The Health

of the
Volunteer
2001

Peace Corps · Office of Medical Services

 STATUS
REPORT
Volume 8
Spring 2002
The 2001 Annual Report of Volunteer Health
TABLE OF CONTENTS
Introduction ................................ 1
2001 Highlights ......................... 2
The 10 Leading Reported Health-Related
Events ................................... 5
In-Service Deaths...................... 10
Tropical Diseases .................... 10
HIV and Conditions Associated With Sexual
Activity................................ 13
Other Health Conditions........... 14
Health Interactions ................... 16
References................................. 17
The Health of the
Volunteer
Office of Medical Services
EDITORS
A. Russell Gerber, M.D., Chief,
Surveillance and Epidemiology Unit
Katie White, M.P.H.,
Analytic Epidemiologist
CONTRIBUTORS
PCMOs Worldwide
Dick Banks, Surveillance and Tracking
Systems Coordinator
Field Support Unit
Post-Service Unit
Introduction OMS Deaths in Service database, and
4) selected Post-Service Unit data for
returned Peace Corps Volunteers
The Health of the Volunteer is a report
(RPCVs). Data management and
produced by the Peace Corps Office of
analysis are provided by the
Medical Services (OMS) for Peace
Surveillance and Epidemiology Unit,
Corps Medical Officers (PCMOs),
OMS.
Peace Corps Volunteers (PCVs), and
agency staff. The current issue
In 2001, unless otherwise noted,
provides summary information for
incidence is reported using events per
calendar year 2001 and trend
100 Volunteer/Trainee-Years (V/T-
information over time. The purpose of
Years) as the denominator. V/T-Years
the report is: 1) to document and
is a measure of person-time that
analyze trends in health conditions
accounts for both the number of PCVs
among in-service and post-service
and the length of time each PCV is at
Volunteers, and 2) to provide feedback
risk for a health event. Each Volunteer
concerning these trends in a format that
contributes only as much person-time
is useful for training and education of
(V/T-Years) to a population at risk for a
Volunteers and staff. The report
health event as he or she is actually at
includes graphic displays of
risk for that health event. For example,
information that can be used as
if a PCV leaves after six months, he/she
educational material during pre-service
is only at risk during the six-month
training (PST) and in-service training
period he/she is present, and
(IST) sessions. Each figure provided in
contributes only half a V/T-Year. If a
Appendix A has been placed on a
PCV leaves after a year, he/she
single page to facilitate transfer to a
contributes one full V/T-Year.
transparency for use during in-country
Incidence per 100 V/T-Years allows
training sessions.
data to be compared in age-, sex-,
region-, and country-specific analyses.
The data used to prepare this report
come from several sources: 1) PCMOs
In calendar year 2001, Peace Corps
worldwide who submit monthly
ended or suspended operations in eight
epidemiologic surveillance system
countries (Bangladesh, Kyrghyzstan,
(ESS) reports to OMS, 2) individual
Macedonia, Papua New Guinea,
case reports concerning assaults, in-
Poland, Turkmenistan, Uzbekistan, and
country hospitalizations, and country-
Zimbabwe). In 2001, the Peace Corps
sponsored (regional) medevacs, 3) the
§ 2 Spring 2001
opened or reopened operations in two
countries: Georgia and Uganda. Closed
and opened programs do not provide
data to OMS for a full calendar year.
Therefore, incidences of health events
for such countries should be interpreted
cautiously.
There are at least four limitations on
interpreting the data presented in this
report. First, comparing incidences
among countries is most valid for
countries that have similar numbers of
Volunteers. Second, incidences in
countries that have few V/T-Years are
more imprecise than incidences in
countries with many V/T-Years.
Statistically, the estimates are said to
have wide confidence intervals.
Caution should therefore be used when
comparing incidences in countries that
have few V/T-Years. Appendix B,
“Numbers and Incidence of Reportable
Health Conditions for Calendar Year
2001,” includes the number of reported
cases for each monitored condition, the
incidences of the condition, and the
V/T-Years in the particular country.
This should help the reader better
understand the distribution of
conditions in individual countries and
regions.
A third limitation is that PCVs may be
selective in reporting medical
conditions to PCMOs (underreporting
and overreporting). PCVs who are in
frequent contact with the PCMO or
who have conditions that are
particularly severe or persistent may
report conditions to PCMOs that might
otherwise not have been reported.
Conversely, PCVs who are in remote
locations may not report or even seek
health care for some reportable
conditions, particularly those that are
mild or self-limited. A fourth
limitation is misclassification of
reportable conditions. This may occur
because different posts have different
capacities to resolve specific diagnoses.
For this reason, in this report, some
conditions may be included in
categories to which they should not be
assigned, and some may not be
included in categories to which they
ought to be assigned.
OMS encourages PCMOs, country
directors, and regional staff to review
the incidences of diseases and
conditions for their respective
countries. OMS staff are available for
consultation on trends of concern or for
discussions about possible
interventions. OMS invites feedback
on the content of this report and any
suggested modifications that would
enhance the report’s usefulness in
future years. In particular, we are
interested in feedback that would assist
PCMOs in better educating and training
Volunteers. Please direct all comments
and suggestions to the Surveillance and
Epidemiology Unit.
2001 Highlights
Four ongoing stories are highlights of
success for the Peace Corps Volunteer
Health System. These four stories are:
1) completeness of epidemiologic
reporting by PCMOs, 2) reduction of
motorcycle injuries, 3) reduction of
viral hepatitis, and 4) control of
malaria.
Completeness of Reporting by
PCMOs
In 2001, PCMOs provided 100% of all
epidemiologic reports that were
expected of them. This was the third
The Health of the Volunteer
consecutive year of 100% completeness
in ESS and Assault Notification and
Surveillance System (ANSS) reporting,
and the second consecutive year of
100% completeness for reporting in-
country hospitalizations (ICHs) and
country-sponsored (regional) medevacs
(CSMs). Complete reporting provides
the most useful data for accuracy in the
analysis of health events. PCMOs are
to be congratulated, and should take
considerable pride in the complete level
of reporting that they have achieved.
Reduction of Motorcycle Injuries
In 2001, the overall incidence of
motorcycle-related injury was 0.3 per
100 V/T-Years (Figure 1). This
incidence was 25% less than the
incidence in 2000 (0.4 per 100 V/T-
Years), and 81% less than the incidence
in 1994 (1.6 per 100 V/T-Years).
There were 18 reported motorcycle-
related injuries in 2001 (Table 8); 11
(61%) in the Africa region (seven
countries), five (28%) in the IAP region
(two countries), and two (11%) in the
EMA region (two countries). Eight
countries reported having only one
motorcycle injury in 2001 and three
countries reported more than one
motorcycle injury (Figure 2).
The distribution of motorcycle injuries
is highly restricted and makes this
health event a promising target for
further reductions or even elimination
through policy interventions in
specified countries. Eight countries
(seven in the Africa region [Benin,
Cameroon, Cote d’Ivoire, Guinea,
Mali, Niger, and Senegal] and one in
the IAP region [Dominican Republic])
account for 85% (51 of 60) of the
§ 3 Spring 2001
motorcycle-related injuries that have
occurred among Peace Corps
Volunteers during the three-year period
1999–2001.
Current Peace Corps policy is to limit
the use of motorcycles to only those
cases where using a motorcycle is
clearly necessary to accomplish the
goals of a particular project. The result
of this policy is that motorcycles for
Volunteers have not been purchased
through headquarters during at least the
last nine years, and Volunteers have
been highly discouraged from using
motorcycles in the field and when on
leave. In addition, most posts have not
purchased motorcycles for Volunteer
use. This combination of policy and
practice has resulted in the reduced
incidence of motorcycle-related injuries
observed. OMS supports the
continuation of these policies and
practices to prevent motorcycle-related
injuries.
Other prevention methods for
motorcycle injuries include the routine
use of helmets that protect motorcycle
riders from head trauma and the
requirement of training for the few
Volunteers who still require motorcycle
use.
Reduction of Viral Hepatitis
Type-specific viral hepatitis is reported
in the monthly ESS and includes
hepatitis A, B, C, and E, as well as
unspecified hepatitis.
Hepatitis A, usually transmitted via the
oral-fecal route, is invariably a self-
limited disease but can impair a
person’s ability to work for one or more
months because of the accompanying
symptoms (fatigue,
malaise, weakness, and anorexia). In
1995, the U.S. Food and Drug
Administration (FDA) approved the use
of hepatitis A vaccine, which involves a
two-dose immunization strategy (1.0
mL vaccine intramuscularly in months
zero and six). The Peace Corps
introduced hepatitis A vaccine use in
1995. Until 1995, immune globulin
had been given to Volunteers every
three to four months in an effort to
provide passive immunity against
symptomatic hepatitis A infection.
However, immune globulin was less
than ideal because of the need for
repeat dosing during Volunteer service
and the variability in product antibody
titer and hence in the immunity it
produced.
In 1994 and 1995 the incidence of
reported hepatitis A in PCVs was 0.19
per 100 V/T-Years (Figure 3). Since
the introduction of hepatitis A vaccine
in 1995, hepatitis A among Volunteers
has virtually disappeared. One case of
hepatitis A was reported in a PCV in
2001 (incidence of 0.01 per 100 V/T-
Years). This case occurred in a
Volunteer in Paraguay who had
received the first dose of hepatitis A
vaccine but had not yet completed the
two-dose series, hence likely had
incomplete immunity. This is the only
case of hepatitis A infection among
Volunteers during the last three years.
Hepatitis B, a sexually transmitted and
blood-borne pathogen, usually has a
similar clinical course to that seen in
patients with hepatitis A. However, it
may be associated with several possible
severe sequelae, including fulminant
hepatitis (requiring liver
transplantation), chronic active
hepatitis, superinfection with hepatitis
D, cirrhosis, and hepatocellular
The Health of the Volunteer
carcinoma. Hepatitis B infection occurs
primarily in young adulthood when
individuals become sexually active.
An FDA-approved hepatitis B vaccine
has been available in the United States
since the 1980s. Because the total
lifetime risk of hepatitis B infection is
approximately 5%, the United States
has adopted a long-range goal of
eliminating hepatitis B virus infection
and its sequelae through the use of
universal childhood immunization
against this virus.1 However, in the
short term, the U.S. Public Health
Service has recommended that all
sexually active adults be immunized
against hepatitis B.2
In 1995 the Peace Corps implemented
universal hepatitis B immunization for
Volunteers. In 1993 the incidence of
hepatitis B was 0.05 per 100 V/T-
Years. In 2001 there were no reported
cases of hepatitis B, and only one case
of hepatitis B infection has been
reported among PCVs during the last
seven years.
As a result of hepatitis B immunization,
infections with hepatitis D have also
been averted. Hepatitis D is a defective
virus that is incapable of replicating in
the absence of hepatitis B.
The virtual elimination of hepatitis A
and hepatitis B as threats to Volunteer
health emphasizes the need to focus
efforts on educating Volunteers in
strategies aimed at preventing other
infectious and noninfectious forms of
hepatitis. Training aimed at preventing
infections caused by the oral-fecal and
sexually transmitted routes is key.
§ 4 Spring 2001
Among the hepatitis virus group,
hepatitis C, E, and G have no effective
vaccine or immune globulin to prevent
infection. Hepatitis C virus can be
sexually transmitted, usually in
practices that compromise the mucosal
barrier, such as anal-receptive
intercourse. Chronic liver disease
occurs in over 60% of hepatitis C
infections in adults.3 In 2001, there
were no reported cases of hepatitis C
infection among PCVs.
Hepatitis E is transmitted via the oral-
fecal route, whereas hepatitis C and G
are primarily transmitted via the
parenteral route. In 2001, there were
no reported cases of hepatitis E
infection.
The “catchall” reporting category,
unspecified hepatitis, is the major type
of hepatitis now reported among PCVs.
It can include a wide variety of
infectious and noninfectious causes.
Causes include hepatitis associated
with other viruses such as
cytomegalovirus (CMV), Epstein-Barr
virus (EBV), herpes simplex virus
(HSV), varicella zoster virus (VZV),
human immunodeficiency virus (HIV),
and dengue virus; bacterial causes
including leptospirosis and syphilis;
and drug or toxic exposures such as
isoniazid that may also cause hepatitis.
In 2001, the incidence of unspecified
hepatitis was 0.13 per 100 V/T-Years,
little changed since 1994.
Control of Malaria
There are four Plasmodium species that
cause malaria in humans. Plasmodium
falciparum is found primarily in
tropical regions and poses the greatest
risk of death for nonimmune persons
because it can
infect and lyse all ages of red blood
cells. Falciparum malaria can progress
rapidly, with a lucid patient becoming
obtunded within minutes. If cerebral
malaria or other major organ
dysfunction occurs, the risk of death is
approximately 20%, even with proper
therapy.4 This picture of rapid
progression is most commonly seen in
individuals without immunity, such as
young children and expatriates, even
those who have lived in malarious areas
for extended periods of time.
Additionally, Plasmodium falciparum
has been the species most likely to
develop resistance to antimalarial
drugs.5
Since 1962 there have been five
Volunteer deaths from falciparum
malaria, but none have occurred since
the introduction of weekly mefloquine
use in 1990 (Figure 4). This change in
the chemoprophylactic strategy aimed
at chloroquine-resistant Plasmodium
falciparum (CRPF) malaria brought
with it a concomitant decrease in
reported incidence of falciparum
malaria among Volunteers serving in
the Africa region.
In 2001, the incidence of reported
falciparum malaria in the Africa region
was 4.6 cases per 100 V/T-Years, a
28% increase compared with 2000 (3.6
cases per 100 V/T-Years), but 71% less
than the rate reported in 1989 (16.0 per
100 Volunteers/year), when CRPF
became widespread in Africa.
The overall incidence of non-
falciparum malaria in 2001 was 0.3 per
100 V/T-Years (Figure 5). Non-
falciparum malaria continues to occur
in the Africa and IAP regions at very
low and relatively constant incidences
(Table 12).
The Health of the Volunteer
All Volunteers serving in malarious
areas are required to take an effective
malaria chemoprophylaxis regimen. As
described above, the introduction of
mefloquine chemoprophylaxis was
temporally linked with a decrease in
deaths from falciparum malaria and the
observed decrease in the incidence of
laboratory-confirmed cases of
falciparum malaria compared with the
late 1980s.
Increasingly, PCMOs are using drugs
other than mefloquine for prophylaxis
in CRPF areas, because of Volunteer
complaints of side effects encountered
with mefloquine use. These drugs
include doxycycline and Malarone.
The half-life of doxycycline is 22 to 24
hours (in individuals on a continuous
dosing regimen), so it must be taken
daily to ensure adequate protection
against malaria. Mefloquine, on the
other hand, has a half-life of about 21
days. Therefore, the potential health
consequences of a single missed dose
for one day are quite different for these
two agents. Delaying a dose of
doxycycline by one day places the
Volunteer at risk for clinical disease
including cerebral malaria and possible
death. A similar dosing delay with
mefloquine does not place the
Volunteer at the same level of risk.
Malarone (a fixed combination of
atovaquone and proguanil) was
approved by the FDA in 2000 as an
antimalarial agent for both
chemoprophylaxis and treatment.6
Dosing frequency with Malarone is
similar to that with doxycycline in that
it must be taken daily to ensure
adequate protection against malaria.
The percentage of PCVs in the Africa
§ 5 Spring 2001
region taking doxycycline as malaria
chemoprophylaxis in 2001 was 11.5%,
a 5% increase compared with 2000
(11.0%) (Figure 6). The percentage of
Volunteers taking Malarone in 2001
was 0.7%. Mefloquine use among
Volunteers decreased by less than 1%
in 2001, and mefloquine continues to
be used by over 80% of Volunteers in
the Africa region every month (83.5%).
These data suggest the need for OMS
to continue working with PCMOs and
Volunteers to find optimal malaria
chemoprophylaxis strategies that reduce
risks of malaria but are acceptable to
Volunteers. Additionally, these
findings suggest that surveillance of
adverse reactions from these agents is
warranted.
In 2001, no cases of falciparum malaria
occurred that were suggestive of
mefloquine resistance. However, in
order to continue surveillance for
mefloquine resistance, as stated in
Technical Guidelines #840 and #845, it
is very important for PCMOs to send
blood smears to confirm malaria
parasites on each Volunteer diagnosed
with malaria; to complete a malaria
case report form on each, including
whether the Volunteer reported
adherence to his/her malaria
chemoprophylaxis prior to developing
symptoms; and to send serum
specimens for Volunteers who are
taking mefloquine or Malarone to
determine if drug levels were adequate
in persons who developed malaria.
The 10 Leading Reported
Health-
Health-Related Events
Worldwide Distribution of “The
Top 10"
The 10 most commonly reported
health-related events among Volunteers
and trainees in 2001 were (in
decreasing frequency) acute diarrhea,
upper respiratory illness, mental health
problems, infectious dermatitis, dental
problems, unintentional injuries, febrile
illnesses, non-sexually transmitted
gynecologic infections, lower
respiratory illness, and environmental
concerns (Figure 7). The rank order of
the top 10 health conditions in 2001 is
the same as that seen in 1999 and
2000.7,8
Examining the rank order of incidences
of health conditions worldwide may
mask region-specific patterns. In 2001,
in all three Peace Corps regions, acute
diarrhea was the most frequently
reported health condition overall and
upper respiratory illness (URI) was the
second leading reported health
condition. Regional differences in the
order of frequent health conditions may
reflect differing health risks, the
number of Volunteers at risk in
different regions, the presence of
Volunteers with preexisting health
conditions that are more readily
accommodated in one location over
another, or PCMO reporting patterns.
In 2001, mental health problems were
overall the third most frequently
reported health condition, although
these ranked fourth in both the Africa
and IAP regions. In 2001, infectious
dermatitis ranked third in both the
Africa and IAP regions, ranked sixth in
The Health of the Volunteer
the EMA region, and ranked worldwide
as the fourth most frequently reported
health condition.
Africa Region. The Africa region top
10 reportable conditions shared
similarities with those reported
worldwide (Figure 8). Acute diarrhea
and URIs ranked first and second,
respectively. Dermatitis ranked third,
febrile illness ranked fifth, and
presumptive malaria ranked ninth. This
rank order reflects the warm climates
and the frequency of tropical and
infectious disease exposures in the
Africa region. Mental health needs
ranked fourth, dental problems ranked
sixth, and unintentional injuries ranked
seventh. Environmental concerns did
not appear among the top 10 health
conditions in the Africa region.
IAP Region. The IAP region top 10
reportable conditions were also similar
to those reported worldwide (Figure 9).
Acute diarrhea and URIs ranked first
and second, respectively. Dermatitis
ranked third, mental health needs
ranked fourth, unintentional injuries
ranked fifth, and dental problems
ranked sixth among leading health
problems in the IAP region. In 2001,
environmental concerns were the 10th
leading health condition reported in the
IAP region, as they were worldwide.
EMA Region. In 2001, acute diarrhea
was the leading reportable health
condition (Figure 10), as it was in 1999
and 2000. In 1997 and 1998, upper
respiratory illness was the leading
reportable health condition in the EMA
region. The EMA region still had a
consistently high incidence of upper
respiratory illness (54.6 per 100 V/T-
Years) compared with the Africa (38.4)
and IAP (53.7) regions (Table
§ 6 Spring 2001
15). This incidence probably reflects
that countries located in the EMA
region are primarily in cold-weather or
temperate climate zones. Mental health
needs ranked third and dental problems
ranked fourth in the EMA region.
Dermatitis dropped to sixth and febrile
illness to seventh, again probably
reflecting cold-weather or temperate
climates. In 2001, unintentional
injuries ranked fifth in the EMA region,
as they did in 2000. In 2001,
environmental concerns were the 10th
leading health problem in the EMA
region, the same rank they had
worldwide.
#1: Acute Diarrhea
Acute diarrhea was the leading cause of
reportable illness among Volunteers
worldwide (79.6 cases per 100 V/T-
Years) (Figure 7). The incidence of
acute diarrhea among Volunteers in
2001 increased 2% compared with
2000, but overall has remained
relatively stable since 1996 (Figure 11).
In 2001, two countries had incidences
of acute diarrhea greater than 200 per
100 V/T-Years (Figure 12), compared
with one country in 2000 and three
countries in 1999. Three countries, all
in the Africa region (Burkina Faso,
Niger, and Senegal), had incidences of
acute diarrhea greater than 160 per 100
V/T-Years in both 2001 and 2000.
The category acute diarrhea includes
laboratory-confirmed cases of
amebiasis, giardiasis, salmonellosis,
shigellosis, and other laboratory- and
nonlaboratory-confirmed cases. The
quality of laboratory services in each
country is variable. Therefore, the
predictive value of positive and
negative laboratory tests is too low to
consider reported results valid in some
countries. However, all these etiologies
can be associated with acute and, at
times, chronic diarrhea.
Because of acute diarrhea’s leading
frequency in reporting and substantial
impact on the health of Volunteers,
preventing it through the practice of
food and water consumption safety
continues to be an appropriate focus of
PST and IST sessions designed for
trainees and Volunteers.
#2: Upper Respiratory Tract
Illnesses
URI was the second leading cause of
reportable illness among Volunteers
worldwide (48.6 per 100 V/T-Years).
The incidence of URI in 2001 was
slightly less (down 3%) than the
incidence in 2000, but has remained
relatively constant since 1996 (Figure
13). Incidences greater than 100 per
100 V/T-Years were reported in five
countries in 2001 (three of these are in
the EMA region) (Figure 14). All three
of the EMA region countries (Armenia,
Macedonia, and Poland) had incidences
of URI in 2000 greater than 100 per
100 V/T-Years as well. However,
Macedonia and Poland both ceased
Peace Corps operations in 2001.
Illnesses reported in this category
include influenza and influenza-like
illnesses, pharyngitis, tonsillitis, acute
laryngitis, otitis media, and sinusitis.
Viruses, bacteria, mycoplasma, and
chlamydia are all associated with URIs.
Epidemic influenza activity is
commonly seen in winter months in
Northern Hemisphere countries with
The Health of the Volunteer
temperate and cold-weather climates.
This includes many countries in the
EMA region. Influenza is a viral
infection that can cause “classic flu”
and a full spectrum of URI conditions.
Influenza may also cause lower
respiratory tract disease, including
bronchitis and pneumonia. In 2000, the
Advisory Committee on Immunization
Practices lowered the age at which
universal yearly influenza
immunization is recommended from 65
to 50 years of age.9 Therefore,
Volunteers who are now 50 years of
age or older, as well as Volunteers who
have required hospitalization or regular
medical follow-up during the preceding
year because of chronic metabolic
disease (including diabetes), renal
dysfunction, hemoglobinopathies, or
immunosuppression should receive
annual influenza immunization to avert
potentially life-threatening events, such
as bacterial pneumonia, that may follow
acute influenza virus infection (see
Technical Guideline #300 for specific
influenza vaccine indications).
#3: Mental Health Problems
In 2001, mental health problems,
defined as one-to-one discussions (in
person or by telephone) between
PCMOs and Volunteers regarding
mental health concerns (not concerning
the environment), ranked third in
reported frequency (34.2 per 100 V/T-
Years). Included in these counseling
interactions are episodes of depression,
problems with interpersonal
relationships, stress reactions, anxiety,
and loneliness. If a Volunteer is seen
numerous times within a month for the
same ongoing mental health problem,
the event is only reported once.
Incidence of mental health problems in
§ 7 Spring 2001
2001 increased 10% from 2000 (31.1
per 100 V/T-Years) and has increased
68% since 1993 (20.4 per 100 V/T-
Years) (Figure 15). This increase may
be the result of a variety of factors: 1)
greater accommodation by the Peace
Corps of persons with stable mental
health problems, 2) more persons in the
Peace Corps service who have
unknown or undisclosed preexisting
mental health problems that become
exacerbated by their service, 3) greater
societal acceptance of seeking mental
health counseling, with an associated
increased demand by Volunteers for
services, or 4) greater availability of
mental health services at post through
PCMOs and other counselors.
Incidences of reported mental health
problems were highly variable from
country to country (Table 14). In 2001,
seven countries had incidences greater
than 130 per 100 V/T-Years (Figure
16) (four in the EMA region, two in the
Africa region, and one in the IAP
region). Only Zimbabwe had an
incidence of mental health problems
greater than 130 per 100 V/T-Years in
both 2000 and 2001. In 2001, three
countries (Kiribati, Papua New Guinea,
and Tonga) reported no mental health
problems among Volunteers.
Zimbabwe and Papua New Guinea both
ceased Peace Corps operations in 2001.
The substantial variability in reported
mental health problems among
countries may reflect overreporting,
nonreporting, or misclassification of
mental health problems, or
misunderstanding by PCMOs of the
surveillance case definition for mental
health problems.
Mental health problems may or may
not lead to medical evacuation
(medevac) to the United States for
additional evaluation. An OMS study
of mental health medevacs during
1996–1998 showed that the incidence
of OMS-authorized mental health
medevacs increased 78% from 1996
(0.9 per 100 V/T-Years) to 1998 (1.6
per 100 V/T-Years).10 A panel of
external experts convened by the Peace
Corps (the Mental Health Task Group)
reviewed mental health issues related to
Peace Corps service and issued a report
in August 2001 describing the basis of
the concerns about Volunteer mental
health, the scope of their impact, and
ways that the Peace Corps might
address the issue.11
#4: Dermatitis
The fourth-ranked health-related event
among Volunteers in 2001 was
infectious dermatitis (31.3 per 100 V/T-
Years), defined as an infection of the
skin due to bacterial, fungal, or
parasitic organisms evaluated by a
health care provider. The diagnosis
does not require laboratory
confirmation. This category does not
include acne, eczema, or nonspecific
rashes. Dermatitis is commonly
encountered in tropical areas, where
secondary bacterial infections of so-
called minor abrasions are more
common than in temperate regions.
Additionally, superficial fungal
infections of the skin, such as
Malasezzia furfur (Tinea versicolor),
are common in moist, humid
environments that promote fungal
growth. In 2001, the highest region-
specific incidence of infectious
dermatitis was in the IAP region (40.7
per 100 V/T-Years) and the lowest was
in the EMA region (18.8 per 100 V/T-
Years) (Table 3).
The Health of the Volunteer
#5: Dental Problems
Dental problems were the fifth leading
cause of reportable health-related
events among Volunteers (27.3 per 100
V/T-Years) in 2001. The incidence of
dental problems has increased 62%
since 1993 (16.9 per 100 V/T-Years)
(Figure 17). PCMOs report any
condition involving the teeth or gums
that required evaluation by a dentist or
other health care professional. The
category does not include repeat visits
for the same problem or routine
screening or prophylaxis visits. The
EMA region had the highest region-
specific incidence of dental problems
(36.4 per 100 V/T-Years) (Table 2), a
finding that may reflect the older
average age of Volunteers serving in
the EMA region. The Africa region had
the lowest incidence of dental problems
(19.1 per 100 V/T-Years), as well as
the youngest average age of Volunteers.
#6: Unintentional Injuries
Unintentional injuries include
pedestrian, bicycle, motorcycle, other
motor vehicle (e.g., automobile, truck,
bus), sports-related, water-related, and
“other” injuries. In 2001, unintentional
injuries ranked as the sixth overall
leading reportable health condition
(22.2 per 100 V/T-Years). The most
frequently reported category of
unintentional injury was “other,” a
category that includes falls, burns,
animal and insect bites, poisoning, and
cuts, abrasions, and puncture wounds
not related to sports, water, or vehicles)
(14.2 per 100 V/T-Years) (Table 10).
Among the specific causes of
unintentional injuries in 2001, sports-
related injuries (a new category
§ 8 Spring 2001
reportable in 2001) had the highest
reported incidence (3.9 per 100 V/T-
Years) and motorcycle injuries had the
lowest incidence (0.3 per 100 V/T-
Years) (Figure 18).
The IAP region had the highest region-
specific incidence of sports-related
injuries (4.9 per 100 V/T-Years) in
2001 and the Africa region had the
lowest (2.2 per 100 V/T-Years) (Table
9). Four countries had incidences of
sports-related injuries greater than 15
per 100 V/T-Years (Figure 19). El
Salvador (31) and Romania (23)
reported the greatest number of sports-
related injuries in 2001.
The overall incidence of bicycle
injuries in 2001 was 1.3 per 100 V/T-
Years, the lowest incidence reported
since reporting of this injury category
began in 1993. In 2001, the Africa
region had 51 (59%) reported bicycle
injuries and the highest region-specific
incidence (2.1 per 100 V/T-Years); the
EMA region had only nine (10%)
reported bicycle injuries and the lowest
incidence (0.4 per 100 V/T-Years).
Five countries (three in the Africa
region and two in the IAP region) had
incidences of bicycle injuries greater
than 5.0 per 100 V/T-Years in 2001
(Figure 20). Three of these countries
(Belize, Burkina Faso, and Togo) also
had incidences of bicycle injuries
greater than 5.0 per 100 V/T-Years in
1999, 2000, and 2001.
Data to analyze bicycle injuries by body
location of the injury is not available.
However, routine use of bicycle
helmets has been proven to reduce head
injuries12 and facial trauma.13 In
September 2001, Manual Section 523
of the Peace Corps Manual was revised
to require all
Peace Corps Volunteers to wear an
approved bicycle helmet while
operating or riding a bicycle.
The incidence of reported pedestrian
injuries in 2001 was 1.1 per 100 V/T-
Years (Table 7). In 2001, the IAP
region had 36 (49%) reported
pedestrian injuries and the highest
region-specific incidence (1.6 per 100
V/T-Years); the EMA region had nine
(12%) reported pedestrian injuries and
the lowest incidence (0.4 per 100 V/T-
Years). Eight countries (four in the
Africa region, three in the IAP region,
and one in the EMA region) had
incidences of reported pedestrian
injuries in 2001 greater than 4.0 per
100 V/T-Years (Figure 21), compared
with five countries exceeding 4.0 per
100 V/T-Years in 2000. Lesotho,
Paraguay, and Thailand had high
incidences of pedestrian injuries in both
2000 and 2001.
The incidence of reported motor
vehicle injuries (excluding
motorcycles) in 2001 was 0.9 per 100
V/T-Years. The annual incidence of
motor vehicle injuries has changed little
since 1993, ranging between 0.9 and
1.4 per 100 V/T-Years. Four countries
(two in the Africa region, one in the
EMA region, and one in the IAP
region) had incidences of motor vehicle
injury greater than 4.0 per 100 V/T-
Years (Figure 22). One country
(Jamaica) had an incidence greater than
3.0 per 100 V/T-Years in both 2000
and 2001.
Injury incidence does not account for
the prevalence of use of motorcycles,
bicycles, and other motor vehicles in a
country. Because of this, some
important underlying trends may be
obscured. OMS continues to explore
The Health of the Volunteer
methods to analyze injuries associated
with motorcycles, bicycles, and other
motor vehicles in conjunction with
information about the numbers of
bicycles, motorcycles, and other
vehicles used at posts in order to more
accurately characterize transportation-
related health risks to Volunteers.
Water-related injuries include any
injury or event associated with
swimming, diving, water-skiing,
boating, or other water-based activity.
Not surprisingly, the highest region-
specific incidence of water-related
injuries in 2001 occurred in the IAP
region (1.0 per 100 V/T-Years) (Table
10). The IAP region reported 23 (66%)
of the 35 total water-related injuries
reported in 2001. Water-related
injuries occurred in 18 countries in
2001. Seven countries had incidences
of water-related injuries greater than
2.0 per 100 V/T-Years (Figure 23);
four of the seven (Cape Verde,
Jamaica, Philippines, and Vanuatu) are
countries that consist primarily of
islands.
Between 1994 and 2001, four (14%) of
29 in-service deaths among Volunteers
were water-related. A water safety PST
module was developed by OMS for
worldwide distribution in 1997.
#7: Febrile Illnesses
The seventh-ranked category, febrile
illnesses (16.2 per 100 V/T-Years),
includes any illness accompanied by a
documented temperature of at least 38
degrees Centigrade that does not have a
separate category in the surveillance
system or is of unknown etiology. The
incidence of febrile illnesses among
Volunteers in 2001 decreased 5%
compared with 2000 (17.1 per 100
§ 9 Spring 2001
V/T-Years).
Some of the decreased incidence of
reported febrile illnesses since 1999
may be due to the initiation of dengue
fever reporting as a separate ESS
category in 2000. In 1999 and earlier,
dengue fever, particularly seen during
summer and autumn months, was
reported as a febrile illness and was not
an independent reporting category (see
“Tropical Diseases” section below for
additional discussion of dengue).
Certain other reporting patterns suggest
different etiologies for some of the
other febrile illnesses. An increase in
the number of reported febrile illnesses
in the EMA region during the winter
months suggests unrecognized
influenza as well as other virus activity.
In addition, fever alone may be the only
manifestation for some infections, most
notably viral infections, which often
resolve rapidly before any definite
diagnosis can be established.
Three countries reported no febrile
illnesses in 2001 (Lithuania, Moldova,
and Poland) (Table 4). This may
reflect increased capacity in these
countries to define specific etiologies
for febrile illnesses, nonreporting, or
misunderstanding by PCMOs of the
surveillance case definition for febrile
illnesses.
#8: Non-Sexually Transmitted
Gynecologic Infections
Non-sexually transmitted gynecologic
infections (NTGI) ranked as the eighth
leading reported health-related event
among Volunteers (12.7 per 100 V/T-
Years). It is important to note that this
is the overall incidence among all
Volunteers, and is used only for
comparison purposes with other
reportable health conditions. As only
female Volunteers are at risk for this
condition, its sex-specific incidence in
2001 was much higher (20.8 per 100
female V/T-Years) (Table 16),
indicating it has a greater impact on the
Volunteer population than the overall
incidence indicates.
This category includes bacterial
vaginosis and vaginal yeast infection.
Although these two conditions are
bothersome to women, they usually are
associated with low morbidity.
However, they are important because of
the risk of human immunodeficiency
virus (HIV) acquisition when a woman
is exposed to HIV in the setting of a
gynecologic infection.14 Vaginal or
cervical inflammation increases the
presence of white cells in the local area,
including CD4+ T-lymphocytes, which
carry receptors for HIV on their
surface. Inflammation is also
associated with microscopic disruption
of the vaginal mucosa, which also may
increase the risk of HIV acquisition.15
Alerting female Volunteers about this
potential risk factor, as well as early
diagnosis and treatment of these
conditions when they occur, is
important.
#9: Lower Respiratory Tract
Illnesses
In 2001, lower respiratory tract illness
(LRI) was the ninth-ranked cause of
reportable illness among Volunteers
(7.1 per 100 V/T-Years) (Table 15).
The EMA region had the highest
region-specific incidence of LRI (9.2
per 100 V/T-Years); the Africa region
had the lowest incidence (4.6 per 100
V/T-Years). Incidences greater than
The Health of the Volunteer
20 per 100 V/T-Years occurred in five
countries in 2001 (Figure 24),
compared with four countries in 2000.
Only Guatemala had an incidence of
LRI greater than 20 per 100 V/T-Years
in both 2000 and 2001.
This reporting category includes
pneumonia, pneumonitis, bronchitis,
and pleural disease. (Asthma is a
separate reporting category in the ESS.)
LRI can be associated with bacteria,
viruses, mycoplasma, and chlamydia.
#10: Environmental Concerns
In 2001, environmental concerns,
defined as one-to-one discussions (in
person or by telephone) between
PCMOs and Volunteers regarding
exposures to environmental threats,
ranked 10th in reported frequency (4.2
per 100 V/T-Years).
Included in these interactions are
concerns about air pollution, heavy
metal exposures, pesticides, radiation,
water pollution/poor water quality, food
sanitation, and disaster threats (e.g.,
earthquakes, hurricanes). These
problems may or may not lead to
medical evacuation or site changes. If a
Volunteer is seen numerous times
within a month for the same ongoing
environmental concern, the event is
only reported once.
Incidence of environmental concerns in
2001 increased 5% compared with
2000 (4.0 per 100 V/T-Years) (Figure
25). The incidence has remained
relatively constant since 1996, although
there was a slight increase in 1999
associated with Y2K concerns.
Environmental concerns were 180%
greater in 2001 than in 1993 (1.5 per
§ 10 Spring 2001
100 V/T-Years).
The incidence of reported
environmental concerns varied greatly
from country to country (Table 3). In
2001, three countries (Romania,
Uganda, and Vanuatu) reported
incidences of environmental concerns
greater than 20 per 100 V/T-Years
(Figure 26). The incidence of
environmental concerns in Romania
was greater than 20 per 100 V/T-Years
in both 2000 and 2001.
Widespread distribution of the
documents Environmental Health:
Answers to Volunteer and Staff
Questions16 and Radiation Health and
Safety: Answers to Volunteer and Staff
Questions17 may help to lessen the
incidence of environmental concerns
among Volunteers.
In-
In-Service Deaths
Between 1961 and 2001 there were 249
in-service Volunteer deaths. The
overall mortality (the number of deaths
per 10,000 Volunteers per year) since
1990 is at historic lows (Figure 27).
Between 1961 and 2001, unintentional
injuries resulted in the highest cause-
specific fatality rates, followed by
medical illnesses (Figure 28). Except
for the periods 1981–1985 and 1996–
2001, medical illnesses resulted in
higher cause-specific fatality rates than
homicides. Transportation-related
deaths represent a substantial portion of
unintended injury deaths, although the
numbers of automobile and motorcycle
deaths have significantly decreased
since the 1967–1976 period (Figure
29). It is notable that there have been
no in-service suicide deaths since 1983.
Five Deaths in 2001
There were five Volunteer deaths in
2001. One death was due to an
unintentional injury, one death was due
to homicide, and two deaths were due
to medical illnesses. For one death, the
cause, and therefore the category, was
not able to be determined.
The unintentional injury death occurred
in a 25-year-old female Volunteer who
was trampled by elephants. She had
exited her vehicle in a game park to
take photographs of a herd of wild
elephants when the herd turned and
charged. She was unable to reach the
safety of her vehicle before she was
trampled.
The homicide occurred in a 63-year-old
female Volunteer, who was killed by a
blow to the head from intruders during
the burglary and robbery of her home.
One death due to medical illness
occurred in a 31-year-old male
Volunteer who was diagnosed with
acute leukemia. He presented a month
prior to his diagnosis with a dental
abscess after having a tooth extracted.
Although the infection was treated, he
continued to feel unwell. Evaluation of
a blood smear revealed the presence of
blast cells. He was evacuated to a
tertiary medical facility, where he was
thought to have sepsis secondary to
immunosuppression from his leukemia.
Despite aggressive medical support, he
suffered a respiratory arrest one day
after hospital admission and died. An
autopsy confirmed the leukemia and
revealed he had suffered a cerebral
hemorrhage.
The second death due to medical
The Health of the Volunteer
illness occurred in a 23-year-old male
Volunteer, who during a vacation
suffered a respiratory arrest at night.
Resuscitation efforts at the scene were
unsuccessful. An autopsy revealed that
he had complete blockage of his trachea
from an aspirated bolus of undigested
food.
The fifth death of a Volunteer in 2001
occurred in a 27-year-old male, who
was found dead in his home after not
having been seen for three days. The
body was in an advanced state of
decomposition when found. An
autopsy did not reveal the cause of
death; therefore, the category of death
for this Volunteer remains
undetermined.
Tropical Diseases
Dengue
Dengue fever is caused by infection
with certain viruses from the family
known as flaviviruses. There are four
serotypes of dengue virus (DEN-1,
DEN-2, DEN-3, DEN-4), all of which
cause human disease. Dengue virus is
transmitted primarily when humans are
bitten by mosquitoes of the species
Aedes aegypti. These are day-biting
mosquitoes that prefer humans to
animals as the source of their blood
meals.
It is estimated that worldwide there are
up to 100 million cases of dengue fever
annually.18 In the last two decades, the
geographic extent of dengue fever has
increased markedly, with more cases
and outbreaks being noted particularly
in Western Hemisphere countries (i.e.,
South and Central America and the
Caribbean). Clinical illness can range
§ 11 Spring 2001
from a self-limited, nonspecific viral
syndrome to severe hemorrhagic
disease with shock and death. The
classic form of the disease is
characterized by fever, chills, myalgia,
headache, and after a few days, the
development of a rash (nonpruritic,
often petechial). Blood examination
often shows thrombocytopenia and
leukopenia. The disease resolves over
a few weeks, although fatigue may last
for months. However, the risk of severe
disease increases when sequential
infections occur with different viral
serotypes. The severe forms of the
disease are dengue hemorrhagic fever
(DHF) and dengue shock syndrome
(DSS). The case definition by the
World Health Organization for DHF, in
addition to fever and
thrombocytopenia, includes
hemorrhagic phenomena (bleeding
from mucosa, intestinal tract, injection
sites, or other locations) and
hemoconcentration (a rise in hematocrit
of at least 20% above baseline). The
case definition of DSS includes all the
criteria of DHF plus clinical evidence
of hypotension (shock).
In 2000, dengue fever was added as a
reportable condition in the ESS.
Separate dengue reporting was added
because it had previously been captured
only as an unspecified febrile illness,
because Volunteers are known to have
become infected with dengue virus, and
because there is a global resurgence of
the disease. In 2001, there were 73
reported cases of dengue fever in 15
countries (Table 2). The incidence of
reported dengue was 1.1 per 100 V/T-
Years. Fifty-five cases (75%) occurred
in the IAP region, where the incidence
was 2.4 per 100 V/T-Years. Reported
dengue cases
show a marked seasonal pattern, with
cases peaking between May and
November (Figure 30). No cases of
dengue in Volunteers in 2000 or 2001
are known to have met the case
definitions for either DHF or DSS.
There are no vaccines and no antiviral
agents that specifically treat or provide
prophylaxis against dengue fever.
Prevention measures are to avoid
mosquito bites by using insect
repellents, clothing that covers exposed
skin, pesticide-impregnated bed nets,
and screens on dwelling doors and
windows. These prevention methods
also prevent malaria.
Schistosomiasis
Schistosomiasis is a clinical entity
characterized by granulomatous
formation resulting from infection with
parasitic trematode blood flukes known
as schistosomes. Almost all human
infections are caused by five species,
Schistosoma mansoni, S. hematobium,
S. japonicum, S. mekongii, and S.
intercalatum. Mixed infections can
occur, particularly in sub-Saharan
Africa. The global distribution of the
parasites, egg morphology, preferred
site of residence in the human host,
snail host, and pathophysiology of the
disease differ among the species.
Nonetheless, all infections are acquired
from freshwater sources containing
free-swimming larval forms (cercariae)
that have developed in snails. The
most common water contact that results
in infection is wading or swimming in
infected water, at which time cercariae
penetrate the skin.
Schistosomiasis is endemic in all the
regions in which Peace Corps
Volunteers serve, although it is most
The Health of the Volunteer
widespread in sub-Saharan Africa. The
incidence and prevalence of
schistosomiasis vary within each
country in which the parasites are
endemic.
In 2001, the incidence of reported
schistosomiasis among in-service
Volunteers was 0.3 per 100 V/T-Years
(Figure 31). This was a 40% decrease
compared with 2000 (0.5 per 100 V/T-
Years). In 1998, OMS implemented
close of service screening procedures
for schistosomiasis in Volunteers who
live in or travel through
schistosomiasis-endemic areas.
Increases in the incidence of
schistosomiasis reported after 1998 are
likely due to increased serologic
screening.
All 23 reported cases of schistosomiasis
in 2001 were in Volunteers serving in
the Africa region (Table 18). Eight
countries reported schistosomiasis cases
in 2001, compared with nine countries
in 2000, underscoring that freshwater
sources other than Lake Malawi may be
sites where Volunteers acquire
infection.
The potential risk of acute clinical
illness in the nonimmune host exists
during the several-month period
following infection and often before the
diagnosis is suspected. During this
time, acute schistosomiasis can occur,
and very rarely, neurologic
schistosomiasis secondary to the
ectopic deposition of eggs in the brain
or spinal cord can occur. The onset of
both conditions is usually within 35 to
40 days of exposure to heavily infested
water and corresponds to the first
period of egg deposition by the now
mature flukes within the body. It is
during this time that the body begins to
§ 12 Spring 2001
mount an antibody response to the
fluke and egg antigens.
When acute schistosomiasis is
suspected in an active-duty Volunteer,
the PCMO should contact the area
PCMO (APCMO) and/or OMS along
with local consultation, when available.
Mild chronic schistosomiasis may
occur in Volunteers who become
infected after exposure to freshwater
infested with cercariae but who remain
asymptomatic. This usually occurs in
the setting of a light infection with few
adult worms present. However, over
time symptoms may develop referable
to the site of infection. Such cases may
come to medical attention following
service. In 2001, 24 post-service
claims for schistosomiasis were filed
with the Department of Labor by
RPCVs. Eighteen completed service in
2000 and six closed service in 2001.
There were 10 countries of service of
the claimants: Mali (four claims),
Niger (four claims), Senegal (four
claims), Zambia (four claims), Cote
d’Ivoire (two claims), Mauritania (two
claims), Ghana, Guinea, South Africa,
and The Gambia (one claim each).
Prevention is key in the control of
schistosomiasis morbidity and disability
among Volunteers and RPCVs. Both
PST and IST are ideal times to stress
the importance of avoiding skin
exposure to suspect freshwater sources,
which in Africa include essentially all
freshwater lakes, slow-moving streams,
etc. Should very brief and accidental
skin exposure occur, cercarial
penetration can be minimized by
vigorous and complete towel drying
followed by the application of 70%
isopropyl alcohol
immediately to the skin to kill surface
cercariae.19
Filariasis
Filariasis is a clinical condition
resulting from infection with one of
several long, threadlike nematodes that
parasitize the tissues of humans and
some animals. These parasites, which
have different vectors for transmission,
include the mosquito-borne parasites
that cause lymphatic filariasis:
Wuchereria bancrofti, Brugia malayi,
and Brugia timor; Onchocerca volvulus
(river blindness), transmitted by black
flies; and Loa loa (eye worm),
transmitted by the tabanid fly. In
addition, some less common varieties
of filaria exist in the Africa and IAP
regions. Each parasite has its own
ecological niche, although some
overlap occurs. W. bancrofti is
endemic in most of the warm, humid
regions of the world, including Latin
America.
Volunteers serving in areas in which
Loa loa is highly endemic receive
diethylcarbamazine (DEC) as a weekly
chemoprophylactic therapy.
In 2001, only one case of filariasis was
reported (Table 4). The overall
incidence of filariasis in 2001 was 0.01
per 100 V/T-Years (Figure 32).
In 2001, one RPCV submitted a claim
to the Department of Labor for service-
related filariasis (Loa loa). This
Volunteer ended service in Cameroon
in 1999.
Neither the ESS nor service-related
claims differentiate among the species
of filariasis. However, based upon the
geographic distribution of the different
The Health of the Volunteer
species, cases in Central Africa are
most likely loiasis, whereas cases from
West Africa are more likely to be
onchocerciasis. Mixed infections with
both Loa loa and O. volvulus can occur
as a result of overlapping endemic
regions.
Eosinophilia is commonly seen with
filarial infections, so filariasis should be
considered in Volunteers living in an
endemic area who have persistent
eosinophilia and in whom an evaluation
for intestinal parasites has been
unrevealing. Significant elevation in
the eosinophil count of several weeks-
duration has been associated with the
development of endocardial lesions,20
although the frequency of this
complication is low. No Volunteers
have thus far been diagnosed with
endocardial lesions. PCMOs who
identify a Volunteer with cryptic
persistent eosinophilia should consult
with their APCMO and/or OMS to
discuss further diagnostic options.
Intestinal Helminths
Soil-transmitted intestinal helminths, or
geohelminths, have been reported in all
regions where Volunteers serve.
Intestinal helminths are divided into
three categories according to their life
cycle. Type 1, the direct geohelminths,
include Enterobius vermicularis and
Trichuris trichiura and do not require a
period in the soil to become infectious
for humans. Type 2, the modified
direct geohelminths, are passed in the
stool and undergo a period of
development in the soil before they can
be infectious upon ingestion. Included
in this group are Ascaris lumbricoides
and Toxocara canis. The type 3
geohelminths infect humans via
§ 13 Spring 2001
penetration of the skin and include
Ancylostoma (hookworm) and
Strongyloides stercoralis.
In 2001, the incidence of reported
geohelminth infection was 2.7 per 100
V/T-Years, 10% less than the incidence
in 2000 (3.0 per 100 V/T-Years)
(Figure 33). The largest number (98)
(55%) and highest region-specific
incidence (4.2 per 100 V/T-Years) was
reported in the IAP region (Table 5).
Although the incidence in the Africa
region (2.4 per 100 V/T-Years) in 2001
was 41% higher than the incidence in
2000, when compared to incidences in
1993, all three regions have
demonstrated slowly decreasing
incidences (Figure 34). Efforts to
reduce infections should continue to
focus on prevention strategies that
interrupt transmission and decrease the
risk of exposure.
HIV and Conditions
Associated
Associated With Sexual
Activity
Human Immunodeficiency Virus
Infections
Four newly identified human
immunodeficiency virus (HIV)
infections were reported among
Volunteers in 2001. The self-reported
risk factor in all four was unprotected
sexual intercourse. The incidence of
HIV infection in PCVs in 2001 was 5.9
per 10,000 V/T-Years (Figure 35).
Routine HIV testing of all Peace Corps
applicants was required beginning in
1987. Also beginning in 1987, all
Volunteers were offered voluntary HIV
testing at close of service. On the
basis of HIV testing, 30 HIV infections
are known to have been acquired
during Peace Corps service.
The overall incidence of HIV infection
for the period 1993–2001 was 3.6 per
10,000 V/T-Years or about one in
3,000. The incidence of HIV infection
in Volunteers decreased from 1995 to
1999, after pre-service training modules
and videotape training materials on
HIV and sexually transmitted disease
(STD) prevention were introduced
(Figure 36). However, since 2000 the
incidence of HIV infection has begun
to increase again.
During the period 1993–2001, the
incidence in women (4.2 per 10,000
V/T-Years) was 1 ½ times the
incidence in men (2.8 per 10,000 V/T-
Years) (Figure 37). This finding
highlights that unprotected sexual
intercourse predominates as a risk
factor for HIV acquisition during Peace
Corps service. Male-to-female
transmission of HIV is known to be
more efficient than female-to-male
transmission,21 and likely accounts for
the higher incidence in women.
The incidence of HIV infection during
1993–2001 in the Africa region (7.9
per 10,000 V/T-Years) was almost four
times the incidence in the IAP region
(2.0 per 10,000 V/T-Years) (Figure
38). No cases of HIV infection
occurred among Volunteers in the
EMA region during 1993–2001.
During the period 1993–2001, the
highest age-specific incidence of HIV
infection occurred in Volunteers ages
30 to 39 years (7.3 per 10,000 V/T-
Years), while the lowest incidence was
in persons under 25 years old (0.4 per
The Health of the Volunteer
10,000 V/T-Years) (Figure 39).
A substantial proportion of Volunteers
have another STD identified in-country
prior to testing positive for HIV
antibody. This finding suggests the
need for continuing education of
Volunteers throughout service
regarding strategies and behaviors for
reducing risk and avoiding HIV
infection and other STDs.
Since 1997, OMS has evaluated
possible HIV exposures for
consideration of post-exposure
prophylaxis (PEP) using antiretroviral
drugs. In 1998, OMS issued a protocol
that requires urgent consultation on
cases in which HIV exposure is
possible and HIV PEP may be
indicated. During the 4 ½ year period
from July 1997 through December
2001, 173 Volunteers received HIV
PEP, an overall incidence of HIV PEP
of 5.8 per 1,000 V/T-Years.22 No PCV
on whom OMS has consulted or who
has received HIV PEP has become
HIV-infected. However, none might be
expected in a group of this size, as the
risk of HIV transmission per sexual
contact with an HIV-infected source is
estimated at one in 1,000.21
There have been three (10%) deaths to
date among the 30 RPCVs who were
infected with HIV during service.
Most of the lost wages, diminished
productivity, emotional stress, and
health care costs for HIV-infected
persons ensue when the individual
moves into the later stages of infection.
Recent advances in combination
antiretroviral therapy, including
introduction of protease inhibitors, have
improved survival in HIV-infected
individuals.23 However, as a
§ 14 Spring 2001
result of the added expense of such
therapies, the average lifetime cost of
medical care for persons living with
HIV/AIDS is anticipated to increase by
at least $50,000 to $100,000.
Sexually Transmitted Diseases
Sexually transmitted diseases, which
include genital-ulcer-producing
conditions (syphilis, genital herpes),
human papillomavirus (genital warts),
and non-ulcer-producing STDs
(chlamydia, gonorrhea, ureaplasma,
trichomoniasis, etc.), were reported in
all regions. The incidence of reported
STDs in 2001 was 3.5 per 100 V/T-
Years, a 9% increase compared with
2000 (3.2 per 100 V/T-Years) (Figure
40). The incidence of STDs among
Volunteers in general has been lower
since 1995, when pre-service training
modules and videotape training
materials on HIV and STD prevention
were introduced.
Review of region-specific trends
reveals that the incidence of reported
STDs has decreased in all three regions
compared with the incidence in 1991–
1993 (Figure 41). In 2001, five
countries had incidences of reported
STDs greater than 10 per 100 V/T-
Years (three in the IAP region, one in
the Africa region, and one in the EMA
region) (Figure 42).
Each STD represents a potential
exposure to HIV. The risk of HIV
infection during a single unprotected
sexual contact with an HIV-infected
partner is greater among individuals
with STDs, and is greatest for those
who have genital ulcer disease.24 The
combination of the compromised
mucosal surface and increased number
of infection-fighting cells with
receptors for HIV (CD4+ T-
lymphocytes) in the ulcer infiltrate is
thought to play a role.25 The
occurrence of an STD represents an
additional opportunity to counsel
Volunteers to reduce their health risks
from intimate behaviors.
Pregnancies
PCMOs report pregnancy confirmed by
appropriate techniques during the
month in which the pregnancy was
confirmed. In 2001, the incidence of
pregnancies was 1.1 per 100 female
V/T-Years (Figure 43). This was 15%
less than the incidence of pregnancies
in 2000 (1.3 per 100 female V/T-
Years), and 50% less than in 1989 (2.2
per 100 female Volunteers). The
reduction in pregnancies since 1989 is
notable because female V/T-Years as a
percentage of all V/T-Years have
increased 18%, from 52% in 1993 to
61% of all V/T-Years in 2001 (Figure
44). Almost all pregnancies in PCVs
are unintended.
There were 45 pregnancies in 2001
(Table 16). The greatest number (26)
(58%) and highest region-specific
incidence of pregnancies (1.9 per 100
female V/T-Years) occurred in the IAP
region (Figure 45). The incidence of
pregnancies in all three regions has
been slowly decreasing since 1996,
with the lowest incidence (0.3 per 100
female V/T-Years) and greatest
decrease in 2001 occurring in the EMA
region. Honduras reported six
pregnancies in 2001, while Mali and
Dominican Republic reported five each.
Eight countries (four in the IAP region,
two in the EMA region, and two in the
Africa region) had incidences of
pregnancies in 2001 greater than or
equal to 4.0 per 100
The Health of the Volunteer
female V/T-Years (Figure 46).
In order to reduce the incidence of
pregnancies, it is important for female
PCVs to have less unprotected sexual
intercourse, which would also protect
them from HIV and other sexually
transmitted diseases. PCMOs should
continue their emphasis on safer sexual
behaviors during PST and IST, as well
as during one-on-one counseling
opportunities that occur with
Volunteers throughout their Peace
Corps service.
Other Health Conditions
Tuberculosis
Tuberculosis (TB) remains one of the
leading causes of death worldwide.
The emergence of multiple-drug-
resistant TB has increased the urgency
for improved surveillance for this
disease.26 The total lifetime risk for the
development of an active case of TB
following infection is 10%. More than
half of this risk is borne in the first two
years following infection. The ideal
way to identify new infections and to
prevent active disease among persons at
risk for acquiring the organism is to
have an annual skin-testing program.
Early identification of infections is
coupled with the use of preventive
therapy, usually isoniazid (INH), for
chemoprophylaxis against the
development of active disease. The use
of INH decreases the total lifetime risk
of developing active TB to 2%.
In 2001, the incidence of tuberculin
skin test (TST) conversions was 1.4 per
100 V/T-Years (Figure 47). Ninety-
two TST conversions occurred in 37
countries in 2001 (Table 19).
§ 15 Spring 2001
The overall incidence of TST
conversions increased 17% compared
with 2000 (1.2 per 100V/T-Years).
The region-specific incidence of TST
conversions in 2001 was highest in the
EMA region (1.9 per 100 V/T-Years)
and lowest in the IAP region (0.8 per
100 V/T-Years) (Figure 48). Country-
specific incidences greater than 4.0 per
100 V/T-Years were reported in seven
countries (five in the EMA region and
two in the Africa region) (Figure 49).
Only Macedonia reported an incidence
of TST conversions greater than 4.0 per
100 V/T-Years in both 2000 and 2001.
However, Macedonia ceased Peace
Corps operations during 2001.
In 2001, one Volunteer was diagnosed
with active TB, compared with none in
2000 and three in 1999.
TB remains a risk for Volunteers
throughout the world. The introduction
of Technical Guideline (TG) #645,
“Pulmonary Tuberculosis,” in 1995
increased awareness of TB infection
and the benefits of initiating treatment
for latent TB infection prior to the
development of active TB. TG #645
stresses the use of the Mantoux
intradermal skin test as the preferred
screening method, and Volunteers are
not allowed to read, interpret, or report
the results of their own tests.
Furthermore, the use of the
multipuncture (tine) skin test is no
longer considered acceptable for
screening Volunteers at close of
service.
Use of proper technique in applying a
TST cannot be overemphasized.
Equally important is when and how the
test is read. The TST must be read by a
health care provider optimally 48 to
72 hours after the test has been applied.
The induration (not redness) at the site
should be measured and recorded by
the PCMO in millimeters.
Misclassification of some Volunteers as
converters may occur when they are in
fact reactors who had their immunity
“boosted” at the time of initial testing
prior to service (this phenomenon is
most likely to occur in those over age
55).
Vaccine-Preventable Diseases and
Vaccine Use
PCMOs report monthly in the ESS the
number of doses of vaccines given to
Volunteers and trainees for hepatitis A,
hepatitis B, Japanese B encephalitis,
meningococcal disease, rabies
(preexposure and postexposure), tick-
borne encephalitis, and typhoid (oral
and injectable). Also reported are the
numbers of doses of rabies
hyperimmune immunoglobulin (HRIG)
given.
In 2001, 23,588 doses of vaccine and
16 doses of HRIG were reported to
have been given to Volunteers and
trainees (Tables 22 and 23). The
largest number of doses given were
7,486 doses of rabies vaccine (7,196
preexposure, 290 postexposure),
followed by 5,217 doses of hepatitis B
vaccine, 4,785 doses of hepatitis A
vaccine, and 3,051 doses of typhoid
vaccine (108 oral, 2,943 injectable).
This distribution is affected in part by
the fact that preexposure rabies vaccine
and hepatitis B vaccine consist of three-
dose series.
The vaccine-preventable diseases
reported among Volunteers in 2001
included three cases of typhoid fever.
The occurrence of such cases might be
The Health of the Volunteer
expected because field trials of the
injectable Vi capsular polysaccharide
typhoid vaccine, the one preferred for
overseas use, demonstrated an efficacy
of only 74% in preventing blood-
culture-confirmed typhoid fever among
vaccine recipients when observed for
20 months in a disease-endemic area.27
Asthma
The incidence of reported asthma cases
in 2001 was 2.2 per 100 V/T-Years, a
10% increase from 2000 (2.0 per 100
V/T-Years) (Figure 50). This category
includes both newly diagnosed cases of
asthma and recurrences of previously
controlled asthma. The IAP region
reported the highest region-specific
incidence of asthma in 2001 (3.0 per
100 V/T-Years) (Table 14). Among
countries with incidences of asthma
greater than 6.0 per 100 V/T-Years
(Figure 51), five (Burkina Faso, China,
Costa Rica, Estonia, and Russia/Far
East) are not designated as countries
that can accommodate Volunteers with
controlled asthma. China has reported
an incidence of asthma greater than 6.0
per 100 V/T-Years every year since
1998. These data suggest that reported
asthma in these countries represents
either new onset asthma or previously
unrevealed asthma. OMS continues to
review which countries are able to
accommodate Volunteers with stable,
controlled asthma and updates country-
specific information as appropriate.
Alcohol Problems
The incidence of reported problems
with alcohol among Volunteers in 2001
was 1.5 per 100 V/T-Years, unchanged
compared with 2000 (Figure 52). The
incidence in 2001 was 40% less than
the peak incidence of alcohol problems
§ 16 Spring 2001
reported in 1996 (2.5 per 100 V/T-
Years). Alcohol problems are defined
as situations in which a Volunteer’s
behavior is altered or physical/mental
acuity is impaired because of alcohol
intoxication. Signs of intoxication
might include violent behavior, slurred
speech, a decrease in physical
coordination, or unconsciousness.
Incidents might be observed by medical
staff, other in-country staff, or other
reliable sources. Multiple incidents of
alcohol problems in the same Volunteer
during the same month should be
reported only once.
The highest region-specific incidence
of alcohol problems was reported in the
EMA region (2.5 per 100 V/T-Years)
(Table 1), a finding that has also been
observed in previous years. This may
be explained by cultural norms
regarding alcohol use in some of the
EMA region countries that promote
social drinking of alcohol by
Volunteers and may lead to problem
drinking.
Cardiovascular Conditions
The incidence of reported
cardiovascular conditions in 2001 was
1.7 per 100 V/T-Years (Table 1). The
highest region-specific incidence was
reported in the EMA region (3.7 per
100 V/T-Years). This may reflect the
older age of Volunteers who serve in
the EMA region. Reported
cardiovascular conditions are those
related to the heart and blood vessels
that are evaluated by a health care
professional. Although one
cardiovascular problem may result in
several visits, it should be reported only
once. Palpitations and chest pain are
not reportable as a cardiovascular
condition unless a specific cardiac
disorder is diagnosed.
Consistent with the association of
cardiovascular conditions with older
age, in a study of OMS-authorized
medevacs ages 65 or older during
1996–1998, cardiovascular conditions
represented the largest percentage
(15%) of final diagnostic categories of
medevacs.28
Health Interactions
Volunteer-PCMO Contacts
PCMOs report the number of contacts
they have with Volunteers about health
conditions on a monthly basis. A
contact is defined as an interaction that
a Volunteer or trainee has with the
health unit for any health- or safety-
related matter. Contacts include office
visits, telephone conversations, letters,
faxes, e-mails, or site visits by the
PCMO in which health- or safety-
related matters are discussed. They
also include visits for routine
immunizations and medical supplies.
These data do not include interactions
between Volunteers and PCMOs that
occur during PST or IST, when the
PCMO is teaching/interacting with a
group of Volunteers.
In 2001, there were 149,184 Volunteer-
PCMO health care contacts, or 12,984
contacts per month (Table 20). This
translates to 1.9 contacts per V/T-Year
each month. The per-country range
was between 0.4 and 5.8
The Health of the Volunteer
contacts per V/T-Year per month.
Contact rates in all three regions in
2001 remained generally stable (Figure
53). These rates provide a better
estimate of the total workload of
PCMOs than the number of illnesses
and conditions reported monthly in the
ESS.
Medevacs
Medevacs include both OMS-
authorized and country-sponsored
(regional) medevacs (CSMs). OMS-
authorized medevacs are reported in the
Peace Corps Medevac Case
Management System managed by the
Field Support Unit. The number of
CSMs is reported monthly in the ESS
and individual case reports of each
CSM is reported as per Technical
Guideline #430. The overall incidence
of all medevacs in 2001 was 10.3 per
100 V/T-Years. In 2001, there were
693 medical evacuations; 558 (80%)
were OMS-authorized medevacs,
primarily to receive care in the United
States, and 135 (20%) were CSMs
(Table 13) (Figure 54). The overall
incidence of all types of medevacs in
2001 decreased 1% compared with
2000 (10.4 per 100 V/T-Years).
However, the incidence of OMS-
authorized medevacs increased by 5%,
from 7.9 per 100 V/T-Years in 2000 to
8.3 per 100 V/T-Years in 2001, while
the incidence of CSMs decreased by
20%, from 2.5 per 100 V/T-Years in
2000 to 2.0 per 100 V/T-Years in 2001
(Figure 55).
The distribution of medevacs varied by
region (Figure 56). In 2001, the
highest region-specific incidence of
OMS-authorized medevacs occurred in
the EMA region (8.9 per 100 V/T-
Years) while the lowest incidence was
§ 17 Spring 2001
in the Africa region (7.5 per 100 V/T-
Years). For CSMs, the highest region-
specific incidence was in the Africa
region (4.1 per 100 V/T-Years) and the
lowest was in the IAP region (0.3 per
100 V/T-Years). The observed
differences likely reflect the overall
health care delivery systems in
countries of a particular region, a
country’s geographic proximity to the
United States, or the availability of
nearby advanced-care tertiary facilities.
In the Africa region, the presence of
APCMOs along with the availability of
advanced medical care in Cote d’Ivoire,
Kenya, Senegal, and South Africa may
account for the higher incidence of
CSMs.
In-Country Hospitalizations
The incidence of in-country
hospitalizations (ICHs) reported in
2001 was 5.4 per 100 V/T-Years, a
decrease of 11% compared with 2000
(Figure 57). In 2001, fewer Volunteers
than in 2000 required medevacs, and
fewer required ICHs.
A hospitalization is defined in
Technical Guideline #410 as an
overnight stay in a clinic, hospital, or
similar facility authorized by medical
staff for the monitoring or treatment of
a health condition that requires
prolonged attendance by a medical
professional. Overnight stay at a non-
health-care facility (e.g., a staff
member’s residence) is included among
hospitalizations if the Volunteer had a
condition that required hospitalization
but an appropriate hospital was not
available.
In 2001, the IAP region had the highest
region-specific incidence of ICHs (8.5
per 100 V/T-Years), over twice the
incidence reported in the Africa region
(4.0 per 100 V/T-Years) or the EMA
region (3.4 per 100 V/T-Years) (Table
6).
Three countries (Honduras, Malawi,
and Philippines) had incidences of
ICHs greater than 20 per 100 V/T-
Years. These patterns of
hospitalization may reflect differences
in locally available facilities and
supporting services including
laboratories, differences in patterns of
medical evacuations for acute illnesses,
and underreporting of hospitalizations
in countries where the PCMO’s home
or the Peace Corps health unit serves as
the de facto hospital.
References
1. CDC. 1991. Hepatitis B virus: a comprehensive
strategy for eliminating transmission in the United
States through universal childhood vaccination. Morb
Mortal Wkly Rpt, 40: RR-13.
2. CDC. 1990. Protection against viral hepatitis. Morb
Mortal Wkly Rpt, 39: RR-2.
3. CDC. 1998. Recommendations for prevention and
control of hepatitis C virus (HCV) infection and HCV-
related chronic disease. Morb Mortal Wkly Rpt, 47:
RR-19.
4. Murphy GS, Oldfield EC. 1996. Falciparum
malaria. Infect Dis Clin N Amer, 10: 747-775.
5. Lobel HO, Kozarsky PE. 1997. Update on
prevention of malaria for travelers. JAMA, 278: 1767-
1771.
6. Shanks GD. 1999. New options for the prevention
and treatment of malaria: focus on the role of
atovaquone and proguanil hydrochloride. J Travel
Med, 6: S1.
7. Gerber AR, Prybylski D (eds.). 2001. The Health of
the Volunteer 2000. Peace Corps, Wash D.C.
8. Gerber AR, Prybylski D (eds.). 2000. The Health
and Safety of the Volunteer 1999. Peace Corps, Wash
D.C.
9. CDC. 2000. Prevention and control of influenza.
Morb Mortal Wkly Rpt, 49: RR-3.
10. Rimoin A, Gerber AR. 1999. Office of Medical
Services-Authorized Mental Health Medical
Evacuations, 1996–1998. Peace Corps, Wash D.C.
11. The Mental Health Task Group. 2001. Mental
Health Report. Peace Corps, Wash D.C.
12. Thompson DC, et al. 1989. A case-control study of
the effectiveness of bicycle safety helmets. N Engl J
Med, 320: 1361-1367.
The Health of the Volunteer
13. Thompson DC, et al. 1996. Effectiveness of
bicycle safety helmets in preventing serious facial
injury. JAMA, 276: 1974-1975.
14. Torian LV, et al. 1995. Increasing HIV-1
seroprevalence associated with genital ulcer disease,
New York City, 1990-1992. AIDS, 9: 177-181.
15. Weir SS, et al. 1994. Gonorrhea as a risk factor for
HIV acquisition. AIDS, 8: 1605-1608.
16. Bergeisen, GH. 1999. Environmental Health:
Answers to Volunteer and Staff Questions. Peace
Corps, Wash D.C.
17. Bergeisen, GH. 2001. Radiation Health and
Safety: Answers to Volunteer and Staff Questions.
Peace Corps, Wash D.C.
18. Rigau-Perez JG, et al. 1998. Dengue and dengue
haemorrhagic fever. Lancet, 352: 971-977.
19. Chin J (ed.). 2000. Control of Communicable
Diseases Manual. Am Pub Health Assn, Wash D.C.
20. Gleich GJ, et al. 1993. The biology of the
eosinophilic leukocyte. Annu Rev Med, 44: 85-101.
21. Mastro TD, de Vincenzi I. 1996. Probabilities of
sexual HIV-1 transmission. AIDS, 10 (suppl A): S75-
S82.
22. Gerber AR, White K. 2002. HIV Post-Exposure
Prophylaxis in Peace Corps Volunteers 1997–2001.
Peace Corps, Wash D.C.
23. Carpenter CCJ, et al. 1996. Antiretroviral therapy
for HIV infection in 1996. JAMA, 276: 146-154.
24. Laga M, et al. 1993. Non-ulcerative sexually
transmitted diseases as risk factors for HIV-1
transmission in women: results from a cohort study.
AIDS, 7: 95-102.
25. Holmberg SD, et al. 1989. Biologic factors in the
sexual transmission of human immunodeficiency
virus. J Infect Dis, 160: 116-125.
26. Garin B, et al. 1995. Drug-resistant
Mycobacterium tuberculosis strains in tuberculosis
inpatients in Bangui, Central African Republic. AIDS,
9: 213-214.
27. Acharya IL, et al. 1987. Prevention of typhoid
fever in Nepal with the Vi capsular polysaccharide of
Salmonella typhi. N Engl J Med, 317: 1101-1104.
28. Gerber AR. 1999. Office of Medical Services-
Authorized Medical Evacuations in Older Volunteers,
1996–1998. Peace Corps, Wash D.C.
Graphic Displays
1993–2001 Volunteer Health Trends Figure 1

Incidence of Motorcycle Injuries

1.6
1.5
Injuries/100 V/T-Years

1.5

1.1

1
0.8 0.8

0.5 0.4 0.4

0.3 0.3

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 2
2001 Volunteer Health Country Profiles

Highest Incidence of Motorcycle Injuries

Benin N=4 3.6

Dom. Republic N=4 2.5

Guinea N=2 1.9

Jordan N=1 1.4

Mongolia N=1 1.3

South Africa N=1 1.1

Niger N=1 1

0 1 2 3 4 5
Cases/100 V/T-Years
1993–2001 Volunteer Health Trends Figure 3

Incidence of Hepatitis
0.5
Hepatitis A
Hepatitis B
Hepatitis B vaccine Hepatitis A vaccine approved by
becomes a universal FDA and replaces gamma globulin Hepatitis C
vaccine for PCVs every 3-6 months
0.4 Hepatitis E
Cases/100 V/T-Years

0.16 Hepatitis Unsp

0.3
0.05
0.19
0.19
0.2 0.03
0.02
0.02 0.03
0.04 0.01
0.24 0.02
0.1 0.01
0.02
0.02
0.14 0.13 0.13
0.11 0.02
0.1 0.1
0.08
0.05
0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 4
1986–2001 Africa Region Volunteer Health Trends
Incidence of Falciparum Malaria

25

Mefloquine
Chloroquine resistance introduced
20
spreads to W. Africa
Cases/100 V/T-Years*

16
15.2 Weekly mefloquine
14.9
15 recommended

9.7
10
8.3
6.2 6.3
5.2
4.5 4.2 4.5 4.5 4.4 4.6
5 3.6
3.3

0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Note: Data represent laboratory-confirmed cases only
*Prior to 1993, rates per 100 Volunteer/Year were used as an approximation of V/T-Years
1993–2001 Volunteer Health Trends Figure 5

Incidence of Non-Falciparum Malaria

0.5

0.4
Cases per 100 V/T-Years

0.3 0.3
0.3

0.2 0.2 0.2 0.2 0.2 0.2

0.2

0.1
0.1

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
Note: Data represent laboratory-confirmed cases
 Figure 6
1995–2001 Africa Region Volunteer Health Trends

Monthly Antimalarials Prescribed

Mefloquine Doxycycline Malarone

100
91.1 89.2
88.7 86.7 86.2
83.9 83.5
80
Percent per month

60

40

20
11 11.5
8 8.9 9 8.8
5.6
0.7
0

1995 1996 1997 1998 1999 2000 2001

2001 Volunteer Health Profile Figure 7

Incidence of the Ten Most Commonly

Reported Health-Related Events
Diarrhea, acute 79.6

Upper respiratory illness 48.6

Mental health needs 34.2

Dermatitis 31.3

Dental problems 27.3

Injuries, unintentional 22.2

Febrile illness 16.2

Non-STD gyn. infections 12.7

Lower respiratory illness 7.1

Environmental concerns 4.2

0 20 40 60 80 100
Events per 100 V/T-Years
2001 Africa Region Volunteer Health Profile Figure 8

Incidence of the Ten Most Commonly

Reported Health-Related Events
Diarrhea, acute 94.1

Upper respiratory illness 38.4

Dermatitis 33

Mental health needs 28.5

Febrile illness 19.2

Dental problems 19.1

Injuries, unintentional 16.5

Non-STD gyn. infections 9.9

Presumptive malaria 6.2

Lower respiratory illness 4.6

0 20 40 60 80 100 120
Events per 100 V/T-Years
2001 Inter-America & the Pacific Region Volunteer Health Profile Figure 9

Incidence of the Ten Most Commonly

Reported Health-Related Events
Diarrhea, acute 81
Upper respiratory illness 53.7
Dermatitis 40.7
Mental health needs 29.5
Injuries, unintentional 28.1
Dental problems 27.8
Non-STD gyn. infections 17.2
Febrile illness 14.6
Lower respiratory illness 8
Environmental concerns 4.6

0 20 40 60 80 100
Events per 100 V/T-Years
2001 Europe, Mediterranean & Asia Region Volunteer Health Profile Figure 10

Incidence of the Ten Most Commonly

Reported Health-Related Events
Diarrhea, acute 60.8

Upper respiratory illness 54.6

Mental health needs 46.2

Dental problems 36.4

Injuries, unintentional 22.2

Dermatitis 18.8

Febrile illness 14.6

Non-STD gyn. infections 10.8

Lower respiratory illness 9.2

Environmental concerns 6.3

0 20 40 60 80 100
Events per 100 V/T-Years
1993–2001 Volunteer Health Trends Figure 11

Incidence of Acute Diarrhea

100
86.9
81.3 79.7 79.6
78.5 78.1
80
Cases/100 V/T-Years

63.4 63.4 65.2

60

40

20

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
2001 Volunteer Health Country Profiles Figure 12

Highest Incidence of Acute Diarrhea

Haiti N=155 285.2

Georgia N=37 235.6

Uganda N=27 196.6

Senegal N=280 195.3

Niger N=185 188

Benin N=209 187.5

Kiribati N=104 187.1

0 50 100 150 200 250 300 350

Cases per 100 V/T-Years
 Figure 13
1995–2001 Volunteer Health Trends
Incidence of Upper Respiratory Tract
Illnesses
60

Implemented TG 410 51.1 51.8

50.2
with new or revised 48 48.6
50 reporting categories
43.6
Cases/100 V/T-Years

40

30
23.6

20

10

0
1995 1996 1997 1998 1999 2000 2001
2001 Volunteer Health Country Profiles Figure 14

Highest Incidence of Upper Respiratory

Tract Illnesses
Macedonia* N=28 142.4

Samoa N=78 125.3

Uganda N=16 116.5

Poland* N=32 111

Armenia N=64 103.1

0 20 40 60 80 100 120 140 160

*Country closed in 2001 Cases per 100 V/T-Years
 Figure 15
1993–2001 Volunteer Health Trends

Incidence of Mental Health Needs

40
Implemented TG 410
34.2
with new or revised
reporting categories 31.1
29.8 30.5
30
26.1 27
Cases/100 V/T-Years

22
20.4
20 18.5

10

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
2001 Volunteer Health Country Profiles Figure 16

Highest Incidence on Mental Health Needs

Georgia N=47 299.3

Lithuania N=63 170.5

Zimbabwe* N=40 164.2

Nepal N=135 141.7

Cape Verde N=65 139.2

Macedonia* N=27
137.3

Vanuatu N=60 130

0 50 100 150 200 250 300 350

*Country closed in 2001

Cases per 100 V/T-Years
1993–2001 Volunteer Health Trends Figure 17

Incidence Of Dental Problems

30
27.3
26 26.5
25 25.6
24.9
25 23.2
Cases/100 V/T-Years

20 18.4
16.9

15

10

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
2001 Volunteer Health Profile Figure 18

Incidence of Unintentional Injuries

5

3.9
4
Cases/100 V/T-Years

1.3
1.1
0.9
1
0.4 0.3

0
Sports Bicycle Pedestrian Motor vehicle* Water Motorcycle
*Note: Includes all motor vehicles other than motorcycles or motorboats
2001 Volunteer Health Country Profiles Figure 19

Highest Incidence of Sports-Related Injuries

Georgia N=6 38.2

N=8
Zimbabwe* 32.8

El Salvador N=31 22.1

Romania N=23 16.6

Mozambique N=5
12.6

Tonga N=9 11.9

Lithuania N=4 10.8

0 10 20 30 40 50
Cases/100 V/T-Years
*Country closed in 2001
2001 Volunteer Health Country Profiles Figure 20

Highest Incidence of Bicycle Injuries

Uganda N=3 21.8

Belize N=4 7.4

Togo N=6 7

Burkina Faso N=6 6.9

Micronesia N=4 6.3

Madagascar N=6 4.4

Nepal N=4
4.2

0 5 10 15 20 25
Cases per 100 V/T-Years
 Figure 21
2001 Volunteer Health Country Profiles

Highest Incidence of Pedestrian Injuries

Paraguay N=18 9.7

Costa Rica N=2 7.9

Togo N=6 7

Eastern Caribbean N=6 6.9

Lesotho N=6 6.6

Thailand N=3 5.4

Gabon N=3 4.8

Malawi N=4 4.1

0 5 10 15 20 25
Cases per 100 V/T-Years
2001 Volunteer Health Country Profiles Figure 22

Highest Incidence of Motor Vehicle*

Injuries
Haiti N=5 9.2

Zambia N=8 6.1

Mauritania N=4 4.7

Kyrghyzstan** N=2 4.2

Ghana N=5 3.4

Jamaica N=3 3.3

0 5 10 15 20 25

*Does not include motorcycles Cases per 100 V/T-Years

**Country closed in 2001
 Figure 23
2001 Volunteer Health Country Profiles

Highest Incidence of Water-Related

Injuries
Vanuatu N=5 10.8

Uganda N=1 7.3

Jamaica N=3 3.3

Russia/Far East N=2 3.1

Jordan N=2 2.7

Philippines N=3 2.2

Cape Verde N=1 2.1

0 5 10 15 20 25
Cases per 100 V/T-Years
 Figure 24
2001 Volunteer Health Country Profiles
Highest Incidence of Lower Respiratory
Tract Illness

Moldova N=25 31.2

Jordan N=19 26

Guatemala N=50 21.7

Samoa N=13 20.9

Jamaica N=19 20.7

0 5 10 15 20 25 30 35
Cases per 100 V/T-Years
1993–2001 Volunteer Health Trends Figure 25

Incidence of Environmental Concerns

8

Implemented TG
6.6
410 with new or
Cases per 100 V/T-Years

6 revised reporting
categories 5.4
5.1
4.7
4.2
4
4 3.6

2.6

2 1.5

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 26
2001 Volunteer Health Country Profiles
Highest Incidence of Environmental
Concerns
Uganda N=9 65.5

Romania N=63 45.5

Vanuatu N=13 28.2

Honduras N=47 18.3

China N=13 16.4

Zimbabwe* N=4 16.4

Eastern Caribbean N=14 16

0 20 40 60 80
*Country closed in 2001 Cases per 100 V/T-Years
1961–2001 Volunteer Health Trends Figure 27

Mortality Rates*
25

20 Strategies implemented to
decrease deaths based on
Deaths/10,000 Volunteers

Johns Hopkins University

study recommendations**
15

10

0
61

65

70

75

80

85

90

95

00
19

19

19

19

19

19

19

19

20
* Rate=deaths per 10,000 Volunteers
**Hargarten SW and Baker SP. 1985. Fatalities in the Peace Corps. JAMA 254:1326-1329.
1961–2001 Volunteer Health and Safety Trends Figure 28

Cause-Specific Fatalities
12
1961–1965
10.6
1966–1970
10 1971–1975
1976–1980
Deaths per 10,000 Volunteers

1981–1985
8 7.5 1986–1990
1991–1995
6.5
5.9 1996–2001
6
4.8

4 3.4 3.5
3.2
2.8 2.7
2.1
1.8
2 1.5
1.3
0.9 1
0.7 0.7 0.6 0.6 0.7 0.7
0.5
0.3 0.2
0 0 0.1 0.1 0 0 0
0
Unintentional Injuries Medical Illnesses Homicides Suicides
1967–2001 Volunteer Health and Safety Trends Figure 29

Number of Transportation-Related Deaths

20
18 1967–1976
1977–1986
1987–1993
15 14
Number of Deaths

1994–2001

10 9

6
5
5 4 4
3 3 3
2 2 2 2
1 1
0 0 0 0 0 0 0 0
0
Auto Motorcycle Bus Truck Plane Bike
 Figure 30
2000–2001 Volunteer Health Trends

Dengue Infections, by Month

20
18

15 14 14 14
Number of PCVs

12

10 10
10 9

6 6 6 6 6
5 5 5
5 4 4 4
3 3
2 2 2

0
J F M A M J J A S O N D J F M A M J J A S O N D

2000 2001
 Figure 31
1993–2001 Volunteer Health Trends

Incidence of Schistosomiasis
1.5

COS screening of all PCVs

Cases/100 V/T-Years

leaving or traveling through

endemic areas

1 0.9

0.7 0.7

0.5 0.5
0.5 0.4 0.4 0.4
0.3

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 32
1993–2001 Volunteer Health Trends

Incidence of Filariasis

0.6

0.49
0.5
Cases/100 V/T-Years

0.4

0.3 0.27
0.22
0.2 0.16
0.11
0.09
0.1 0.06

0 0.01
0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 33
1993–2001 Volunteer Health Trends

Incidence of Intestinal Helminths

10

8
Cases/100 V/T-Years

6
4.8

3.8 4
4 3.6
3 3 3
2.7
2.4
2

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
1993–2001 Volunteer Health Regional Trends Figure 34

Incidence of Intestinal Helminths

10
1993 1994
8.4 1995 1996
8
1997 1998
1999 2000
Cases/100 V/T-Years

2001
6
5.4 5.6 5.6
4.8 4.7 5
4.2
4
3.8
3.3 3.2 3.3
3
2.4 2.5 2.4
2.2 2.2 2.1 2 1.8 2.1 2.3 1.9 2.1
2 1.7
1.2

0
AF Region IAP Region EMA Region
 Figure 35
1989–2001 Volunteer Health Trends

HIV Infections, by Year Reported

5

STD and HIV

4 PST Modules and 4 4
4 Video "Come
Back Healthy"
Introduced
Number of Cases

3 3
3

2 2 2 2
2

1 1 1 1
1

0
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Note: All infections have been with HIV-1
 Figure 36
1989–2001 Volunteer Health Trends

Incidence of HIV Infections

10

STD and HIV PST

Modules and Video
7.8
8 "Come Back Healthy"
Cases/10,000 V/T-Years

Introduced

6.1 5.9
6
4.7
4.2 4.4
4 3.5
3.2 3.1

1.8
2 1.5 1.5 1.5

0
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Note: All infections have been with HIV-1
*Prior to 1993, rates per 10,000 Volunteer/Year were used as an approximation of V/T-Years
 Figure 37
1993–2001 Volunteer Health Trends

Incidence of HIV Infections by Gender

10
Cases per 10,000 V/T-Years

4.2
4 3.6
2.8

0
Female Male All
Gender
1993–2001 Volunteer Health Trends Figure 38

Incidence of HIV Infections by Region

10
Cases per 10,000 V/T-Years

7.9
8

4 3.6

2
2

0
0
AFRICA EMA IAP All
Region
 Figure 39
1993–2001 Volunteer Health Trends

Incidence of HIV Infections by Age

Cases per 10,000 V/T-Years
10

8 7.3

6 5.4
4.7

4 3.6

0.4
0
<25 25-29 30-39 40+ All
Age
 Figure 40
1986–2001 Volunteer Health Trends

Incidence of Sexually Transmitted Diseases*

20

15.1
Cases/100 V/T-Years**

15 STD and HIV PST

Modules and Video
"Come Back Healthy"
Introduced

10
7.8
6.1 6
5.4 5
4.5 4.8
5 4.2 3.9 3.9 3.8 3.9 3.5 3.2 3.5

0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

*Includes chlamydia, genital herpes, genital warts, gonorrhea, syphilis, and other STDs
**Prior to 1993, rates per 100 Volunteers/Year were used an approximation of V/T-Years
 Figure 41
1991–2001 Volunteer Health Regional Trends

Incidence of Sexually Transmitted Diseases*

8
1991 1992 1993
7 1994 1995 1996
6.2 1997 1998 1999
Cases/100 V/T-Years**

6 5.7
2000 2001
5.1 5.2 5.2 5.1
4.8 4.9 5
5 4.7
4.4 4.4 4.4 4.3 4.4 4.3
4 4.1
3.9 3.8 3.8
4 3.7
3.5 3.5 3.4 3.4 3.4
3.2 3.3
3
3 2.7
2.5 2.5

0
AF Region IAP Region EMA Region

*Includes chlamydia, genital herpes, genital warts, gonorrhea, syphilis, and other STDs
**Prior to 1993, rates per 100 Volunteers/Year were used an approximation of V/T-Years
 Figure 42
2001 Volunteer Health Country Profiles

Highest Incidence of Sexually Transmitted

Diseases
Samoa N=12 19.3

Guyana N=5 13.5

South Africa N=10 11.2

Bolivia N=19 10.9

China N=8 10.1

Belize N=5 9.3

Morocco N=12 9.1

0 5 10 15 20 25
Cases per 100 V/T-Years
1989–2001 Volunteer Health Trends Figure 43

Incidence of Pregnancy
3
Cases/100 Female V/T-Years*

2.3
2.2 2.2
2.1
2 1.8 1.8
1.7
1.6
1.5
1.3
1.1 1.1
1
1

0
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001

*Prior to 1993, rates per 100 female Volunteer/Year were used as an approximation of female V/T-Years.
1993–2001 Volunteer Health Trends Figure 44

Percentage of Female V/T-Years

100

75

59.3 60.4 61.1 60.8

57.6
53.9 55.3
51.5 52.3
50

25

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 45
1996–2001 Volunteer Health Regional Trends

Incidence of Pregnancy
3
1996
2.5 1997
Cases/100 Female V/T-Years

1998
2.2
1999
2 1.9 1.9 2000
1.7 2001
1.5 1.5
1.3
1.2
1.1 1.1
1 1
1 0.9 0.9
0.7
0.5
0.3

0
AF Region IAP Region EMA Region
 Figure 46
2001 Volunteer Health Country Profiles

Highest Incidence of Pregnancy

Mali N=5 5.8

Mozambique N=1 5.2

Costa Rica N=1 4.6

Suriname N=1 4.5

Dom. Republic N=5 4.5

Lithuania N=1 4.5

Honduras N=6 4.4

Kyrghyzstan* N=1 4

0 1 2 3 4 5 6 7
Cases/100 Female V/T-Years
*Country closed in 2001
 Figure 47
1996–2001 Volunteer Health Trends

Incidence of Tuberculin Skin Test

Conversions
3
Conversions/100 V/T-Years

1.5 1.5
1.4 1.4
1.2 1.2

0
1996 1997 1998 1999 2000 2001
 Figure 48
1996–2001 Volunteer Health Regional Trends

Incidence of Tuberculin Skin Test

Conversions
3
1996 1997 1998 1999 2000 2001
Conversions/100 V/T-Years

2
2 1.9
1.8
1.7
1.6 1.6 1.6
1.5 1.5
1.3
1.2 1.2
1.1 1.1
1 1
1
0.8 0.8

0
AF Region IAP Region EMA Region
 Figure 49
2001 Volunteer Health Country Profiles

Highest Incidence of Tuberculin Skin Test

Conversions
Moldova N=5 6.2

Latvia N=2 5.3

Macedonia* N=1 5.1

Namibia N=4 4.8

Burkina Faso N=4 4.6

Russia/Western N=5 4.4

Kyrghyzstan* N=2 4.2

0 1 2 3 4 5 6 7
Number of Conversions/100 V/T-Years
*Country closed in 2001
 Figure 50
1993–2001 Volunteer Health Trends

Incidence of Asthma
3

2.3
2.2
2.1
Cases/100 V/T-Years

2 2 2
2

1.6
1.5
1.3

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 51
2001 Volunteer Health Country Profiles

Highest Incidence of Asthma

Costa Rica N=8 31.6

Russia/Far East N=8 12.2

China N=9 11.4

Guatemala* N=25 10.8

Estonia N=3 10.5

Jamaica* N=8 8.7

Burkina Faso N=6 6.9

0 5 10 15 20 25 30 35
Cases/100 V/T-Years
*This country accepts Trainees/Volunteers with known stable asthma documented on pre-service exam
1993–2001 Volunteer Health Trends Figure 52

Incidence of Alcohol Problems

3

2.5
Cases/100 V/T-Years

2
1.7
1.5 1.5 1.5
1.4
1.3
1.2

1
0.8

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Figure 53
1995–2001 Volunteer Health and Safety Regional Trends
Incidence of Monthly PCMO-Volunteer
Contacts
3
1995 1996 1997 1998 1999 2000 2001

2.2
Contacts/100 V/T-Years

2.1
2 2 2 2 2 2 2
2 1.9
1.8 1.8 1.8
1.7
1.6 1.6
1.5 1.5

1 0.9 0.9
0.8

0
AF Region IAP Region EMA Region
 Figure 54
1996–2001 Volunteer Health Trends

Medical Evacuations
800
Regional
OMS-Authorized

170 135
600 187
176
Number of PCVs

130
151

400

541 558
482 501 479
200 419

0
1996 1997 1998 1999 2000 2001
1996–2001 Volunteer Health Trends Figure 55

Incidence of Medical Evacuations

15
Regional
OMS-Authorized
Events/100 V/T Years

10
2.9 2.5 2
2.7
2
2.2

5
7.7 7.9 8.3
7.3 7.4
6.2

0
1996 1997 1998 1999 2000 2001
2001 Volunteer Health Regional Profile Figure 56

Incidence of Medical Evacuations

15
OMS-Authorized
Regional
Events/100 V/T-Years

10
8.6 8.9

7.5

5 4.1

1.5
0.3
0
AF Region IAP Region EMA Region
 Figure 57
1993–2001 Volunteer Health Trends

Incidence of In-Country Hospitalization

10

8 7.5
Events/100 V/T-Years

7
6.7
5.9 6.1
5.8 5.8 5.7
6 5.4

0
1993 1994 1995 1996 1997 1998 1999 2000 2001
 Numbers and Incidence of
Reportable Health Conditions for
Calendar Year 2001

Based on Monthly Epidemiologic

Reports and Event Reports
Submitted by PCMOs
 Table 1. In 2001, Numbers and Incidence of Reported Alcohol and Cardiovascular Problems

V/T- Alcohol Prob. Cardiovasc. V/T- Alcohol Prob. Cardiovasc.

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 1 .9 4 3.6 BELIZE 12 54 . . . .

BURKINA FASO 12 88 2 2.3 5 5.7 BOLIVIA 12 175 1 .6 8 4.6
CAMEROON 12 127 . . . . COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 5 10.7 1 2.1 DOMINICAN REPUBL 12 158 . . 1 .6
COTE D'IVOIRE 12 132 1 .8 2 1.5 EASTERN CARIBBEA 12 87 2 2.3 . .
GABON 12 62 . . . . ECUADOR 12 165 3 1.8 8 4.9
GHANA 12 146 2 1.4 . . EL SALVADOR 12 140 . . 2 1.4
GUINEA 12 106 1 .9 . . GUATEMALA 12 231 3 1.3 1 .4
KENYA 12 120 . . 1 .8 GUYANA 12 37 . . . .
LESOTHO 12 91 1 1.1 . . HAITI 12 54 . . . .
MADAGASCAR 12 135 4 3.0 . . HONDURAS 12 257 3 1.2 2 .8
MALAWI 12 98 2 2.0 . . JAMAICA 12 92 1 1.1 . .
MALI 12 136 . . . . KIRIBATI 12 56 1 1.8 . .
MAURITANIA 12 86 1 1.2 . . MICRONESIA 12 64 . . . .
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 . . . .
NAMIBIA 12 84 1 1.2 . . PANAMA 12 119 . . . .
NIGER 12 98 2 2.0 . . PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 1 .7 4 2.8 PARAGUAY 12 185 . . 1 .5
SOUTH AFRICA 12 89 . . 1 1.1 SAMOA 12 62 1 1.6 . .
TANZANIA 12 117 1 .9 . . SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . . . TONGA 12 75 1 1.3 . .
TOGO 12 86 1 1.2 1 1.2 VANUATU 12 46 . . . .
UGANDA * 9 14 . . . . TOTAL IAP 258 2,307 16 .7 23 1.0
ZAMBIA 12 131 1 .8 . .
ZIMBABWE ** 11 24 5 20.5 . .
TOTAL AFRICA 296 2,388 32 1.3 19 .8 ALL COUNTRIES 839 6,725 99 1.5 117 1.7

EMA Region

ARMENIA 12 62 2 3.2 . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 5 4.3 2 1.7
CHINA 12 79 3 3.8 11 13.9 ** Peace Corps country programs closed in calendar
ESTONIA 12 28 . . . . year 2001: Bangladesh, Kyrghyzstan, Macedonia,
GEORGIA * 8 16 1 6.4 . . Papua New Guinea, Poland, Turkmenistan, Uzbekistan,
JORDAN 12 73 . . 1 1.4 Zimbabwe.
KAZAKHSTAN 12 138 10 7.3 1 .7
KYRGHYZSTAN ** 9 48 2 4.2 5 10.4 Table does not include Bosnia, where only Crisis
LATVIA 12 38 . . 3 7.9 Corps Volunteers were present.
LITHUANIA 12 37 . . 10 27.1
MACEDONIA ** 6 20 1 5.1 . . Incidence = events/100 V/T-Years
MOLDOVA 12 80 3 3.7 1 1.2
MONGOLIA 12 80 2 2.5 . .
MOROCCO 12 131 . . 6 4.6
NEPAL 12 95 1 1.0 5 5.2
PHILIPPINES 12 135 2 1.5 1 .7
POLAND ** 6 29 . . . .
ROMANIA 12 138 7 5.1 13 9.4
RUSSIA/FAR EAST 12 65 3 4.6 2 3.1
RUSSIA/WESTERN 12 113 4 3.5 2 1.8
SLOVAKIA 12 66 3 4.6 7 10.6
THAILAND 12 55 1 1.8 . .
TURKMENISTAN** 9 57 . . 1 1.7
UKRAINE 12 180 . . 3 1.7
UZBEKISTAN ** 9 109 1 .9 1 .9
TOTAL EMA 285 2,030 51 2.5 75 3.7
 Table 2. In 2001, Numbers and Incidence of Reported Dengue and Dental Problems

V/T- Dengue Dental V/T- Dengue Dental

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 10 9.0 BELIZE 12 54 . . 14 26.0

BURKINA FASO 12 88 . . 16 18.3 BOLIVIA 12 175 . . 74 42.3
CAMEROON 12 127 . . 11 8.6 COSTA RICA 12 25 . . 11 43.4
CAPE VERDE 12 47 . . 21 45.0 DOMINICAN REPUBL 12 158 4 2.5 28 17.8
COTE D'IVOIRE 12 132 . . 22 16.7 EASTERN CARIBBEA 12 87 4 4.6 84 96.2
GABON 12 62 3 4.8 8 12.9 ECUADOR 12 165 2 1.2 67 40.6
GHANA 12 146 . . 11 7.5 EL SALVADOR 12 140 . . 30 21.4
GUINEA 12 106 . . 34 32.0 GUATEMALA 12 231 . . 55 23.8
KENYA 12 120 1 .8 9 7.5 GUYANA 12 37 1 2.7 5 13.5
LESOTHO 12 91 . . 30 33.1 HAITI 12 54 3 5.5 10 18.4
MADAGASCAR 12 135 . . 24 17.8 HONDURAS 12 257 1 .4 52 20.3
MALAWI 12 98 . . 27 27.5 JAMAICA 12 92 . . 23 25.1
MALI 12 136 . . 18 13.2 KIRIBATI 12 56 . . 5 9.0
MAURITANIA 12 86 . . 14 16.3 MICRONESIA 12 64 1 1.6 18 28.1
MOZAMBIQUE 12 40 . . 6 15.2 NICARAGUA 12 168 14 8.3 15 8.9
NAMIBIA 12 84 . . 29 34.4 PANAMA 12 119 . . 19 16.0
NIGER 12 98 . . 21 21.3 PAPUA NEW GUINEA**6 15 . . 8 51.8
SENEGAL 12 143 . . 55 38.4 PARAGUAY 12 185 . . 43 23.2
SOUTH AFRICA 12 89 . . 40 44.9 SAMOA 12 62 25 40.2 15 24.1
TANZANIA 12 117 . . 11 9.4 SURINAME 12 42 . . 16 38.2
THE GAMBIA 12 76 . . 7 9.2 TONGA 12 75 . . 35 46.4
TOGO 12 86 . . 12 14.0 VANUATU 12 46 . . 14 30.3
UGANDA * 9 14 . . 3 21.8 TOTAL IAP 258 2,307 55 2.4 641 27.8
ZAMBIA 12 131 . . 13 9.9
ZIMBABWE ** 11 24 . . 5 20.5
TOTAL AFRICA 296 2,388 4 .2 457 19.1 ALL COUNTRIES 839 6,725 73 1.1 1837 27.3

EMA Region

ARMENIA 12 62 . . 9 14.5 * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 2 5.1 6 15.4 2001: Georgia and Uganda.
BULGARIA 12 118 . . 53 45.1
CHINA 12 79 2 2.5 27 34.1 ** Peace Corps country programs closed in calendar
ESTONIA 12 28 . . 13 45.6 year 2001: Bangladesh, Kyrghyzstan, Macedonia,
GEORGIA * 8 16 . . 11 70.1 Papua New Guinea, Poland, Turkmenistan, Uzbekistan,
JORDAN 12 73 . . 27 36.9 Zimbabwe.
KAZAKHSTAN 12 138 . . 48 34.8
KYRGHYZSTAN ** 9 48 . . 26 54.0 Table does not include Bosnia, where only Crisis
LATVIA 12 38 . . 7 18.4 Corps Volunteers were present.
LITHUANIA 12 37 . . 24 64.9
MACEDONIA ** 6 20 . . 12 61.0 Incidence = events/100 V/T-Years
MOLDOVA 12 80 . . 33 41.1
MONGOLIA 12 80 . . 25 31.4
MOROCCO 12 131 . . 54 41.1
NEPAL 12 95 . . 32 33.6
PHILIPPINES 12 135 6 4.5 18 13.4
POLAND ** 6 29 . . 16 55.5
ROMANIA 12 138 . . 74 53.5
RUSSIA/FAR EAST 12 65 . . 32 48.9
RUSSIA/WESTERN 12 113 . . 48 42.4
SLOVAKIA 12 66 . . 36 54.8
THAILAND 12 55 4 7.2 12 21.7
TURKMENISTAN** 9 57 . . 27 47.2
UKRAINE 12 180 . . 37 20.5
UZBEKISTAN ** 9 109 . . 32 29.5
TOTAL EMA 285 2,030 14 .7 739 36.4
 Table 3. In 2001, Numbers and Incidence of Reported Dermatitis and Environmental Concerns

V/T- Dermatitis Env. Concerns V/T- Dermatitis Env. Concerns

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 54 48.4 1 .9 BELIZE 12 54 32 59.4 . .

BURKINA FASO 12 88 21 24.0 5 5.7 BOLIVIA 12 175 80 45.7 6 3.4
CAMEROON 12 127 19 14.9 . . COSTA RICA 12 25 7 27.6 . .
CAPE VERDE 12 47 3 6.4 2 4.3 DOMINICAN REPUBL 12 158 57 36.2 . .
COTE D'IVOIRE 12 132 93 70.6 2 1.5 EASTERN CARIBBEA 12 87 101 116 14 16.0
GABON 12 62 13 20.9 2 3.2 ECUADOR 12 165 84 50.9 9 5.5
GHANA 12 146 1 .7 . . EL SALVADOR 12 140 60 42.7 . .
GUINEA 12 106 84 79.0 . . GUATEMALA 12 231 52 22.5 . .
KENYA 12 120 13 10.8 . . GUYANA 12 37 9 24.3 . .
LESOTHO 12 91 7 7.7 12 13.3 HAITI 12 54 26 47.8 . .
MADAGASCAR 12 135 63 46.7 . . HONDURAS 12 257 89 34.7 47 18.3
MALAWI 12 98 8 8.1 . . JAMAICA 12 92 29 31.6 2 2.2
MALI 12 136 35 25.7 . . KIRIBATI 12 56 7 12.6 . .
MAURITANIA 12 86 46 53.5 . . MICRONESIA 12 64 23 36.0 2 3.1
MOZAMBIQUE 12 40 13 32.9 . . NICARAGUA 12 168 46 27.4 . .
NAMIBIA 12 84 12 14.3 1 1.2 PANAMA 12 119 26 21.9 . .
NIGER 12 98 51 51.8 . . PAPUA NEW GUINEA**6 15 2 12.9 . .
SENEGAL 12 143 129 90.0 5 3.5 PARAGUAY 12 185 37 20.0 8 4.3
SOUTH AFRICA 12 89 14 15.7 1 1.1 SAMOA 12 62 50 80.3 2 3.2
TANZANIA 12 117 46 39.4 1 .9 SURINAME 12 42 20 47.7 . .
THE GAMBIA 12 76 40 52.7 4 5.3 TONGA 12 75 37 49.1 2 2.7
TOGO 12 86 11 12.8 . . VANUATU 12 46 65 141 13 28.2
UGANDA * 9 14 9 65.5 9 65.5 TOTAL IAP 258 2,307 939 40.7 105 4.6
ZAMBIA 12 131 3 2.3 1 .8
ZIMBABWE ** 11 24 . . 4 16.4
TOTAL AFRICA 296 2,388 788 33.0 50 2.1 ALL COUNTRIES 839 6,725 2108 31.3 282 4.2

EMA Region

ARMENIA 12 62 4 6.4 8 12.9 * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 11 28.3 1 2.6 2001: Georgia and Uganda.
BULGARIA 12 118 24 20.4 2 1.7
CHINA 12 79 19 24.0 13 16.4 ** Peace Corps Countries closed in calendar year
ESTONIA 12 28 4 14.0 1 3.5 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 7 44.6 1 6.4 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 17 23.2 . .
KAZAKHSTAN 12 138 3 2.2 6 4.4 Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 4 8.3 . . Corps Volunteers were present.
LATVIA 12 38 7 18.4 . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 2 10.2 . .
MOLDOVA 12 80 42 52.3 . .
MONGOLIA 12 80 2 2.5 5 6.3
MOROCCO 12 131 24 18.3 7 5.3
NEPAL 12 95 47 49.3 1 1.0
PHILIPPINES 12 135 18 13.4 3 2.2
POLAND ** 6 29 . . . .
ROMANIA 12 138 34 24.6 63 45.5
RUSSIA/FAR EAST 12 65 3 4.6 4 6.1
RUSSIA/WESTERN 12 113 6 5.3 4 3.5
SLOVAKIA 12 66 2 3.0 . .
THAILAND 12 55 18 32.6 . .
TURKMENISTAN** 9 57 3 5.2 . .
UKRAINE 12 180 58 32.2 5 2.8
UZBEKISTAN ** 9 109 22 20.3 3 2.8
TOTAL EMA 285 2,030 381 18.8 127 6.3
 Table 4. In 2001, Numbers and Incidence of Reported Febrile Illness and Filariasis

V/T- Febrile Illness Filariasis V/T- Febrile Illness Filariasis

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 19 17.0 . . BELIZE 12 54 3 5.6 . .

BURKINA FASO 12 88 50 57.1 . . BOLIVIA 12 175 2 1.1 . .
CAMEROON 12 127 24 18.9 . . COSTA RICA 12 25 8 31.6 . .
CAPE VERDE 12 47 4 8.6 . . DOMINICAN REPUBL 12 158 65 41.3 . .
COTE D'IVOIRE 12 132 25 19.0 . . EASTERN CARIBBEA 12 87 61 69.9 . .
GABON 12 62 7 11.2 1 1.6 ECUADOR 12 165 34 20.6 . .
GHANA 12 146 1 .7 . . EL SALVADOR 12 140 19 13.5 . .
GUINEA 12 106 40 37.6 . . GUATEMALA 12 231 6 2.6 . .
KENYA 12 120 38 31.7 . . GUYANA 12 37 4 10.8 . .
LESOTHO 12 91 4 4.4 . . HAITI 12 54 13 23.9 . .
MADAGASCAR 12 135 7 5.2 . . HONDURAS 12 257 8 3.1 . .
MALAWI 12 98 28 28.5 . . JAMAICA 12 92 13 14.2 . .
MALI 12 136 12 8.8 . . KIRIBATI 12 56 8 14.4 . .
MAURITANIA 12 86 27 31.4 . . MICRONESIA 12 64 3 4.7 . .
MOZAMBIQUE 12 40 11 27.8 . . NICARAGUA 12 168 5 3.0 . .
NAMIBIA 12 84 4 4.8 . . PANAMA 12 119 2 1.7 . .
NIGER 12 98 17 17.3 . . PAPUA NEW GUINEA**6 15 1 6.5 . .
SENEGAL 12 143 65 45.3 . . PARAGUAY 12 185 31 16.7 . .
SOUTH AFRICA 12 89 14 15.7 . . SAMOA 12 62 4 6.4 . .
TANZANIA 12 117 19 16.3 . . SURINAME 12 42 8 19.1 . .
THE GAMBIA 12 76 3 4.0 . . TONGA 12 75 19 25.2 . .
TOGO 12 86 11 12.8 . . VANUATU 12 46 19 41.2 . .
UGANDA * 9 14 3 21.8 . . TOTAL IAP 258 2,307 336 14.6 . .
ZAMBIA 12 131 18 13.7 . .
ZIMBABWE ** 11 24 7 28.7 . .
TOTAL AFRICA 296 2,388 458 19.2 1 <.1 ALL COUNTRIES 839 6,725 1090 16.2 1 <.1

EMA Region

ARMENIA 12 62 8 12.9 . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 7 18.0 . . 2001: Georgia and Uganda.
BULGARIA 12 118 7 6.0 . .
CHINA 12 79 24 30.3 . . ** Peace Corps Countries closed in calendar year
ESTONIA 12 28 7 24.6 . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 2 12.7 . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 2 2.7 . .
KAZAKHSTAN 12 138 12 8.7 . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 21 43.6 . . Corps Volunteers were present.
LATVIA 12 38 5 13.2 . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 1 5.1 . .
MOLDOVA 12 80 . . . .
MONGOLIA 12 80 2 2.5 . .
MOROCCO 12 131 67 51.0 . .
NEPAL 12 95 1 1.0 . .
PHILIPPINES 12 135 6 4.5 . .
POLAND ** 6 29 . . . .
ROMANIA 12 138 15 10.8 . .
RUSSIA/FAR EAST 12 65 16 24.5 . .
RUSSIA/WESTERN 12 113 14 12.4 . .
SLOVAKIA 12 66 21 31.9 . .
THAILAND 12 55 4 7.2 . .
TURKMENISTAN** 9 57 46 80.4 . .
UKRAINE 12 180 2 1.1 . .
UZBEKISTAN ** 9 109 6 5.5 . .
TOTAL EMA 285 2,030 296 14.6 . .
 z and Helminths
Table 5. In 2001, Numbers and Incidence of Reported Gastrointestinal Problems (Diarrhea)z

V/T- Diarrhea Helminths V/T- Diarrhea Helminths

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 209 187 . . BELIZE 12 54 28 52.0 3 5.6

BURKINA FASO 12 88 148 169 6 6.9 BOLIVIA 12 175 302 173 1 .6
CAMEROON 12 127 105 82.5 6 4.7 COSTA RICA 12 25 14 55.2 . .
CAPE VERDE 12 47 48 103 . . DOMINICAN REPUBL 12 158 132 83.8 1 .6
COTE D'IVOIRE 12 132 139 105 3 2.3 EASTERN CARIBBEA 12 87 56 64.2 . .
GABON 12 62 9 14.5 1 1.6 ECUADOR 12 165 173 105 13 7.9
GHANA 12 146 42 28.7 . . EL SALVADOR 12 140 203 144 4 2.8
GUINEA 12 106 129 121 9 8.5 GUATEMALA 12 231 198 85.8 8 3.5
KENYA 12 120 57 47.5 . . GUYANA 12 37 11 29.7 . .
LESOTHO 12 91 33 36.4 . . HAITI 12 54 155 285 48 88.3
MADAGASCAR 12 135 120 89.0 16 11.9 HONDURAS 12 257 94 36.6 3 1.2
MALAWI 12 98 82 83.4 . . JAMAICA 12 92 18 19.6 1 1.1
MALI 12 136 134 98.4 1 .7 KIRIBATI 12 56 104 187 . .
MAURITANIA 12 86 76 88.4 . . MICRONESIA 12 64 25 39.1 1 1.6
MOZAMBIQUE 12 40 31 78.4 2 5.1 NICARAGUA 12 168 136 80.9 5 3.0
NAMIBIA 12 84 40 47.5 . . PANAMA 12 119 55 46.4 5 4.2
NIGER 12 98 185 188 1 1.0 PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 280 195 8 5.6 PARAGUAY 12 185 61 32.9 3 1.6
SOUTH AFRICA 12 89 30 33.7 . . SAMOA 12 62 29 46.6 . .
TANZANIA 12 117 69 59.1 1 .9 SURINAME 12 42 13 31.0 2 4.8
THE GAMBIA 12 76 46 60.6 1 1.3 TONGA 12 75 30 39.8 . .
TOGO 12 86 130 152 . . VANUATU 12 46 32 69.3 . .
UGANDA * 9 14 27 197 2 14.6 TOTAL IAP 258 2,307 1869 81.0 98 4.2
ZAMBIA 12 131 58 44.2 . .
ZIMBABWE ** 11 24 21 86.2 . .
TOTAL AFRICA 296 2,388 2248 94.1 57 2.4 ALL COUNTRIES 839 6,725 5351 79.6 179 2.7

EMA Region

ARMENIA 12 62 83 134 . . zDiarrhea includes all field-confirmed cases of

BANGLADESH ** 10 39 32 82.3 . . amebiasis, giardiasis, salmonellosis, shigellosis,
BULGARIA 12 118 20 17.0 . . and “other” diarrheal conditions as defined in OMS
CHINA 12 79 38 48.0 2 2.5 Technical Guideline 410.
ESTONIA 12 28 4 14.0 1 3.5
GEORGIA * 8 16 37 236 . . * Peace Corps countries opened in calendar year
JORDAN 12 73 39 53.3 1 1.4 2001: Georgia and Uganda.
KAZAKHSTAN 12 138 56 40.6 . .
KYRGHYZSTAN ** 9 48 40 83.1 2 4.2 ** Peace Corps countries closed in calendar year
LATVIA 12 38 2 5.3 . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
LITHUANIA 12 37 3 8.1 1 2.7 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
MACEDONIA ** 6 20 15 76.3 . .
MOLDOVA 12 80 20 24.9 . . Table does not include Bosnia, where only Crisis
MONGOLIA 12 80 93 117 5 6.3 Corps Volunteers were present.
MOROCCO 12 131 159 121 1 .8
NEPAL 12 95 122 128 2 2.1
Incidence = events/100 V/T-Years
PHILIPPINES 12 135 49 36.4 3 2.2
POLAND ** 6 29 3 10.4 . .
ROMANIA 12 138 78 56.4 . .
RUSSIA/FAR EAST 12 65 25 38.2 1 1.5
RUSSIA/WESTERN 12 113 15 13.2 . .
SLOVAKIA 12 66 16 24.3 . .
THAILAND 12 55 20 36.2 . .
TURKMENISTAN** 9 57 75 131 1 1.7
UKRAINE 12 180 44 24.4 2 1.1
UZBEKISTAN ** 9 109 146 134 2 1.8
TOTAL EMA 285 2,030 1234 60.8 24 1.2
 Table 6. In 2001, Numbers and Incidence of Reported Hepatitis and Hospitalizations

V/T- Hepatitis Hospitaliz. V/T- Hepatitis Hospitaliz.

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 1 .9 BELIZE 12 54 . . . .

BURKINA FASO 12 88 . . 3 3.4 BOLIVIA 12 175 . . 24 13.7
CAMEROON 12 127 . . 5 3.9 COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 . . . . DOMINICAN REPUBL 12 158 . . 23 14.6
COTE D'IVOIRE 12 132 . . 6 4.6 EASTERN CARIBBEA 12 87 . . 4 4.6
GABON 12 62 . . 4 6.4 ECUADOR 12 165 . . 3 1.8
GHANA 12 146 . . 1 .7 EL SALVADOR 12 140 . . 17 12.1
GUINEA 12 106 . . 3 2.8 GUATEMALA 12 231 . . 20 8.7
KENYA 12 120 . . 12 10.0 GUYANA 12 37 . . 1 2.7
LESOTHO 12 91 . . 7 7.7 HAITI 12 54 . . 2 3.7
MADAGASCAR 12 135 . . 1 .7 HONDURAS 12 257 . . 68 26.5
MALAWI 12 98 1 1.0 21 21.4 JAMAICA 12 92 . . 1 1.1
MALI 12 136 2 1.5 3 2.2 KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . . . MICRONESIA 12 64 . . 7 10.9
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 . . 2 1.2
NAMIBIA 12 84 . . 13 15.4 PANAMA 12 119 . . 7 5.9
NIGER 12 98 1 1.0 4 4.1 PAPUA NEW GUINEA**6 15 . . 2 12.9
SENEGAL 12 143 . . 1 .7 PARAGUAY 12 185 1 .5 8 4.3
SOUTH AFRICA 12 89 . . 6 6.7 SAMOA 12 62 . . 5 8.0
TANZANIA 12 117 . . 2 1.7 SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . . . TONGA 12 75 . . 3 4.0
TOGO 12 86 . . 2 2.3 VANUATU 12 46 1 2.2 . .
UGANDA * 9 14 . . 1 7.3 TOTAL IAP 258 2,307 2 .1 197 8.5
ZAMBIA 12 131 . . . .
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 4 .2 96 4.0 ALL COUNTRIES 839 6,725 10 .1 363 5.4

EMA Region

ARMENIA 12 62 . . 1 1.6 * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 . . 1 .9
CHINA 12 79 . . 1 1.3 ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . 1 3.5 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . 1 6.4 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . 9 12.3
KAZAKHSTAN 12 138 . . . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . . . Corps Volunteers were present.
LATVIA 12 38 . . 1 2.6
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 1 5.1 . .
MOLDOVA 12 80 . . 1 1.2
MONGOLIA 12 80 . . 1 1.3
MOROCCO 12 131 . . 1 .8
NEPAL 12 95 1 1.0 2 2.1
PHILIPPINES 12 135 1 .7 33 24.5
POLAND ** 6 29 . . . .
ROMANIA 12 138 1 .7 2 1.4
RUSSIA/FAR EAST 12 65 . . . .
RUSSIA/WESTERN 12 113 . . 3 2.6
SLOVAKIA 12 66 . . 1 1.5
THAILAND 12 55 . . 7 12.7
TURKMENISTAN** 9 57 . . 3 5.2
UKRAINE 12 180 . . 1 .6
UZBEKISTAN ** 9 109 . . . .
TOTAL EMA 285 2,030 4 .2 70 3.4
 Table 7. In 2001, Numbers and Incidence of Reported Pedestrian and Bicycle Injuries

V/T- Pedestrian Inj. Bicycle Inj. V/T- Pedestrian Inj. Bicycle Inj.
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 1 .9 3 2.7 BELIZE 12 54 2 3.7 4 7.4

BURKINA FASO 12 88 1 1.1 6 6.9 BOLIVIA 12 175 1 .6 1 .6
CAMEROON 12 127 . . 1 .8 COSTA RICA 12 25 2 7.9 . .
CAPE VERDE 12 47 1 2.1 1 2.1 DOMINICAN REPUBL 12 158 1 .6 3 1.9
COTE D'IVOIRE 12 132 . . 2 1.5 EASTERN CARIBBEA 12 87 6 6.9 . .
GABON 12 62 3 4.8 1 1.6 ECUADOR 12 165 . . 1 .6
GHANA 12 146 . . . . EL SALVADOR 12 140 . . . .
GUINEA 12 106 . . 4 3.8 GUATEMALA 12 231 . . 6 2.6
KENYA 12 120 . . 2 1.7 GUYANA 12 37 . . . .
LESOTHO 12 91 6 6.6 . . HAITI 12 54 . . . .
MADAGASCAR 12 135 . . 6 4.4 HONDURAS 12 257 3 1.2 . .
MALAWI 12 98 4 4.1 1 1.0 JAMAICA 12 92 . . 2 2.2
MALI 12 136 3 2.2 4 2.9 KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . 1 1.2 MICRONESIA 12 64 . . 4 6.3
MOZAMBIQUE 12 40 1 2.5 . . NICARAGUA 12 168 3 1.8 2 1.2
NAMIBIA 12 84 1 1.2 1 1.2 PANAMA 12 119 . . 1 .8
NIGER 12 98 . . . . PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 1 .7 2 1.4 PARAGUAY 12 185 18 9.7 2 1.1
SOUTH AFRICA 12 89 . . . . SAMOA 12 62 . . . .
TANZANIA 12 117 . . 1 .9 SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . 1 1.3 TONGA 12 75 . . 1 1.3
TOGO 12 86 6 7.0 6 7.0 VANUATU 12 46 . . . .
UGANDA * 9 14 . . 3 21.8 TOTAL IAP 258 2,307 36 1.6 27 1.2
ZAMBIA 12 131 . . 5 3.8
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 28 1.2 51 2.1 ALL COUNTRIES 839 6,725 73 1.1 87 1.3

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 1 2.6 1 2.6 2001: Georgia and Uganda.
BULGARIA 12 118 . . . .
CHINA 12 79 . . . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . . .
KAZAKHSTAN 12 138 1 .7 . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . . . Corps Volunteers were present.
LATVIA 12 38 1 2.6 . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . . .
MOLDOVA 12 80 . . 1 1.2
MONGOLIA 12 80 1 1.3 . .
MOROCCO 12 131 . . 1 .8
NEPAL 12 95 1 1.0 4 4.2
PHILIPPINES 12 135 . . . .
POLAND ** 6 29 . . . .
ROMANIA 12 138 . . . .
RUSSIA/FAR EAST 12 65 1 1.5 . .
RUSSIA/WESTERN 12 113 . . . .
SLOVAKIA 12 66 . . . .
THAILAND 12 55 3 5.4 1 1.8
TURKMENISTAN** 9 57 . . 1 1.7
UKRAINE 12 180 . . . .
UZBEKISTAN ** 9 109 . . . .
TOTAL EMA 285 2,030 9 .4 9 .4
 Table 8. In 2001, Numbers and Incidence of Reported Motorcycle and Motor Vehicle Injuries

V/T- Motorcycle Motor Vehicle V/T- Motorcycle Motor Vehicle

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 4 3.6 1 .9 BELIZE 12 54 . . . .

BURKINA FASO 12 88 . . . . BOLIVIA 12 175 . . 4 2.3
CAMEROON 12 127 1 .8 1 .8 COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 . . . . DOMINICAN REPUBL 12 158 4 2.5 . .
COTE D'IVOIRE 12 132 1 .8 . . EASTERN CARIBBEA 12 87 . . 1 1.1
GABON 12 62 . . 1 1.6 ECUADOR 12 165 . . 2 1.2
GHANA 12 146 . . 5 3.4 EL SALVADOR 12 140 . . . .
GUINEA 12 106 2 1.9 1 .9 GUATEMALA 12 231 . . 3 1.3
KENYA 12 120 . . . . GUYANA 12 37 . . . .
LESOTHO 12 91 . . 1 1.1 HAITI 12 54 . . 5 9.2
MADAGASCAR 12 135 . . . . HONDURAS 12 257 1 .4 3 1.2
MALAWI 12 98 . . 1 1.0 JAMAICA 12 92 . . 3 3.3
MALI 12 136 . . . . KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . 4 4.7 MICRONESIA 12 64 . . 1 1.6
MOZAMBIQUE 12 40 . . 1 2.5 NICARAGUA 12 168 . . . .
NAMIBIA 12 84 . . 2 2.4 PANAMA 12 119 . . 2 1.7
NIGER 12 98 1 1.0 . . PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 1 .7 3 2.1 PARAGUAY 12 185 . . . .
SOUTH AFRICA 12 89 1 1.1 1 1.1 SAMOA 12 62 . . . .
TANZANIA 12 117 . . . . SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . . . TONGA 12 75 . . 1 1.3
TOGO 12 86 . . . . VANUATU 12 46 . . . .
UGANDA * 9 14 . . . . TOTAL IAP 258 2,307 5 .2 25 1.1
ZAMBIA 12 131 . . 8 6.1
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 11 .5 30 1.3 ALL COUNTRIES 839 6,725 18 .3 63 .9

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 . . 2 1.7
CHINA 12 79 . . . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 1 1.4 . .
KAZAKHSTAN 12 138 . . . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . 2 4.2 Corps Volunteers were present.
LATVIA 12 38 . . . .
LITHUANIA 12 37 . . 1 2.7 Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . . .
MOLDOVA 12 80 . . . .
MONGOLIA 12 80 1 1.3 . .
MOROCCO 12 131 . . . .
NEPAL 12 95 . . . .
PHILIPPINES 12 135 . . . .
POLAND ** 6 29 . . . .
ROMANIA 12 138 . . . .
RUSSIA/FAR EAST 12 65 . . . .
RUSSIA/WESTERN 12 113 . . 2 1.8
SLOVAKIA 12 66 . . . .
THAILAND 12 55 . . 1 1.8
TURKMENISTAN** 9 57 . . . .
UKRAINE 12 180 . . . .
UZBEKISTAN ** 9 109 . . . .
TOTAL EMA 285 2,030 2 .1 8 .4
 Table 9. In 2001, Numbers and Incidence of Reported Sports- and Assault-Related Injuries

V/T- Sports Inj. Assault Inj. V/T- Sports Inj. Assault Inj.
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 4 3.6 BELIZE 12 54 . . 1 1.9

BURKINA FASO 12 88 . . 1 1.1 BOLIVIA 12 175 2 1.1 1 .6
CAMEROON 12 127 2 1.6 1 .8 COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 2 4.3 1 2.1 DOMINICAN REPUBL 12 158 6 3.8 0 .0
COTE D'IVOIRE 12 132 . . 4 3.0 EASTERN CARIBBEA 12 87 4 4.6 3 3.4
GABON 12 62 . . 0 .0 ECUADOR 12 165 8 4.9 3 1.8
GHANA 12 146 3 2.1 0 .0 EL SALVADOR 12 140 31 22.1 0 .0
GUINEA 12 106 . . 0 .0 GUATEMALA 12 231 9 3.9 2 .9
KENYA 12 120 . . 3 2.5 GUYANA 12 37 . . 1 2.7
LESOTHO 12 91 . . 0 .0 HAITI 12 54 . . 0 .0
MADAGASCAR 12 135 2 1.5 0 .0 HONDURAS 12 257 5 1.9 1 .4
MALAWI 12 98 2 2.0 3 3.1 JAMAICA 12 92 4 4.4 1 1.1
MALI 12 136 8 5.9 0 .0 KIRIBATI 12 56 3 5.4 1 1.8
MAURITANIA 12 86 4 4.7 1 1.2 MICRONESIA 12 64 6 9.4 1 1.6
MOZAMBIQUE 12 40 5 12.6 0 .0 NICARAGUA 12 168 2 1.2 3 1.8
NAMIBIA 12 84 3 3.6 1 1.2 PANAMA 12 119 . . 0 .0
NIGER 12 98 2 2.0 0 .0 PAPUA NEW GUINEA**6 15 . . 1 6.5
SENEGAL 12 143 7 4.9 8 5.6 PARAGUAY 12 185 17 9.2 1 .5
SOUTH AFRICA 12 89 . . . . SAMOA 12 62 4 6.4 1 1.6
TANZANIA 12 117 . . . . SURINAME 12 42 . . 0 .0
THE GAMBIA 12 76 2 2.6 0 .0 TONGA 12 75 9 11.9 0 .0
TOGO 12 86 2 2.3 0 .0 VANUATU 12 46 4 8.7 . .
UGANDA * 9 14 . . 0 .0 TOTAL IAP 258 2,307 114 4.9 21 .9
ZAMBIA 12 131 . . 0 .0
ZIMBABWE ** 11 24 8 32.8 2 8.2
TOTAL AFRICA 296 2,388 52 2.2 29 1.2 ALL COUNTRIES 839 6,725 264 3.9 92 1.4

EMA Region

ARMENIA 12 62 4 6.4 . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 3 7.7 3 7.7 2001: Georgia and Uganda.
BULGARIA 12 118 8 6.8 2 1.7
CHINA 12 79 3 3.8 0 .0 ** Peace Corps countries closed in calendar year
ESTONIA 12 28 2 7.0 1 3.5 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 6 38.2 0 .0 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . 1 1.4
KAZAKHSTAN 12 138 7 5.1 3 2.2 Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 3 6.2 2 4.2 Corps Volunteers were present.
LATVIA 12 38 1 2.6 0 .0
LITHUANIA 12 37 4 10.8 . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . 0 .0
MOLDOVA 12 80 2 2.5 6 7.5
MONGOLIA 12 80 6 7.5 1 1.3
MOROCCO 12 131 4 3.0 1 .8
NEPAL 12 95 3 3.1 3 3.1
PHILIPPINES 12 135 1 .7 0 .0
POLAND ** 6 29 . . 0 .0
ROMANIA 12 138 23 16.6 2 1.4
RUSSIA/FAR EAST 12 65 . . 3 4.6
RUSSIA/WESTERN 12 113 2 1.8 5 4.4
SLOVAKIA 12 66 6 9.1 1 1.5
THAILAND 12 55 . . . .
TURKMENISTAN** 9 57 4 7.0 3 5.2
UKRAINE 12 180 4 2.2 5 2.8
UZBEKISTAN ** 9 109 2 1.8 0 .0
TOTAL EMA 285 2,030 98 4.8 42 2.1
 Table 10. In 2001, Numbers and Incidence of Reported Water-Related Injuries and
“Other” Unintentional In juries

V/T- Water Inj. “Other” Inj. V/T- Water Inj. “Other” Inj.
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 9 8.1 BELIZE 12 54 . . 15 27.9

BURKINA FASO 12 88 . . 2 2.3 BOLIVIA 12 175 . . 26 14.9
CAMEROON 12 127 . . 4 3.1 COSTA RICA 12 25 . . 1 3.9
CAPE VERDE 12 47 1 2.1 1 2.1 DOMINICAN REPUBL 12 158 3 1.9 13 8.3
COTE D'IVOIRE 12 132 1 .8 14 10.6 EASTERN CARIBBEA 12 87 1 1.1 26 29.8
GABON 12 62 . . . . ECUADOR 12 165 3 1.8 56 34.0
GHANA 12 146 . . . . EL SALVADOR 12 140 1 .7 19 13.5
GUINEA 12 106 . . 20 18.8 GUATEMALA 12 231 3 1.3 66 28.6
KENYA 12 120 . . 9 7.5 GUYANA 12 37 . . 6 16.2
LESOTHO 12 91 . . 6 6.6 HAITI 12 54 . . 7 12.9
MADAGASCAR 12 135 . . 21 15.6 HONDURAS 12 257 1 .4 58 22.6
MALAWI 12 98 . . 11 11.2 JAMAICA 12 92 3 3.3 28 30.6
MALI 12 136 1 .7 42 30.8 KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . 5 5.8 MICRONESIA 12 64 . . 8 12.5
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 1 .6 6 3.6
NAMIBIA 12 84 . . 11 13.1 PANAMA 12 119 2 1.7 18 15.2
NIGER 12 98 . . 15 15.2 PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 . . 22 15.3 PARAGUAY 12 185 . . 25 13.5
SOUTH AFRICA 12 89 . . 5 5.6 SAMOA 12 62 . . 4 6.4
TANZANIA 12 117 . . 2 1.7 SURINAME 12 42 . . 4 9.5
THE GAMBIA 12 76 . . 2 2.6 TONGA 12 75 . . 9 11.9
TOGO 12 86 . . 4 4.7 VANUATU 12 46 5 10.8 24 52.0
UGANDA * 9 14 1 7.3 5 36.4 TOTAL IAP 258 2,307 23 1.0 419 18.2
ZAMBIA 12 131 . . 6 4.6
ZIMBABWE ** 11 24 . . 2 8.2
TOTAL AFRICA 296 2,388 4 .2 218 9.1 ALL COUNTRIES 839 6,725 35 .5 955 14.2

EMA Region

ARMENIA 12 62 . . 3 4.8 * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . 1 2.6 2001: Georgia and Uganda.
BULGARIA 12 118 . . 47 40.0
CHINA 12 79 . . 20 25.3 ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . 7 24.6 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . 4 25.5 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 2 2.7 9 12.3
KAZAKHSTAN 12 138 . . 17 12.3 Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . 5 10.4 Corps Volunteers were present.
LATVIA 12 38 . . 12 31.6
LITHUANIA 12 37 . . 9 24.4 Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . 7 35.6
MOLDOVA 12 80 . . 35 43.6
MONGOLIA 12 80 . . 9 11.3
MOROCCO 12 131 . . 3 2.3
NEPAL 12 95 . . 8 8.4
PHILIPPINES 12 135 3 2.2 7 5.2
POLAND ** 6 29 . . 4 13.9
ROMANIA 12 138 . . 37 26.7
RUSSIA/FAR EAST 12 65 2 3.1 3 4.6
RUSSIA/WESTERN 12 113 . . 5 4.4
SLOVAKIA 12 66 . . 7 10.6
THAILAND 12 55 . . 3 5.4
TURKMENISTAN** 9 57 . . 9 15.7
UKRAINE 12 180 . . 31 17.2
UZBEKISTAN ** 9 109 1 .9 16 14.7
TOTAL EMA 285 2,030 8 .4 318 15.7
 Table 11. In 2001, Numbers and Incidence of Reported Leishmaniasis and Confirmed Falciparum Malaria

V/T- Leishmaniasis Falcip. Malaria V/T- Leishmaniasis Falcip. Malaria

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 12 10.8 BELIZE 12 54 . . . .

BURKINA FASO 12 88 . . 3 3.4 BOLIVIA 12 175 . . . .
CAMEROON 12 127 . . 13 10.2 COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 . . . . DOMINICAN REPUBL 12 158 . . . .
COTE D'IVOIRE 12 132 . . 6 4.6 EASTERN CARIBBEA 12 87 . . . .
GABON 12 62 . . 1 1.6 ECUADOR 12 165 . . . .
GHANA 12 146 . . 13 8.9 EL SALVADOR 12 140 . . . .
GUINEA 12 106 . . 16 15.0 GUATEMALA 12 231 . . . .
KENYA 12 120 . . . . GUYANA 12 37 . . . .
LESOTHO 12 91 . . . . HAITI 12 54 . . 3 5.5
MADAGASCAR 12 135 . . 2 1.5 HONDURAS 12 257 . . . .
MALAWI 12 98 . . 7 7.1 JAMAICA 12 92 . . . .
MALI 12 136 . . 15 11.0 KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . . . MICRONESIA 12 64 . . . .
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 . . . .
NAMIBIA 12 84 . . 2 2.4 PANAMA 12 119 1 .8 . .
NIGER 12 98 . . 1 1.0 PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 . . 4 2.8 PARAGUAY 12 185 . . . .
SOUTH AFRICA 12 89 . . . . SAMOA 12 62 . . . .
TANZANIA 12 117 . . . . SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . 1 1.3 TONGA 12 75 . . . .
TOGO 12 86 . . 3 3.5 VANUATU 12 46 . . . .
UGANDA * 9 14 . . 1 7.3 TOTAL IAP 258 2,307 1 .0 3 .1
ZAMBIA 12 131 . . 9 6.9
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 . . 109 4.6 ALL COUNTRIES 839 6,725 3 .0 113 1.7

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 . . . .
CHINA 12 79 . . . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . . .
KAZAKHSTAN 12 138 . . . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . . . Corps Volunteers were present.
LATVIA 12 38 . . . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . . .
MOLDOVA 12 80 . . . .
MONGOLIA 12 80 . . . .
MOROCCO 12 131 . . . .
NEPAL 12 95 . . . .
PHILIPPINES 12 135 . . 1 .7
POLAND ** 6 29 . . . .
ROMANIA 12 138 . . . .
RUSSIA/FAR EAST 12 65 . . . .
RUSSIA/WESTERN 12 113 . . . .
SLOVAKIA 12 66 . . . .
THAILAND 12 55 . . . .
TURKMENISTAN** 9 57 2 3.5 . .
UKRAINE 12 180 . . . .
UZBEKISTAN ** 9 109 . . . .
TOTAL EMA 285 2,030 2 .1 1 <.1
 Table 12. In 2001, Numbers and Incidence of Reported Confirmed Non-Falciparum Malaria and
Presumptive Malaria

V/T- NonFal. Malaria Pres. Malaria V/T- NonFal. Malaria Pres. Malaria
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 2 1.8 BELIZE 12 54 1 1.9 1 1.9

BURKINA FASO 12 88 . . 1 1.1 BOLIVIA 12 175 . . . .
CAMEROON 12 127 . . 9 7.1 COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 . . . . DOMINICAN REPUBL 12 158 . . . .
COTE D'IVOIRE 12 132 . . 9 6.8 EASTERN CARIBBEA 12 87 . . . .
GABON 12 62 . . 7 11.2 ECUADOR 12 165 . . . .
GHANA 12 146 2 1.4 9 6.2 EL SALVADOR 12 140 . . . .
GUINEA 12 106 1 .9 35 32.9 GUATEMALA 12 231 . . . .
KENYA 12 120 . . 8 6.7 GUYANA 12 37 . . . .
LESOTHO 12 91 . . 4 4.4 HAITI 12 54 . . 3 5.5
MADAGASCAR 12 135 1 .7 1 .7 HONDURAS 12 257 5 1.9 1 .4
MALAWI 12 98 . . 2 2.0 JAMAICA 12 92 . . . .
MALI 12 136 . . 28 20.6 KIRIBATI 12 56 . . . .
MAURITANIA 12 86 1 1.2 7 8.1 MICRONESIA 12 64 . . . .
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 2 1.2 . .
NAMIBIA 12 84 . . . . PANAMA 12 119 . . . .
NIGER 12 98 1 1.0 10 10.2 PAPUA NEW GUINEA**6 15 . . 1 6.5
SENEGAL 12 143 . . 6 4.2 PARAGUAY 12 185 . . . .
SOUTH AFRICA 12 89 . . . . SAMOA 12 62 . . . .
TANZANIA 12 117 . . 6 5.1 SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . 2 2.6 TONGA 12 75 . . . .
TOGO 12 86 . . 1 1.2 VANUATU 12 46 3 6.5 . .
UGANDA * 9 14 . . . . TOTAL IAP 258 2,307 11 .5 6 .3
ZAMBIA 12 131 . . 2 1.5
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 6 .3 149 6.2 ALL COUNTRIES 839 6,725 18 .3 156 2.3

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 . . . .
CHINA 12 79 . . . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . 1 6.4 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . . .
KAZAKHSTAN 12 138 . . . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . . . Corps Volunteers were present.
LATVIA 12 38 . . . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . . .
MOLDOVA 12 80 . . . .
MONGOLIA 12 80 . . . .
MOROCCO 12 131 . . . .
NEPAL 12 95 . . . .
PHILIPPINES 12 135 1 .7 . .
POLAND ** 6 29 . . . .
ROMANIA 12 138 . . . .
RUSSIA/FAR EAST 12 65 . . . .
RUSSIA/WESTERN 12 113 . . . .
SLOVAKIA 12 66 . . . .
THAILAND 12 55 . . . .
TURKMENISTAN** 9 57 . . . .
UKRAINE 12 180 . . . .
UZBEKISTAN ** 9 109 . . . .
TOTAL EMA 285 2,030 1 .0 1 <.1
 Table 13. In 2001, Numbers and Incidence of Office of Medical Services (OMS)¹ Medevacs and
Regional² Medevacs

V/T- OMS Medevacs Reg. Medevacs V/T- OMS Medevacs Reg. Medevacs
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 12 10.8 6 4.5 BELIZE 12 54 10 18.6 . 1.9

BURKINA FASO 12 88 11 12.6 2 2.3 BOLIVIA 12 175 11 6.3 . .
CAMEROON 12 127 13 10.2 2 1.6 COSTA RICA 12 25 3 11.8 . .
CAPE VERDE 12 47 4 8.6 12 25.7 DOMINICAN REPUBL 12 158 11 7.0 . .
COTE D'IVOIRE 12 132 8 6.1 . . EASTERN CARIBBEA 12 87 7 8.0 . .
GABON 12 62 6 9.6 . . ECUADOR 12 165 14 8.5 . .
GHANA 12 146 6 4.1 10 6.8 EL SALVADOR 12 140 14 10.0 . .
GUINEA 12 106 4 3.8 4 3.8 GUATEMALA 12 231 13 5.6 . .
KENYA 12 120 10 8.3 1 .8 GUYANA 12 37 10 27.0 . .
LESOTHO 12 91 3 3.3 5 5.5 HAITI 12 54 6 11.0 . .
MADAGASCAR 12 135 5 3.7 11 8.2 HONDURAS 12 257 35 13.6 . .
MALAWI 12 98 8 8.1 5 5.1 JAMAICA 12 92 5 5.5 . .
MALI 12 136 18 13.2 4 3.7 KIRIBATI 12 56 4 7.2 . .
MAURITANIA 12 86 5 5.8 1 1.2 MICRONESIA 12 64 4 6.3 1 1.6
MOZAMBIQUE 12 40 1 2.5 10 27.8 NICARAGUA 12 168 20 11.9 . .
NAMIBIA 12 84 6 7.1 3 3.6 PANAMA 12 119 7 5.9 . .
NIGER 12 98 17 17.3 11 11.2 PAPUA NEW GUINEA**6 15 0 .0 1 6.5
SENEGAL 12 143 16 11.2 . . PARAGUAY 12 185 3 1.6 . .
SOUTH AFRICA 12 89 4 4.5 . . SAMOA 12 62 4 6.4 . .
TANZANIA 12 117 6 5.1 2 1.7 SURINAME 12 42 4 9.5 . .
THE GAMBIA 12 76 2 2.6 . . TONGA 12 75 13 17.2 . .
TOGO 12 86 10 11.7 1 1.2 VANUATU 12 46 0 .0 4 8.7
UGANDA * 9 14 1 7.3 . . TOTAL IAP 258 2,307 198 8.6 6 .3
ZAMBIA 12 131 2 1.5 7 5.3
ZIMBABWE ** 11 24 2 8.2 1 4.1
TOTAL AFRICA 296 2,388 180 7.5 98 4.1 ALL COUNTRIES 839 6,725 558 8.3 135 2.0

EMA Region

ARMENIA 12 62 7 11.3 . .
Data are from the Peace Corps Medevac Case
BANGLADESH ** 10 39 1 2.6 3 7.7
Management System. The majority of OMS-authorized
BULGARIA 12 118 10 8.5 . .
medevacs are to the United States; however, on
CHINA 12 79 5 6.3 7 8.8
occasion, PCVs may be medevaced to another country,
ESTONIA 12 28 4 14.0 . .
such as Germany, for immediate care.
GEORGIA * 8 16 0 .0 . .
JORDAN 12 73 9 12.3 . .
KAZAKHSTAN 12 138 15 10.9 5 3.6 Regional medevacs involve the evacuation of PCVs
KYRGHYZSTAN ** 9 48 3 6.2 4 8.3 from their host country to an approved intermediate
LATVIA 12 38 8 21.1 . . medevac point, other than the United States, that
LITHUANIA 12 37 5 13.5 . . does not require prior authorization from OMS.
MACEDONIA ** 6 20 3 15.3 . .
MOLDOVA 12 80 5 6.2 . .
MONGOLIA 12 80 5 6.3 1 1.3 * Peace Corps countries opened in calendar year
MOROCCO 12 131 7 5.3 . . 2001: Georgia and Uganda.
NEPAL 12 95 14 14.7 1 1.0
PHILIPPINES 12 135 6 4.5 . . ** Peace Corps countries closed in calendar year
POLAND ** 6 29 3 10.4 . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
ROMANIA 12 138 18 13.0 . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
RUSSIA/FAR EAST 12 65 4 6.1 4 6.1
RUSSIA/WESTERN 12 113 7 6.2 . . Table does not include Bosnia, where only Crisis
SLOVAKIA 12 66 3 4.6 . . Corps Volunteers were present.
THAILAND 12 55 0 .0 . .
TURKMENISTAN** 9 57 8 14.0 . . Incidence = events/100 V/T-Years
UKRAINE 12 180 12 6.7 . .
UZBEKISTAN ** 9 109 18 16.6 6 5.5
TOTAL EMA 285 2,030 180 8.9 31 1.5
 Table 14. In 2001, Numbers and Incidence of Reported Mental Health Problems and Asthma

V/T- Mental Health Asthma V/T- Mental Health Asthma

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 31 27.8 2 1.8 BELIZE 12 54 12 22.3 . .

BURKINA FASO 12 88 37 42.3 6 6.9 BOLIVIA 12 175 46 26.3 1 .6
CAMEROON 12 127 9 7.1 1 .8 COSTA RICA 12 25 7 27.6 8 31.6
CAPE VERDE 12 47 65 139 . . DOMINICAN REPUBL 12 158 30 19.0 4 2.5
COTE D'IVOIRE 12 132 27 20.5 1 .8 EASTERN CARIBBEA 12 87 82 93.9 . .
GABON 12 62 1 1.6 1 1.6 ECUADOR 12 165 99 60.0 5 3.0
GHANA 12 146 2 1.4 . . EL SALVADOR 12 140 81 57.7 1 .7
GUINEA 12 106 55 51.7 2 1.9 GUATEMALA 12 231 28 12.1 25 10.8
KENYA 12 120 25 20.8 . . GUYANA 12 37 7 18.9 . .
LESOTHO 12 91 49 54.1 . . HAITI 12 54 10 18.4 . .
MADAGASCAR 12 135 13 9.6 4 3.0 HONDURAS 12 257 59 23.0 8 3.1
MALAWI 12 98 12 12.2 5 5.1 JAMAICA 12 92 55 60.0 8 8.7
MALI 12 136 35 25.7 . . KIRIBATI 12 56 . . 1 1.8
MAURITANIA 12 86 17 19.8 4 4.7 MICRONESIA 12 64 4 6.3 . .
MOZAMBIQUE 12 40 5 12.6 . . NICARAGUA 12 168 21 12.5 . .
NAMIBIA 12 84 17 20.2 2 2.4 PANAMA 12 119 20 16.9 2 1.7
NIGER 12 98 13 13.2 1 1.0 PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 108 75.3 1 .7 PARAGUAY 12 185 42 22.7 7 3.8
SOUTH AFRICA 12 89 6 6.7 2 2.2 SAMOA 12 62 17 27.3 . .
TANZANIA 12 117 29 24.9 2 1.7 SURINAME 12 42 1 2.4 . .
THE GAMBIA 12 76 43 56.7 . . TONGA 12 75 . . . .
TOGO 12 86 26 30.3 1 1.2 VANUATU 12 46 60 130 . .
UGANDA * 9 14 8 58.3 . . TOTAL IAP 258 2,307 681 29.5 70 3.0
ZAMBIA 12 131 7 5.3 1 .8
ZIMBABWE ** 11 24 40 164 . .
TOTAL AFRICA 296 2,388 680 28.5 36 1.5 ALL COUNTRIES 839 6,725 2299 34.2 149 2.2

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 19 48.9 . . 2001: Georgia and Uganda.
BULGARIA 12 118 51 43.4 3 2.6
CHINA 12 79 70 88.5 9 11.4 ** Peace Corps countries closed in calendar year
ESTONIA 12 28 18 63.2 3 10.5 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 47 299 . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 18 24.6 1 1.4
KAZAKHSTAN 12 138 72 52.2 . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 29 60.2 1 2.1 Corps Volunteers were present.
LATVIA 12 38 26 68.5 . .
LITHUANIA 12 37 63 170 . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 27 137 . .
MOLDOVA 12 80 8 10.0 1 1.2
MONGOLIA 12 80 48 60.2 . .
MOROCCO 12 131 30 22.8 2 1.5
NEPAL 12 95 135 142 4 4.2
PHILIPPINES 12 135 26 19.3 5 3.7
POLAND ** 6 29 12 41.6 . .
ROMANIA 12 138 56 40.5 3 2.2
RUSSIA/FAR EAST 12 65 13 19.9 8 12.2
RUSSIA/WESTERN 12 113 12 10.6 . .
SLOVAKIA 12 66 28 42.6 1 1.5
THAILAND 12 55 5 9.1 . .
TURKMENISTAN** 9 57 39 68.2 . .
UKRAINE 12 180 18 10.0 2 1.1
UZBEKISTAN ** 9 109 68 62.6 . .
TOTAL EMA 285 2,030 938 46.2 43 2.1
 Table 15. In 2001, Numbers and Incidence of Reported Lower (LRI) and
Upper Respiratory Illnesses (URI)

V/T- LRI URI V/T- LRI URI

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 8 7.2 53 47.5 BELIZE 12 54 9 16.7 35 65.0

BURKINA FASO 12 88 5 5.7 36 41.1 BOLIVIA 12 175 7 4.0 145 82.8
CAMEROON 12 127 8 6.3 41 32.2 COSTA RICA 12 25 4 15.8 16 63.1
CAPE VERDE 12 47 . . 20 42.8 DOMINICAN REPUBL 12 158 8 5.1 117 74.3
COTE D'IVOIRE 12 132 1 .8 71 53.9 EASTERN CARIBBEA 12 87 14 16.0 81 92.8
GABON 12 62 . . 14 22.5 ECUADOR 12 165 10 6.1 106 64.3
GHANA 12 146 . . 3 2.1 EL SALVADOR 12 140 . . 100 71.2
GUINEA 12 106 2 1.9 37 34.8 GUATEMALA 12 231 50 21.7 97 42.0
KENYA 12 120 1 .8 7 5.8 GUYANA 12 37 . . 5 13.5
LESOTHO 12 91 10 11.0 17 18.8 HAITI 12 54 . . 20 36.8
MADAGASCAR 12 135 4 3.0 62 46.0 HONDURAS 12 257 7 2.7 53 20.7
MALAWI 12 98 15 15.3 60 61.0 JAMAICA 12 92 19 20.7 51 55.6
MALI 12 136 14 10.3 55 40.4 KIRIBATI 12 56 . . 40 72.0
MAURITANIA 12 86 6 7.0 51 59.3 MICRONESIA 12 64 1 1.6 33 51.6
MOZAMBIQUE 12 40 2 5.1 10 25.3 NICARAGUA 12 168 9 5.4 78 46.4
NAMIBIA 12 84 1 1.2 35 41.6 PANAMA 12 119 2 1.7 47 39.6
NIGER 12 98 1 1.0 36 36.6 PAPUA NEW GUINEA**6 15 . . 6 38.8
SENEGAL 12 143 17 11.9 119 83.0 PARAGUAY 12 185 30 16.2 46 24.8
SOUTH AFRICA 12 89 . . 18 20.2 SAMOA 12 62 13 20.9 78 125
TANZANIA 12 117 3 2.6 41 35.1 SURINAME 12 42 1 2.4 25 59.7
THE GAMBIA 12 76 2 2.6 24 31.6 TONGA 12 75 . . 36 47.8
TOGO 12 86 9 10.5 32 37.3 VANUATU 12 46 . . 25 54.2
UGANDA * 9 14 1 7.3 16 117 TOTAL IAP 258 2,307 184 8.0 1240 53.7
ZAMBIA 12 131 . . 44 33.5
ZIMBABWE ** 11 24 . . 14 57.5
TOTAL AFRICA 296 2,388 110 4.6 916 38.4 ALL COUNTRIES 839 6,725 480 7.1 3265 48.6

EMA Region

ARMENIA 12 62 1 1.6 64 103 * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 5 12.9 17 43.7 2001: Georgia and Uganda.
BULGARIA 12 118 22 18.7 96 81.7
CHINA 12 79 13 16.4 34 43.0 ** Peace Corps countries closed in calendar year
ESTONIA 12 28 3 10.5 26 91.3 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . 15 95.5 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 19 26.0 35 47.8
KAZAKHSTAN 12 138 . . 80 58.0 Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 6 12.5 21 43.6 Corps Volunteers were present.
LATVIA 12 38 1 2.6 22 58.0
LITHUANIA 12 37 . . 24 64.9 Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 3 15.3 28 142
MOLDOVA 12 80 25 31.2 72 89.7
MONGOLIA 12 80 5 6.3 53 66.5
MOROCCO 12 131 3 2.3 51 38.8
NEPAL 12 95 8 8.4 72 75.6
PHILIPPINES 12 135 13 9.6 9 6.7
POLAND ** 6 29 1 3.5 32 111
ROMANIA 12 138 22 15.9 83 60.0
RUSSIA/FAR EAST 12 65 3 4.6 31 47.4
RUSSIA/WESTERN 12 113 3 2.6 28 24.7
SLOVAKIA 12 66 7 10.6 30 45.6
THAILAND 12 55 . . 16 29.0
TURKMENISTAN** 9 57 6 10.5 22 38.5
UKRAINE 12 180 12 6.7 102 56.6
UZBEKISTAN ** 9 109 5 4.6 46 42.4
TOTAL EMA 285 2,030 186 9.2 1109 54.6
 Table 16. In 2001, Numbers and Incidence of Reported Pregnancy and Non-STD (“Other”)
Gynecological Infections

V/T- Pregnancy “Other” Gyn. Inf. V/T- Pregnancy “Other” Gyn. Inf.
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 76 2 2.6 26 34.2 BELIZE 12 34 1 3.0 22 65.3

BURKINA FASO 12 62 . . 3 4.9 BOLIVIA 12 98 1 1.0 23 23.4
CAMEROON 12 75 1 1.3 14 18.6 COSTA RICA 12 22 1 4.6 22 101
CAPE VERDE 12 32 . . 2 6.3 DOMINICAN REPUBL 12 111 5 4.5 38 34.2
COTE D'IVOIRE 12 87 . . 15 17.3 EASTERN CARIBBEA 12 60 1 1.7 57 94.4
GABON 12 41 1 2.5 7 17.2 ECUADOR 12 102 2 2.0 33 32.2
GHANA 12 85 . . 3 3.5 EL SALVADOR 12 83 3 3.6 26 31.3
GUINEA 12 62 . . 20 32.1 GUATEMALA 12 129 2 1.5 25 19.3
KENYA 12 58 1 1.7 2 3.5 GUYANA 12 29 . . 1 3.5
LESOTHO 12 59 . . 13 22.1 HAITI 12 28 . . 1 3.6
MADAGASCAR 12 96 . . 30 31.1 HONDURAS 12 137 6 4.4 12 8.8
MALAWI 12 63 1 1.6 17 27.0 JAMAICA 12 49 . . 19 38.7
MALI 12 86 5 5.8 5 5.8 KIRIBATI 12 44 . . . .
MAURITANIA 12 52 . . 10 19.3 MICRONESIA 12 34 . . 6 17.6
MOZAMBIQUE 12 19 1 5.2 . . NICARAGUA 12 110 1 .9 14 12.8
NAMIBIA 12 59 . . 4 6.8 PANAMA 12 73 . . 2 2.7
NIGER 12 68 . . 10 14.6 PAPUA NEW GUINEA**6 6 . . . .
SENEGAL 12 100 2 2.0 23 23.1 PARAGUAY 12 125 1 .8 36 28.7
SOUTH AFRICA 12 67 1 1.5 7 10.5 SAMOA 12 38 . . 19 49.7
TANZANIA 12 62 . . 4 6.4 SURINAME 12 22 1 4.5 9 40.6
THE GAMBIA 12 53 . . 3 5.7 TONGA 12 38 1 2.6 2 5.3
TOGO 12 65 1 1.5 11 16.8 VANUATU 12 22 . . 29 135
UGANDA * 9 8 . . 6 74.9 TOTAL IAP 258 1,394 26 1.9 396 28.4
ZAMBIA 12 82 . . 1 1.2
ZIMBABWE ** 11 16 . . . .
TOTAL AFRICA 296 1,534 16 1.0 236 15.4 ALL COUNTRIES 839 4,088 45 1.1 851 20.8

EMA Region

ARMENIA 12 32 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 19 . . 2 10.6 2001: Georgia and Uganda.
BULGARIA 12 68 . . 38 55.9
CHINA 12 41 . . 1 2.4 ** Peace Corps countries closed in calendar year
ESTONIA 12 16 . . 1 6.1 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 8 . . 1 12.1 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 64 . . 23 35.9
KAZAKHSTAN 12 66 . . 9 13.6 Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 25 1 4.0 2 8.0 Corps Volunteers were present.
LATVIA 12 24 . . 2 8.4
LITHUANIA 12 22 1 4.5 1 4.5 Incidence = events/100 Female V/T-Years
MACEDONIA ** 6 13 . . 6 46.5
MOLDOVA 12 50 . . 9 17.9
MONGOLIA 12 36 . . 12 33.6
MOROCCO 12 76 . . 16 21.0
NEPAL 12 57 . . 20 35.3
PHILIPPINES 12 76 1 1.3 . .
POLAND ** 6 17 . . . .
ROMANIA 12 84 . . 28 33.4
RUSSIA/FAR EAST 12 38 . . 2 5.2
RUSSIA/WESTERN 12 58 . . . .
SLOVAKIA 12 34 . . 14 40.7
THAILAND 12 40 . . 4 10.1
TURKMENISTAN** 9 35 . . 4 11.5
UKRAINE 12 94 . . 19 20.3
UZBEKISTAN ** 9 67 . . 5 7.5
TOTAL EMA 285 1,161 3 .3 219 18.9
 Table 17. In 2001, Numbers and Incidence of Reported Genital Ulcers and Genital Warts

V/T- Genital Ulcers Genital Warts V/T- Genital Ulcers Genital Warts
# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 1 .9 BELIZE 12 54 3 5.6 1 1.9

BURKINA FASO 12 88 . . . . BOLIVIA 12 175 3 1.7 3 1.7
CAMEROON 12 127 . . . . COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 . . . . DOMINICAN REPUBL 12 158 1 .6 2 1.3
COTE D'IVOIRE 12 132 2 1.5 2 1.5 EASTERN CARIBBEA 12 87 . . . .
GABON 12 62 . . . . ECUADOR 12 165 1 .6 3 1.8
GHANA 12 146 . . 1 .7 EL SALVADOR 12 140 . . 2 1.4
GUINEA 12 106 . . . . GUATEMALA 12 231 . . 6 2.6
KENYA 12 120 . . . . GUYANA 12 37 2 5.4 . .
LESOTHO 12 91 . . 1 1.1 HAITI 12 54 1 1.8 1 1.8
MADAGASCAR 12 135 . . 4 3.0 HONDURAS 12 257 . . 2 .8
MALAWI 12 98 . . . . JAMAICA 12 92 . . . .
MALI 12 136 1 .7 . . KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . . . MICRONESIA 12 64 1 1.6 1 1.6
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 3 1.8 5 3.0
NAMIBIA 12 84 1 1.2 . . PANAMA 12 119 . . 5 4.2
NIGER 12 98 . . . . PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 1 .7 . . PARAGUAY 12 185 . . . .
SOUTH AFRICA 12 89 4 4.5 2 2.2 SAMOA 12 62 . . . .
TANZANIA 12 117 . . 1 .9 SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . . . TONGA 12 75 . . . .
TOGO 12 86 1 1.2 . . VANUATU 12 46 . . . .
UGANDA * 9 14 . . . . TOTAL IAP 258 2,307 15 .7 31 1.3
ZAMBIA 12 131 . . . .
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 10 .4 12 .5 ALL COUNTRIES 839 6,725 32 .5 60 .9

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 . . . .
CHINA 12 79 2 2.5 . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 1 6.4 . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . . .
KAZAKHSTAN 12 138 . . . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 . . 1 2.1 Corps Volunteers were present.
LATVIA 12 38 1 2.6 . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . . .
MOLDOVA 12 80 . . . .
MONGOLIA 12 80 . . . .
MOROCCO 12 131 . . 3 2.3
NEPAL 12 95 . . . .
PHILIPPINES 12 135 . . 5 3.7
POLAND ** 6 29 . . . .
ROMANIA 12 138 . . 2 1.4
RUSSIA/FAR EAST 12 65 . . 1 1.5
RUSSIA/WESTERN 12 113 . . 3 2.6
SLOVAKIA 12 66 1 1.5 . .
THAILAND 12 55 . . . .
TURKMENISTAN** 9 57 . . . .
UKRAINE 12 180 2 1.1 2 1.1
UZBEKISTAN ** 9 109 . . . .
TOTAL EMA 285 2,030 7 .3 17 .8
 Table 18. In 2001, Numbers and Incidence of Reported “Other” Sexually Transmitted Diseases (STDs)
and Schistosomiasis

V/T- “Other” STDs Schistosomiasis V/T- “Other” STDs Schistosomiasis

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 . . 1 .9 BELIZE 12 54 1 1.9 . .

BURKINA FASO 12 88 . . . . BOLIVIA 12 175 13 7.4 . .
CAMEROON 12 127 8 6.3 . . COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 2 4.3 . . DOMINICAN REPUBL 12 158 2 1.3 . .
COTE D'IVOIRE 12 132 2 1.5 . . EASTERN CARIBBEA 12 87 4 4.6 . .
GABON 12 62 . . . . ECUADOR 12 165 1 .6 . .
GHANA 12 146 2 1.4 2 1.4 EL SALVADOR 12 140 . . . .
GUINEA 12 106 3 2.8 . . GUATEMALA 12 231 1 .4 . .
KENYA 12 120 1 .8 . . GUYANA 12 37 3 8.1 . .
LESOTHO 12 91 1 1.1 . . HAITI 12 54 1 1.8 . .
MADAGASCAR 12 135 6 4.4 4 3.0 HONDURAS 12 257 2 .8 . .
MALAWI 12 98 1 1.0 3 3.1 JAMAICA 12 92 1 1.1 . .
MALI 12 136 . . . . KIRIBATI 12 56 . . . .
MAURITANIA 12 86 1 1.2 2 2.3 MICRONESIA 12 64 . . . .
MOZAMBIQUE 12 40 . . 1 2.5 NICARAGUA 12 168 3 1.8 . .
NAMIBIA 12 84 . . . . PANAMA 12 119 2 1.7 . .
NIGER 12 98 2 2.0 4 4.1 PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 . . . . PARAGUAY 12 185 7 3.8 . .
SOUTH AFRICA 12 89 4 4.5 . . SAMOA 12 62 12 19.3 . .
TANZANIA 12 117 . . 6 5.1 SURINAME 12 42 . . . .
THE GAMBIA 12 76 . . . . TONGA 12 75 . . . .
TOGO 12 86 2 2.3 . . VANUATU 12 46 . . . .
UGANDA * 9 14 . . . . TOTAL IAP 258 2,307 53 2.3 . .
ZAMBIA 12 131 2 1.5 . .
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 37 1.5 23 1.0 ALL COUNTRIES 839 6,725 143 2.1 23 .3

EMA Region

ARMENIA 12 62 . . . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 . . . . 2001: Georgia and Uganda.
BULGARIA 12 118 7 6.0 . .
CHINA 12 79 6 7.6 . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 . . . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . . .
KAZAKHSTAN 12 138 3 2.2 . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 3 6.2 . . Corps Volunteers were present.
LATVIA 12 38 1 2.6 . .
LITHUANIA 12 37 1 2.7 . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 . . . .
MOLDOVA 12 80 . . . .
MONGOLIA 12 80 1 1.3 . .
MOROCCO 12 131 9 6.9 . .
NEPAL 12 95 3 3.1 . .
PHILIPPINES 12 135 3 2.2 . .
POLAND ** 6 29 . . . .
ROMANIA 12 138 6 4.3 . .
RUSSIA/FAR EAST 12 65 . . . .
RUSSIA/WESTERN 12 113 . . . .
SLOVAKIA 12 66 . . . .
THAILAND 12 55 . . . .
TURKMENISTAN** 9 57 1 1.7 . .
UKRAINE 12 180 8 4.4 . .
UZBEKISTAN ** 9 109 1 .9 . .
TOTAL EMA 285 2,030 53 2.6 . .
 Table 19. In 2001, Numbers and Incidence of Reported Tuberculosis PPD Conversion and
Active Tuberculosis (TB)

V/T- PPD+ Active TB V/T- PPD+ Active TB

# Rpts Years No. Incidence No. Incidence # Rpts Years No. Incidence No. Incidence
AFRICA Region IAP Region

BENIN 12 111 1 .9 . . BELIZE 12 54 . . . .

BURKINA FASO 12 88 4 4.6 . . BOLIVIA 12 175 . . . .
CAMEROON 12 127 5 3.9 1 .8 COSTA RICA 12 25 . . . .
CAPE VERDE 12 47 . . . . DOMINICAN REPUBL 12 158 3 1.9 . .
COTE D'IVOIRE 12 132 2 1.5 . . EASTERN CARIBBEA 12 87 . . . .
GABON 12 62 . . . . ECUADOR 12 165 1 .6 . .
GHANA 12 146 1 .7 . . EL SALVADOR 12 140 3 2.1 . .
GUINEA 12 106 1 .9 . . GUATEMALA 12 231 3 1.3 . .
KENYA 12 120 . . . . GUYANA 12 37 . . . .
LESOTHO 12 91 . . . . HAITI 12 54 . . . .
MADAGASCAR 12 135 5 3.7 . . HONDURAS 12 257 5 1.9 . .
MALAWI 12 98 3 3.1 . . JAMAICA 12 92 2 2.2 . .
MALI 12 136 3 2.2 . . KIRIBATI 12 56 . . . .
MAURITANIA 12 86 . . . . MICRONESIA 12 64 . . . .
MOZAMBIQUE 12 40 . . . . NICARAGUA 12 168 2 1.2 . .
NAMIBIA 12 84 4 4.8 . . PANAMA 12 119 . . . .
NIGER 12 98 3 3.0 . . PAPUA NEW GUINEA**6 15 . . . .
SENEGAL 12 143 . . . . PARAGUAY 12 185 . . . .
SOUTH AFRICA 12 89 . . . . SAMOA 12 62 . . . .
TANZANIA 12 117 1 .9 . . SURINAME 12 42 . . . .
THE GAMBIA 12 76 2 2.6 . . TONGA 12 75 . . . .
TOGO 12 86 . . . . VANUATU 12 46 . . . .
UGANDA * 9 14 . . . . TOTAL IAP 258 2,307 19 .8 . .
ZAMBIA 12 131 . . . .
ZIMBABWE ** 11 24 . . . .
TOTAL AFRICA 296 2,388 35 1.5 1 <.1 ALL COUNTRIES 839 6,725 92 1.4 1 <.1

EMA Region

ARMENIA 12 62 2 3.2 . . * Peace Corps countries opened in calendar year

BANGLADESH ** 10 39 1 2.6 . . 2001: Georgia and Uganda.
BULGARIA 12 118 4 3.4 . .
CHINA 12 79 2 2.5 . . ** Peace Corps countries closed in calendar year
ESTONIA 12 28 1 3.5 . . 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 . . . . Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 . . . .
KAZAKHSTAN 12 138 4 2.9 . . Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 2 4.2 . . Corps Volunteers were present.
LATVIA 12 38 2 5.3 . .
LITHUANIA 12 37 . . . . Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 1 5.1 . .
MOLDOVA 12 80 5 6.2 . .
MONGOLIA 12 80 . . . .
MOROCCO 12 131 1 .8 . .
NEPAL 12 95 3 3.1 . .
PHILIPPINES 12 135 . . . .
POLAND ** 6 29 . . . .
ROMANIA 12 138 1 .7 . .
RUSSIA/FAR EAST 12 65 2 3.1 . .
RUSSIA/WESTERN 12 113 5 4.4 . .
SLOVAKIA 12 66 1 1.5 . .
THAILAND 12 55 . . . .
TURKMENISTAN** 9 57 . . . .
UKRAINE 12 180 . . . .
UZBEKISTAN ** 9 109 1 .9 . .
TOTAL EMA 285 2,030 38 1.9 . .
 Table 20. In 2001, Numbers and Rates of Peace Corps Volunteer Contacts with
Peace Corps Medical Officer (PCMO)

V/T- Contacts/ Contacts/ V/T- Contacts/ Contacts/

# Rpts Years Contacts Month V/T-Y/Month #Rpts Years Contacts Month V/T-Y/Month
AFRICA Region IAP Region

BENIN 12 111 2798 233 2.1 BELIZE 12 54 1540 128 2.4

BURKINA FASO 12 88 2201 183 2.1 BOLIVIA 12 175 5189 432 2.5
CAMEROON 12 127 2612 218 1.7 COSTA RICA 12 25 433 36 1.4
CAPE VERDE 12 47 1574 131 2.8 DOMINICAN REPUBL 12 158 5103 425 2.7
COTE D'IVOIRE 12 132 2677 223 1.7 EASTERN CARIBBEA 12 87 2074 173 2.0
GABON 12 62 945 79 1.3 ECUADOR 12 165 4517 376 2.3
GHANA 12 146 1863 155 1.1 EL SALVADOR 12 140 5758 480 3.4
GUINEA 12 106 2140 178 1.7 GUATEMALA 12 231 4720 393 1.7
KENYA 12 120 2895 241 2.0 GUYANA 12 37 346 29 .8
LESOTHO 12 91 1360 113 1.3 HAITI 12 54 1112 93 1.7
MADAGASCAR 12 135 665 55 .4 HONDURAS 12 257 5861 488 1.9
MALAWI 12 98 1879 157 1.6 JAMAICA 12 92 2329 194 2.1
MALI 12 136 2310 193 1.4 KIRIBATI 12 56 647 54 1.0
MAURITANIA 12 86 901 75 .9 MICRONESIA 12 64 1001 83 1.3
MOZAMBIQUE 12 40 641 53 1.4 NICARAGUA 12 168 4112 343 2.0
NAMIBIA 12 84 1308 109 1.3 PANAMA 12 119 2627 219 1.8
NIGER 12 98 1899 158 1.6 PAPUA NEW GUINEA**6 15 130 22 1.4
SENEGAL 12 143 5993 499 3.5 PARAGUAY 12 185 2678 223 1.2
SOUTH AFRICA 12 89 777 65 .7 SAMOA 12 62 1327 111 1.8
TANZANIA 12 117 1345 112 1.0 SURINAME 12 42 . . .
THE GAMBIA 12 76 1364 114 1.5 TONGA 12 75 2319 193 2.6
TOGO 12 86 2287 191 2.2 VANUATU 12 46 1427 119 2.6
UGANDA * 9 14 557 62 4.5 TOTAL IAP 258 2,307 55,250 4,710 2.0
ZAMBIA 12 131 915 76 .6
ZIMBABWE ** 11 24 401 36 1.5
TOTAL AFRICA 296 2,388 44,307 3,742 1.6 ALL COUNTRIES 839 6,725 149,184 12,984 1.9

EMA Region

ARMENIA 12 62 1279 107 1.7 * Peace Corps countries opened in calendar year
BANGLADESH ** 10 39 722 72 1.9 2001: Georgia and Uganda.
BULGARIA 12 118 3186 266 2.3
CHINA 12 79 1615 135 1.7 ** Peace Corps countries closed in calendar year
ESTONIA 12 28 566 47 1.7 2001: Bangladesh, Kyrghyzstan, Macedonia, Papua New
GEORGIA * 8 16 496 62 3.9 Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.
JORDAN 12 73 2393 199 2.7
KAZAKHSTAN 12 138 3080 257 1.9 Table does not include Bosnia, where only Crisis
KYRGHYZSTAN ** 9 48 1101 122 2.5 Corps Volunteers were present.
LATVIA 12 38 904 75 2.0
LITHUANIA 12 37 580 48 1.3 Incidence = events/100 V/T-Years
MACEDONIA ** 6 20 680 113 5.8
MOLDOVA 12 80 2517 210 2.6
MONGOLIA 12 80 1684 140 1.8 Contacts/month= (Total no. of reported PCV-PCMO contacts)
MOROCCO 12 131 1878 157 1.2 (no. of months country reported ESR)
NEPAL 12 95 3464 289 3.0
PHILIPPINES 12 135 2259 188 1.4
POLAND ** 6 29 717 120 4.1 Contacts/V/T-Year/Month=(Total no. of reported PCV-PCMO contacts)
ROMANIA 12 138 4957 413 3.0 (V/T-Year)
RUSSIA/FAR EAST 12 65 1256 105 1.6
RUSSIA/WESTERN 12 113 1608 134 1.2 (No. of months reported)
SLOVAKIA 12 66 2918 243 3.7
THAILAND 12 55 3470 289 5.2
TURKMENISTAN** 9 57 1354 150 2.6
UKRAINE 12 180 2811 234 1.3
UZBEKISTAN ** 9 109 2132 237 2.2
TOTAL EMA 285 2,030 49,627 4,528 2.2
 Table 21. In 2001, Malaria Chemoprophylaxis Use Patterns Among Peace Corps Volunteers

V/T- Percent of Volunteers Taking Agent

# Report Years Mefloquine Chloroquine Malarone Chlorpal Doxycycline Other On Any Agent
Africa Region

BENIN 12 111 82.3 . .2 . 18.6 . 101.1

BURKINA FASO 12 88 85.2 . .7 . 12.6 1.5 100.0
CAMEROON 12 127 93.4 . . . 6.6 . 100.0
CAPE VERDE 12 47 10.7 . .2 . 4.4 . 15.3
COTE D'IVOIRE 12 132 86.2 . . . 17.1 . 103.3
GABON 12 62 95.2 . . . 4.8 . 100.0
GHANA 12 146 79.1 . .3 . 20.7 . 100.0
GUINEA 12 106 90.6 . .9 . 8.2 . 99.6
KENYA 12 120 87.1 . .1 . 12.9 . 100.1
LESOTHO 12 91 8.6 . .4 . 1.2 . 10.1
MADAGASCAR 12 135 83.8 . 3.5 3.1 9.8 . 100.1
MALAWI 12 98 87.6 . . . 7.3 . 95.0
MALI 12 136 86.0 . . . 14.3 . 100.2
MAURITANIA 12 86 94.8 . . . 5.3 . 100.1
MOZAMBIQUE 12 40 96.1 . . . 2.5 . 98.6
NAMIBIA 12 84 89.7 . 1.8 . 9.7 . 101.2
NIGER 12 98 92.6 . .1 . 6.1 1.3 100.0
SENEGAL 12 143 69.2 . 2.3 . 28.6 . 100.0
SOUTH AFRICA 12 89 88.4 . . . 11.4 . 99.7
TANZANIA 12 117 93.6 . .1 . 5.7 . 99.3
THE GAMBIA 12 76 89.2 . 3.7 . 8.1 . 101.1
TOGO 12 86 76.3 . 1.4 . 22.2 . 99.9
UGANDA * 9 14 100.0 . . . . . 100.0
ZAMBIA 12 131 94.7 . . . 4.9 . 99.6
ZIMBABWE ** 11 24 96.7 . . . 3.6 . 100.3
TOTAL AFRICA 296 2,388 83.5 . .7 .2 11.5 .1 95.9

EMA Region

ARMENIA 12 62 . . . . . . .
BANGLADESH ** 10 39 94.6 . . . 5.6 . 100.2
BULGARIA 12 118 . . . . . . .
CHINA 12 79 . . . . . . .
ESTONIA 12 28 . . . . . . .
GEORGIA * 8 16 . . . . . . .
JORDAN 12 73 . . . . . . .
KAZAKHSTAN 12 138 . . . . . . .
KYRGHYZSTAN ** 9 48 . . . . . . .
LATVIA 12 38 . . . . . . .
LITHUANIA 12 37 . . . . . . .
MACEDONIA ** 6 20 . . . . . . .
MOLDOVA 12 80 . . . . . . .
MONGOLIA 12 80 . . . . . . .
MOROCCO 12 131 . . . . . . .
NEPAL 12 95 . 60.2 . . . . 60.2
PHILIPPINES 12 135 6.7 93.2 . . .2 . 100.0
POLAND ** 6 29 . . . . . . .
ROMANIA 12 138 . . . . . . .
RUSSIA/FAR EAST 12 65 . . . . . . .
RUSSIA/WESTERN 12 113 . . . . . . .
SLOVAKIA 12 66 . . . . . . .
THAILAND 12 55 . . . . . . .
TURKMENISTAN** 9 57 . . . . . . .
UKRAINE 12 180 . . . . . . .
UZBEKISTAN ** 9 109 . . . . . . .
TOTAL EMA 285 2,030 2.3 9.5 . . .1 . 11.9
 (Continued)
Table 21. In 2001, Malaria Chemoprophylaxis Use Patterns Among Peace Corps Volunteers

V/T- Percent of Volunteers Taking Agent

# Report Years Mefloquine Chloroquine Malarone Chlorpal Doxycycline Other On Any Agent
IAP Region

BELIZE 12 54 . 45.5 . . 4.5 . 49.9

BOLIVIA 12 175 .0 35.5 . . . . 35.6
COSTA RICA 12 25 1.4 95.8 . . 2.8 . 100.0
DOMINICAN REPUBL 12 158 . 97.9 . . 1.1 . 98.9
EASTERN CARIBBEA 12 87 . . . . . . .
ECUADOR 12 165 42.1 . . . 16.5 . 58.7
EL SALVADOR 12 140 . 99.5 . . .5 . 100.0
GUATEMALA 12 231 1.1 98.9 . . . . 100.0
GUYANA 12 37 84.9 . 3.0 . 12.1 . 100.0
HAITI 12 54 . 97.0 . . 2.7 . 99.7
HONDURAS 12 257 . 99.1 . . .2 .7 100.0
JAMAICA 12 92 . . . . . . .
KIRIBATI 12 56 . . . . . . .
MICRONESIA 12 64 2.8 . . . .4 . 3.1
NICARAGUA 12 168 . 95.9 . . 1.5 . 97.5
PANAMA 12 119 14.9 82.1 . . 3.1 . 100.1
PAPUA NEW GUINEA**6 15 98.0 . . . 3.0 . 101.0
PARAGUAY 12 185 . . . . . . .
SAMOA 12 62 . . . . . . .
SURINAME 12 42 55.3 . 1.4 . 8.6 . 65.2
TONGA 12 75 . . . . . . .
VANUATU 12 46 90.4 . . . 13.9 . 104.3
TOTAL IAP 258 2,307 8.9 52.5 .1 . 2.5 .1 64.1

ALL COUNTRIES 839 6,725 33.6 20.9 .3 .1 5.0 .1 59.9

N.B. Country-specific percentages= (summation of number of PCVs on each malaria prophlyaxis

over 12 months) / number of reports per country in 2001 / average number of PCVs in country
in 2001.

Region and All countries percentages= (summation of number of PCVs on each malaria
prophylaxis over 12 months) / average number of reports per country, by region (or
worldwide), in 2001 / average number of PCVs in region (or worldwide) in 2001.

* Peace Corps countries opened in calendar year 2001: Georgia and Uganda.

** Peace Corps countries closed in calendar year 2001: Bangladesh, Kyrghyzstan, Macedonia,
Papua New Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.

Table does not include Bosnia, where only Crisis Corps Volunteers were present.

Incidence = events/100 V/T-Years

 Table 22. In 2001, Reported Vaccine and Immunobiologic Use Among
Peace Corps Volunteers

Number of Doses Given

V/T - Rabies Rabies Rabies Tick-borne
# Reports Years Hep A Hep B Jap. B Mening. Pre-exp. Post-exp. HRIG Encephalitis
Africa Region

BENIN 12 111 65 66 . 63 183 4 4 .

BURKINA FASO 12 88 40 63 . 40 114 2 1 .
CAMEROON 12 127 95 91 . 74 217 8 . .
CAPE VERDE 12 47 36 45 . 25 92 . 2 .
COTE D'IVOIRE 12 132 113 126 . 78 204 4 . .
GABON 12 62 38 36 . 72 72 . . .
GHANA 12 146 40 57 . 27 50 6 . .
GUINEA 12 106 101 142 . 49 169 . . .
KENYA 12 120 72 85 . 70 196 . . .
LESOTHO 12 91 100 103 . 18 133 2 . .
MADAGASCAR 12 135 65 75 . 42 80 10 . .
MALAWI 12 98 127 141 . 87 187 16 . .
MALI 12 136 72 109 . 78 185 . . .
MAURITANIA 12 86 52 64 . 18 69 1 . .
MOZAMBIQUE 12 40 35 33 . . 51 2 . .
NAMIBIA 12 84 37 66 . 44 150 1 . .
NIGER 12 98 73 57 . 54 51 4 . .
SENEGAL 12 143 112 142 . 78 221 2 . .
SOUTH AFRICA 12 89 35 49 . 27 27 1 . .
TANZANIA 12 117 60 101 . 55 70 6 . .
THE GAMBIA 12 76 67 80 . 45 57 . . .
TOGO 12 86 69 73 . 51 143 4 . .
UGANDA * 9 14 34 40 . 19 60 . . .
ZAMBIA 12 131 51 51 . 53 149 3 . .
ZIMBABWE ** 11 24 45 82 . 36 72 3 . .
TOTAL AFRICA 296 2,388 1,634 1,977 . 1,203 3,002 79 7 .

EMA Region

ARMENIA 12 62 69 63 . . . 3 . .
BANGLADESH ** 10 39 32 47 99 26 96 . . .
BULGARIA 12 118 58 37 . . . 3 1 .
CHINA 12 79 59 67 129 . 126 . . .
ESTONIA 12 28 20 19 . . 4 . . 20
GEORGIA * 8 16 36 52 . . 72 . . .
JORDAN 12 73 62 60 . 42 44 30 . .
KAZAKHSTAN 12 138 132 78 . 45 148 1 . 58
KYRGHYZSTAN ** 9 48 29 64 . 34 98 . . 76
LATVIA 12 38 11 22 . . . 2 . 21
LITHUANIA 12 37 16 16 . . . . . 20
MACEDONIA ** 6 20 26 38 . . 3 . . .
MOLDOVA 12 80 61 77 . . 138 6 . .
MONGOLIA 12 80 81 89 73 . 73 4 . .
MOROCCO 12 131 117 123 . 77 233 2 . .
NEPAL 12 95 70 56 113 68 70 32 . .
PHILIPPINES 12 135 48 45 124 . 121 2 . .
POLAND ** 6 29 . . . . . . . .
ROMANIA 12 138 122 165 . . . 10 2 .
RUSSIA/FAR EAST 12 65 59 75 . 34 102 2 . 100
RUSSIA/WESTERN 12 113 159 111 . . . 2 1 160
SLOVAKIA 12 66 32 . . . 1 . . 46
THAILAND 12 55 27 35 82 . 114 8 . .
TURKMENISTAN** 9 57 66 34 . 75 . . 1 .
UKRAINE 12 180 195 162 . 53 . 15 3 3
UZBEKISTAN ** 9 109 97 122 . 135 194 4 . .
TOTAL EMA 285 2,030 1,684 1,657 620 589 1,637 126 8 504
 (Continued)
Table 22. In 2001, Reported Vaccine and Immunobiologic Use Among
Peace Corps Volunteers

Number of Doses Given

V/T - Rabies Rabies Rabies Tick-borne
# Reports Years Hep A Hep B Jap. B Mening. Pre-exp. Post-exp. HRIG Encephalitis
IAP Region

BELIZE 12 54 31 49 . . 88 4 . .
BOLIVIA 12 175 59 78 . . 169 5 1 .
COSTA RICA 12 25 12 15 . . 36 . . .
DOMINICAN REPUBL 12 158 96 151 . 66 258 . . .
EASTERN CARIBBEA 12 87 63 55 . . 19 3 . .
ECUADOR 12 165 96 57 . . 230 9 . .
EL SALVADOR 12 140 90 92 . . 228 2 . .
GUATEMALA 12 231 164 231 . . 387 17 . .
GUYANA 12 37 33 40 . . 50 . . .
HAITI 12 54 59 75 . 43 117 . . .
HONDURAS 12 257 124 117 . . 399 44 . .
JAMAICA 12 92 70 75 . . . . . .
KIRIBATI 12 56 41 30 . . . . . .
MICRONESIA 12 64 41 50 . . . . . .
NICARAGUA 12 168 127 119 . . 232 . . .
PANAMA 12 119 63 88 . . 161 . . .
PAPUA NEW GUINEA**6 15 6 6 . . . . . .
PARAGUAY 12 185 124 107 . . 138 1 . .
SAMOA 12 62 39 32 . . . . . .
SURINAME 12 42 42 40 . . 45 . . .
TONGA 12 75 53 51 . . . . . .
VANUATU 12 46 34 25 . 24 . . . .
TOTAL IAP 258 2,307 1,467 1,583 . 133 2,557 85 1 .

ALL COUNTRIES 839 6,725 4,785 5,217 620 1,925 7,196 290 16 504

* Peace Corps countries opened in calendar year 2001: Georgia and Uganda.

** Peace Corps countries closed in calendar year 2001: Bangladesh, Kyrghyzstan,

Macedonia, Papua New Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.

Table does not include Bosnia, where only Crisis Corps Volunteers were present.

Incidence = events/100 V/T-Years

 Table 23. In 2001, Typhoid Vaccine Among Peace Corps Volunteers

V/T - Oral Heat Inactivated VI Injection

# Reports Years # Doses % of all Doses # Doses % of all Doses # Doses % of all Doses TOTAL
Africa Region

BENIN 12 111 . . . . 49 100.0 49

BURKINA FASO 12 88 . . . . 41 100.0 41
CAMEROON 12 127 . . . . 73 100.0 73
CAPE VERDE 12 47 . . . . 25 100.0 25
COTE D'IVOIRE 12 132 . . . . 84 100.0 84
GABON 12 62 . . . . . . .
GHANA 12 146 . . . . 25 100.0 25
GUINEA 12 106 . . . . 55 100.0 55
KENYA 12 120 . . . . 67 100.0 67
LESOTHO 12 91 . . . . 34 100.0 34
MADAGASCAR 12 135 . . . . 57 100.0 57
MALAWI 12 98 . . . . 86 100.0 86
MALI 12 136 . . . . 67 100.0 67
MAURITANIA 12 86 . . . . 22 100.0 22
MOZAMBIQUE 12 40 . . . . 25 100.0 25
NAMIBIA 12 84 . . . . 56 100.0 56
NIGER 12 98 . . . . 104 100.0 104
SENEGAL 12 143 . . . . 32 100.0 32
SOUTH AFRICA 12 89 . . . . 25 100.0 25
TANZANIA 12 117 . . . . 50 100.0 50
THE GAMBIA 12 76 . . . . 45 100.0 45
TOGO 12 86 . . . . 48 100.0 48
UGANDA * 9 14 . . . . 16 100.0 16
ZAMBIA 12 131 . . . . 52 100.0 52
ZIMBABWE ** 11 24 . . . . 57 100.0 57
TOTAL AFRICA 296 2,388 . . . . 1,195 100.0 1,195

EMA Region

ARMENIA 12 62 . . . . . . .
BANGLADESH ** 10 39 . . . . 30 100.0 30
BULGARIA 12 118 . . . . . . .
CHINA 12 79 . . . . 37 100.0 37
ESTONIA 12 28 . . . . . . .
GEORGIA * 8 16 . . . . 23 100.0 23
JORDAN 12 73 . . . . . . .
KAZAKHSTAN 12 138 . . . . 53 100.0 53
KYRGHYZSTAN ** 9 48 . . . . 35 100.0 35
LATVIA 12 38 . . . . . . .
LITHUANIA 12 37 . . . . . . .
MACEDONIA ** 6 20 . . . . 52 100.0 52
MOLDOVA 12 80 . . . . 48 100.0 48
MONGOLIA 12 80 . . . . 40 100.0 40
MOROCCO 12 131 . . . . 75 100.0 75
NEPAL 12 95 . . . . 40 100.0 40
PHILIPPINES 12 135 108 100.0 . . . . 108
POLAND ** 6 29 . . . . . . .
ROMANIA 12 138 . . . . . . .
RUSSIA/FAR EAST 12 65 . . . . 34 100.0 34
RUSSIA/WESTERN 12 113 . . . . 2 100.0 2
SLOVAKIA 12 66 . . . . . . .
THAILAND 12 55 . . . . 26 100.0 26
TURKMENISTAN** 9 57 . . . . 35 100.0 35
UKRAINE 12 180 . . . . 102 100.0 102
UZBEKISTAN ** 9 109 . . . . 160 100.0 160
TOTAL EMA 285 2,030 108 12.0 . . 792 88.0 900
 (Continued)
Table 23. In 2001, Typhoid Vaccine Among Peace Corps Volunteers

V/T - Oral Heat Inactivated VI Injection

# Reports Years # Doses % of all Doses # Doses % of all Doses # Doses % of all Doses TOTAL

IAP Region

BELIZE 12 54 . . . . 44 100.0 44
BOLIVIA 12 175 . . . . 43 100.0 43
COSTA RICA 12 25 . . . . 1 100.0 1
DOMINICAN REPUBL 12 158 . . . . 61 100.0 61
EASTERN CARIBBEA 12 87 . . . . 33 100.0 33
ECUADOR 12 165 . . . . 76 100.0 76
EL SALVADOR 12 140 . . . . 70 100.0 70
GUATEMALA 12 231 . . . . 120 100.0 120
GUYANA 12 37 . . . . 24 100.0 24
HAITI 12 54 . . . . 39 100.0 39
HONDURAS 12 257 . . . . 49 100.0 49
JAMAICA 12 92 . . . . 67 100.0 67
KIRIBATI 12 56 . . . . 31 100.0 31
MICRONESIA 12 64 . . . . 38 100.0 38
NICARAGUA 12 168 . . . . 81 100.0 81
PANAMA 12 119 . . . . 34 100.0 34
PAPUA NEW GUINEA**6 15 . . . . . . .
PARAGUAY 12 185 . . 35 48.6 37 51.4 72
SAMOA 12 62 . . . . 29 100.0 29
SURINAME 12 42 . . 19 100.0 . . 19
TONGA 12 75 . . . . 2 100.0 2
VANUATU 12 46 . . . . 23 100.0 23
TOTAL IAP 258 2,307 . . 54 5.6 902 94.4 956

ALL COUNTRIES 839 6,725 108 3.5 54 1.8 2,889 94.7 3,051

* Peace Corps countries opened in calendar year 2001: Georgia and Uganda.

** Peace Corps countries closed in calendar year 2001: Bangladesh, Kyrghyzstan, Macedonia,
Papua New Guinea, Poland, Turkmenistan, Uzbekistan, Zimbabwe.

Table does not include Bosnia, where only Crisis Corps Volunteers were present.

Incidence = events/100 V/T-Years

 HOV 2001 Subject Index
Subject Text (page #) Figure # Table #
Alcohol Problems 15 52 1
Antimalarials 4 6 21
Asthma 15 50, 51 14
Cardiovascular Problems 16 1
Deaths 10 27, 28, 29
Dengue 10 30 2
Dental Problems 7 17 2
Dermatitis 7 3
Diarrhea 6 11, 12 5
Environmental Concerns 9 25, 26 3
Febrile Illnesses 8 4
Female V/T-Years 14 44
Filariasis 12 32 4
Hepatitis 3 3 6
HIV Infections 13 35-39
Hospitalizations, In-Country 17 57 6
Injuries, Assault-Related 9
Injuries, Bicycle 8 20 7
Injuries, Motor Vehicle 8 22 8
Injuries, Motorcycle 2 1, 2 8
Injuries, Pedestrian 8 21 7
Injuries, Sports-Related 8 19 9
Injuries, Unintentional 7 18-23 7,8,9,10
Injuries, Water-Related 8 23 10
Intestinal Helminths 12 33, 34 5
Leishmaniasis 11
Lower Respiratory Tract Illnesses 9 24 15
Malaria 4 4, 5 11, 12
Medical Evacuations (Medevacs) 16 54, 55, 56 13
Mental Health Problems 6 15, 16 14
Non Sexually-Transmitted Gyn. Infections 9 16
PCMO Contacts 16 53 20
Pregnancy 14 43, 45, 46 16
Schistosomiasis 11 31 18
Sexually Transmitted Diseases 14 40, 41, 42
Tuberculosis 14 47, 48, 49 19
Upper Respiratory Tract Illnesses 6 13, 14 15
Vaccines 15 22, 23