Volume 21, Number 10—October 2015
Environmental Factors Related to Fungal Wound Contamination after Combat Trauma in Afghanistan, 2009–2011
|Characteristic||Southern Afghanistan, median (IQR)||Eastern Afghanistan, median (IQR)||p value†|
|NDVI‡||7.64 (7.23–7.95)||7.69 (7.52–8.00)||0.384|
|Elevation, m||902 (859–946)||1,670 (1,050–2,117)||<0.001|
|Annual mean||18.8 (18.6–19.5)||13.9 (10.3–18.3)||<0.001|
|Seasonality¶||880.7 (877.9–884)||861.7 (853.6–964.0)||0.471|
|Mean diurnal range||17.4 (17.3–17.5)||13.5 (12.7–15.0)||<0.001|
|Maximum of warmest month||40.8 (40.5–41.3)||33.4 (31.5–36.6)||<0.001|
|Minimum of coldest month||−0.6 (−0.8 to 0)||−3.8 (−12 to 0.5)||0.194|
|Annual range||41.4 (41.3–41.5)||36.5 (35.8–43.3)||0.138|
|Mean of wettest quarter||9.6 (9.2–10.3)||8.1 (4.8–12.5)||0.681|
|Mean of driest quarter||30.1 (29.6–30.8)||19.3 (17.8–21.3)||<0.001|
|Mean of warmest quarter||30.2 (29.9–30.8)||25.3 (22.5–29.3)||<0.001|
|Mean of coldest quarter
||2.7 (−2.9 to 7.1)
|Annual||145 (130–154)||443 (2,795–546)||<0.001|
|Wettest month||39 (35–40)||89 (64–123)||<0.001|
|Driest month||0||6 (0–12.5)||<0.001|
|Seasonality#||110 (108–115)||82 (73–90)||<0.001|
|Wettest quarter||103 (92–109)||210 (168–307)||<0.001|
|Driest quarter||0||28 (8–51)||<0.001|
|Warmest quarter||0||46 (10–66)||<0.001|
|*Environmental characteristics were obtained in relation to grid coordinates on a per-individual basis: southern Afghanistan region (147 patients) and eastern Afghanistan region (20 patients). IQR, interquartile range; NDVI, normalized difference vegetation index. †p values were calculated using Wilcoxon rank-sum test. The regional variables were treated as dependent, whereas the environmental characteristic was independent. ‡NDVI uses a mathematical formula to quantify the density of healthy green vegetation in a region. Higher values indicate healthy green vegetation (e.g., forests), while lower values are associated with water, snow, sand, rock, and dead vegetation (25,26). The NDVI values were normalized by taking the natural log of the index. §Mean diurnal range divided by temperature annual range and then multiplied by 100. ¶SD of weekly mean temperature multiplied by 100. #Coefficient of variation.|
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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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