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U.S. forces struck three facilities used by Iranian-backed militia groups in Iraq, Secretary of Defense Lloyd Austin said Tuesday, as American troops based in the country continue to come under rocket and missile attacks.

Pentagon spokesman Maj. Gen. Pat Ryder also said Tuesday that the number of American troops diagnosed with traumatic brain injuries from a recent attack on al-Asad air base has increased, bringing the total to four. All of them have returned to duty, he added.

Two troops were originally diagnosed with TBIs after a rocket and ballistic missile attack on al-Asad in Iraq’s western Anbar Province over the weekend. Ryder said there was no significant damage in the attack.

After October drone attacks by Iranian-backed groups on Al Asad Air Base in Iraq and the Al Tanf garrison in Syria, 19 troops were diagnosed with TBI.

Austin called the strikes “necessary and proportionate” and said the sites were used by Iranian-backed Kataib Hezbollah militia group and other Iran-affiliated groups. The strike came, he said, in response to the more than 150 attacks against U.S. service members and personnel in Iraq and Syria which began in October.

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The U.S. has around 2,500 troops in Iraq who are there at the invitation of the government. Earlier this month, the Pentagon quelled rumors about a U.S. withdrawal from the country.

This strike is the latest in a series on Iranian-backed groups operating in the country. 

Earlier this month, a U.S. airstrike in Baghdad killed a leader and a member of the Harakat-al-Nujaba militia, an Iranian proxy group that targeted U.S. forces. In November, the U.S. struck a truck in Western Iraq after an American crew watched Iranian-backed militia fighters use it to launch a ballistic missile attack on U.S. troops which injured eight Americans.

“I am grateful for both the skill and professionalism with which our personnel planned and conducted these strikes and the continued efforts of our troops on the ground as they work with regional partners to further dismantle and degrade ISIS,” Austin said.

Austin reiterated U.S. desires to prevent further escalation in the region but added that “we are fully prepared to take further measures to protect our people and our facilities.” 

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