Health Risks for Temporary Residents of Developing Countries: The U.S. Peace Corps as an Epidemiologic Model

Health risks for temporary residents of developing countries may differ markedly from those in the vacation traveler. While some expatriates may live in protected communities in capital cities, many live in the rural towns and villages where they work. The United States Peace Corps is an international volunteer organization which supports over 5500 volunteers working in development projects in 62 countries worldwide. Peace Corps uses a computerized epidemiologic surveillance system to monitor trends in 31 health conditions and events. Data are collected monthly from each country and quarterly and annual incidence rates are calculated. In 1987, the most commonly reported health problems were diarrhea (unclassified), 48 cases/100 yolunteers/year; amebiasis, 24 cases/100 volunteers/year; injuries, 20 cases/100 volunteers/year; dental problems 19 cases/100 volunteers/year; and bacterial skin infections, 19 cases/100 volunteers/year. Based on these data, specific studies and disease control efforts have been initiated. Health problems with very low rates (less than 0.1/100 volunteers/year) include hepatitis, schistosomiasis, non-falciparum malaria, and filariasis. The epidemiologic surveillance system provides the health data needed to plan, implement, and evaluate health programs for Peace Corps Volunteers, and provides a model for surveillance in other groups of temporary and permanent residents of developing countries.