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Zawadzka M, Lis A, Marszałkowska-Jakubik J, Szymański P. Evaluation of Soldiers' Knowledge and Sense of Threats Regarding Exposure to Biological Risk Factors at the Place of Service. Healthcare (Basel) 2024; 12:1777. [PMID: 39273800 PMCID: PMC11394985 DOI: 10.3390/healthcare12171777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/24/2024] [Accepted: 08/30/2024] [Indexed: 09/15/2024] Open
Abstract
Exposure to harmful biological agents and the level of knowledge about specific risk factors are extremely important topics, especially among military personnel. This study evaluates the knowledge and perceptions of soldiers regarding exposure to biological risk factors during their service. This research was conducted using an online survey distributed through the WBBS research panel, in which 1331 soldiers from various demographic groups and ranks participated. The survey assessed awareness of biological threats, the level of knowledge about preventive measures, and the perceived adequacy of occupational health and safety training. The findings reveal that over 80% of respondents possess some level of knowledge about the types of biological agents they may encounter, yet significant gaps remain, particularly in training related to region-specific infectious diseases, with more than 75% of participants having not received such training. Additionally, approximately 5% of respondents reported high exposure, and around 4% reported very high exposure to harmful biological agents, highlighting the need for enhanced educational programs and preventive measures in military contexts. The study underscores the importance of continuous education and training to mitigate risks associated with biological hazards in military environments.
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Affiliation(s)
- Magdalena Zawadzka
- Department of Epidemiology and Public Health, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland
- Department of Organization of the Health Care System, Prevention and Treatment Team, Military Institute of Hygiene and Epidemiology, Kozielska 4, 01-163 Warsaw, Poland
| | - Aleksandra Lis
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Łódź, Poland
| | - Justyna Marszałkowska-Jakubik
- Department of Organization of the Health Care System, Prevention and Treatment Team, Military Institute of Hygiene and Epidemiology, Kozielska 4, 01-163 Warsaw, Poland
| | - Paweł Szymański
- Department of Pharmaceutical Chemistry, Drug Analyses and Radiopharmacy, Medical University of Lodz, Muszyńskiego 1, 90-151 Łódź, Poland
- Department of Radiobiology and Radiation Protection, Military Institute of Hygiene and Epidemiology, Kozielska 4, 01-163 Warsaw, Poland
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A single dose of ciprofloxacin reduces the duration of diarrhea among service members deployed in Africa. Infect Dis Now 2023; 53:104643. [PMID: 36642099 DOI: 10.1016/j.idnow.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/27/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To assess the effectiveness of the adjunction of a one-gram single dose of ciprofloxacin to a symptomatic treatment for the early treatment of uncomplicated diarrhea during military operations of the French service members in Africa. PATIENTS AND METHODS This phase IV, multicentric, randomized, open-label, controlled trial was conducted in Chad, Mali, and in Central African Republic. A total of 267 French service members having at least one loose stool in the previous 24 hours were enrolled from May 2015 to June 2016. Participants were randomized to receive ciprofloxacin 1 g and a symptomatic treatment (racecadotril 100 mg three times a day and ad libidum oral rehydration solution) or a symptomatic treatment alone. The primary outcome was the duration of the diarrhea. Secondary outcomes were evaluated at the 72-hour endpoint and included recovery status, number of loose stools, frequency and duration of associated symptoms and safety of treatments. RESULTS Among 267 participants, 242 completed the trial. Participants receiving ciprofloxacin and a symptomatic treatment (n = 124) were significantly more likely to be cured at the endpoint than those who only received a symptomatic treatment (118): 94.4 % versus 74.6 % (OR = 5.7; 95 %CI: [2.4-13.6]; p < 10-3). The antibiotic therapy reduced the average diarrhea duration by 30 % (p = 10-4). Fever at inclusion was associated with a longer episode (HR = 0.61; 95 %CI: [0.41-0.89]; p = 0.012). No adverse event of medications was reported. CONCLUSION A single dose of ciprofloxacin was effective and safe in treating uncomplicated diarrhea among service members in Africa.
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Meynard JB, de Laval F, Texier G, Gorgé O, Degui H, Pommier de Santi V. [Management of the COVID-19 epidemic in the carrier battle group (January-April 2020) by the Armed Forces Epidemiology and Public Health Center]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2022; 206:997-1010. [PMID: 35879932 PMCID: PMC9301959 DOI: 10.1016/j.banm.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives Faced with the COVID-19 epidemic that occurred within the naval air group and the nuclear aircraft carrier Charles de Gaulle, the French Armed Forces Epidemiology and Public Health Center (CESPA) carried out an investigation (January - April 2020) whose objectives were: to identify the possible routes of introduction of the virus ; to describe the characteristics of the epidemic and to describe and model the dynamics of the epidemic's spread. Methods A telephone survey was conducted. The biological diagnoses were transmitted by the medical antennas. A time/place/population analysis was carried out, as well as the description of the clinical pictures with their exposure factors. The instantaneous reproduction rate Rt of the epidemic was modeled. A spatial analysis of the epidemic on board was carried out. Forty-three viral genomes were sequenced and compared to the reference bases. Results 0f 1767 sailors, 1568 (89%) participated in the telephone survey and 1064 (67.9%) were confirmed cases. Four patient profiles have been described: asymptomatic (13.0%); non-specific symptomatic (8.1%); specific symptomatic (76.3%); severe cases (2.6%). In univariate and multivariate analysis, age, overweight and obesity were significantly associated with the risk of having a severe form. Smoking was a protective factor. The evolution kinetics of Rt was in favor of an introduction of the virus at the end of February with a reintroduction during the stopover in Brest. Analysis of viral genomes ruled out introduction and spread of a single strain. Conclusion Despite the control measures taken, an epidemic occurred. The often pauci-symptomatic clinical pictures resulted in a delay in identification. CESPA was able to carry out this epidemiological investigation within a highly constrained timeframe, showing all the interest of its integrated public health model.
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Affiliation(s)
- J-B Meynard
- Direction de la formation, de la recherche et de l'innovation du service de santé des armées, Val-de-Grâce, 1, place Alphonse Laveran, 75005 Paris, France
- UMR 1252-sciences économiques et sociales de la santé et traitement de l'information médicale, SESSTIM, Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean Moulin, 13385 Marseille cedex 5, France
- École du Val-de-Grâce, Val-de-Grâce, 1, place Alphonse Laveran, 75005 Paris, France
| | - F de Laval
- UMR 1252-sciences économiques et sociales de la santé et traitement de l'information médicale, SESSTIM, Inserm/IRD/Aix-Marseille université, faculté de médecine, 27, boulevard Jean Moulin, 13385 Marseille cedex 5, France
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
| | - G Texier
- École du Val-de-Grâce, Val-de-Grâce, 1, place Alphonse Laveran, 75005 Paris, France
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
- UMR 257-Vecteurs, infections tropicales et méditerranéennes-VITROME-IRD/SSA/AP-HM/Aix-Marseille université, 19-21, boulevard Jean Moulin, 13005 Marseille, France
| | - O Gorgé
- Institut de recherche biomédicale des armées, 1, place du général Valérie André BP 73, 91223 Brétigny-sur-Orge, France
| | - H Degui
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
| | - V Pommier de Santi
- Centre d'épidémiologie et de santé publique des armées, base de défense Marseille Aubagne - 111, avenue de la Corse BP40026, 13568 Marseille cedex 02, France
- UMR 257-Vecteurs, infections tropicales et méditerranéennes-VITROME-IRD/SSA/AP-HM/Aix-Marseille université, 19-21, boulevard Jean Moulin, 13005 Marseille, France
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de Laval F, Chaudet H, Gorgé O, Marchi J, Lacrosse C, Dia A, Marbac V, Mmadi Mrenda B, Texier G, Letois F, Chapus C, Sarilar V, Tournier JN, Levasseur A, Cobola J, Nolent F, Dutasta F, Janvier F, Meynard JB, Pommier de Santi V. Investigation of a COVID-19 outbreak on the Charles de Gaulle aircraft carrier, March to April 2020: a retrospective cohort study. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 35620999 PMCID: PMC9137271 DOI: 10.2807/1560-7917.es.2022.27.21.2100612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background SARS-CoV-2 emergence was a threat for armed forces. A COVID-19 outbreak occurred on the French aircraft carrier Charles de Gaulle from mid-March to mid-April 2020. Aim To understand how the virus was introduced, circulated then stopped circulation, risk factors for infection and severity, and effectiveness of preventive measures. Methods We considered the entire crew as a cohort and collected personal, clinical, biological, and epidemiological data. We performed viral genome sequencing and searched for SARS-CoV-2 in the environment. Results The attack rate was 65% (1,148/1,767); 1,568 (89%) were included. The male:female ratio was 6.9, and median age was 29 years (IQR: 24–36). We examined four clinical profiles: asymptomatic (13.0%), non-specific symptomatic (8.1%), specific symptomatic (76.3%), and severe (i.e. requiring oxygen therapy, 2.6%). Active smoking was not associated with severe COVID-19; age and obesity were risk factors. The instantaneous reproduction rate (Rt) and viral sequencing suggested several introductions of the virus with 4 of 5 introduced strains from within France, with an acceleration of Rt when lifting preventive measures. Physical distancing prevented infection (adjusted OR: 0.55; 95% CI: 0.40–0.76). Transmission may have stopped when the proportion of infected personnel was large enough to prevent circulation (65%; 95% CI: 62–68). Conclusion Non-specific clinical pictures of COVID-19 delayed detection of the outbreak. The lack of an isolation ward made it difficult to manage transmission; the outbreak spread until a protective threshold was reached. Physical distancing was effective when applied. Early surveillance with adapted prevention measures should prevent such an outbreak.
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Affiliation(s)
- Franck de Laval
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - Hervé Chaudet
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA (French Military Health Service), VITROME, Marseille, France.,University Hospital Institute Méditerranée Infection, Marseille, France
| | - Olivier Gorgé
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
| | - Joffrey Marchi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Constance Lacrosse
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Aissata Dia
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | | | - Bakridine Mmadi Mrenda
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Gaëtan Texier
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA (French Military Health Service), VITROME, Marseille, France
| | - Flavie Letois
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Charles Chapus
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
| | - Véronique Sarilar
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
| | | | - Anthony Levasseur
- University Hospital Institute Méditerranée Infection, Marseille, France.,Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France
| | | | - Flora Nolent
- French Armed Forces Biomedical Research Institute (IRBA), Brétigny-sur-Orge, France
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- PA-CDG COVID-19 investigation group members are listed under Collaborators
| | - Jean-Baptiste Meynard
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - Vincent Pommier de Santi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.,Aix-Marseille University, IRD, AP-HM, SSA (French Military Health Service), VITROME, Marseille, France
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5
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Mura M, Haus-Cheymol R, Tournier JN. Immunization on the French Armed Forces: Impact, organization, limits and perspectives. Infect Dis Now 2021; 51:583-589. [PMID: 34581277 DOI: 10.1016/j.idnow.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/08/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022]
Abstract
Vaccination plays a key role in the prevention of the infectious diseases, which the armed forces are exposed to during overseas deployments. Historically, the French military health service have always contributed greatly to progress in vaccination. The military immunization schedule has often been used as a model for the national schedule. It is a powerful tool, which is constantly evolving to take into account the risks of infection inherent in deployment and to include new scientific data, while still remaining aware of the limitations of vaccination from an individual and collective standpoint. In the current context of increasingly fast emergence or re-emergence of pathogens with a high epidemic potential, developing preventive medical measures is more necessary than ever before, and the French military health service is actively participating.
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Affiliation(s)
- M Mura
- Institut de recherche biomédicale des armées, unité Bactériologie et biothérapies anti-infectieuses et immunité, 1 place du Général-Valérie-André, BP73, Brétigny-sur-orge Cédex, France; Walter Reed Army Institute of Research, 503 Robert Grant Avenue, MD20910 Silver Spring, USA
| | - R Haus-Cheymol
- Direction centrale du service de santé des armées, Division expertise stratégie de santé de défense, Bureau plans de santé, France
| | - J-N Tournier
- Institut de recherche biomédicale des armées, unité Bactériologie et biothérapies anti-infectieuses et immunité, 1 place du Général-Valérie-André, BP73, Brétigny-sur-orge Cédex, France; Institut Pasteur, Innovative vaccine Laboratory, 28, rue du docteur Roux, 75015 Paris, France.
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6
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Gentile G, Tong C, Renaud C, Menoud N, Casanova L, Blatteau JE, Christen JR, Texier G, Mayet A, Simon F. Incidence of leptospirosis in the French armed forces from 2004 to 2018: Retrospective analysis. Travel Med Infect Dis 2020; 39:101951. [PMID: 33333213 DOI: 10.1016/j.tmaid.2020.101951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND 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. The aim of this study was to assess the incidence of leptospirosis from epidemiological surveillance and cases data from 2004 to 2018, and to propose tools to assess leptospirosis risk prior to any mission or leisure activity. METHOD A retrospective epidemiological study on leptospirosis cases among French Armed Forces was conducted. More data were collected for 2 clusters in Martinique, as most of leptospirosis cases among French military personnel were identified in Martinique. RESULTS Eighty-eight cases of leptospirosis were reported, 15 cases in continental France and 73 cases in overseas (including 42 cases in the French West Indies). The global leptospirosis incidence rate in continental France was 0.3/100,000 person-years and in overseas 24/100,000 person-years with the higher incidence rate in Martinique (99/100,000 person-years) and in Mayotte (36.9/100,000 person-years). For the clusters in Martinique, between January and June 2009, 7 cases were declared; between 2016 and 2018, 16 cases were reported, high proportions of severe cardiac, renal and neurological forms (6/16) and hospitalizations (9/16). CONCLUSION The occupational risk is real in French Armed Forces, particularly in malaria-free intertropical areas where chemoprophylaxis by doxycycline is not applied. Prevention can be optimized by the use of practical tools such as tables and cartographies, leading to a better leptospirosis risk assessment and application of preventive recommendations.
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Affiliation(s)
- Gaetan Gentile
- Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France; Aix-Marseille Université, Institut des Neurosciences des Systèmes, INSERM UMR 1106, France; Comité Pédagogique, Pôle Formation-enseignement-recherche, Laveran Military Teaching Hospital, Marseille, France.
| | - Christelle Tong
- Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France.
| | - Christophe Renaud
- Centre Médical des Armées de Toulon, Antenne de L'école de Plongée de Saint-Mandrier, France.
| | - Nastasia Menoud
- Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France.
| | - Ludovic Casanova
- Aix-Marseille Université, Département Universitaire de Médecine Générale, Faculté des Sciences Médicales et Paramédicales, 13885, Marseille, France; Aix-Marseille Université, VITROME-IHU Méditerranée & ORS PACA (Observatoire Régional de La Santé), France.
| | - Jean-Eric Blatteau
- Service de Médecine Hyperbare et D'Expertise Plongée, HIA Sainte-Anne, Toulon, France.
| | - Jacques-Robert Christen
- Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, Marseille, France.
| | - Gaetan Texier
- Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France; Aix-Marseille Université, VITROME-IHU Méditerranée & ORS PACA (Observatoire Régional de La Santé), France; École Du Val de Grâce, Paris, France.
| | - Aurelie Mayet
- Centre D'épidémiologie et de Santé Publique des Armées. GSBDD Marseille Aubagne, 111 Avenue de La Corse BP40026, 13568, Marseille Cedex 02, France; École Du Val de Grâce, Paris, France; Aix-Marseille Université, INSERM, IRD, SESSTIM UMR1252, Marseille, France.
| | - Fabrice Simon
- Comité Pédagogique, Pôle Formation-enseignement-recherche, Laveran Military Teaching Hospital, Marseille, France; Department of Infectious Diseases and Tropical Medicine, Laveran Military Teaching Hospital, Marseille, France; École Du Val de Grâce, Paris, France.
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Tong C, Javelle E, Grard G, Dia A, Lacrosse C, Fourié T, Gravier P, Watier-Grillot S, Lancelot R, Letourneur F, Comby F, Grau M, Cassou L, Meynard JB, Briolant S, Leparc-Goffart I, Pommier de Santi V. Tracking Rift Valley fever: From Mali to Europe and other countries, 2016. ACTA ACUST UNITED AC 2020; 24. [PMID: 30808441 PMCID: PMC6446957 DOI: 10.2807/1560-7917.es.2019.24.8.1800213] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
On 16 September 2016, the World Health Organization confirmed a Rift Valley fever (RVF) outbreak in Niger. Epidemiological surveillance was reinforced among the French Armed Forces deployed in Niger and bordering countries: Chad, Mali and Burkina Faso. On 26 October, a probable case of RVF was reported in a service member sampled in Mali 3 weeks earlier. At the time the result was reported, the patient was on vacation on Martinique. An epidemiological investigation was conducted to confirm this case and identify other cases. Finally, the case was not confirmed, but three suspected cases of RVF were confirmed using serological and molecular testing. RVF viral RNA was detectable in whole blood for 57 and 67 days after onset of symptoms for two cases, although it was absent from plasma and serum. At the time of diagnosis, these cases had already returned from Mali to Europe. The infectivity of other arboviruses in whole blood has already been highlighted. That RVF virus has been detected in whole blood that long after the onset of symptoms (67 days) raises the question of its potential prolonged infectivity. Because of exposure to tropical infectious diseases during deployment, military populations could import emerging pathogens to Europe.
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Affiliation(s)
- Christelle Tong
- French Armed Forces Centre for Epidemiology and Public Health (CESPA), Marseille, France
| | | | - Gilda Grard
- Unité des Virus Émergents (UVE), Aix-Marseille Université - IRD 190 - Inserm 1207 - IHU Méditerranée Infection, Marseille, France.,French Armed Forces Biomedical Research Institute (IRBA), National Reference Centre for Arboviruses, Marseille, France
| | - Aissata Dia
- French Armed Forces Centre for Epidemiology and Public Health (CESPA), Marseille, France
| | - Constance Lacrosse
- French Armed Forces Centre for Epidemiology and Public Health (CESPA), Marseille, France
| | - Toscane Fourié
- Unité des Virus Émergents (UVE), Aix-Marseille Université - IRD 190 - Inserm 1207 - IHU Méditerranée Infection, Marseille, France.,French Armed Forces Biomedical Research Institute (IRBA), National Reference Centre for Arboviruses, Marseille, France
| | - Patrick Gravier
- Unité des Virus Émergents (UVE), Aix-Marseille Université - IRD 190 - Inserm 1207 - IHU Méditerranée Infection, Marseille, France.,French Armed Forces Biomedical Research Institute (IRBA), National Reference Centre for Arboviruses, Marseille, France
| | | | - Renaud Lancelot
- UMR ASTRE, Univ. Montpellier, CIRAD, INRA, Montpellier, France.,International Centre of Agricultural Research for Development (CIRAD), Animals, Health, Territories, Risks and Ecosystems Unit (ASTRE), Montpellier, France
| | | | - Frédéric Comby
- French Military Health Service, 10th Medical Unit, Laudun, France
| | - Martin Grau
- French Military Health Service, 18th Medical Unit, Fréjus, France
| | - Lionel Cassou
- French Military Health Service, 11th Medical Unit, Toulouse, France
| | - Jean-Baptiste Meynard
- French Armed Forces Centre for Epidemiology and Public Health (CESPA), Marseille, France
| | - Sébastien Briolant
- UMR VITROME, Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,French Armed Forces Biomedical Research Institute (IRBA), Marseille, France
| | - Isabelle Leparc-Goffart
- Unité des Virus Émergents (UVE), Aix-Marseille Université - IRD 190 - Inserm 1207 - IHU Méditerranée Infection, Marseille, France.,French Armed Forces Biomedical Research Institute (IRBA), National Reference Centre for Arboviruses, Marseille, France
| | - Vincent Pommier de Santi
- UMR VITROME, Aix-Marseille Université, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France.,French Armed Forces Centre for Epidemiology and Public Health (CESPA), Marseille, France
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8
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Gentile G, Fréchard G, Dia A, Buzens A, Vives R, Jego M, Pommier de Santi V, Simon F. Incidence of acute respiratory tract infections (2006-2015) and influenza (2006-2013) among French armed forces. Med Mal Infect 2019; 50:689-695. [PMID: 31759689 DOI: 10.1016/j.medmal.2019.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/21/2018] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We aimed to assess the incidence of respiratory tract infections in military settings between 2006 and 2015. PATIENTS AND METHODS We performed a retrospective epidemiological study of the entire military population from 2006 to 2015. Comprehensive data was collected from all medical centers, operational medical units, naval services, and army training hospitals and provided by the epidemiological surveillance of the armies. RESULTS The annual average population of the study was 331,394 soldiers. For acute respiratory tract infections (2006-2015), 22,818 cases were reported in metropolitan France, 3,211 cases in French overseas territories, 1,595 cases in the French Navy, and 1,318 cases in external military operations for a total of 28,942 cases. For influenza (2006-2013), 934 cases were reported in metropolitan France, 101 cases in French overseas territories, and 23 cases in external operations, for a total of 1,058 cases. The mean incidence rate of acute respiratory tract infections expressed as case number per 1,000 person-years (PY) was 8.7 PY (95% CI [8.6-8.8]) with an exceptional increased incidence rate in 2009 (25.9 PY, 95% CI [25.4-26.4]). The mean incidence rate of influenza was 0.35 PY (95% CI [0.33-0.37]) with a peak incidence rate of 1.9 PY in 2009. CONCLUSION Acute respiratory tract infections are at the forefront of infectious episodes in the French armies. Although not necessarily severe, current prevention measures are not enough to reduce the incidence threshold of these infections and need to be improved.
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Affiliation(s)
- G Gentile
- Département universitaire de médecine générale, faculté de médecine, Aix Marseille université, 13885 Marseille, France; Inserm 1106, Institut des neurosciences des systèmes, Aix Marseille université, 13885 Marseille, France; Comité pédagogique, hôpital d'instruction des Armées Laveran, 13384 Marseille, France.
| | - G Fréchard
- Département universitaire de médecine générale, faculté de médecine, Aix Marseille université, 13885 Marseille, France
| | - A Dia
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - A Buzens
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - R Vives
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - M Jego
- Département universitaire de médecine générale, faculté de médecine, Aix Marseille université, 13885 Marseille, France; Centre d'études et de recherche sur les services de santé et qualité de vie (CERESS), Aix Marseille université, 13385 Marseille, France
| | - V Pommier de Santi
- Centre d'épidémiologie et de santé publique des armées, 13014 Marseille, France
| | - F Simon
- Comité pédagogique, hôpital d'instruction des Armées Laveran, 13384 Marseille, France; Department of infectious diseases and tropical medicine, Laveran military teaching hospital, 13384 Marseille, France
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Grosset A, Mangin P, MacNab C, Pfister G, de l'Escalopier N, Cournac JM, Aletti M, Samson T, Rigal S, Mathieu L. Input of a Multi-Disciplinary Meeting in the Treatment of Osteoarticular Infections in French War Casualties. Mil Med 2019; 184:e359-e364. [PMID: 30535350 DOI: 10.1093/milmed/usy369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/02/2018] [Accepted: 11/14/2018] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Extremity war-wounds present an elevated risk of infection and compromise reconstructive procedures. In a French military hospital, a multi-disciplinary meeting (MDM) was created to standardize the care given to soldiers with osteoarticular infection. The aim of this study was to evaluate the usefulness of MDM decisions. METHODS An observational case study was performed including the French wounded at war treated for an osteoarticular infection between 2004 and 2016. They were separated into two groups according to their time of management: before (group A) or after (group B) the MDM creation in September 2010. Various operative and bacteriological parameters were analyzed retrospectively. A questionnaire was created to evaluate healthcare professionals' satisfaction toward the usefulness of the MDM on their practice. RESULTS During the study period, 38 patients were included: 19 in group A and 19 in group B. Initial tests found an infection with one pathogen in 15 patients, an infection with 2 pathogens in 11 patients, and an infection with 3 or more pathogens in 12 patients. Enterobacter cloacae was the most common pathogen. Pseudomonas aeruginosa and Escherichia coli were also frequent. The mean number of samples taken to conduct the bacteriological tests per operating session was significantly higher for group B than for group A. Twelve of the 14 questioned healthcare professionals believed the MDM was very useful in their patient management. CONCLUSION The MDM seems to have had a beneficial impact on orthopedic surgeon practices. A significant increase of the number of samples taken was the most obvious sign that the French recommended practices for osteoarticular infections were followed since the creation of MDM.
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Affiliation(s)
- Antoine Grosset
- Department of Orthopedic, Traumatology and Reconstructive Surgery and Trauma, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Philippe Mangin
- Department of Orthopedic, Traumatology and Reconstructive Surgery and Trauma, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Christine MacNab
- Department of Microbiology, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Georges Pfister
- Department of Orthopedic, Traumatology and Reconstructive Surgery and Trauma, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Nicolas de l'Escalopier
- Department of Orthopedic, Traumatology and Reconstructive Surgery and Trauma, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Jean-Marie Cournac
- Department of Internal Medicine, Infectious Disease, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Marc Aletti
- Department of Internal Medicine, Infectious Disease, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Thierry Samson
- Department of Microbiology, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Sylvain Rigal
- Department of Orthopedic, Traumatology and Reconstructive Surgery and Trauma, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
| | - Laurent Mathieu
- Department of Orthopedic, Traumatology and Reconstructive Surgery and Trauma, PERCY Military Teaching Hospital, 101 Avenue Henri Barbusse, Clamart, France
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Morais S, Costa AR, Ferro A, Lunet N, Peleteiro B. Contemporary migration patterns in the prevalence of Helicobacter pylori infection: A systematic review. Helicobacter 2017; 22. [PMID: 28098406 DOI: 10.1111/hel.12372] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND A rapid growth in the number of international migrants over the past years has occurred with most traveling to more affluent settings. As Helicobacter pylori infects over half of the adult population and its prevalence is higher in developing countries, understanding the prevalence of infection in migrants can provide insight into future trends in the burden and management of infection. We aimed to describe the prevalence of H. pylori among migrants through a systematic literature review. METHODS We searched PubMed® from inception to September 2015 to identify studies reporting the prevalence of H. pylori in international migrants according to country of birth for first-generation, and country of birth and parents' nationality for successive generations. Comparable data from origin and destination populations were obtained from the same studies or, when not present, from a previous systematic review on H. pylori worldwide. RESULTS A total of 28 eligible studies were identified with data for 29 origin and 12 destination countries. Two studies that evaluated refugees presented prevalences of infection higher than both the origin and destination countries. Otherwise, the prevalences among migrants were generally similar or below that of the origin and higher than the destination. Second- or more generation had lower prevalences compared to first-generation migrants. CONCLUSIONS Our study findings are consistent with what would be expected based on the prevalence of H. pylori worldwide. The results of this review show that migrants are particularly at risk of infection and help to identify gaps in the knowledge of migrants' prevalence of infection globally.
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Affiliation(s)
| | | | - Ana Ferro
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal
| | - Nuno Lunet
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Epidemiologia, Saúde Pública, Ciências Forenses, Educação e Simulação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Bárbara Peleteiro
- ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal.,Departamento de Epidemiologia, Saúde Pública, Ciências Forenses, Educação e Simulação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Succo T, De Laval F, Sicard S, Belleoud D, Marimoutou C, Mayet A, Sagaon-Teyssier L, Michel R. Do alcohol-based hand rubs reduce the incidence of acute diarrhea during military deployments? A prospective randomized trial. Travel Med Infect Dis 2017; 15:48-51. [DOI: 10.1016/j.tmaid.2016.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
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Tuck J, Williams J, Doyle A. Gastro Enteritis in a military population deployed in West Africa in the UK Ebola response; was the observed lower disease burden due to handwashing? Travel Med Infect Dis 2016; 14:131-6. [DOI: 10.1016/j.tmaid.2015.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 11/28/2022]
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Tubb RJ. Travel medicine for the President at the White House, aboard Air Force One, and around the world. Travel Med Infect Dis 2014; 12:300-2. [PMID: 25022611 DOI: 10.1016/j.tmaid.2014.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/12/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022]
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