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De Laval F, Pommier De Santi V. [Epidemiology of malaria in the French Armed Forces]. MEDECINE TROPICALE ET SANTE INTERNATIONALE 2023; 3:mtsi.v3i1.2023.311. [PMID: 37525641 PMCID: PMC10387290 DOI: 10.48327/mtsi.v3i1.2023.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 08/02/2023]
Abstract
Because of the individual morbidity and lethality and the resulting collective incapacity, malaria has always been a risk for the Armed Forces in operation. The fight against malaria is a real public health plan carried out by the Armed Forces Health Service (SSA) for the benefit of the Forces. This plan has four main components: vector control, which targets larvae and adult mosquitoes of the genus Anopheles, personal vector protection, which limits human-vector contact, chemoprophylaxis, and early diagnosis and treatment of malaria.Since 2001, the epidemiology of malaria in the Armed Forces have suffered from large-scale epidemics during operational engagements in Côte d'Ivoire, Guyana and the Central African Republic. The start of a military operation is accompanied by strategic and logistical priorities that take precedence over prevention. In addition, the rigorous application of personal protection measures remains difficult and even more so in a combat situation.The development of urban malaria in Africa, the use of causal chemoprophylaxis, the alternative to "nothing but insecticides", and the development of efficient diagnostic tools allowing for early and adapted management are the challenges ahead for the SSA.
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Affiliation(s)
- Franck De Laval
- Service de surveillance épidémiologique et investigations, Centre d’épidémiologie et de santé publique des Armées (CESPA), BdD Marseille-Aubagne 111, avenue de la Corse, BP 40026, 13568 Marseille Cedex 02, France
| | - Vincent Pommier De Santi
- Service de prévention du risque vectoriel, Centre d’épidémiologie et de santé publique des Armées (CESPA), BdD Marseille-Aubagne 111, avenue de la Corse, BP 40026, 13568 Marseille Cedex 02, France
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Velut G, de Laval F, Delon F, d'Oléon A, Douine M, Mosnier E, Mmadi Mrenda B, Dia A, Musset L, Briolant S, Pommier de Santi V. Sharp decrease in malaria incidence among the French armed forces in French Guiana. Travel Med Infect Dis 2023; 52:102547. [PMID: 36740087 DOI: 10.1016/j.tmaid.2023.102547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/12/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023]
Affiliation(s)
- Guillaume Velut
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France.
| | - 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
| | - François Delon
- Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France; Joint Directorate of the Armed Forces Health Service for French Guiana DIASS, Cayenne, French Guiana
| | - Albane d'Oléon
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France
| | - Maylis Douine
- French West Indies-French Guiana Center for Clinical Investigation, CIC Inserm 1424, DRISP, Cayenne Hospital, Avenue des Flamboyants, Cayenne, French Guiana
| | - Emilie Mosnier
- Aix-Marseille University, INSERM, IRD, SESSTIM (Economic and Social Sciences, Health Systems, and Medical Informatics), Marseille, France
| | - Bakridine Mmadi Mrenda
- 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
| | - Lise Musset
- Laboratory of Parasitology, National Reference Center for Malaria, Institut Pasteur in French Guiana, Collaborating Center for the Surveillance of Resistance to Antimalarial Drugs, Cayenne, French Guiana
| | - Sébastien Briolant
- Parasitology and Entomology Unit, Department of Infectious Diseases, Armed Forces Biomedical Research Institute, Marseille, France; University Hospital Institute Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Vincent Pommier de Santi
- French Armed Forces Center for Epidemiology and Public Health (CESPA), Marseille, France; University Hospital Institute Méditerranée Infection, Marseille, France; Aix-Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France
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Lin CY, Chang K, Chang CJ. Questionnaire-Based Analysis of Adverse Events and Compliance with Malaria Chemoprophylaxis in Taiwan. J Pers Med 2023; 13:jpm13020179. [PMID: 36836413 PMCID: PMC9967687 DOI: 10.3390/jpm13020179] [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: 11/28/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
Malaria was eradicated in Taiwan in 1952; however, imported malaria cases are reported every year. The subtropical climate in Taiwan permits mosquito propagation and possible outbreaks of mosquito-borne diseases. The aim of this study was to investigate travelers' compliance and side effects of malaria prophylaxis to prevent a malaria outbreak in Taiwan. In this prospective study, we enrolled travelers who visited our travel clinic before going to malarious areas. A total of 161 questionnaires were collected and analyzed. Associations between the occurrence of side effects and compliance with antimalarial drugs were analyzed. Adjusted odds ratios were calculated after adjusting for potential risk factors in multiple logistic regression analysis. Of the 161 enrolled travelers, 58 (36.0%) reported side effects. Insomnia, somnolence, irritability, nausea, and anorexia were associated with poor compliance. Mefloquine was not associated with more neuropsychological side effects than doxycycline. Multiple logistic regression analysis showed that chemoprophylaxis compliance was affected by a younger age, visiting friends and relatives, visiting the travel clinic more than 1 week before the trip, and preferring to use the same antimalarial regimen on the next trip. Our findings could provide information to travelers besides labeled side effects to improve compliance with malaria prophylaxis and consequently help to prevent malaria outbreaks in Taiwan.
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Affiliation(s)
- Ching-Yun Lin
- Department of Family Medicine, Kaohsiung Municipal SiaoGang Hospital, Kaohsiung 812, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Ko Chang
- Tropical Medicine Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chai-Jan Chang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence:
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Nzoumbou-Boko R, Velut G, Imboumy-Limoukou RK, Manirakiza A, Lekana-Douki JB. Malaria research in the Central African Republic from 1987 to 2020: an overview. Trop Med Health 2022; 50:70. [PMID: 36131331 PMCID: PMC9490699 DOI: 10.1186/s41182-022-00446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/27/2022] [Indexed: 11/12/2022] Open
Abstract
Background The national malaria control policy in the Central African Republic (CAR) promotes basic, clinical, and operational research on malaria in collaboration with national and international research institutions. Preparatory work for the elaboration of National Strategic Plans for the implementation of the national malaria control policy includes developing the research component, thus requiring an overview of national malaria research. Here, this survey aims to provide an inventory of malaria research as a baseline for guiding researchers and health authorities in choosing the future avenues of research. Methods Data sources and search strategy were defined to query the online Medline/PubMed database using the “medical subject headings” tool. Eligibility and study inclusion criteria were applied to the selected articles, which were classified based on year, research institute affiliations, and research topic. Results A total of 118 articles were retrieved and 51 articles were ultimately chosen for the bibliometric analysis. The number of publications on malaria has increased over time from 1987 to 2020. These articles were published in 32 different journals, the most represented being the Malaria Journal (13.73%) and the American Journal of Tropical Medicine and Hygiene (11.76%). The leading research topics were drug evaluation (52.94%), expatriate patients (23.54%), malaria in children (17.65%), morbidity (13.7%), and malaria during pregnancy (11.76%). The publications’ authors were mainly affiliated with the Institut Pasteur of Bangui (41%), the French Military Medical Service (15.5%), and the University of Bangui (11.7%). Collaborations were mostly established with France, the UK, and the USA; some collaborations involved Switzerland, Austria, Pakistan, Japan, Sri Lanka, Benin, Cameroun, Ivory Coast, and Madagascar. The main sources of research funding were French agencies (28.6%) and international agencies (18.3%). Most studies included were not representative of the whole country. The CAR has the capacity to carry out research on malaria and to ensure the necessary collaborations. Conclusion Malaria research activities in the CAR seem to reflect the priorities of national policy. One remaining challenge is to develop a more representative approach to better characterize malaria cases across the country. Finally, future research and control measures need to integrate the effect of COVID-19.
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Affiliation(s)
- Romaric Nzoumbou-Boko
- Laboratoire de Parasitologie, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic.
| | - Guillaume Velut
- French Military Health Service, French Armed Forces Centre for Epidemiology and Public Health (CESPA), Marseille, France
| | - Romeo-Karl Imboumy-Limoukou
- Unité Évolution, Épidémiologie Et Résistances Parasitaires (UNEEREP), Centre International de Recherche Médicale de Franceville (CIRMF), BP769, Franceville, Gabon
| | - Alexandre Manirakiza
- Service d'épidémiologie, Institut Pasteur de Bangui, PO Box 923, Bangui, Central African Republic
| | - Jean-Bernard Lekana-Douki
- Unité Évolution, Épidémiologie Et Résistances Parasitaires (UNEEREP), Centre International de Recherche Médicale de Franceville (CIRMF), BP769, Franceville, Gabon.,Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, Libreville, B.P. 4009, Franceville, Gabon
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Penot M, Linard C, Taudon N. A Validated Volumetric Absorptive Microsampling-Liquid Chromatography Tandem Mass Spectrometry Method to Quantify Doxycycline Levels in Urine: An Application to Monitor the Malaria Chemoprophylaxis Compliance. JOURNAL OF ANALYTICAL METHODS IN CHEMISTRY 2020; 2020:8868396. [PMID: 33489416 PMCID: PMC7787799 DOI: 10.1155/2020/8868396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
Because of logistics and cost constraints, monitoring of the compliance to antimalarial chemoprophylaxis by the quantitation of drugs in biological samples is not a simple operation on the field. Indeed, analytical devices are fragile to transport and must be used in a perfectly controlled environment. This is also the case for reagents and supplies, and the waste management is constraining. Thus, samples should be repatriated. They should be frozen after collection and transported with no rupture in the cold chain. This is crucial to generate available and interpretable data but often without any difficulties. Hence, to propose an alternative solution easier to implement, a quantitation method of determining doxycycline in urine has been validated using a volumetric absorptive microsampling (VAMS®) device. As blotting paper, the device is dried after collection and transferred at room temperature, but contrarily to dried spot, the collection volume is perfectly repeatable. Analysis of VAMS® was performed with a high-performance liquid chromatography coupled to a mass spectrometer. The chromatographic separation was achieved on a core-shell C18 column. The mean extraction recovery was 109% (mean RSD, 5.4%, n = 6) for doxycycline and 102% (mean RSD, 7.0%) for the internal standard. No matrix effect has been shown. Within-run as within-day precision and accuracy were, respectively, below 14% and ranged from 96 to 106%. The signal/concentration ratio was studied in the 0.25-50 µg/mL range, and recoveries from back-calculated concentrations were in the 96-105% range (RSD < 11.0%). The RSD on slope was 10%. To achieve the validation, this new quantitation method was applied to real samples. In parallel, samples were analyzed directly after a simple dilution. No statistical difference was observed, confirming that the use of VAMS® is an excellent alternative device to monitor the doxycycline compliance.
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Affiliation(s)
- Mylène Penot
- Unité de Développements Analytiques et Bioanalyse, Institut de Recherche Biomédicale des Armées, 1 place du Général Valérie André, BP 73, Brétigny-sur-Orge 91220, France
| | - Cyril Linard
- Unité de Développements Analytiques et Bioanalyse, Institut de Recherche Biomédicale des Armées, 1 place du Général Valérie André, BP 73, Brétigny-sur-Orge 91220, France
| | - Nicolas Taudon
- Unité de Développements Analytiques et Bioanalyse, Institut de Recherche Biomédicale des Armées, 1 place du Général Valérie André, BP 73, Brétigny-sur-Orge 91220, France
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6
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Perisse A, Velut G, Javelle E, Loarer G, Michel R, Simon F. Treatment for Uncomplicated Plasmodium falciparum Malaria in French Soldiers Deployed in Sub-Saharan Africa: Gaps Between Policy and Field Practice. Mil Med 2019; 183:e638-e643. [PMID: 29425320 DOI: 10.1093/milmed/usx117] [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: 08/26/2017] [Revised: 10/27/2017] [Accepted: 11/14/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Malaria prevention and treatment are big challenges for the French forces deployed in sub-Saharan Africa. Since December 2013, 1,800 French soldiers have been deployed at any one time in the Central African Republic in the framework of "Operation Sangaris" and European Union Force (EUFOR). Over the 2014-2015 period, about 500 cases of malaria were notified in these troops during the operation or after their return (annual incidence: 13.4 p.100 person-year). The recommendation to use dihydroartemisinin-piperaquine (DHA-PQ) as the first-line treatment for French soldiers suffering from uncomplicated Plasmodium falciparum malaria in endemic areas is not always followed in practice in the field by French military general practitioners (GPs). METHODS We conduced a retrospective Knowledge-Attitude-Practice study by self-administered questionnaire, to all military French doctors who were in mission in Central African Republic from January 2014 to July 2015 to try to understand what were the reasons for the GP not to prescribe DHA-PQ on the field. FINDINGS Thirty-six GPs (53%) answered to the questionnaire. Eighty-three percent of them knew about the recommendation to use DHA-PQ for un uncomplicated Pf malaria. Fifty-eight percent had a favorable attitude toward DHA-PQ. The factors associated with the prescription of another drug (Atovaquone-proguanil) were: the habit (odds ratio [OR] 0.1, confidence interval (CI) 0-0.6], the fact that Atovaquone-proguanil is more practical to use [OR 0.01, CI 0-0.1]. In practice, only 37.5% prescribed DHA-PQ the most of the time during their mission. Factors associated with a non-favorable attitude toward DHA-PQ were: the necessity to calculate a QTc interval during the treatment [OR 0.2, confidence interval 0-0.9], and the fact that DHA-PQ must be taken on an empty stomach [OR 0.3, CI 0.1-0.8]. GP who received a formation before their mission about malaria and treatment had a favorable attitude toward DHA-PQ. DISCUSSION There is very satisfactory knowledge by the military GPs stationed in the Central African Republic on both the recommendations and prescription of antimalarial drugs. The present study highlights some difficulties in implementing the recommendations in an operational context, notably factors limiting the prescription of DHA-PQ during military deployment (need for ECG monitoring, empty stomach, and lack of habit). Proposals can be made to improve the efficacy, tolerance, and practicability of malaria treatment in the field. The main focus should be a more flexible application of the French DHA-PQ risk management plan in the field, specific training and communication about DHA-PQ use, the generalization of ECG printing equipment in the field, and the switch from DHA-PQ to an alternative artemisinin-based combination therapy during deployments in malaria-endemic areas.
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Affiliation(s)
- Anne Perisse
- Antenne Médicale de Vincennes, Fort neuf de Vincennes, cours des Maréchaux, Paris Cedex, France
| | - Guillaume Velut
- Military Centre for Epidemiology and Public Health, Caserne Ste Marthe, 111 avenue de la Corse, BP, Marseille Cedex 02, France
| | - Emilie Javelle
- Infectious Diseases and Tropical Medicine Department, Laveran Military Teaching Hospital, 34 Bd Laveran, CS, Marseille Cedex 13, France
| | - Gwion Loarer
- French Military Medical Service, Surgeon General's Headquarters, Fort neuf de Vincennes, cours des Maréchaux, Paris Cedex 12, France
| | - Remy Michel
- Military Centre for Epidemiology and Public Health, Caserne Ste Marthe, 111 avenue de la Corse, BP, Marseille Cedex 02, France.,French Military Health Service Academy - Ecole du Val de Grâce, 74 Bd Port Royal, Paris, France
| | - F Simon
- Infectious Diseases and Tropical Medicine Department, Laveran Military Teaching Hospital, 34 Bd Laveran, CS, Marseille Cedex 13, France.,French Military Health Service Academy - Ecole du Val de Grâce, 74 Bd Port Royal, Paris, France
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Hoefnagel JGM, Massar K, Hautvast JLA. Non-adherence to malaria prophylaxis: The influence of travel-related and psychosocial factors. J Infect Public Health 2019; 13:532-537. [PMID: 31704047 DOI: 10.1016/j.jiph.2019.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/05/2019] [Accepted: 10/15/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The effectiveness of malaria chemoprophylaxis is limited by a lack of compliance in travellers. This study assesses the demographic, travel-related, and psychosocial determinants of non-compliance with chemoprophylaxis. METHODS 715 adults, who received a pre-travel malaria prophylaxis prescription, were invited to complete a post-travel digital questionnaire on non-compliance, demographics, travel-related and psychosocial variables. RESULTS 330 travellers (53% response) reported 32% non-compliance with malaria chemoprophylaxis. Logistic regression analyses revealed that 3/11 assessed psychosocial variables uniquely predicted non-compliance: 'negative attitude towards chemoprophylaxis' (β=0.694, OR 2.0, p<0.01), 'low perceived severity of malaria' (β=0.277, p=0.04) and 'fatigue during travel' (β=2.225, OR 9.3, p<0.01). Furthermore, the age and education of the traveller were uniquely predictive of non-compliance (β=-0.023 (p=0.02) and β=0.684 (p=0.04)). None of the travel-related variables predicted non-compliance. CONCLUSIONS About one-third of the travellers in our study were non-compliant with malaria prophylaxis, especially young travellers and highly educated travellers. Fatigue during travel seems to lead to non-compliance. Further research should focus on addressing the psychosocial factors in pre-travel consultation, since these appear to be better predictors for intention to comply than travel-related variables.
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Affiliation(s)
- Jolanda G M Hoefnagel
- Regional Public Health Service 'GGD Gelderland-Zuid', PO Box 1120, 6501BC, Nijmegen, the Netherlands.
| | - Karlijn Massar
- Work & Social Psychology, Maastricht University, PO Box 616, 6200MD, Maastricht, the Netherlands.
| | - Jeannine L A Hautvast
- Regional Public Health Service 'GGD Gelderland-Zuid', PO Box 1120, 6501BC, Nijmegen, the Netherlands; Department of Primary and Community Care, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
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8
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Medical evacuations of members of the French armed forces for infectious diseases in foreign operations. Med Mal Infect 2019; 50:545-554. [PMID: 31672468 DOI: 10.1016/j.medmal.2019.09.011] [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: 03/18/2018] [Revised: 11/15/2018] [Accepted: 09/13/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Medical evacuations from foreign settings are a major health and strategic problem for the armed forces. This work aimed to study the characteristics of French military evacuations due to infectious diseases. PATIENTS AND METHODS We performed a retrospective study based on the registers of the French operational military staff for health to assess the characteristics of the strategic medical evacuation of French armed forces members on missions abroad between January 1, 2011 and December 31, 2016. RESULTS Out of 4633 included cases, 301 medical evacuations (6.5%) were carried out due to infectious situations. More than half of patients were repatriated to surgical wards (162 patients, 54%), 108 patients (36%) to medical wards, 21 patients (7%) to intensive care units, six patients (2%) to an armed forces medical center, and four files (1%) were incomplete. Among infectious emergencies, malaria led to 30 evacuations (10%) including 11 to intensive care units and one death before evacuation. Infectious diseases requiring medical evacuation were most often mild and community-acquired. Most soldiers were evacuated without medical assistance. CONCLUSIONS Infectious diseases during missions and medical repatriations carried out for infectious reasons are important epidemiological indicators to monitor. They make it possible to adapt preventive measures, training, and diagnostic and therapeutic tools which can be made available to front-line military physicians.
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Kain D, Findlater A, Lightfoot D, Maxim T, Kraemer MUG, Brady OJ, Watts A, Khan K, Bogoch II. Factors Affecting Pre-Travel Health Seeking Behaviour and Adherence to Pre-Travel Health Advice: A Systematic Review. J Travel Med 2019; 26:5549355. [PMID: 31407776 DOI: 10.1093/jtm/taz059] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Recent years have seen unprecedented growth in international travel. Travellers are at high risk for acquiring infections while abroad and potentially bringing these infections back to their home country. There are many ways to mitigate this risk by seeking pre-travel advice (PTA), including receiving recommended vaccinations and chemoprophylaxis, however many travellers do not seek or adhere to PTA. We conducted a systematic review to further understand PTA-seeking behaviour with an ultimate aim to implement interventions that improve adherence to PTA and reduce morbidity and mortality in travellers. METHODS We conducted a systematic review of published medical literature selecting studies that examined reasons for not seeking PTA and non-adherence to PTA over the last ten years. 4484 articles were screened of which 56 studies met our search criteria after full text review. RESULTS The major reason for not seeking or non-adherence to PTA was perceived low risk of infection while travelling. Side effects played a significant role for lack of adherence specific to malaria prophylaxis. CONCLUSIONS These data may help clinicians and public health providers to better understand reasons for non-adherence to PTA and target interventions to improve travellers understanding of potential and modifiable risks. Additionally, we discuss specific recommendations to increase public health education that may enable travellers to seek PTA.
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Affiliation(s)
- Dylan Kain
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Aidan Findlater
- Department of Medicine, McMaster University, Hamilton, Canada
| | | | - Timea Maxim
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | | | - Oliver J Brady
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Alexander Watts
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Kamran Khan
- Department of Medicine, University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, Canada.,Divisions of General Internal Medicine and Infectious Diseases, University Health Network, Toronto, Canada
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Thellier M, Simard F, Musset L, Cot M, Velut G, Kendjo E, Pradines B. Changes in malaria epidemiology in France and worldwide, 2000-2015. Med Mal Infect 2019; 50:99-112. [PMID: 31257063 DOI: 10.1016/j.medmal.2019.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/11/2019] [Indexed: 12/15/2022]
Abstract
In 2015, 212 million new cases of malaria were reported, causing 429,000 deaths. The World Health Organization (WHO) estimated a 41% decrease in the number of new cases worldwide between 2000 and 2015. The number of deaths from malaria fell by 62% worldwide and by 71% in Africa. In mainland France, malaria is mainly imported by travelers or migrants from endemic areas, in particular sub-Saharan Africa (95%). In France, the number of imported malaria cases, mainly due to Plasmodium falciparum (85%), was estimated at about 82,000 for the period 2000-2015. Over the same period, 6,468 cases of malaria were reported in the French armed forces, of which 2,430 cases (37.6%) were considered as imported because occurring outside of endemic areas. The number of malaria cases also fell between 2000 and 2015 in Mayotte and French Guiana, a malaria transmission zone. Mayotte has entered the elimination of malaria with less than 15 cases per year. In French Guiana, between 300 and 500 cases have been reported annually in recent years. The decline in morbidity and mortality is usually attributed to vector control measures and improved access to effective treatments. However, the Anopheles mosquitoes that transmit the disease have developed resistance against most insecticides. Similarly, malaria parasites have developed resistance against most of the antimalarial drugs used as prevention or treatment, even the latest marketed combinations such as artemisinin-based combination therapies.
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Affiliation(s)
- M Thellier
- Service de parasitologie-mycologie, Centre national de référence du paludisme, hôpital Pitié-Salpêtrière, Assistance publique Hôpitaux de Paris, 47, boulevard de l'Hôpital, 75013 Paris, France; UMRS 1136, iPLESP, institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne université, 27, rue Chaligny, 75571 Paris 12, France; UPMC, faculté de médecine, Sorbonne université, université Pierre-et-Marie-Curie, 91, boulevard de l'Hôpital, 75013 Paris, France
| | - F Simard
- MIVEGEC, IRD-CNRS-university Montpellier, 911, avenue Agropolis, BP 64501, 34394 Montpellier, France
| | - L Musset
- Laboratoire de parasitologie, Centre collaborateur OMS pour la surveillance des résistances aux antipaludiques, institut Pasteur de la Guyane, 23, avenue Louis Pasteur, 97300 Cayenne, France; Centre national de référence du paludisme, institut Pasteur de la Guyane, 23, avenue Louis Pasteur, 97300 Cayenne, France
| | - M Cot
- UMR2016, unité Mère et enfant face aux infections tropicales, institut de recherche pour le développement, 4, avenue de l'Observatoire, 75006 Paris, France
| | - G Velut
- Centre d'épidémiologie et de santé publique des armées, GSBdD Marseille Aubagne, BP 40026, 13568 Marseille cedex 02, France; Direction interarmées du service de santé des armées, Quartier La Madeleine, 97306 Cayenne, France
| | - E Kendjo
- Service de parasitologie-mycologie, Centre national de référence du paludisme, hôpital Pitié-Salpêtrière, Assistance publique Hôpitaux de Paris, 47, boulevard de l'Hôpital, 75013 Paris, France; UMRS 1136, iPLESP, institut Pierre-Louis d'épidémiologie et de santé publique, Sorbonne université, 27, rue Chaligny, 75571 Paris 12, France; UPMC, faculté de médecine, Sorbonne université, université Pierre-et-Marie-Curie, 91, boulevard de l'Hôpital, 75013 Paris, France
| | - B Pradines
- Unité parasitologie et entomologie, institut de recherche biomédicale des armées, institut hospitalo-universitaire Méditerranée Infection, 19-21, boulevard Jean-Moulin, 13005 Marseille, France; Aix Marseille université, IRD, AP-HM, SSA, VITROME, institut hospitalo-universitaire Méditerranée Infection, 19-21, boulevard Jean-Moulin, 13005 Marseille, France; Institut hospitalo-universitaire Méditerranée Infection, 19-21, boulevard Jean-Moulin, 13005 Marseille, France; Centre national de référence du paludisme, institut hospitalo-universitaire Méditerranée Infection, 19-21, boulevard Jean-Moulin, 13005 Marseille, France.
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Lau CL, Ramsey L, Mills LC, Furuya-Kanamori L, Mills DJ. Drug-free Holidays: Compliance, Tolerability, and Acceptability of a 3-Day Atovaquone/Proguanil Schedule for Pretravel Malaria Chemoprophylaxis in Australian Travelers. Clin Infect Dis 2018; 69:137-143. [DOI: 10.1093/cid/ciy854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 09/28/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory
- Dr Deb the Travel Doctor, Travel Medicine Alliance, Brisbane, Queensland
| | - Lani Ramsey
- Travel-Bug Vaccination Clinic, Travel Medicine Alliance, Adelaide, South Australia, Australia
| | - Laura C Mills
- Dr Deb the Travel Doctor, Travel Medicine Alliance, Brisbane, Queensland
| | - Luis Furuya-Kanamori
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory
- Department of Population Medicine, College of Medicine, Qatar University, Doha
| | - Deborah J Mills
- Dr Deb the Travel Doctor, Travel Medicine Alliance, Brisbane, Queensland
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Carfantan C, Goudard Y, Butin C, Duron-Martinaud S, Even JP, Anselme A, Dulaurent E, Géhant M, Vitalis V, Bay C, Bancarel J, Bordes J. Forward medevac during Serval and Barkhane operations in Sahel: A registry study. Injury 2017; 48:58-63. [PMID: 27829492 DOI: 10.1016/j.injury.2016.10.043] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/19/2016] [Accepted: 10/28/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The French army has been deployed in Mali since January 2013 with the Serval Operation and since July 2014 in the Sahel-Saharan Strip (SSS) with the Barkhane Operation where the distances (up to 1100km) can be very long. French Military Medical Service deploys an inclusive chain from the point of injury (POI) to hospital in France. A patient evacuation coordination cell (PECC) has been deployed since February 2013 to organise forward medical evacuation (MEDEVAC) in the area between the POI and three forward surgical units. The purpose of this work was to study the medical evacuation length and duration between the call for Medevac location accidents and forward surgical units (role 2) throughout the five million square kilometers French joint operation area. MATERIALS AND METHODS Our retrospective study concerns the French patients evacuated by MEDEVAC from February 2013 to July 2016. The PECC register was analysed for patients' characteristics, NATO categorisation of gravity (Alpha, Bravo or Charlie who must be respectively at hospital facility within 90min, 4h or 24h), medical motive for MEDEVAC and the time line of each MEDEVAC (from operational commander request to entrance in role 2). RESULTS A total of 1273 French military were evacuated from February to 2013 to July 2016; 533 forward MEDEVAC were analysed. 12,4% were Alpha, 28,1% Bravo, 59,5% Charlie. War-related injury represented 18,2% of MEDEVAC. The median time for Alpha category MEDEVAC patients was 145min [100-251], for Bravo category patients 205min [125-273] and 310min [156-669] for Charlie. The median distance from the point of injury to role 2 was 126km [90-285] for Alpha patients, 290km [120-455] km for Bravo and 290km [105-455] for Charlie. CONCLUSIONS Patient evacuation in such a large area is a logistic and human challenge. Despite this, Bravo and Charlie patients were evacuated in NATO recommended time frame. However, due to distance, Alpha patients time frame was longer than this recommended by NATO organisation. That's where French doctrine with forward medical teams embedded in the platoons is relevant to mitigate this distance and time frame challenge.
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Affiliation(s)
- Cyril Carfantan
- French Military Medical Service, Medical Center of Solenzara air base, BA 126 RN 198 Cs 10001 Ventiseri 20223 Ghisonaccia Cedex, France.
| | - Yvain Goudard
- French Military Medical Service, 7th paratrooper forward surgical unit, Laveran Military teaching hospital, general surgery unit, Marseille France
| | - Christophe Butin
- French Military Medical Service, 7th paratrooper forward surgical unit, Sainte-Anne Military teaching hospital, orthopedic surgery unit, Toulon France
| | - Sandrine Duron-Martinaud
- French Military Medical Service, French Military Center for Epidemiology and Public Health, France
| | - Jean-Philippe Even
- French Military Medical Service, Medical Center of Luxeuil air base, France
| | - Anthony Anselme
- French Military Medical Service, Medical Center of Angers, France
| | - Erwan Dulaurent
- French Military Medical Service, Medical Center of Mont-de-Marsan air base, France
| | - Mélanie Géhant
- French Military Medical Service, Medical Center of Solenzara air base, BA 126 RN 198 Cs 10001 Ventiseri 20223 Ghisonaccia Cedex, France
| | - Vicky Vitalis
- French Military Medical Service, Medical Center of Lyon, France
| | - Christian Bay
- French Military Medical Service, French Military Medical Service Academy - École du Val-de-Grâce, France
| | - Jérôme Bancarel
- French Military Medical Service, Operational headquarters, M3 Current operations officer, France
| | - Julien Bordes
- French Military Medical Service, 7th paratrooper forward surgical unit, Sainte-Anne Military teaching hospital, intensive care and anaesthesiology unit, Toulon, France
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