Name
#122 Adherence to Standardized Disease and Injury Surveillance During Two US Africa Command Exercises
Speakers
Lt Col Zachary Rupert
Lt Col Dianne Frankel DO, MPH, MTM&H, CTropMed, FACP , Uniformed Services University of the Health Sciences (USU)
Lt Col Dianne Frankel DO, MPH, MTM&H, CTropMed, FACP , Uniformed Services University of the Health Sciences (USU)
Content Presented On Behalf Of:
Uniformed Services University
Session Type
Poster
Date
Tuesday, March 3, 2026
Start Time
5:00 PM
End Time
7:00 PM
Location
Prince Georges Expo Hall E
Focus Areas/Topics
Clinical Care, Wellbeing, Policy/Management/Administrative, Trending/Hot Topics or Other not listed
Learning Outcomes
1. DNBI Remains a Major Threat to Force Health Protection
--DNBI continues to exceed combat-related injuries and degrade readiness during operations.
--In African Lion and Flintlock, over 500 DNBI were reported, most commonly gastrointestinal, respiratory, orthopedic, and dermatologic conditions.
--Accurate DNBI surveillance is essential for maintaining a fit force, detecting outbreaks early, and preventing mission degradation from avoidable illness or injury.
2. Standardization of DNBI Classification Is Critical
--Only 49–55% of DNBI reports mapped to standardized DHA-PI 6490.03 categories.
--Misclassification, especially broad use of “Other Medical,” limits operational utility and cross-mission comparisons.
--Standardized surveillance enables actionable, comparable data across combatant commands.
3. Simple Process Improvements Can Enhance Data Quality
--Embedding preventive medicine teams, adding a D&I checklist to the SF 600, and clarifying Annex Q instructions would improve accuracy and consistency.
--These low-burden interventions strengthen biosurveillance and ensure DNBI data support real-time medical decision-making.
--DNBI continues to exceed combat-related injuries and degrade readiness during operations.
--In African Lion and Flintlock, over 500 DNBI were reported, most commonly gastrointestinal, respiratory, orthopedic, and dermatologic conditions.
--Accurate DNBI surveillance is essential for maintaining a fit force, detecting outbreaks early, and preventing mission degradation from avoidable illness or injury.
2. Standardization of DNBI Classification Is Critical
--Only 49–55% of DNBI reports mapped to standardized DHA-PI 6490.03 categories.
--Misclassification, especially broad use of “Other Medical,” limits operational utility and cross-mission comparisons.
--Standardized surveillance enables actionable, comparable data across combatant commands.
3. Simple Process Improvements Can Enhance Data Quality
--Embedding preventive medicine teams, adding a D&I checklist to the SF 600, and clarifying Annex Q instructions would improve accuracy and consistency.
--These low-burden interventions strengthen biosurveillance and ensure DNBI data support real-time medical decision-making.
Session Currently Live
Description
Poster or presentation covering the following:
Disease and non-battle injuries (DNBI) remain a major challenge to force health protection during military operations. This study evaluated DNBI reported from two U.S. Africa Command (USAFRICOM) exercises, African Lion 2024 and Flintlock 2024, and assessed the burden of DNBI and the accuracy of DNBI classification. A total of 314 DNBI were reported during African Lion and 203 during Flintlock. However, only 49.4% and 55.2% of reported cases, respectively, could be mapped to standardized surveillance categories outlined in to Defense Health Agency Procedural Instruction (DHA-PI) 6490.03. Secondary analysis of African Lion data revealed misclassification of reported DNBI and widespread use of non-standardized DNBI categorization. These findings underscore the need for standardized surveillance, integration of preventive medicine teams, and improved reporting workflows to enhance the operational utility of DNBI data.