted for 71 percent of the reported cases.
IAP had no change in its rate of malaria.
Most common conditions
2010 Results
In 2010, Peace Corps Volunteers, trainees, and Peace
Corps Response Volunteers served a total of 7,728
Volunteer-trainee years (VT years). The overall
number of VT years has increased an average of 2
percent per year.
As seen in previous years, the three most commonly

reported conditions included gastrointestinal illness,
infectious dermatitis, and dental problems.
Gastrointestinal conditions remained the most
reported condition, with 66.7 cases per 100 VT years,
while infectious dermatitis ranked second, with a rate
of 25.4 cases reported per 100 VT years.
Female Volunteers served 4,678 VT years, accounting

for over half of the total VT years served (60.5
percent). The proportion of VT years served by
females has remained relatively constant since 1999.
Conditions with significant rate differences
Volunteer demographics
Worldwide, six conditions had statistically significant

differences in rate from 2009 to 2010 (p-value <0.05).
Dengue and mental health issues had significant rate
increases during this time period, increasing 29
percent, from 1.4 to 1.8 cases per 100 VT years (101
to 138 cases), and 15 percent, from 15.8 to 18.1 per
100 VT years (1,142 to 1,399 cases), respectively.
Volunteers age 50 years and over served 499 VT years

in 2010, 6.5 percent of the total VT years served. The
proportion of VT years served by Volunteers 50 years
of age and over has increased an average of 1 percent
per year.
Gastrointestinal conditions, febrile illnesses,
pregnancy, and colposcopies performed in-county saw
a significant decrease in incidence rates from 2009 to
2010.
In EMA, from 2009 to 2010, the rate of dengue
infections increased by 200 percent, from 0.5 to 1.5
cases per 100 VT years (11 to 35 cases). During this
period, the rate of in-country hospitalizations
increased 67 percent, from 2.4 to 4.0 (51 to 93
hospitalizations). This increase was mainly caused by
an increase in the number of Volunteers needing
5

Some conditions with significant rate differences
appeared in multiple regions. The incidence of
gastrointestinal conditions decreased in EMA and
Africa. Asthma and gynecological infections
decreased in Africa while increasing in IAP.
hospitalization in the Philippines. There was a

significant decrease in the number of gastrointestinal
conditions reported in the EMA region as depicted in
the graph below.
Infectious Conditions
Dengue
Dengue is a viral disease transmitted to humans by
infected mosquitoes. Symptoms include high fever,
severe headache, and joint and muscle pain. Dengue
Hemorrhagic Fever (DHF) is a severe form of dengue
that causes internal bleeding.
An increase in the rate of mental health issues was

seen in EMA but not the other regions, with a rate
increase of 24 percent, from 16.4 to 20.3 (343 to 470
cases) per 100 VT years. This increase was seen
predominantly in the Kyrgyz Republic.
According to the World Health Organization, the

incidence of dengue cases is increasing globally as the
disease spreads to new areas. Large outbreaks of
dengue occur every few years in tropical countries.
In 2010, the IAP regional rate of asthma increased 40

percent, from 2.5 to 3.5 cases per 100 VT years (60 to
90 cases.) There was also an increase in the incidence
of gynecological infections, from 19.2 to 22.8 cases
per 100 VT years (275 to 355 cases).
In 2010, the number of dengue cases reported was

greater than the average number of cases reported per
year during 2001-2009 (mean: 96 cases). One hundred
and thirty-eight cases of dengue were reported in 2010
for a rate of 1.8 cases per 100 VT years. This
represents a 29 percent rise in dengue infections from
the previous year.
Cases were reported from 14 countries in the IAP
region, four countries in EMA and one country in
Africa. A significant increase in cases was seen in
Cambodia, Honduras, Nicaragua, and the Philippines.
In 2010, most of the reported dengue cases were from
Nicaragua.
The Africa region had significant rate decreases in

many conditions from 2009 to 2010. The rate of
asthma decreased from 2.0 to 1.0 cases per 100 VT
years (56 to 29 cases), while in-country colposcopies
decreased by 83 percent, from 0.6 to 0.1 (16 to two
procedures).
From 2000 to 2002, there was an 11 percent per year

decrease in dengue cases among Volunteers. Since
2002, dengue rates have increased by an average of 7
percent per year.
An increase in the rate of malaria cases was seen only

in the Africa region, with a rate increase from 5.4 to
6.8 cases per 100 VT years (145 to 189 cases.)
Dengue infection is found in the tropics and

subtropics. The IAP region routinely accounts for the
greatest number of cases among Volunteers. IAP
6

reported 102 (74 percent) of the 138 cases seen in
2010, with an increase in incidence rate, from 2009, of
3.2 to 4.0 cases per 100 VT years. This compared to
EMA, with 35 cases (25 percent) and an incidence
rate of 1.5 cases per 100 VT years, and Africa, which
had a decrease in rate to 0.01 cases per 100 VT years
and had 1 (0.07 percent) of the cases.
In 2010, rates in Africa declined, while a slight

increase has been seen in IAP since 2009, from 10.5
to 10.9 cases per 100 VT years (249 to 278 cases).
Dermatitis, infectious
As in 2009, the second most commonly reported
condition among Volunteers in 2010 was infectious
dermatitis, with a rate of 25.4 cases per 100 VT years
(1,961 cases).
Infectious dermatitis includes any infection of the skin
by bacterial, fungal or parasitic organisms. These
conditions may or may not be laboratory-confirmed.
Noninfectious skin conditions such as acne, eczema,
or non-specific rashes were not included.
Filariasis
Filariasis is a group of parasitic diseases caused by
microscopic, threadlike worms. Lymphatic filariasis
is contracted through the bite of an infected mosquito
and can cause swelling (lymphedema), as well as
thickening, hardening, and disfiguration of the skin
(elephantiasis), usually affecting the limbs, breasts,
and genitals. Onchocerciasis (river blindness) is
contracted through the bite of an infected black fly
and can cause inflammation, while chronic infection
can produce blindness. Loa loa, or African eye worm,
is contracted through the bite of an infected horsefly
and can cause lymphedema, itching, inflammation,
and migration of worms through the eyeballs.
From 2000 to 2004, the rates of infectious dermatitis

increased by 5 percent per year and then decreased by
6 percent per year from 2004 to 2010.
There were two cases of filariasis reported among

Volunteers in the Africa region in 2010. This category
includes lymphatic filariasis, onchocerciasis, and loa
loa.
Febrile illness, other

Other febrile illnesses had a rate of 8.9 cases per 100
VT years (687 cases) in 2010. Reports of febrile
illness have decreased 5 percent per year since 2000.

Bacterial diarrhea, other or presumed captures
infections of the gastrointestinal tract confirmed by
laboratory testing or with a clinical presentation
consistent with bacterial infection in which antibiotic
treatment was administered but etiology was not labconfirmed. The bacterial agents are those that do not
apply to other ESS categories (e.g., amebiasis,
giardiasis, salmonellosis, or shigellosis).
Viral diarrhea, other or presumed includes
infections of the gastrointestinal tract due to a viral
species confirmed by laboratory testing or a clinical
presentation consistent with viral infection that is not
confirmed by laboratory testing.
Gastrointestinal conditions
Gastrointestinal conditions include laboratory
confirmed and non-laboratory confirmed illnesses
with four or more liquid or watery stools per day.
Among the 5,152 gastrointestinal conditions reported

in 2010, 32 percent were of bacterial etiology, 16
percent were of viral origin, 12 percent were
amebiasis, 9 percent giardiasis, 2 percent intestinal
helminths, 0.1 percent salmonellosis, and 0.1 percent
shigellosis. The remaining 28 percent of cases were
classified as other diarrhea.
This category continues to lead reportable condition

categories, with a rate of 66.7 cases per 100 VT years
(5,152 cases). From 2000 to 2003, the rate of
gastrointestinal conditions increased 6 percent per
year and then from 2003 to 2010 the rate decreased by
an average of 4 percent per year.
Other diarrhea represents gastrointestinal tract

infections caused by parasites not identified in the
categories above, noninfectious causes (e.g., heavy
metals, chemicals, food allergies, medications), or an
unknown etiology.
Figure 17: Percent of gastrointestional conditions,
by typePeace Corps Volunteers, 2010
Amoebas 12%
Giardia 9%
12%
28%
9%
2%
<1%
16%
A statistically significant decrease in rates of

gastrointestinal conditions was seen among
Volunteers in the EMA and Africa regions.
32%
Intestinal Helminths 2%
Salmonella & Shigella <1%
Bacterial diarrhea 32%
Viral diarrhea 16%
Other diarrhea 28%
n = 5,152
Gynecological infections, other

Other gynecological infections include bacterial
vaginosis, vaginal yeast infection, and pelvic
inflammatory disease.
There were 673 other gynecological infections
reported in 2010 for a rate of 14.4 cases per 100
female VT years. This rate increased an average of 6
percent per year from 2000 to 2004 and decreased 7
percent per year from 2004 to 2010.

Volunteers have tested positive for HIV during
service.
Post-exposure prophylaxis
HIV post-exposure prophylaxis (PEP) was prescribed
to 110 Volunteers for a rate of 4.0 prescriptions per
100 VT years in 2010. The majority of PEP (74
percent; 81 cases) was prescribed in Africa. The rate
of PEP in Africa increased from 2009 to 2010 (2.2 to
2.8 prescriptions per 100 VT years; 61 to 81 cases).
The PEP prescription rate in EMA increased 67
percent during this period (0.3 to 0.5 prescriptions per
100 VT years; 7 to 12 cases). In IAP, the rate of PEP
prescriptions decreased from 2009 to 2010 (0.8 to 0.7
prescriptions per 100 VT years; 20 to 17 cases).
Hepatitis
There were three cases of hepatitis reported among
Volunteers in 2010. All the cases were in the
Hepatitis, Other or Presumed category. This
category includes hepatitis E and presumed hepatitis,
as well as infectious and noninfectious causes of
elevated amino-transferase levels.
PEP has been available since 1997 to Volunteers

potentially exposed to HIV. Data on PEP use was
first collected in 2006.
Leishmaniasis
Leishmaniasis is a parasitic disease spread to humans
through the bite of infected sand flies. The two most
common forms are cutaneous, which produces skin
sores, and visceral, which affects internal organs such
as the spleen, liver, and bone marrow.
Human Immunodeficiency Virus

In 2010, four Volunteers tested positive for human
immunodeficiency virus (HIV) infection.
Peace Corps initiated HIV screening in 1987.

Volunteers have been screened both prior to, and at
the end of, service since 1989. Since 1989, 43

There were four cases of leishmaniasis reported
among Volunteers in 2010; all cases were in Panama.
Malaria
The overall rate of malaria among Volunteers was 2.5
cases per 100 VT years in 2010 (194 cases).
This rate has decreased an average of 5 percent per
year since 2000.
Antimalarial chemoprophylaxis
The ESS tracks the number of Volunteers taking longterm antimalarial chemoprophylaxis each month.
Short-term use, defined as less than 30 days (e.g., for
travel), is not recorded.
The average yearly estimate of all Volunteers on
antimalarial chemoprophylaxis in 2010 was similar to
2009 at 58 percent overall (93 percent of Africa
Volunteers, 61 percent of IAP Volunteers, and 12
percent of EMA Volunteers).
Regionally, Africa saw the most malaria (97 percent;

189 cases). This represents a significant increase in
cases since 2009 (97 percent; 145 cases). Twenty
countries in Africa reported malaria cases; however,
six countries (Benin, Cameroon, Ghana, Mali,
Uganda, and Zambia) accounted for 71 percent (135
cases).
In 2010, 81 percent of Volunteers in malaria endemic

countries were on antimalarial chemoprophylaxis: 96
percent of Africa Volunteers, 72 percent of IAP
Volunteers, and 42 percent of EMA Volunteers.
Since the average yearly estimate includes both the
number of Volunteers and the time they were taking
chemoprophylaxis, the average is interpreted using
both measures. For example, if 50 percent of
Volunteers took chemoprophylaxis for the whole year
or if 100 percent of Volunteers took it for half of the
year, both instances would produce an average yearly
estimate of 50 percent. The average yearly estimate is
most accurate if the number of Volunteers in a country
remains stable throughout the year.
Five cases of malaria were reported from IAP, three

non-falciparum and one case of falciparum malaria.
Of the 189 malaria infections among Africa
Volunteers, 36 percent (69 cases) were confirmed
Plasmodium falciparum, 60 percent (113 cases) were
presumptive malaria, and 4 percent (7 cases) were
confirmed as non-Plasmodium falciparum species.
For Volunteers in the Africa region who took

antimalarial chemoprophylaxis, mefloquine was used
by 69 percent, doxycycline was used by 26 percent,
atovaquone/proguanil (Malarone) was used by 5
percent, and 0.001 percent used minocycline (a variant
of doxycycline used to treat acne with the same
antimalarial properties).
The rate of falciparum malaria in Africa was 2.4 per

100 VT years in 2010 (69 cases). This rate has
decreased an average of 6 percent per year since 2000.
10

Schistosomiasis cases and antibodies
Schistosomiasis is a parasitic disease caused by
flatworms that penetrate the skin of people who swim
or wade in contaminated water. Many schistosomiasis
infections are asymptomatic. Acute and chronic
infections can produce progressive damage to the
bladder, ureters, and kidneys (urinary
schistosomiasis), as well as progressive enlargement
of the liver and spleen, with intestinal damage and
hypertension of the abdominal blood vessels
(intestinal schistosomiasis).
In 2010, among the 194 Volunteers who were

diagnosed with malaria, 56 percent were taking
mefloquine, 38 percent were taking doxycycline, 5
percent were taking atovaquone/proguanil (Malarone),
and 2 percent were taking chloroquine.
In 1998, the Peace Corps instituted universal

schistosomiasis antibody screening for Volunteers
completing service in endemic areas (described in
Technical Guideline 850).
Volunteers taking doxycycline, mefloquine, and

atovaquone/proguanil (Malarone) had similar rates of
malaria, with 7.4, 4.8, and 4.5 per 100 VT years,
respectively. The differences between these three
rates were not statistically significant, as shown by
their overlapping 95 percent confidence intervals.
There were six cases of schistosomiasis and 79

positive antibody reports in 2010. Most of the
reported cases of schistosomiasis (two cases, 33
percent) and positive antibody reports (21 cases, 26
percent) were from Mozambique.
The cases of schistosomiasis among Volunteers have
increased by 10 percent per year since 2000. Prior to
2006, schistosomiasis cases and positive antibodies
were reported in a combined category.
Volunteers on chloroquine had the lowest rate of

malaria, 0.2 per 100 VT years. This rate was
significantly lower than the rates of malaria among the
other three groups.
Sexually transmitted diseases, non-HIV

In 2010, 258 cases of sexually transmitted diseases
(STDs) were reported among Volunteers, representing
a rate of 3.3 cases per 100 VT years. This rate does
not include HIV or the other gynecological conditions
reported in the ESS. Since 2000, this rate has
increased 2 percent per year.
11

If an individual has been exposed to someone with
active tuberculosis infection, the PPD skin test or
IGRA will be read as positive. A PPD converter is a
person who has had a negative tuberculosis screening
test in the past and now has a positive tuberculosis
screening test. PPD converters are at increased risk
for developing active tuberculosis and must receive
tuberculosis chemoprophylaxis treatment to minimize
this risk.
Volunteers are tested for tuberculosis with the PPD
skin test during the application process, at close of
service, and after any significant exposure.
Forty-one percent (106 cases) of the 258 STDs

diagnosed in 2010 were of viral etiology. Fifty-nine
percent were of bacterial origin. Viral STDs include
genital herpes and human papillomavirus. Bacterial
STDs include syphilis, gonorrhea, chlamydia,
trichomonas, and chancroid.
In 2010, 65 Volunteers were diagnosed with latent

tuberculosis by using PPD tests. A 27 percent
decrease in tuberculosis skin test conversions among
Volunteers was seen from 2009 to 2010 (from 1.1 to
0.8 cases per 100 VT years).
During this period, EMA reported an increase in its
PPD conversion rate, from 1.1 to 1.2 cases per 100 VT
years (23 cases to 27 cases). Africa saw a decrease of
0.9 to 0.6 cases per 100 VT years (25 to 17 cases).
The IAP region reported a decrease in PPD
conversion rate, from 1.4 to 0.8 cases per 100 VT
years (33 to 21 cases), during the same time period.
The overall average rate of PPD conversions has
decreased by 3 percent per year since 2000.
An increase in STD rates represents an increase in the

risk for HIV infection, certain cancers, heart disease,
and infertility among other complications. Individuals
with an STD infection are more susceptible to HIV
infection. The increase in STD infection among
Volunteers signals an opportunity for improved
counseling and preventive measures to reduce health
risks from intimate behavior.
Tuberculosis
In 2010, there were two cases of active tuberculosis
among Volunteers. Since 2000, a total of nine cases of
Tuberculosis remains a leading cause of death

worldwide. Early detection of infection and
preventing active tuberculosis are essential to
reducing the mortality risk from this disease. The
ideal way to achieve these goals is to establish a
screening program.
active tuberculosis have been reported. Five of the

nine tuberculosis cases were from the Africa region.
Either a purified protein derivative (PPD) skin test or

an interferon-gamma release assay (IGRA) blood test
is used to detect exposure to tuberculosis. IGRA tests
are relatively new and are not performed by all
laboratories.
12
Noninfectious conditions
Alcohol-related problems
Alcohol-related problems include any incident in
which behavior was altered or impaired due to alcohol
intoxication. These include incidents observed by
staff, Volunteers, or any reliable source.
From 2009 to 2010, the rate of alcohol-related
problems among Volunteers decreased from 1.0 to 0.7
cases per 100 VT years. From 2000 to 2002, the rate
increased by 2 percent per year. Since 2002, the rate
of reported problems has decreased an average of 8
percent per year.
Vaccine-preventable diseases
A vaccine-preventable disease is an infectious disease
for which a preventive vaccine exists. In 2010, there
were eight cases of vaccine-preventable diseases
reported among Volunteers. This involved three cases
of Varicella Zoster (two cases of shingles and one
case of chicken pox), three cases of typhoid, two cases
of pertussis and one case each of diphtheria,
meningitis, and an unspecified infection.
The reduction is likely due to revisions in Peace Corps

policy regarding alcohol use and behavioral problems
associated with alcohol. It may also be due to
changing support practices by PCMOs, in-country and
headquarters staff, and improved training methods.
From 2009 to 2010, the rate of alcohol-related

problems remained relatively unchanged in the three
regions. The rates of reported alcohol-related incidents
decreased in the EMA and IAP regions, from 1.4 to
1.3 cases and 0.8 to 0.7 cases per 100 VT years,
respectively. There was a slight increase in reported
alcohol-related problems in the Africa region, from
0.8 to 0.9 cases per 100 VT years. These changes were
not statistically significant.
In 2010, there were two cases of typhoid among

Cameroon Volunteers and one from El Salvador.
Since 2000, the Philippines has reported 22 of 36 (61
percent) typhoid cases.
13

per 100 VT years (18 to eight cases). This compares to
1.2 cases per 100 VT years (27 cases) in EMA and 0.9
cases per 100 VT years (23 cases) in the IAP region.
Asthma
The rate of reported asthma (new asthma and asthma
exacerbations) was 3.5 cases per 100 VT years. This
rate has increased an average of 4 percent per year
since 2000.
Colposcopies, in-country
Colposcopy is a medical procedure used to diagnose
the cause of abnormal pap smears in women. The
number of in-country colposcopies performed was
tracked for the first time in 2008.
From 2009 to 2010, the asthma rate among Volunteers

in the IAP region increased by 40 percent, from 2.5 to
3.5 per 100 VT years (60 to 90 cases). Costa Rica,
Honduras, Nicaragua, and Paraguay reported
significant increases in the number of Volunteers
treated for asthma.
Any colposcopy performed in the Volunteers country

of service at a clinic, hospital, or facility authorized by
medical staff for the diagnosis and/or treatment of a
gynecological condition is reported.
During the same period, the Africa region reported a

50 percent decrease in its asthma rate, from 2.0 to 1.0
per 100 VT years (56 to 29 cases.) EMA had no
change in cases.
Colposcopies performed in another country or region

(e.g., Volunteer medevaced to another country for this
procedure) are not reported in this category.
Cardiovascular problems
A total of 34 colposcopies were performed in 2010.

There was a significant decrease in the rate of
colposcopies performed in-country from 2009 to
2010, a rate of 0.8 to 0.4 colposcopies per 100 VT
years (59 to 34 colposcopies.) The Africa region
reported a significant decrease in the rate of incountry colposcopies, from 0.6 to 0.1 procedures per
100 VT years. The decrease in colposcopies occurred
mainly in Senegal and was likely due to the temporary
suspension in the use of Senegal as a medevac site.
Cardiovascular problems include conditions related to

the heart and blood vessels as determined by the
PCMO or another health care professional.
The rate of cardiovascular problems among
Volunteers was 0.8 problems per 100 VT years in
2010. This rate has decreased an average of 2 percent
per year since 2000.
The Africa region reported a decrease in the rate of

cardiovascular problems, from 0.6 to 0.3 treated cases
14

Environmental concerns were at a peak in the EMA
region in 2005. This was due to anxiety over Avian flu
that year.
Dental problems
Dental issues include all dental and periodontal
conditions evaluated by a dentist or other health care
professional. Follow-up visits for a single problem or
routine cleanings are not included.
Dental problems are the third most reported condition
among Volunteers, with an overall rate of 21.0
problems per 100 VT years in 2010. This rate has
decreased by 2 percent per year since 2000.
Injuries, unintentional
Unintentional injuries are reported if they require
medical evaluation or treatment by the PCMO or other
health care professional.
This category includes pedestrian injuries, bicyclerelated injuries, motorcycle-related injuries, motor
vehicle-related injuries, water-related injuries, sportsrelated injuries, and other injuries. Other injuries
include falls, burns, animal bites, poisoning, cuts,
abrasions, and puncture wounds not related to sports,
water, or vehicles.
Environmental Concerns
Environmental concerns are one-on-one discussions
(in person or by telephone) regarding exposure to
environmental threats. Topics may include air
pollution, pesticides, food sanitation, natural disasters,
and emerging diseases, among others.
The overall unintentional injury rate in 2010 was 15.7

injuries per 100 VT years. This rate is similar to 2009
(15.8 cases per 100 VT years). The highest incidence
of unintentional injuries occurred in the EMA region
(17.0 cases per 100 VT years), followed by IAP (16.6)
and Africa (13.8).
There was an increase in the overall rate of reported

environmental concerns, from 1.9 concerns per 100
VT years in 2009 to 2.3 concerns per 100 VT years in
2010. During this period, the EMA and IAP regions
reported an increase of 2.6 to 3.3 concerns and 2.3 to
2.9 concerns per 100 VT years, respectively. Africa
was the only region to post a decrease in the rate of
environmental concerns, from 1.1 to 0.9 concerns per
100 VT years. Reports of environmental concerns
have decreased an average of 3 percent per year.
The rate of unintentional injuries increased 3 percent

per year from 2000 to 2004 and then decreased 6
percent per year from 2004 to 2010. Decreases in the
incidences of motor vehicle-related, sports-related,
and other injuries account for the overall decrease
seen in this category.
15
Injuries, Alcohol-related
Since 2000, Africa has reported the lowest number of

unintentional injuries by region.
Injuries, alcohol-related is a category introduced in

2008. Alcohol-related injuries are reported for any
injury associated with reported alcohol use by a
Volunteer or trainee that requires evaluation and/or
treatment by a health care professional.
In 2010, there were 25 cases of reported alcoholrelated injuries. The rate of 0.3 cases per 100 VT
years is similar to 2009. Fifty-six percent (14 cases) of
the alcohol-related injuries came from the Africa
region.
Among the 1,212 unintentional injuries reported in

2010, 56 percent were classified in the other
category. Sports-related injuries accounted for 21
percent of the injuries, pedestrian accidents 8 percent,
and bicycle accidents 6 percent. The remainder
consisted of motor vehicle accidents (4 percent),
water-related accidents (2 percent), and motorcycle
accidents (1 percent).
Mental health issues

A mental health issue is a one-on-one discussion (in
person or by telephone) regarding such factors as
depression, problems with interpersonal relationships,
reactions to stress, and loneliness.
There was an increase in the number of reported
mental health issues in 2010. From 2009 to 2010, the
rate of mental health issues increased by 15 percent,
from 15.8 to 18.1 issues per 100 VT years (1,142 to
1,399 issues).
From 2009 to 2010, the rate of pedestrian injuries

decreased from 1.5 to 1.3 cases per 100 VT years (107
to 103 cases).
The rate of motorcycle injuries remains low compared
to other traffic-related injuries (bicycle, motor vehicle,
motorcycle, and pedestrian).
16

Counseling and Outreach Unit
Mental health consultations
EMA was the only region to demonstrate a significant

increase in its rate of mental health issues. From 2009
to 2010, the number of reported mental issues
increased 24 percent, from 343 to 470 cases (rate of
16.4 to 20.3 issues per 100 VT years). Volunteers in
the Kyrgyz Republic and Mongolia experienced the
greatest increase in mental health issues seen in the
region.
The Counseling and Outreach Unit (COU) maintains

records of mental health consultations it provided to
Volunteers and trainees. Consultations take place
either over the telephone or in person at Peace Corps
headquarters (HQ).
Symptoms leading to a consultation may include
depression, anxiety, post-traumatic stress disorder
(PTSD) or other acute stress, alcohol or drug
problems, behavioral problems, or other mental health
conditions. Information on COU mental health
consultations was first included in The Health of the
Volunteer 2007.
In 2010, there was an increase in violence and

political instability throughout the Krygyz Republic,
which may have contributed to the increase reporting
of mental health issues in the EMA region.
The rate of mental health issues increased an average
of 1 percent per year from 2000 to 2003 and then
decreased 8 percent per year from 2003 to 2010.
Among the 1,399 mental health problems reported in

2010, there were 352 telephone consultations
conducted by COU, accounting for a rate of 4.5
consultations per 100 VT years. There were 51 inperson consultations by COU at Peace Corps
headquarters, representing a rate of 0.7 consultations
per 100 VT years. Both types of consultations were
evenly distributed between EMA (83 phone, seven
HQ), IAP (134 phone, 13 HQ), and Africa (135
phone, 31 HQ) regions.
The Office of Volunteer Support determines whether

an applicant is medically qualified for service and
identifies country-specific resources that will allow
applicants with conditions requiring accommodation
to serve safely and effectively. This is referred to as an
accommodated condition.
Among the 1,399 mental health issues reported in
2010, 39 percent (553 cases) were adjustment issuerelated conditions, 11 percent (148 cases) were
recurrences of accommodated conditions, and the
remaining 50 percent (698 cases) were other mental
health issues.
Most of the telephone consultations were for anxiety

(132, 38 percent) and depression (78, 22 percent).
PTSD and acute stress were responsible for 18 percent
(62) of the phone consultations.
17

Pregnancy
In 2010, there were 28 pregnancies among female
Volunteers for a rate of 0.6 pregnancies per 100
female VT years. This rate has decreased an average
of 4 percent per year since 2000.
The majority of headquarters consultations were for

post-traumatic stress disorder (PTSD) or other acute
stress (18, 36 percent) and other mental health
conditions (14, 28 percent), while anxiety (nine, 18
percent) and depression (nine, 18 percent) were seen
less frequently.
Severe outcomes
Medevacs
Medical evacuations (medevacs) include all medical
evacuations to a third country when a Volunteers
illness or injury requires evaluation or treatment not
available in the Volunteers country of service.
Volunteers may be medevaced more than once or the
same Volunteer may be medevaced to a regional
center and then to the U.S. In these instances, each of
the medevacs has been counted separately.
The overall medevac rate in 2010 was 4.9 evacuations
per 100 VT years. Medevacs to regional centers had a
rate of 2.3 evacuations per 100 VT years, while
medevacs to the U.S. had a rate of 2.6 evacuations per
100 VT years.
New accommodated conditions

New accommodated conditions are accommodations
made at post by the PCMO. There were 10 new
accommodated conditions reported: four from IAP
and three each from EMA and Africa.
For the first time since 2006, the rate of medevacs to

the U.S. was higher than the rate of medevacs to
regional centers (2.6 U.S. medevacs to 2.3 regional
medevacs per 100 VT years).
18

Of 379 medevacs in 2010, 53 percent (200 cases)
were medevacs to the U.S. (Washington, D.C.,
Hawaii, or home of record). Regional medevacs
comprised 47 percent (179) of all medevacs. Most
regional medevacs went to South Africa or other
medevac sites, including Australia, Kenya, Panama,
the Philippines, and Thailand.
Pre- and Post-service

Pre-service accommodations
The Office of Medical Services assesses all Peace
Corps applicants individually to evaluate their
physical and mental capacity to perform the essential
functions of a Peace Corps Volunteer. With
reasonable accommodation, Volunteers must be able
to perform these functions without undue disruption
due to health problems. OMS determines whether an
applicant is medically qualified for Peace Corps
service and identifies country-specific resources that
will allow applicants with conditions requiring
accommodation to serve safely and effectively.
In-country hospitalizations
In 2010, the rate of in-country hospitalizations for
Volunteers was 4.8 hospitalizations per 100 VT years.
This rate has decreased an average of 3 percent per
year since 2000.
The EMA region reported an increase in the rate of incountry hospitalizations since 2009, from 2.4 to 4.0
hospitalized cases per 100 VT years (51 to 93 cases).
The medical accommodation program within OMS

makes decisions regarding applicants with special
medical or site-placement needs. The medical preservice team and/or the medical accommodation
coordinator review all applicants who have special
medical needs or require special site placement.
Applicants with conditions requiring special medical
monitoring (i.e., beyond routine care) are cleared by
the pre-service team for countrywide service in
countries that can support such monitoring. Applicants
with conditions that require a specific geographic
location or require proximity to an urgent-care
medical facility or other care are cleared for sitespecific service by the medical accommodation
coordinator. This process includes consultation among
the OMS and Peace Corps staff at posts.
This increase was caused by the increase seen in the

rate of hospitalizations in the Philippines, from 5.7 to
23.7 cases per 100 VT years (seven to 39
hospitalizations).
In 2010, there were 2,116 accommodations, resulting

in a rate of 27.4 accommodations per 100 VT years.
This rate has been increasing an average of 15 percent
per year since 2001.
In-service deaths
Two Volunteers died while serving in calendar year
2010. A homicide occurred in Lesotho and a
Volunteer in Niger died from an unknown cause.
19

(103 claims, 17 percent), and diseases of the
musculoskeletal system and connective tissue (91
claims, 15 percent). Thirty-one claims were filed for
mental disorders (5 percent).
The most common accommodations in 2010 were

psychotropic medication monitoring (8B), with 678
accommodations, and access to mammography
services, with 217 accommodations. Volunteers may
be accommodated for more than one condition.
During the 2010 calendar year, the Peace Corps paid
$13,566,233 for Volunteer claims accepted by the
Department of Labor. This is based on 2008 dollars.
There has been a 4 percent per year increase in
payments since 2004.
Post-service claims
After their close of service, Volunteers have three
years in which to file claims under the Federal
Employees Compensation Act (FECA) for conditions
that were caused, accelerated, or exacerbated by their
service. Claims are filed with the Peace Corps,
adjudicated by the Department of Labor, and paid by
the Department of Labor with Peace Corps funds.
In 2010, post-service medical claims were filed by
609 returned Volunteers. As in 2009, the most
common claims were for infectious and parasitic
diseases (121 claims, 20 percent), dental problems
20
Appendix B: Peace Corps Volunteers by Countries and Regions, 2010

Africa
Country
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea**
Kenya
Lesotho
Liberia
Volunteer
Years
108
118
132
144
60
78
152
4
101
87
26
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone*
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
Africa Total
81
122
157
144
108
82
101
183
22
138
68
144
90
102
139
168
2,859
Peace Corps Total:
Europe, Mediterranean & Asia

(EMA)
Volunteer
Country
Years
Albania
86
Armenia
94
Azerbaijan
123
Bulgaria
148
Cambodia
75
China
125
Georgia
50
Indonesia*
15
Jordan
58
Kazakhstan
124
Kyrgyz Republic
103
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
EMA Total
78
107
125
245
165
100
105
43
344
2,313
7,728
Data as of September 30, 2010

* Opened in 2010
** Reopened in September 2010
21
Inter-America & Pacific (IAP)
Country
Belize
Colombia*
Costa Rica
Dominican Republic
Eastern Caribbean
Volunteer
Years
91
2
125
185
103
Antigua and Barbuda

Dominica
Grenada
St. Kitts & Nevis
St. Lucia
St. Vincent & the
Grenadines
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia & Palau
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
IAP Total
181
144
68
217
71
186
87
48
51
195
178
209
206
43
46
46
74
2,556
Appendix C: Peace Corps Countries with Endemic Malaria, by Region in 2010

Africa
Country
Europe, Mediterranean & Asia

(EMA)
Inter-America & Pacific (IAP)

Country
Country
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
Azerbaijan
Cambodia
China
Georgia
Indonesia
Philippines
Belize
Colombia
Costa Rica
Dominican Republic
Ecuador
El Salvador
Guatemala
Guyana
Honduras
Jamaica
Mexico
Nicaragua
Panama
Paraguay
Peru
Suriname
Vanuatu
Thailand
22
Appendix D: Tables
Table 1. Number and percent of prescribed antimalarial chemoprophylaxis, by year and type
Peace Corps Volunteers (Africa region only), 20002010
Year
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Mefloquine
No. *
1978
1994
1811
1900
1849
1766
1834
2039
1954
1917
1839
%
88
87
85
79
73
72
76
78
76
73
69
Doxycycline
No.
%
259
12
275
12
274
13
403
17
553
22
569
23
498
21
509
19
545
21
636
24
701
26
Atovaquone/
proguanil
No.
0
17
37
82
117
99
73
72
75
81
122
%
1
2
3
5
4
3
3
3
3
5
Other
No.
7
7
3
6
6
3
1
1
1
1
1
%
<1
<1
<1
<1
<1
<1
<1
<1
<1
<1
<1
* Average number prescribed per month
Table 2: Number and percent of medical evacuations by destinationPeace Corps Volunteers, 2010
Location
Washington, D.C.
Home of Record
U.S.
No.
139
61
%
69.5
30.5
Total U.S. medevacs
200
100
Location
South Africa
Senegal
Thailand
Panama
Australia
Kenya
Other*
Total regional medevacs
Regional
No.
101
0
27
12
9
5
25
179
%
56.4
0.0
15.1
6.7
5.0
2.8
14.0
100
* Includes: Austria, Fiji, Italy, Krygyz Republic, Macedonia, Morocco, New Zealand, Philippines, and
Vienna
23

Table 3: Number and percent of medical accommodations by category Peace Corps Volunteers, 2010
Accommodation
Psychotropic medication monitoring(8B)
Mammography
Asthma
Gynecology
GYN IUD
Rare Accommodation
Shellfish allergy
Ophthalmology
Adderall
Nonmalarial
Dermatology
Nut allergy
Cardiology
Gluten
Psychiatrist available in-country (8A)
Ritalin available
Seizure
Endocrinology
Seasonal Affective Disorder
Urology
Gastroenterology
PSA
Egg allergy
Total
2010
No.
678
217
181
150
140
131
112
84
76
73
66
46
33
32
27
25
20
9
5
5
3
2
1
2,116
%
32.0
10.3
8.6
7.1
6.6
6.2
5.3
4.0
3.6
3.4
3.1
2.2
1.6
1.5
1.3
1.2
0.9
0.4
0.2
0.2
0.1
0.1
0.1
100
Table 4: Number and incidence of medical accommodations, by year and type Peace Corps Volunteers,
20012010
Year
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Psychotropic
medication
monitoring (8B)
No.
216
252
458
445
348
299
340
575
527
678
Asthma
No.
67
74
175
150
141
159
117
170
150
181
Mammography
No.
79
91
125
108
86
103
154
230
207
217
24
Other
Accommodation
No.
273
380
526
501
457
577
710
1108
729
1040
Total
Accommodations
No.
635
797
1284
1204
1032
1138
1321
2083
1613
2116

Table 5: Number and percent of post-service medical claims filed by category and year Peace Corps Volunteers,
20062010
Post-service medical claim diagnostic
category
2006
No.
2007
No.
2008
No.
2009
No.
2010
No.
Diseases of the musculoskeletal system and

connective tissue
85
13.5
136
25.6
118
18.4
90
18.4
91
15.0
Dental
131
20.8
88
16.5
98
15.2
99
16.1
103
17.0
Infectious and parasitic diseases
118
18.7
78
14.7
98
15.2
103
16.8
121
20.0
Mental disorders
33
5.2
47
8.8
44
6.8
48
7.8
31
5.1
Diseases of the skin and subcutaneous

system
41
6.5
36
6.8
52
8.1
52
8.5
48
7.9
Diseases of the genitourinary system
32
5.0
25
4.7
21
3.2
29
4.7
22
3.6
Diseases of the nervous system and sense

organs
22
3.5
20
3.8
32
5.0
22
3.6
18
3.0
Pregnancy
32
5.0
18
3.4
20
3.1
31
5.0
18
3.0
Neoplasms
15
2.4
16
3.0
18
2.8
15
2.4
12
2.0
Injury
69
10.9
14
2.5
73
11.4
57
9.3
79
13.0
Diseases of the digestive system
20
3.2
11
2.1
29
4.5
23
3.7
25
4.1
Diseases of the circulatory system
1.1
11
2.1
0.8
11
1.8
0.5
Endocrine, nutritional, and metabolic

diseases and immunity disorders
0.5
1.7
1.4
12
2.0
1.0
Diseases of the blood and blood-forming

organs
0.2
1.5
0.2
0.5
1.3
Diseases of the respiratory system
12
1.9
1.3
17
2.6
1.5
12
2.0
Symptoms, signs, and ill-defined conditions
1.1
1.1
1.1
1.1
1.3
Complication of pregnancy, childbirth and

the puerperium
0.5
0.4
0.2
Conditions originating in the prenatal

period
0.2
0.0
Congenital anomalies
0.2
0.0
Total
631
100
532
100
643
100
612
100
606
100
25
EPIDEMIOLOGIC SURVEILLANCE (ESS) REPORT FORM

Country:
Region:
Africa
ALCOHOL-RELATED PROBLEMS:
ASTHMA (NEW & EXACERBATIONS):
CARDIOVASCULAR PROBLEMS:
COLPOSCOPIES (IN-COUNTRY):
DENGUE:
DENTAL PROBLEMS:
DERMATITIS (INFECTIOUS):
ENVIRONMENTAL HEALTH CONCERNS:
OTHER FEBRILE ILLNESS:
FILARIASIS:
GASTROINTESTINAL CONDITIONS
Amebiasis:
Giardiasis:
Helminths:
Salmonellosis:
Shigellosis:
Bacterial Diarrhea, Other or Presumed:
Viral Diarrhea, Other or Presumed:
Other Diarrheal Condition:
HEPATITIS
Hepatitis A:
Hepatitis B:
Hepatitis C:
Hepatitis, Other or Presumed:
IN-COUNTRY HOSPITALIZATIONS:
INJURIES (UNINTENTIONAL)
Pedestrian:
Bicycle Riding (NOTE HELMET USE IN NOTES):
Motorcycle Riding:
Motor Vehicle (non-Motorcycle):
Water-Related Injury/Event:
Sports-Related (NOTE SPORT IN NOTES):
Other Unintentional Injuries:
(SPECIFY TYPE & NUMBER FOR EACH):
INJURIES, ALCOHOL-RELATED:
LEISHMANIASIS::
MEDEVACS
Medevac to US Home of Record.:
Medevac to US Washington, DC.:
Medevac to South Africa:
Medevac to Senegal:
Medevac to Kenya:
Medevac to Thailand:
Medevac to Panama:
Medevac to Australia:
Medevac to Other Location:
(SPECIFY LOCATION):
MENTAL HEALTH PROBLEMS
Recurrence of Accommodated Condition:
New adjustment disorder to Peace Corps:
Other Mental Health Problem:
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Month:
January
Year:
2010
NEW ACCOMMODATED CONDITIONS:

PREGNANCY:
HIV POST-EXPOSURE PROPHYLAXIS (PEP):
MALARIA CHEMOPROPHYLAXIS
(LONG-TERM ONLY; NOT FOR SHORT-TERM TRAVEL)
Mefloquine (Lariam):
Chloroquine (Aralen):
Doxycycline (Vibramycin):
Malarone (atovaquone/proguanil):
Other Chemoprophylaxis:
(SPECIFY AGENT USED):
FALCIPARUM MALARIA (CONFIRMED)
Falciparum on MEFLOQUINE:
Falciparum on CHLOROQUINE:
Falciparum on DOXYCYCLINE:
Falciparum on MALARONE:
NON-FALCIPARUM MALARIA (CONFIRMED)
Non-Falciparum on MEFLOQUINE:
Non-Falciparum on CHLOROQUINE:
Non-Falciparum on DOXYCYCLINE:
Non-Falciparum on MALARONE:
PRESUMPTIVE MALARIA
Presumptive on MEFLOQUINE:
Presumptive on CHLOROQUINE:
Presumptive on DOXYCYCLINE:
Presumptive on MALARONE:
SCHISTOSOMIASIS
Clinical Symptoms/Visualized Ova & Parasite:
Positive Antibody Test:
SEXUALLY TRANSMITTED DISEASE
Bacterial STD:
Presumptive Bacterial STD:
Viral STD (non-HIV):
Other Gynecologic Infections:
HIV (Western Blot Positive):
TUBERCULOSIS
PPD Skin Test Conversion:
Active Tuberculosis:
VACCINE-PREVENTABLE DISEASES :
(SPECIFY TYPE AND NUMBER FOR EACH):
CORRECTIONS:
(SPECIFY NUMBER OF CASES, CATEGORY, AND MONTH)
ADD:
DELETE:
NOTES AND OTHER MAJOR CONDITIONS:
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Country
VT
Years
Alcohol Related
Problems
No.
Rate
0
0.0
4
3.4
1
0.8
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
4
4.0
3
3.4
0
0.0
1
1.2
0
0.0
1
0.6
0
0.0
5
4.6
0
0.0
0
0.0
3
1.6
0
0.0
0
0.0
0
0.0
2
1.4
0
0.0
1
1.0
1
0.7
0
0.0
Asthma
No.
Rate
0
0.0
2
1.7
1
0.8
2
1.4
1
1.7
1
1.3
0
0.0
0
0.0
7
6.9
1
1.1
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.2
1
1.0
3
1.6
0
0.0
0
0.0
6
8.8
0
0.0
0
0.0
0
0.0
2
1.4
1
0.6
Cardiovascular
Problems
No.
Rate
0
0.0
1
0.8
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.8
0
0.0
2
1.4
0
0.0
0
0.0
1
1.0
2
1.1
0
0.0
0
0.0
1
1.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Colposcopies
(In-Country)
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.5
0
0.0
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Dengue
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.2
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Dental
Problems
No.
Rate
13
12.0
37
31.4
22
16.7
5
3.5
3
5.0
18
23.0
19
12.5
3
67.3
30
29.7
19
21.7
3
11.8
27
33.3
12
9.8
22
14.0
15
10.4
28
25.9
10
12.3
25
24.6
16
8.8
2
9.3
14
10.2
8
11.8
8
5.5
27
30.0
10
9.8
47
33.9
15
8.9
Dermatitis,
Infectious
No.
Rate
41
37.8
18
15.3
15
11.4
9
6.2
23
38.3
12
15.3
34
22.4
0
0.0
7
6.9
4
4.6
23
90.2
37
45.6
35
28.6
59
37.7
65
45.2
4
3.7
44
53.9
23
22.7
128
70.0
33
153.1
7
5.1
3
4.4
15
10.4
76
84.4
11
10.8
26
18.8
1
0.6
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
26
0
3
0
0
0
0
0
0
0
5
0
1
6
2
1
3
7
0
0
1
0.9
0.0
3.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
4.0
0.0
1.3
5.6
1.6
0.4
1.8
7.0
0.0
0.0
0.3
29
1
0
0
2
0
3
2
0
2
1
0
0
9
3
18
6
5
5
0
9
1.0
1.2
0.0
0.0
1.4
0.0
2.4
4.0
0.0
3.4
0.8
0.0
0.0
8.4
2.4
7.4
3.6
5.0
4.8
0.0
2.6
8
0
1
1
1
0
0
0
0
1
1
0
3
0
0
4
2
3
3
0
7
0.3
0.0
1.1
0.8
0.7
0.0
0.0
0.0
0.0
1.7
0.8
0.0
3.9
0.0
0.0
1.6
1.2
3.0
2.9
0.0
2.0
2
0
0
0
0
0
1
0
0
0
0
0
0
0
0
5
1
1
1
0
1
0.1
0.0
0.0
0.0
0.0
0.0
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.0
0.6
1.0
1.0
0.0
0.3
1
0
0
0
0
13
0
0
1
0
0
0
0
0
0
0
16
0
5
0
0
0.0
0.0
0.0
0.0
0.0
17.2
0.0
0.0
6.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
9.7
0.0
4.8
0.0
0.0
458
24
41
15
91
2
38
5
1
11
31
51
13
11
23
57
50
62
20
12
53
16.0
28.0
43.5
12.2
61.6
2.7
30.4
10.0
6.8
18.8
25.1
49.3
16.8
10.3
18.4
23.3
30.4
61.9
19.1
27.7
15.4
753
4
2
9
18
10
5
19
3
2
8
9
1
29
1
34
54
53
20
6
66
26.3
4.7
2.1
7.3
12.2
13.3
4.0
38.1
20.4
3.4
6.5
8.7
1.3
27.0
0.8
13.9
32.8
52.9
19.1
13.9
19.2
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
29
1
0
0
2
2
0
3
1
0
0
1
0
0
0
0
0
4
1
1
0
0
2
1.3
1.1
0.0
0.0
1.1
1.9
0.0
2.1
1.5
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
1.9
0.5
2.3
0.0
0.0
2.7
66
1
0
7
5
0
0
4
0
14
2
17
6
0
2
17
1
11
2
0
0
1
0
2.9
1.1
0.0
5.6
2.7
0.0
0.0
2.8
0.0
6.5
2.8
9.1
6.9
0.0
3.9
8.7
0.6
5.3
1.0
0.0
0.0
2.2
0.0
27
0
0
2
1
0
3
1
2
0
0
7
0
0
0
0
0
1
1
0
0
1
4
1.2
0.0
0.0
1.6
0.5
0.0
1.7
0.7
3.0
0.0
0.0
3.8
0.0
0.0
0.0
0.0
0.0
0.5
0.5
0.0
0.0
2.2
5.4
10
2
0
1
7
0
5
0
0
5
0
0
0
0
0
2
0
0
0
0
0
0
0
0.4
2.2
0.0
0.8
3.8
0.0
2.8
0.0
0.0
2.3
0.0
0.0
0.0
0.0
0.0
1.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
35
0
0
1
12
4
10
7
0
1
4
15
1
0
1
34
0
0
2
0
2
0
8
1.5
0.0
0.0
0.8
6.5
3.9
5.5
4.9
0.0
0.5
5.7
8.1
1.1
0.0
1.9
17.4
0.0
0.0
1.0
0.0
4.4
0.0
10.7
611
12
0
15
36
19
34
24
37
61
4
69
12
13
6
57
21
28
55
9
13
12
18
26.4
13.2
0.0
12.0
19.5
18.5
18.8
16.7
54.6
28.1
5.7
37.0
13.8
27.0
11.7
29.1
11.9
13.4
26.6
21.0
28.5
26.0
24.1
353
49
0
10
67
3
40
62
22
72
8
68
19
15
39
57
106
13
28
29
17
43
88
15.3
54.0
0.0
8.0
36.2
2.9
22.1
43.1
32.5
33.2
11.3
36.5
21.8
31.2
75.9
29.1
60.0
6.2
13.6
67.7
37.2
93.2
118.0
IAP TOTAL
2556.1
18
0.7
90
3.5
23
0.9
22
0.9
102
4.0
555
21.7
855
33.4
PEACE CORPS TOTAL
7727.9
73
0.9
185
2.4
58
0.8
34
0.4
138
1.8
1624
21.0
1961
25.4
27

Country
VT
Years
Environmental
Health Concerns
No.
Rate
0
0.0
3
2.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
4
3.3
0
0.0
0
0.0
0
0.0
1
1.2
2
2.0
5
2.7
0
0.0
0
0.0
1
1.5
2
1.4
9
10.0
0
0.0
0
0.0
0
0.0
Febrile Illness
(Other)
No.
Rate
6
5.5
2
1.7
3
2.3
5
3.5
17
28.3
10
12.8
8
5.3
0
0.0
13
12.9
2
2.3
11
43.1
8
9.9
3
2.5
3
1.9
28
19.5
0
0.0
10
12.3
13
12.8
47
25.7
2
9.3
11
8.0
0
0.0
8
5.5
50
55.5
6
5.9
4
2.9
0
0.0
Filariasis
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
2
1.3
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Amebiasis
No.
Rate
39
36.0
0
0.0
28
21.3
17
11.8
0
0.0
4
5.1
0
0.0
2
44.8
1
1.0
0
0.0
0
0.0
3
3.7
0
0.0
72
46.0
0
0.0
0
0.0
119
145.9
3
3.0
54
29.5
0
0.0
0
0.0
0
0.0
4
2.8
5
5.6
24
23.5
8
5.8
0
0.0
Gastrointestinal Conditions
Intestinal
Giardiasis
Helminths
No.
Rate
No.
Rate
17
15.7
0
0.0
1
0.8
0
0.0
33
25.1
0
0.0
1
0.7
1
0.7
1
1.7
0
0.0
3
3.8
2
2.6
9
5.9
0
0.0
0
0.0
0
0.0
5
4.9
2
2.0
0
0.0
0
0.0
0
0.0
0
0.0
9
11.1
3
3.7
0
0.0
0
0.0
7
4.5
1
0.6
0
0.0
1
0.7
1
0.9
0
0.0
38
46.6
0
0.0
0
0.0
0
0.0
25
13.7
4
2.2
9
41.7
0
0.0
0
0.0
1
0.7
0
0.0
0
0.0
2
1.4
0
0.0
10
11.1
2
2.2
22
21.5
0
0.0
24
17.3
0
0.0
4
2.4
0
0.0
Salmonellosis
No.
Rate
0
0.0
1
0.8
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
4
2.2
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
27
0
7
0
0
0
21
0
0
1
1
0
0
0
2
3
1
28
3
0
8
0.9
0.0
7.4
0.0
0.0
0.0
16.8
0.0
0.0
1.7
0.8
0.0
0.0
0.0
1.6
1.2
0.6
27.9
2.9
0.0
2.3
270
3
36
0
3
3
0
0
6
0
3
4
0
22
1
19
10
18
9
1
1
9.4
3.5
38.2
0.0
2.0
4.0
0.0
0.0
40.8
0.0
2.4
3.9
0.0
20.5
0.8
7.8
6.1
18.0
8.6
2.3
0.3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
383
0
2
2
0
4
1
1
0
1
0
0
0
0
0
12
17
0
0
0
2
13.4
0.0
2.1
1.6
0.0
5.3
0.8
2.0
0.0
1.7
0.0
0.0
0.0
0.0
0.0
4.9
10.3
0.0
0.0
0.0
0.6
221
7
2
0
0
24
3
7
0
2
1
0
0
19
3
17
1
0
1
7
4
7.7
8.2
2.1
0.0
0.0
31.8
2.4
14.0
0.0
3.4
0.8
0.0
0.0
17.7
2.4
6.9
0.6
0.0
1.0
16.2
1.2
17
0
1
1
0
3
2
6
0
0
1
0
0
0
0
3
5
1
2
2
3
0.6
0.0
1.1
0.8
0.0
4.0
1.6
12.0
0.0
0.0
0.8
0.0
0.0
0.0
0.0
1.2
3.0
1.0
1.9
4.6
0.9
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
75
2
0
0
0
1
0
1
1
19
2
0
0
0
0
2
0
0
14
0
2
0
29
3.2
2.2
0.0
0.0
0.0
1.0
0.0
0.7
1.5
8.8
2.8
0.0
0.0
0.0
0.0
1.0
0.0
0.0
6.8
0.0
4.4
0.0
38.9
139
0
1
3
19
10
3
18
6
16
6
1
4
4
0
19
3
20
44
1
27
32
41
6.0
0.0
41.6
2.4
10.3
9.7
1.7
12.5
8.9
7.4
8.5
0.5
4.6
8.3
0.0
9.7
1.7
9.6
21.3
2.3
59.1
69.3
55.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
42
0
0
1
7
0
47
32
0
7
1
9
0
1
2
75
21
0
0
0
0
0
0
1.8
0.0
0.0
0.8
3.8
0.0
25.9
22.2
0.0
3.2
1.4
4.8
0.0
2.1
3.9
38.3
11.9
0.0
0.0
0.0
0.0
0.0
0.0
98
0
0
0
3
0
6
4
0
16
0
9
0
0
0
50
10
23
20
4
6
0
0
4.2
0.0
0.0
0.0
1.6
0.0
3.3
2.8
0.0
7.4
0.0
4.8
0.0
0.0
0.0
25.6
5.7
11.0
9.7
9.3
13.1
0.0
0.0
30
1
0
2
7
0
6
1
0
3
0
2
0
0
3
5
12
3
1
0
3
0
0
1.3
1.1
0.0
1.6
3.8
0.0
3.3
0.7
0.0
1.4
0.0
1.1
0.0
0.0
5.8
2.6
6.8
1.4
0.5
0.0
6.6
0.0
0.0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
1.1
0.0
0.0
0.0
0.0
0.0
0.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
IAP TOTAL
2556.1
73
2.9
278
10.9
0.0
203
7.9
151
5.9
49
1.9
0.1
PEACE CORPS TOTAL
7727.9
175
2.3
687
8.9
0.0
628
8.1
470
6.1
96
1.2
0.1
28

Gastrointestinal Conditions (continued)
Country
VT
Years
Shigellosis
No.
Rate
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
3
2.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Hepatitis
Bacterial
Diarrhea
No.
Rate
23
21.2
8
6.8
72
54.7
5
3.5
5
8.3
49
62.5
19
12.5
2
44.8
59
58.4
3
3.4
9
35.3
31
38.2
43
35.2
48
30.6
4
2.8
6
5.6
127
155.7
30
29.6
38
20.8
6
27.8
25
18.2
7
10.3
14
9.7
48
53.3
27
26.4
48
34.6
7
4.2
Viral
Diarrhea
No.
Rate
1
0.9
13
11.0
14
10.6
6
4.2
27
45.0
15
19.1
13
8.6
2
44.8
8
7.9
13
14.9
4
15.7
1
1.2
16
13.1
3
1.9
0
0.0
0
0.0
24
29.4
20
19.7
44
24.1
0
0.0
2
1.5
4
5.9
0
0.0
12
13.3
0
0.0
3
2.2
17
10.1
Other Diarrhea
No.
Rate
53
48.9
13
11.0
1
0.8
22
15.2
1
1.7
0
0.0
8
5.3
4
89.7
13
12.9
9
10.3
36
141.2
27
33.3
11
9.0
52
33.2
53
36.8
22
20.4
18
22.1
17
16.8
16
8.8
14
64.9
9
6.5
9
13.3
8
5.5
38
42.2
48
47.0
72
51.9
37
22.0
No.
133
36
148
53
34
73
49
10
88
25
49
74
73
183
58
29
326
70
185
29
37
20
28
115
121
155
65
Total GI
Rate
122.6
30.5
112.5
36.7
56.6
93.1
32.3
224.2
87.1
28.6
192.2
91.2
59.7
116.8
40.3
26.9
399.6
69.0
101.2
134.5
26.9
29.5
19.4
127.7
118.4
111.8
38.7
No.
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Rate
0.0
0.0
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
No.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Rate
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.0
0.0
0.0
763
12
1
15
3
45
23
16
0
2
2
26
0
15
24
29
47
4
10
8
9
26.7
14.0
1.1
12.2
2.0
59.6
18.4
32.1
0.0
3.4
1.6
25.1
0.0
14.0
19.2
11.9
28.5
4.0
9.5
18.5
2.6
262
0
23
15
20
8
15
0
14
0
3
8
1
10
23
40
11
19
10
30
25
9.2
0.0
24.4
12.2
13.5
10.6
12.0
0.0
95.2
0.0
2.4
7.7
1.3
9.3
18.4
16.3
6.7
19.0
9.5
69.3
7.3
611
7
43
1
5
0
0
15
4
24
43
12
3
2
6
51
5
43
3
10
50
21.4
8.2
45.6
0.8
3.4
0.0
0.0
30.1
27.2
41.0
34.8
11.6
3.9
1.9
4.8
20.8
3.0
42.9
2.9
23.1
14.5
2266
26
72
34
28
84
44
45
18
29
50
46
4
46
56
152
86
67
27
57
93
79.3
30.3
76.4
27.7
18.9
111.3
35.2
90.2
122.3
49.5
40.4
44.5
5.2
42.9
44.8
62.1
52.2
66.8
25.7
131.7
27.0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
291
1
0
6
31
0
76
76
4
44
0
93
0
2
7
102
9
39
48
12
19
1
5
12.6
1.1
0.0
4.8
16.8
0.0
41.9
52.8
5.9
20.3
0.0
49.9
0.0
4.2
13.6
52.1
5.1
18.7
23.2
28.0
41.6
2.2
6.7
275
1
0
11
24
0
0
27
1
7
0
27
0
0
7
25
1
23
83
6
0
38
28
11.9
1.1
0.0
8.8
13.0
0.0
0.0
18.7
1.5
3.2
0.0
14.5
0.0
0.0
13.6
12.8
0.6
11.0
40.2
14.0
0.0
82.4
37.5
327
33
0
17
41
8
2
31
33
128
33
18
7
21
1
15
81
20
6
0
3
1
33
14.1
36.4
0.0
13.6
22.2
7.8
1.1
21.5
48.7
59.0
46.7
9.7
8.0
43.7
1.9
7.7
45.8
9.6
2.9
0.0
6.6
2.2
44.2
1064
37
0
37
114
8
137
172
38
205
34
158
7
24
20
272
134
108
158
22
31
40
66
46.0
40.8
0.0
29.6
61.7
7.8
75.6
119.4
56.1
94.6
48.1
84.8
8.0
49.9
38.9
139.1
75.8
51.6
76.5
51.4
67.9
86.7
88.5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
IAP TOTAL
2556.1
0.0
575
22.5
309
12.1
532
20.8
1822
71.3
0.0
0.0
PEACE CORPS TOTAL
7727.9
0.1
1629
21.1
846
10.9
1470
19.0
5152
66.7
0.0
0.0
29

Hepatitis (continued)
Country
VT
Years
C
Rate
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
Injury (Unintentional)
Other or
Presumed
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Hospitalization
(In-Country)
No.
Rate
1
0.9
3
2.5
14
10.6
10
6.9
0
0.0
0
0.0
0
0.0
0
0.0
18
17.8
6
6.9
0
0.0
3
3.7
2
1.6
3
1.9
4
2.8
3
2.8
5
6.1
0
0.0
3
1.6
0
0.0
6
4.4
5
7.4
3
2.1
1
1.1
2
2.0
6
4.3
4
2.4
Pedestrian
No.
Rate
1
0.9
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
8
7.9
0
0.0
1
3.9
9
11.1
0
0.0
9
5.7
0
0.0
0
0.0
0
0.0
3
3.0
6
3.3
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
0
0.0
1
0.7
0
0.0
No.
0
0
18
4
0
0
0
0
2
0
0
0
2
3
0
0
1
3
2
2
0
0
0
0
4
5
6
Bicycle
Rate
0.0
0.0
13.7
2.8
0.0
0.0
0.0
0.0
2.0
0.0
0.0
0.0
1.6
1.9
0.0
0.0
1.2
3.0
1.1
9.3
0.0
0.0
0.0
0.0
3.9
3.6
3.6
Motorcycle
No.
Rate
3
2.8
0
0.0
0
0.0
6
4.2
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
3
3.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.0
0
0.0
0
0.0
Motor Vehicle
No.
Rate
3
2.8
3
2.5
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
1
1.0
0
0.0
0
0.0
1
1.2
0
0.0
1
0.6
2
1.4
1
0.9
0
0.0
1
1.0
2
1.1
0
0.0
4
2.9
1
1.5
0
0.0
0
0.0
7
6.8
0
0.0
5
3.0
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
No.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0.0
0.0
0.0
0.0
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.3
0.0
102
2
0
4
6
2
0
2
1
4
2
1
2
0
3
1
39
0
18
0
6
3.6
2.3
0.0
3.3
4.1
2.7
0.0
4.0
6.8
6.8
1.6
1.0
2.6
0.0
2.4
0.4
23.7
0.0
17.2
0.0
1.7
40
1
0
0
1
3
0
0
0
0
0
0
2
9
0
0
0
12
0
0
1
1.4
1.2
0.0
0.0
0.7
4.0
0.0
0.0
0.0
0.0
0.0
0.0
2.6
8.4
0.0
0.0
0.0
12.0
0.0
0.0
0.3
52
0
0
0
1
5
1
0
0
0
0
0
0
0
0
0
0
0
3
0
0
1.8
0.0
0.0
0.0
0.7
6.6
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.9
0.0
0.0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
33
0
0
1
0
1
0
0
0
2
1
1
0
1
0
2
2
0
0
0
0
1.2
0.0
0.0
0.8
0.0
1.3
0.0
0.0
0.0
3.4
0.8
1.0
0.0
0.9
0.0
0.8
1.2
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
93
4
0
3
8
4
3
24
3
34
2
16
3
1
2
18
28
12
1
1
0
5
2
4.0
4.4
0.0
2.4
4.3
3.9
1.7
16.7
4.4
15.7
2.8
8.6
3.4
2.1
3.9
9.2
15.8
5.7
0.5
2.3
0.0
10.8
2.7
29
8
0
1
1
0
2
0
0
2
0
1
2
0
0
9
3
4
1
0
0
0
0
1.3
8.8
0.0
0.8
0.5
0.0
1.1
0.0
0.0
0.9
0.0
0.5
2.3
0.0
0.0
4.6
1.7
1.9
0.5
0.0
0.0
0.0
0.0
10
1
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
1
0
3
0
3
0
0.4
1.1
0.0
0.0
0.0
0.0
0.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.9
0.0
0.0
0.5
0.0
7.0
0.0
6.5
0.0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
11
0
0
0
1
0
3
0
1
3
0
0
0
0
0
0
0
0
0
1
0
0
0
0.5
0.0
0.0
0.0
0.5
0.0
1.7
0.0
1.5
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.3
0.0
0.0
0.0
IAP TOTAL
2556.1
0.0
0.0
174
6.8
34
1.3
10
0.4
0.0
0.4
PEACE CORPS TOTAL
7727.9
0.0
0.0
369
4.8
103
1.3
72
0.9
14
0.2
53
0.7
30

Injury (Unintentional)
Country
VT
Years
Water-Related
No.
Rate
1
0.9
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
3.9
2
2.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.0
1
0.5
0
0.0
0
0.0
0
0.0
0
0.0
2
2.2
0
0.0
1
0.7
0
0.0
No.
0
1
6
0
3
0
1
0
4
0
2
1
0
2
3
0
1
0
13
1
6
1
2
6
1
1
2
Sports
Rate
0.0
0.8
4.6
0.0
5.0
0.0
0.7
0.0
4.0
0.0
7.8
1.2
0.0
1.3
2.1
0.0
1.2
0.0
7.1
4.6
4.4
1.5
1.4
6.7
1.0
0.7
1.2
Other Injury
No.
Rate
15
13.8
10
8.5
5
3.8
4
2.8
6
10.0
6
7.7
1
0.7
1
22.4
14
13.9
0
0.0
2
7.8
2
2.5
6
4.9
5
3.2
11
7.6
27
25.0
6
7.4
20
19.7
11
6.0
0
0.0
7
5.1
10
14.7
4
2.8
8
8.9
2
2.0
6
4.3
1
0.6
Alcohol-Related
No.
Rate
0
0.0
1
0.8
1
0.8
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
2
7.8
0
0.0
1
0.8
0
0.0
1
0.7
1
0.9
0
0.0
1
1.0
2
1.1
0
0.0
2
1.5
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
Total Injury
No.
Rate
23
21.2
14
11.9
29
22.0
14
9.7
9
15.0
6
7.7
4
2.6
1
22.4
29
28.7
0
0.0
6
23.5
15
18.5
8
6.5
20
12.8
16
11.1
28
25.9
8
9.8
31
30.6
35
19.1
3
13.9
17
12.4
12
17.7
7
4.8
16
17.8
15
14.7
14
10.1
14
8.3
Leishmaniasis
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
79.0
84.3
101.9
142.6
54.9
92.8
15.4
4.0
50.9
126.0
110.0
78.0
119.6
115.6
229.4
122.4
127.6
99.2
71.3
4.0
274.2
79.0
84.3
101.9
142.6
54.9
92.8
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2658.6
15.4
50.9
126.0
110.0
78.0
119.6
115.6
4.0
229.4
122.4
127.6
99.2
71.3
274.2
79.0
84.3
101.9
142.6
54.9
92.8
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
3.6
0.0
0.0
0.0
0.0
57
7
1
7
9
1
5
4
1
1
1
8
7
5
12
5
9
1
2
1
7
2.0
8.2
1.1
5.7
6.1
1.3
4.0
8.0
6.8
1.7
0.8
7.7
9.0
4.7
9.6
2.0
5.5
1.0
1.9
2.3
2.0
190
4
5
18
16
7
4
12
1
2
23
10
0
6
13
40
6
21
15
0
41
6.6
4.7
5.3
14.6
10.8
9.3
3.2
24.1
6.8
3.4
18.6
9.7
0.0
5.6
10.4
16.3
3.6
21.0
14.3
0.0
11.9
14
0
0
0
0
0
0
0
0
0
0
0
1
1
5
0
0
0
0
0
0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.3
0.9
4.0
0.0
0.0
0.0
0.0
0.0
0.0
394
12
6
26
27
17
10
16
2
5
25
19
9
21
25
47
23
34
20
1
49
13.8
14.0
6.4
21.2
18.3
22.5
8.0
32.1
13.6
8.5
20.2
18.4
11.6
19.6
20.0
19.2
14.0
33.9
19.1
2.3
14.2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2099.1
15.4
4.0
50.9
126.0
110.0
78.0
119.6
115.6
229.4
122.4
127.6
99.2
71.3
274.2
158.2
159.5
160.7
161.9
163.1
164.3
165.5
4.0
6
0
0
0
1
0
0
1
0
1
0
1
0
1
1
0
0
0
0
0
0
4
5
0.3
0.0
0.0
0.0
0.5
0.0
0.0
0.7
0.0
0.5
0.0
0.5
0.0
2.1
1.9
0.0
0.0
0.0
0.0
0.0
0.0
8.7
6.7
94
2
0
7
2
2
8
16
1
20
0
9
2
0
2
14
4
0
6
3
1
0
8
4.1
2.2
0.0
5.6
1.1
1.9
4.4
11.1
1.5
9.2
0.0
4.8
2.3
0.0
3.9
7.2
2.3
0.0
2.9
7.0
2.2
0.0
10.7
244
10
1
4
6
10
0
25
0
62
2
36
7
5
1
2
6
30
1
1
1
5
33
10.5
11.0
41.6
3.2
3.2
9.7
0.0
17.4
0.0
28.6
2.8
19.3
8.0
10.4
1.9
1.0
3.4
14.3
0.5
2.3
2.2
10.8
44.2
7
0
0
0
1
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0.3
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
394
21
1
12
12
12
14
42
2
88
2
47
11
6
5
25
13
35
8
8
2
12
46
17.0
23.2
41.6
9.6
6.5
11.7
7.7
29.2
3.0
40.6
2.8
25.2
12.6
12.5
9.7
12.8
7.4
16.7
3.9
18.7
4.4
26.0
61.7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.3
0.0
0.0
0.0
0.0
0.0
0.0
IAP TOTAL
2680.7
15
0.6
107
4.2
248
9.7
0.2
424
16.6
0.2
PEACE CORPS TOTAL
7438.4
30
0.4
258
3.3
682
8.8
25
0.3
1212
15.7
0.1
31

Malaria (by type)
Country
Malaria
Years
NonFalciparum
No.
Rate
0
0.0
0
0.0
0
0.0
5
3.5
0
0.0
0
0.0
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
Malaria (by prophylaxis)

Presumptive
No.
Rate
9
8.3
1
0.8
1
0.8
7
4.8
0
0.0
1
1.3
17
11.2
2
44.8
7
6.9
0
0.0
3
11.8
5
6.2
2
1.6
11
7.0
0
0.0
0
0.0
2
2.5
3
3.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.0
9
6.5
32
19.1
on
Mefloquine
No.
Rate
4
3.7
1
0.8
1
0.8
24
16.6
0
0.0
1
1.3
13
8.6
1
22.4
1
1.0
0
0.0
3
11.8
3
3.7
1
0.8
15
9.6
2
1.4
0
0.0
4
4.9
3
3.0
0
0.0
0
0.0
1
0.7
0
0.0
2
1.4
0
0.0
1
1.0
1
0.7
24
14.3
on
Chloroquine
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.6
on
Doxycycline
No.
Rate
8
7.4
0
0.0
3
2.3
4
2.8
0
0.0
1
1.3
6
4.0
1
22.4
7
6.9
0
0.0
1
3.9
2
2.5
6
4.9
5
3.2
2
1.4
0
0.0
2
2.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
4
3.9
13
9.4
8
4.8
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
0.0
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2771.6
0.0
0.0
122.9
0.0
75.5
124.9
49.9
14.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
164.6
0.0
104.9
0.0
0.0
69
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
113
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
106
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
73
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
189
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
657.4
90.7
2.4
124.9
184.8
0.0
181.3
144.0
0.0
216.8
70.7
186.3
87.0
48.1
0.0
195.6
176.7
209.1
206.6
0.0
45.7
0.0
74.6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.3
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.7
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
4.0
IAP TOTAL
2245.2
0.0
0.1
0.0
0.1
0.1
0.0
0.0
0.2
PEACE CORPS TOTAL
5674.2
70
1.2
10
0.2
114
2.0
108
1.9
0.1
74
1.3
0.2
194
2.5
32
on Malarone
No.
Rate
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.6
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
6
3.6
Total
Malaria
No.
Rate
12
11.1
1
0.8
4
3.0
29
20.1
0
0.0
2
2.6
19
12.5
2
44.8
8
7.9
0
0.0
4
15.7
5
6.2
7
5.7
21
13.4
4
2.8
0
0.0
6
7.4
3
3.0
0
0.0
0
0.0
1
0.7
0
0.0
2
1.4
0
0.0
5
4.9
15
10.8
39
23.2
Falciparum
No.
Rate
3
2.8
0
0.0
3
2.3
17
11.8
0
0.0
1
1.3
1
0.7
0
0.0
1
1.0
0
0.0
1
3.9
0
0.0
5
4.1
10
6.4
4
2.8
0
0.0
4
4.9
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
2
1.4
0
0.0
4
3.9
5
3.6
7
4.2

Ave. Monthly Antimalaria Chemoprophylaxis
Country
Malaria
Years
Mefloquine
Ave. No.
%
67.4
61%
76.3
66%
87.8
72%
109.3
74%
19.4
87%
48.0
60%
118.3
80%
10.5
72%
52.8
50%
0.0
23.3
96%
55.0
65%
77.3
63%
112.8
73%
111.3
73%
67.0
61%
59.1
72%
90.0
83%
141.3
76%
34.5
95%
11.6
44%
55.5
78%
101.1
71%
78.1
90%
61.2
59%
63.3
46%
107.3
63%
Chloroquin
Ave. No.
%
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
-
Doxycycline
Ave. No.
%
41.42
38%
39.33
34%
30.00
25%
35.50
24%
3.00
13%
29.83
37%
29.58
20%
3.00
21%
26.75
25%
0.00
1.08
4%
23.67
28%
39.25
32%
36.42
24%
34.50
23%
39.33
36%
17.08
21%
17.67
16%
39.58
21%
2.00
5%
13.92
53%
7.67
11%
40.25
28%
5.33
6%
38.08
37%
59.58
44%
46.92
28%
Malarone
Ave. No.
%
1.6
1%
0.3
0%
4.0
3%
2.0
1%
0.0
1.4
2%
0.9
1%
1.0
7%
25.4
24%
0.0
0.0
6.5
8%
5.5
5%
4.4
3%
6.3
4%
4.2
4%
5.8
7%
1.1
1%
4.8
3%
0.0
0.6
2%
7.6
11%
0.7
0%
3.6
4%
4.8
5%
13.9
10%
15.8
9%
Other
(Minocycline)
Ave. No.
%
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.33
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.00
0.0
0.08
0.0
Any Prophylaxis
Ave. No.
Ave. Rate
110.4
101.8
115.9
98.3
121.8
92.5
146.8
101.6
22.4
37.3
79.6
101.5
148.8
98.1
14.5
325.1
104.9
103.8
0.0
0.0
24.4
95.8
85.2
104.9
122.0
99.8
153.7
98.1
152.0
105.7
110.5
102.3
82.0
100.5
108.8
107.2
185.6
101.5
36.5
169.3
26.1
19.0
70.8
104.3
142.0
98.3
87.0
96.6
104.1
101.8
136.8
98.7
170.1
101.3
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
0.0
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2771.6
0.0
0.0
122.9
0.0
75.5
124.9
49.9
14.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
164.6
0.0
104.9
0.0
0.0
70.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
17.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
5.1
0.0
0.0
0.0
0.0
69%
95%
3%
-
0.00
0.00
0.00
8.17
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
155.83
0.00
0.00
0.00
0.00
93%
92%
-
27.10
0.00
0.00
0.58
0.00
80.58
0.00
0.00
1.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
7.50
0.00
0.00
0.00
0.00
26%
7%
100%
5%
4%
-
4.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
5%
0.3%
-
0.02
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
102.3
0.0
0.0
8.8
0.0
80.6
0.0
0.0
18.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
168.9
0.0
0.0
0.0
0.0
99.7
0.0
0.0
7.1
0.0
106.8
0.0
0.0
124.6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
102.6
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
657.4
90.7
2.4
124.9
184.8
0.0
181.3
144.0
0.0
216.8
70.7
186.3
87.0
48.1
0.0
195.6
176.7
209.1
206.6
0.0
45.7
0.0
74.6
0.9
0.0
0.0
0.0
0.0
0.0
72.3
0.0
0.0
0.0
41.3
0.0
0.0
0.0
0.0
0.0
24.3
0.0
0.0
0.0
18.9
0.0
50.8
7%
75%
58%
14%
61%
67%
8.30
76.17
0.00
77.92
177.50
0.00
0.00
140.25
0.00
202.50
0.00
181.92
0.00
0.00
0.00
194.33
137.67
0.00
7.33
0.00
0.00
0.00
0.00
60%
95%
96%
94%
98%
95%
97%
94%
77%
100%
-
4.53
4.33
0.00
3.58
11.00
0.00
24.33
2.92
0.00
11.75
15.08
4.83
0.00
0.00
0.00
11.92
16.17
0.00
0.00
0.00
6.92
0.00
23.67
33%
5%
4%
6%
25%
2%
5%
21%
3%
6%
9%
22%
31%
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
14.3
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
5.4
0.0
0.0
0.2%
20%
17%
-
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1.33
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
13.8
80.5
0.0
81.5
188.5
0.0
96.6
143.2
0.0
214.3
70.6
186.8
0.0
0.0
0.0
206.3
178.1
0.0
7.3
0.0
31.3
0.0
75.8
41.9
88.8
0.0
65.3
102.0
0.0
53.3
99.4
0.0
98.8
99.8
100.2
0.0
0.0
0.0
105.4
100.8
0.0
3.5
0.0
68.4
0.0
101.7
IAP TOTAL
2245.2
9.8
13%
56.26
77%
6.42
9%
0.9
1%
0.06
0.0
73.4
72.0
PEACE CORPS TOTAL
5674.2
30.6
46%
20.44
30%
13.91
21%
2.2
3%
0.10
0.0
67.3
41.5
33

Medevac
Country
VT
Years
Home of Record
No.
Rate
1
0.9
0
0.0
1
0.8
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.1
2
7.8
0
0.0
1
0.8
3
1.9
0
0.0
2
1.9
3
3.7
0
0.0
0
0.0
0
0.0
0
0.0
1
1.5
1
0.7
0
0.0
3
2.9
0
0.0
0
0.0
DC
No.
6
0
1
1
1
4
2
0
0
5
0
0
1
4
3
2
0
5
5
0
0
1
1
7
4
3
1
Rate
5.5
0.0
0.8
0.7
1.7
5.1
1.3
0.0
0.0
5.7
0.0
0.0
0.8
2.6
2.1
1.9
0.0
4.9
2.7
0.0
0.0
1.5
0.7
7.8
3.9
2.2
0.6
Mental Health Issues
US Total
No.
Rate
7
6.5
0
0.0
2
1.5
1
0.7
1
1.7
4
5.1
2
1.3
0
0.0
0
0.0
6
6.9
2
7.8
0
0.0
2
1.6
7
4.5
3
2.1
4
3.7
3
3.7
5
4.9
5
2.7
0
0.0
0
0.0
2
2.9
2
1.4
7
7.8
7
6.8
3
2.2
1
0.6
Regional Total
No.
Rate
4
3.7
5
4.2
1
0.8
7
4.8
0
0.0
4
5.1
2
1.3
1
22.4
2
2.0
6
6.9
0
0.0
1
1.2
1
0.8
4
2.6
3
2.1
2
1.9
5
6.1
11
10.8
0
0.0
0
0.0
0
0.0
14
20.6
3
2.1
7
7.8
6
5.9
8
5.8
13
7.7
Total Medevacs
No.
Rate
11
10.1
5
4.2
3
2.3
8
5.5
1
1.7
8
10.2
4
2.6
1
22.4
2
2.0
12
13.7
2
7.8
1
1.2
3
2.5
11
7.0
6
4.2
6
5.6
8
9.8
16
15.8
5
2.7
0
0.0
0
0.0
16
23.6
5
3.5
14
15.6
13
12.7
11
7.9
14
8.3
Accommodated
Condition
No.
Rate
1
0.9
6
5.1
2
1.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
14
13.9
2
2.3
0
0.0
2
2.5
2
1.6
1
0.6
2
1.4
2
1.9
0
0.0
0
0.0
0
0.0
0
0.0
2
1.5
0
0.0
3
2.1
0
0.0
1
1.0
2
1.4
0
0.0
Adjustment Issue
No.
Rate
1
0.9
17
14.4
16
12.2
1
0.7
2
3.3
9
11.5
5
3.3
0
0.0
35
34.6
14
16.0
1
3.9
5
6.2
13
10.6
10
6.4
13
9.0
0
0.0
6
7.4
32
31.5
6
3.3
0
0.0
5
3.6
12
17.7
5
3.5
7
7.8
14
13.7
7
5.0
1
0.6
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
19
1
0
0
0
0
0
2
0
0
2
1
1
0
1
2
2
2
2
1
2
0.7
1.2
0.0
0.0
0.0
0.0
0.0
4.0
0.0
0.0
1.6
1.0
1.3
0.0
0.8
0.8
1.2
2.0
1.9
2.3
0.6
57
0
0
0
0
0
3
1
0
1
3
3
3
1
1
2
3
1
0
0
9
2.0
0.0
0.0
0.0
0.0
0.0
2.4
2.0
0.0
1.7
2.4
2.9
3.9
0.9
0.8
0.8
1.8
1.0
0.0
0.0
2.6
76
1
0
0
0
0
3
3
0
1
5
4
4
1
2
4
5
3
2
1
11
2.7
1.2
0.0
0.0
0.0
0.0
2.4
6.0
0.0
1.7
4.0
3.9
5.2
0.9
1.6
1.6
3.0
3.0
1.9
2.3
3.2
110
3
0
2
2
5
2
0
0
0
3
2
0
0
9
0
0
0
0
2
3
3.8
3.5
0.0
1.6
1.4
6.6
1.6
0.0
0.0
0.0
2.4
1.9
0.0
0.0
7.2
0.0
0.0
0.0
0.0
4.6
0.9
186
4
0
2
2
5
5
3
0
1
8
6
4
1
11
4
5
3
2
3
14
6.5
4.7
0.0
1.6
1.4
6.6
4.0
6.0
0.0
1.7
6.5
5.8
5.2
0.9
8.8
1.6
3.0
3.0
1.9
6.9
4.1
42
0
6
0
4
0
0
0
0
4
7
1
4
3
2
8
14
4
6
0
4
1.5
0.0
6.4
0.0
2.7
0.0
0.0
0.0
0.0
6.8
5.7
1.0
5.2
2.8
1.6
3.3
8.5
4.0
5.7
0.0
1.2
237
3
2
6
7
8
11
0
5
2
13
2
5
5
15
29
10
9
3
11
18
8.3
3.5
2.1
4.9
4.7
10.6
8.8
0.0
34.0
3.4
10.5
1.9
6.4
4.7
12.0
11.9
6.1
9.0
2.9
25.4
5.2
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
19
1
0
1
1
0
2
0
0
5
0
1
1
0
1
6
1
1
2
0
0
0
0
0.8
1.1
0.0
0.8
0.5
0.0
1.1
0.0
0.0
2.3
0.0
0.5
1.1
0.0
1.9
3.1
0.6
0.5
1.0
0.0
0.0
0.0
0.0
31
2
0
2
2
2
9
3
2
2
4
5
1
0
0
5
3
2
5
0
1
1
0
1.3
2.2
0.0
1.6
1.1
1.9
5.0
2.1
3.0
0.9
5.7
2.7
1.1
0.0
0.0
2.6
1.7
1.0
2.4
0.0
2.2
2.2
0.0
50
3
0
3
3
2
11
3
2
7
4
6
2
0
1
11
4
3
7
0
1
1
0
2.2
3.3
0.0
2.4
1.6
1.9
6.1
2.1
3.0
3.2
5.7
3.2
2.3
0.0
1.9
5.6
2.3
1.4
3.4
0.0
2.2
2.2
0.0
33
2
0
0
0
0
0
0
4
0
3
4
0
0
5
0
0
0
2
2
1
7
6
1.4
2.2
0.0
0.0
0.0
0.0
0.0
0.0
5.9
0.0
4.2
2.1
0.0
0.0
9.7
0.0
0.0
0.0
1.0
4.7
2.2
15.2
8.0
83
5
0
3
3
2
11
3
6
7
7
10
2
0
6
11
4
3
9
2
2
8
6
3.6
5.5
0.0
2.4
1.6
1.9
6.1
2.1
8.9
3.2
9.9
5.4
2.3
0.0
11.7
5.6
2.3
1.4
4.4
4.7
4.4
17.3
8.0
67
3
0
1
4
0
0
2
0
2
1
6
5
1
0
4
0
2
5
0
1
0
2
2.9
3.3
0.0
0.8
2.2
0.0
0.0
1.4
0.0
0.9
1.4
3.2
5.7
2.1
0.0
2.0
0.0
1.0
2.4
0.0
2.2
0.0
2.7
164
2
1
4
14
0
4
16
0
1
1
22
0
0
3
46
1
23
3
3
0
2
6
7.1
2.2
41.6
3.2
7.6
0.0
2.2
11.1
0.0
0.5
1.4
11.8
0.0
0.0
5.8
23.5
0.6
11.0
1.5
7.0
0.0
4.3
8.0
IAP TOTAL
2556.1
23
0.9
51
2.0
74
2.9
36
1.4
110
4.3
39
1.5
152
5.9
PEACE CORPS TOTAL
7727.9
61
0.8
139
1.8
200
2.6
179
2.3
379
4.9
148
1.9
553
7.2
34

Mental Health Issues (continued)
Country
VT
Years
Total Mental
Health Issues
No.
Rate
16
14.8
36
30.5
22
16.7
5
3.5
2
3.3
9
11.5
9
5.9
0
52
51.5
26
29.8
19
74.5
10
12.3
19
15.5
16
10.2
16
11.1
10
9.3
22
27.0
47
46.3
15
8.2
3
13.9
19
13.8
21
31.0
16
11.1
47
52.2
23
22.5
35
25.2
22
13.1
New
Accommodated
Condition
No.
Rate
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2.9
1
0.7
0
0
0
0
-
Pre-Service Accommodations
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
Other Mental
Health Issue
No.
Rate
14
12.9
13
11.0
4
3.0
4
2.8
0
0
4
2.6
0
3
3.0
10
11.4
18
70.6
3
3.7
4
3.3
5
3.2
1
0.7
8
7.4
16
19.6
15
14.8
9
4.9
3
13.9
12
8.7
9
13.3
8
5.5
40
44.4
8
7.8
26
18.8
21
12.5
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
258
9
6
0
10
2
16
5
0
7
0
95
5
20
8
6
4
8
5
2
31
9.0
10.5
6.4
6.8
2.7
12.8
10.0
11.9
91.9
6.4
18.6
6.4
2.5
2.4
8.0
4.8
4.6
9.0
537
12
14
6
21
10
27
5
5
13
20
98
14
28
25
43
28
21
14
13
53
18.8
14.0
14.9
4.9
14.2
13.3
21.6
10.0
34.0
22.2
16.2
94.8
18.0
26.1
20.0
17.6
17.0
21.0
13.3
30.0
15.4
3
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0.1
0.8
0.4
0.6
-
391
12
29
37
34
0
22
4
0
29
11
14
25
24
13
65
56
31
38
10
106
13.7
14.0
30.8
30.1
23.0
17.6
8.0
49.5
8.9
13.5
32.2
22.4
10.4
26.6
34.0
30.9
36.2
23.1
30.8
156
8
8
13
18
0
13
1
0
9
6
4
5
12
6
18
16
5
5
4
31
5.5
9.3
8.5
10.6
12.2
10.4
2.0
15.4
4.9
3.9
6.4
11.2
4.8
7.4
9.7
5.0
4.8
9.2
9.0
2
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
3
2
3
0
0
0.1
3.4
1.8
2.0
2.9
-
36
1
3
5
3
0
1
0
0
0
1
0
3
3
1
3
13
5
6
0
9
1.3
1.2
3.2
4.1
2.0
0.8
0.8
3.9
2.8
0.8
1.2
7.9
5.0
5.7
2.6
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
239
2
0
1
9
1
4
49
5
59
5
11
9
0
3
9
1
5
0
5
7
0
16
10.3
2.2
0.8
4.9
1.0
2.2
34.0
7.4
27.2
7.1
5.9
10.3
5.8
4.6
0.6
2.4
11.7
15.3
21.5
470
7
1
6
27
1
8
67
5
62
7
39
14
1
6
59
2
30
8
8
8
2
24
20.3
7.7
41.6
4.8
14.6
1.0
4.4
46.5
7.4
28.6
9.9
20.9
16.1
2.1
11.7
30.2
1.1
14.3
3.9
18.7
17.5
4.3
32.2
3
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0.1
1.4
1.1
-
560
37
1
36
46
38
34
26
11
47
10
13
33
21
6
24
33
26
37
5
10
1
9
24.2
40.8
41.6
28.8
24.9
36.9
18.8
18.1
16.2
21.7
14.1
7.0
37.9
43.7
11.7
12.3
18.7
12.4
17.9
11.7
21.9
2.2
12.1
182
9
0
6
19
3
13
8
5
15
4
6
8
6
2
7
10
9
16
3
2
0
4
7.9
9.9
4.8
10.3
2.9
7.2
5.6
7.4
6.9
5.7
3.2
9.2
12.5
3.9
3.6
5.7
4.3
7.7
7.0
4.4
5.4
10
0
0
0
1
0
0
1
0
1
0
0
3
1
0
0
0
2
0
0
0
0
0
0.4
0.5
0.7
0.5
3.4
2.1
1.0
-
57
8
0
6
3
2
0
2
0
7
4
3
1
3
0
0
8
3
1
0
4
0
2
2.5
8.8
4.8
1.6
1.9
1.4
3.2
5.7
1.6
1.1
6.2
4.5
1.4
0.5
8.8
2.7
IAP TOTAL
2556.1
201
7.9
392
15.3
0.2
504
19.7
155
6.1
0.4
57
2.2
PEACE CORPS TOTAL
7727.9
698
9.0
1399
18.1
10
0.1
1455
18.8
493
6.4
21
0.3
150
1.9
35
Total
Accommodations
No.
Rate
16
14.8
31
26.3
14
10.6
10
6.9
3
5.0
0
31
20.4
1
22.4
20
19.8
13
14.9
3
11.8
8
9.9
14
11.5
8
5.1
4
2.8
12
11.1
18
22.1
6
5.9
13
7.1
0
44
32.0
30
44.2
37
25.6
1
1.1
15
14.7
17
12.3
22
13.1
8b
8a
No.
9
10
10
7
0
0
12
1
8
2
0
4
8
6
1
0
10
0
1
0
12
2
16
0
10
8
19
Rate
8.3
8.5
7.6
4.8
7.9
22.4
7.9
2.3
4.9
6.5
3.8
0.7
12.3
0.5
8.7
2.9
11.1
9.8
5.8
11.3
No.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
Rate
1.5
-
No.
1
6
1
1
2
0
3
0
3
1
0
2
1
0
0
3
0
0
1
0
4
5
1
0
0
1
0
MACs
Rate
0.9
5.1
0.8
0.7
3.3
2.0
3.0
1.1
2.5
0.8
2.8
0.5
2.9
7.4
0.7
0.7
-
Country
VT
Years
Female
VT
Years
Pregnancy
No.
Rate
0
0.0
1
1.2
0
0.0
0
0.0
0
0.0
1
2.3
0
0.0
0
0.0
1
1.8
1
1.8
0
0.0
0
0.0
1
1.4
0
0.0
0
0.0
0
0.0
0
0.0
1
1.3
0
0.0
0
0.0
1
1.2
0
0.0
1
1.1
1
1.7
0
0.0
0
0.0
0
0.0
Sexually Transmitted Disease (non-HIV)
Other
Gynecological
Infections
No.
Rate
9
12.9
19
22.7
3
3.7
9
9.5
2
7.0
2
4.7
5
6.6
0
0.0
2
3.6
3
5.4
1
8.3
6
9.5
4
5.8
14
15.3
26
26.0
5
7.1
7
12.4
13
17.4
12
11.3
4
32.3
0
0.0
0
0.0
2
2.2
7
11.8
0
0.0
12
16.1
4
3.8
Confirmed
Bacterial
No.
Rate
0
0.0
1
0.8
0
0.0
0
0.0
1
1.7
0
0.0
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.9
3
3.7
1
1.0
0
0.0
0
0.0
6
4.4
2
2.9
0
0.0
5
5.6
6
5.9
2
1.4
1
0.6
Presumed
Bacteria
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
0
0.0
1
1.0
0
0.0
3
11.8
1
1.2
0
0.0
0
0.0
2
1.4
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
2
2.9
6
4.2
2
2.2
0
0.0
1
0.7
0
0.0
No.
0
1
0
3
0
0
3
0
0
0
0
2
1
1
5
1
0
10
0
0
1
0
0
4
3
3
0
Viral
Rate
0.0
0.8
0.0
2.1
0.0
0.0
2.0
0.0
0.0
0.0
0.0
2.5
0.8
0.6
3.5
0.9
0.0
9.9
0.0
0.0
0.7
0.0
0.0
4.4
2.9
2.2
0.0
No.
0
2
0
3
1
0
5
0
1
0
3
3
1
1
7
2
3
11
0
0
7
4
6
11
9
6
1
Total
Rate
0.0
1.7
0.0
2.1
1.7
0.0
3.3
0.0
1.0
0.0
11.8
3.7
0.8
0.6
4.9
1.9
3.7
10.8
0.0
0.0
5.1
5.9
4.2
12.2
8.8
4.3
0.6
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
69.7
83.5
80.1
94.7
28.4
42.8
75.2
2.4
56.1
55.1
12.0
63.2
69.3
91.7
99.9
70.4
56.3
74.6
106.0
12.4
86.4
43.0
89.4
59.1
65.0
74.7
105.5
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
1766.9
53.4
46.4
83.8
79.4
44.0
67.1
26.8
9.6
35.6
73.2
52.8
50.4
58.1
63.6
139.2
99.3
62.3
62.8
26.8
216.5
9
0
0
0
0
0
0
0
0
0
1
0
0
2
0
0
0
0
0
0
1
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.4
0.0
0.0
3.4
0.0
0.0
0.0
0.0
0.0
0.0
0.5
171
0
0
0
11
5
2
8
0
0
7
11
0
12
6
20
6
21
8
0
30
9.7
0.0
0.0
0.0
13.8
11.4
3.0
29.9
0.0
0.0
9.6
20.8
0.0
20.6
9.4
14.4
6.0
33.7
12.7
0.0
13.9
30
0
3
0
0
3
4
0
0
0
1
0
0
0
1
13
4
6
1
1
1
1.0
0.0
3.2
0.0
0.0
4.0
3.2
0.0
0.0
0.0
0.8
0.0
0.0
0.0
0.8
5.3
2.4
6.0
1.0
2.3
0.3
19
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
3
0
1
2
1
0.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.9
0.0
0.4
1.8
0.0
1.0
4.6
0.3
38
1
3
0
2
1
0
0
0
0
2
0
0
0
2
12
2
1
1
1
3
1.3
1.2
3.2
0.0
1.4
1.3
0.0
0.0
0.0
0.0
1.6
0.0
0.0
0.0
1.6
4.9
1.2
1.0
1.0
2.3
0.9
87
1
6
0
2
4
4
0
0
0
3
0
0
2
3
26
9
7
3
4
5
3.0
1.2
6.4
0.0
1.4
5.3
3.2
0.0
0.0
0.0
2.4
0.0
0.0
1.9
2.4
10.6
5.5
7.0
2.9
9.2
1.5
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
1351.1
56.8
0.8
79.9
119.3
75.2
121.6
78.6
37.5
148.8
46.5
106.6
46.9
22.4
30.6
125.3
92.1
118.7
122.5
25.0
24.6
31.1
48.9
4
0
0
0
1
0
1
1
1
1
2
1
1
0
0
0
2
2
1
0
0
0
1
0.3
0.0
0.0
0.0
0.8
0.0
0.8
1.3
2.7
0.7
4.3
0.9
2.1
0.0
0.0
0.0
2.2
1.7
0.8
0.0
0.0
0.0
2.0
147
15
0
12
32
22
13
25
12
36
5
38
9
3
14
43
14
12
36
0
9
1
4
10.9
26.4
0.0
15.0
26.8
29.3
10.7
31.8
32.0
24.2
10.8
35.6
19.2
13.4
45.7
34.3
15.2
10.1
29.4
0.0
36.5
3.2
8.2
38
1
0
4
6
1
1
2
0
0
0
3
0
0
0
5
0
3
1
5
2
0
1
1.6
1.1
0.0
3.2
3.2
1.0
0.6
1.4
0.0
0.0
0.0
1.6
0.0
0.0
0.0
2.6
0.0
1.4
0.5
11.7
4.4
0.0
1.3
10
0
0
0
6
0
0
2
0
0
0
0
0
0
0
6
0
1
5
0
0
0
0
0.4
0.0
0.0
0.0
3.2
0.0
0.0
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
3.1
0.0
0.5
2.4
0.0
0.0
0.0
0.0
31
1
0
2
4
2
1
2
0
14
0
2
0
0
0
3
2
3
1
0
0
0
0
1.3
1.1
0.0
1.6
2.2
1.9
0.6
1.4
0.0
6.5
0.0
1.1
0.0
0.0
0.0
1.5
1.1
1.4
0.5
0.0
0.0
0.0
0.0
79
2
0
6
16
3
2
6
0
14
0
5
0
0
0
14
2
7
7
5
2
0
1
3.4
2.2
0.0
4.8
8.7
2.9
1.1
4.2
0.0
6.5
0.0
2.7
0.0
0.0
0.0
7.2
1.1
3.3
3.4
11.7
4.4
0.0
1.3
IAP TOTAL
2556.1
1559.7
15
1.0
355
22.8
35
1.4
20
0.8
37
1.4
92
3.6
PEACE CORPS TOTAL
7727.9
4677.7
28
0.6
673
14.4
103
1.3
49
0.6
106
1.4
258
3.3
36
Country
VT
Years
HIV
Rate
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
HIV PostExposure
Prophylaxis
No.
Rate
6
5.5
2
1.7
7
5.3
3
2.1
1
1.7
2
2.6
2
1.3
0
0.0
1
1.0
5
5.7
2
7.8
2
2.5
4
3.3
1
0.6
11
7.6
3
2.8
0
0.0
5
4.9
1
0.5
1
4.6
1
0.7
0
0.0
3
2.1
7
7.8
2
2.0
6
4.3
3
1.8
Schistosomiasis
Symptoms/
Parasites
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
1.2
0
0.0
0
0.0
2
1.4
0
0.0
0
0.0
0
0.0
1
0.5
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.7
1
0.6
Tuberculosis
Positive
Antibody
No.
Rate
0
0.0
2
1.7
4
3.0
0
0.0
0
0.0
7
8.9
2
1.3
0
0.0
2
2.0
0
0.0
0
0.0
1
1.2
5
4.1
10
6.4
21
14.6
0
0.0
5
6.1
3
3.0
6
3.3
0
0.0
1
0.7
0
0.0
0
0.0
2
2.2
4
3.9
2
1.4
2
1.2
Positive PPD
No.
Rate
0
0.0
1
0.8
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
2
2.0
1
1.1
0
0.0
0
0.0
0
0.0
4
2.6
1
0.7
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
3
2.2
0
0.0
0
0.0
0
0.0
1
1.0
1
0.7
3
1.8
Active Disease
No.
Rate
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
VaccinePreventable
Disease
No.
Rate
0
0.0
0
0.0
0
0.0
2
1.4
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
0
0.0
1
0.6
Benin
Botswana
Burkina Faso
Cameroon
Cape Verde
Ethiopia
Ghana
Guinea
Kenya
Lesotho
Liberia
Madagascar
Malawi
Mali
Mozambique
Namibia
Niger
Rwanda
Senegal
Sierra Leone
South Africa
Swaziland
Tanzania
The Gambia
Togo
Uganda
Zambia
108.4
117.9
131.6
144.4
60.0
78.4
151.7
4.5
101.0
87.4
25.5
81.2
122.2
156.7
143.9
108.0
81.6
101.5
182.9
21.6
137.6
67.8
144.5
90.0
102.2
138.7
167.9
No.
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
AFRICA TOTAL
Albania
Armenia
Azerbaijan
Bulgaria
Cambodia
China
Georgia
Indonesia
Jordan
Kazakhstan
Kyrgyz Republic
Macedonia
Moldova
Mongolia
Morocco
Philippines
Romania
Thailand
Turkmenistan
Ukraine
2859.0
85.8
94.2
122.9
147.8
75.5
124.9
49.9
14.7
58.6
123.7
103.4
77.6
107.3
124.9
244.7
164.6
100.2
104.9
43.3
344.0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.0
0.0
0.0
81
0
1
1
1
0
2
0
0
0
0
2
0
0
0
1
0
0
1
0
3
2.8
0.0
1.1
0.8
0.7
0.0
1.6
0.0
0.0
0.0
0.0
1.9
0.0
0.0
0.0
0.4
0.0
0.0
1.0
0.0
0.9
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
79
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
17
1
2
2
0
0
2
1
0
1
1
2
0
1
1
2
0
0
0
1
10
0.6
1.2
2.1
1.6
0.0
0.0
1.6
2.0
0.0
1.7
0.8
1.9
0.0
0.9
0.8
0.8
0.0
0.0
0.0
2.3
2.9
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0.0
0.0
0.0
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.3
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.1
0.0
0.0
0.0
0.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
EMA TOTAL
Belize
Colombia
Costa Rica
Dominican Republic
Eastern Caribbean
Ecuador
El Salvador
Fiji
Guatemala
Guyana
Honduras
Jamaica
Mexico
Micronesia
Nicaragua
Panama
Paraguay
Peru
Samoa
Suriname
Tonga
Vanuatu
2312.8
90.7
2.4
124.9
184.8
102.9
181.3
144.0
67.7
216.8
70.7
186.3
87.0
48.1
51.4
195.6
176.7
209.1
206.6
42.8
45.7
46.1
74.6
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
12
1
0
0
1
1
1
0
0
5
0
1
0
0
0
2
0
3
2
0
0
0
0
0.5
1.1
0.0
0.0
0.5
1.0
0.6
0.0
0.0
2.3
0.0
0.5
0.0
0.0
0.0
1.0
0.0
1.4
1.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
27
0
0
2
2
0
0
1
0
11
2
0
0
2
0
1
0
0
0
0
0
0
0
1.2
0.0
0.0
1.6
1.1
0.0
0.0
0.7
0.0
5.1
2.8
0.0
0.0
4.2
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1
0
0
0
0
0
0
3
0
2
0
0
0
0
0
1
0
0
0
0
0
0
1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.1
0.0
0.9
0.0
0.0
0.0
0.0
0.0
0.5
0.0
0.0
0.0
0.0
0.0
0.0
1.3
IAP TOTAL
2556.1
0.0
17
0.7
0.0
0.0
21
0.8
0.0
0.3
PEACE CORPS TOTAL
7727.9
0.1
110
1.4
0.1
79
1.0
65
0.8
0.0
11
0.1
37
Common Acronyms and Definitions

8A ...
8B ...
Pre-service accommodation for in-country psychiatrist

Pre-service accommodation for psychotropic medication monitoring
Avg.
Average
Colposcopy
Procedure used to diagnose cause of an abnormal pap smear in women
D.C.
Dengue ..
Washington, D.C.
Viral disease transmitted by mosquitoes
EMA
ENT
ESS
Europe, Mediterranean, and Asia region

Ear, Nose, and Throat
Epidemiologic Surveillance System
FECA .
Febrile illness.
Filariasis
Federal Employees Compensation Act

Illness with a temperature of at least 38 degrees Celsius (100.4 degrees
Fahrenheit)
Diseases caused by microscopic, threadlike worms
HIV .
HOV
HQ ..
Human Immunodeficiency Virus

The Health of the Volunteer annual report
Peace Corps headquarters
IAP ..
Inter-America and the Pacific region
Leishmaniasis ...
Parasitic disease transmitted by sand flies
Medevac
Medical evacuation
No. ..
Number
OMS ...
OSS
Office of Medical Services

Office of Special Services
PCMO
PCV
PEP
PPD
PSA
PTSD .
Peace Corps Medical Officer

Peace Corps Volunteer
Post exposure prophylaxis for HIV
Purified protein derivative tuberculosis test
Prostate specific antigen
Post-traumatic stress disorder
SAD
STD
Schistosomiasis
Seasonal affective disorder

Sexually transmitted disease
Parasitic disease caused by flatworms that penetrate skin submerged in
contaminated water
TB ...
TG ..
Tuberculosis
Technical guideline
U.S.
United States
VT years
Volunteer years
38
Subject Index
Alcohol-related problems ....................................................................................................... 14
Antimalarial chemoprophylaxis ............................................................................................. 11
Asthma ................................................................................................................................... 15
Cardiovascular problems ........................................................................................................ 15
Colposcopies, in-country ........................................................................................................ 15
Dengue ..................................................................................................................................... 7
Dental problems ..................................................................................................................... 16
Febrile illness, other ................................................................................................................. 8
Filariasis ................................................................................................................................... 8
Gastrointestinal conditions ....................................................................................................... 9
Gynecological infections, other................................................................................................ 9
Hepatitis ................................................................................................................................. 10
Highlights ................................................................................................................................. 5
Human Immunodeficiency Virus ........................................................................................... 10
In-country hospitalizations ..................................................................................................... 20
Injuries, alcohol-related .......................................................................................................... 17
Injuries, unintentional............................................................................................................. 16
In-service deaths..................................................................................................................... 20
Introduction .............................................................................................................................. 3
Leishmaniasis ......................................................................................................................... 10
Malaria ................................................................................................................................... 11
Medevacs................................................................................................................................ 19
Mental health consultations .................................................................................................... 18
Mental health issues ............................................................................................................... 17
New accommodated conditions.............................................................................................. 19
Post-exposure prophylaxis ..................................................................................................... 10
Post-service claims ................................................................................................................. 21
Pregnancy ............................................................................................................................... 19
Pre-service accommodations .................................................................................................. 20
Schistosomiasis cases and antibodies ..................................................................................... 12
Sexually transmitted diseases, non-HIV ................................................................................ 12
Tuberculosis ........................................................................................................................... 13
Vaccine-preventable diseases ................................................................................................. 14
39

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Peace Corps The Health of The Volunteer 2010 Annual Report of Volunteer Health

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The Health

Peace Corps Ofce of Medical Services

The Health of the Volunteer

Peace Corps Medical Officers

Data Methods ..................................................... 2

2010 Results ....................................................... 5

Common Acronyms and Definitions ............. 38

cases of disease in a year by the VT year count and

Number of new cases of disease

The Health of the Volunteer 2010 reflects OMS

Female Volunteer Years

The report is designed to facilitate the education and

Malaria Volunteer Years

Rates for malaria (by type), malaria (by prophylaxis),

Throughout this document the term Volunteer

Trendlines were created using Joinpoint, a program

Incidence is the number of new cases of a disease or

There are several limitations to the information

In The Health of the Volunteer, incidence rates are

The Health of the Volunteer 2010

Not all conditions can be precisely confirmed, so

The Health of the Volunteer 2010

Increase in In-Country Hospitalizations (page 19)

In 2010, the rate of in-country hospitalizations for

Increase in Dengue Rates (Page 6)

The Health of the Volunteer 2010

Most common conditions

As seen in previous years, the three most commonly

Female Volunteers served 4,678 VT years, accounting

Conditions with significant rate differences

Worldwide, six conditions had statistically significant

Volunteers age 50 years and over served 499 VT years

The Health of the Volunteer 2010

hospitalization in the Philippines. There was a

An increase in the rate of mental health issues was

According to the World Health Organization, the

In 2010, the IAP regional rate of asthma increased 40

In 2010, the number of dengue cases reported was

The Africa region had significant rate decreases in

From 2000 to 2002, there was an 11 percent per year

An increase in the rate of malaria cases was seen only

Dengue infection is found in the tropics and

The Health of the Volunteer 2010

In 2010, rates in Africa declined, while a slight

From 2000 to 2004, the rates of infectious dermatitis

There were two cases of filariasis reported among

Febrile illness, other

The Health of the Volunteer 2010

Among the 5,152 gastrointestinal conditions reported

This category continues to lead reportable condition

Other diarrhea represents gastrointestinal tract

A statistically significant decrease in rates of

Gynecological infections, other

The Health of the Volunteer 2010

PEP has been available since 1997 to Volunteers

Human Immunodeficiency Virus

Peace Corps initiated HIV screening in 1987.

The Health of the Volunteer 2010

Regionally, Africa saw the most malaria (97 percent;

In 2010, 81 percent of Volunteers in malaria endemic

Five cases of malaria were reported from IAP, three

For Volunteers in the Africa region who took

The rate of falciparum malaria in Africa was 2.4 per

The Health of the Volunteer 2010

In 2010, among the 194 Volunteers who were

In 1998, the Peace Corps instituted universal