Infectious diseases related aeromedical evacuation of French soldiers in a level 4 military treatment facility: A ten year retrospective analysis☆
Introduction
Infectious diseases are an important cause of morbidity in deployed soldiers [1], [2], [3], [4], [5], [6], [7], [8]. Most often benign, they are managed by deployed field physicians. There are few data available on severe or complex cases leading to air medevac to a level 4 military treatment facility (MTF) in France [9], [10], [11], [12].
Section snippets
Methods
A ten year retrospective study was conducted from January 1, 2004 to October 30, 2013. We included all military personnel admitted to our infectious diseases unit (hospital stay > 24 h) following an air medevac during deployment abroad.
Inclusion criteria: medically evacuated servicemen after authorization of the medical chain of command.
Exclusion criteria: military personnel staying abroad for leisure and civilian humanitarians workers were excluded.
Demographics, health itinerary, clinical data
Patient data
A total of 125 individuals (117 males, 8 females) were medically evacuated from abroad. Their main epidemiological characteristics are summarized in Table 1.
The majority of soldiers were deployed for short term missions (median duration was 62 days). Main destinations of deployment were: sub-Saharan Africa (80), Afghanistan (15), French Guiana (10). Details on geographic data of transport origin are shown in Table 2.
Military branches were Army (78), French foreign legion (15), Air force (10),
Discussion
Each year, more than 40 000 French soldiers deploy or travel abroad among which 15 000 permanently exposed to malaria. Among the several risks to which they are exposed, like other foreign troops, infections are a frequent cause of morbidity on the field [1], [2], [3], [4], [5], [6], [7], [8]. Dominated by diarrhea, respiratory and cutaneous infections, they are most often benign and successfully managed in the deployed medical MTF [3], [8], [9].
According to the doctrine of the French Joint
Conclusion
Infections represent a small proportion of air medical evacuations. Malaria and meningitis are the leading causes but remain rare. Severity of infection and difficulties in accessing good quality health care are the main determinants of evacuation. These data are useful to reinforce disease prevention strategies in French soldiers and other occupational groups deployed overseas.
Conflict of interest
The authors state no conflict of interest.
References (22)
- et al.
Les risques infectieux chez les militaires en opération
Med Mal Infect
(1996) - et al.
Impact of infectious diseases on war
Infect Dis Clin North Am
(2004) - et al.
Diagnoses and factors associated with medical evacuation and return to duty for service members participating in operation Iraqi Freedom or Operation enduring freedom: a prospective cohort study
Lancet
(2010) - et al.
Frequency and causes of non battle injuries air evacuated from operations iraqi freedom and enduring freedom, u.s. Army, 2001–2006
Am J Prev Med
(2010) - et al.
Sexually transmitted diseases and sexual contamination with human immunodeficiency virus in the French Forces in 2006
Ann Dermatol Venereol
(2009) - et al.
Les risques infectieux en opérations extérieures
Médecine et armées
(2009) - et al.
Impact of illness and non combat injury during operation Iraqi freedom and enduring freedom (Afghanistan)
Am J Trop Med Hyg
(2005) - et al.
An approach to prevention of infectious diseases during military deployments
Clin Infect Dis
(2007) A brief history of British military experiences with infectious and tropical diseases
J R Army Med Corps
(2013)- et al.
Operational impact of health problems observed during a four-month military deployment in Ivory Coast
Mil Med
(2009)
UK role 4 military infectious diseases at Birmingham Heartlands Hospital in 2005–2009
JR Army Med Corps
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2023, Infectious Diseases NowIncidence of leptospirosis in the French armed forces from 2004 to 2018: Retrospective analysis
2021, Travel Medicine and Infectious DiseaseCitation Excerpt :Less than one third of the cases in France are occupational: sewer workers, fish farmers, professional divers, vets, gamekeepers, military personal, etc. [6]. The French military personnel may be exposed to leptospirosis during their training or on duty on the field in continental France, and most of all, in intertropical areas in the French departments and in Africa [11,12]. They may have to train or work in highly rustic conditions in natural environment: assault course in mud, commando training in mangroves, canyoning on rivers, etc. [13–17].
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2020, Medecine et Maladies InfectieusesCitation Excerpt :We also noticed suboptimal notification of some infections. For instance Rapp et al. reported a significant number of HIV primary infections or risky sexual behaviors, that we did not observe in our cohort [22]. “Risky sexual behavior” kits have been implemented on the field, and this may explain the reduced number of patients evacuated for such reasons.
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2020, Medecine et Maladies InfectieusesCitation Excerpt :Patients with severe P. falciparum malaria were most often prescribed intravenous quinine up to 2014, and then artesunate from 2015 on. The impact of malaria on the operations of the French armed forces can be considerable, temporarily saturating evacuation capabilities and medical facilities [47,48] with a median period of unavailability of 7 days (extreme values: 0–90 days) adding up to more than 41,000 days of soldiers’ unavailability from 2010 to 2015. The first-line treatment of non-vomiting patients presenting with uncomplicated P. falciparum malaria is artemisinin-based combination therapy (ACT): artemether-lumefantrine and dihydroartemisinin-piperaquine (available since 2013).
Aeromedical Evacuations Within the French Armed Forces: Analysis of 2,129 Patients
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2020, Principles of Occupational Health and Hygiene: An introduction, 3rd edition
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Data from the manuscript has been presented at the 3rd North European Conference of Travel Medicine, May 26–29, 2010, Hamburg, Germany.