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Volume 21, Number 10—October 2015
Research

Environmental Factors Related to Fungal Wound Contamination after Combat Trauma in Afghanistan, 2009–2011

David R. TribbleComments to Author , Carlos J. Rodriguez, Amy C. Weintrob, Faraz Shaikh, Deepak Aggarwal, M. Leigh Carson, Clinton K. Murray, Penny Masuoka, on behalf of the Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group
Author affiliations: Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA (D.R. Tribble, A.C. Weintrob, F. Shaikh, D. Aggarwal, M.L. Carson, P. Masuoka); Walter Reed National Military Medical Center, Bethesda (C.J. Rodriguez, A.C. Weintrob); Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda (A.C. Weintrob, F. Shaikh, D. Aggarwal, M.L. Carson, P. Masuoka); San Antonio Military Medical Center, Joint Base San Antonio, Fort Sam Houston, Texas, USA (C.K. Murray)

Main Article

Table 1

Environmental risk factor analysis for mold contamination of wounds, Afghanistan, 2009–2011*

Environmental factor Univariable OR (95% CI) p value† Multivariable OR (95% CI) p value‡
NDVI§ 0.93 (0.49–1.77) 0.89 1.16 (0.58–2.33) 0.68
Elevation 1.00 (0.99–1.00) 0.11 1.00 (1.00–1.01) 0.61
Annual precipitation¶ 0.99 (0.99–1.00) 0.01 − −
Annual mean temperature 1.09 (0.95–1.24) 0.22 0.84 (0.42–1.67) 0.61
Temperature annual range
 1.19 (0.97–1.47)
 0.10
 0.74 (0.50–1.09)
 0.12
Regional area
East Reference Reference
South
 7.76 (2.46–24.4)
 0.001
 129.9 (7.71–>999)#
 0.001
*OR, odds ratio; NDVI, normalized difference vegetation index.
†For univariable analysis.
‡For multivariable analysis.
§The NDVI uses a mathematical formula to quantify the density of healthy green vegetation in a region (25,26). The NDVI values were normalized by taking the natural log of the index.
¶Because of its high correlation with the temperature variables, annual precipitation was not included in the final multivariable model.
#The wide CI is due to correlation between the regional and the environmental variables.

Main Article

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Main Article

1A portion of this material was presented at the Military Health System Research Symposium, August 18–21, 2014, Fort Lauderdale, Florida, USA.

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