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Fever; French fortified forces; contagious conditions; Malaria; Medical evacuations

Introduction

Contagious conditions have always been part of the life of military labor force, and have told the history of countries. Contagious conditions contracted during foreign operations remain a major health and strategic issue for the fortified forces. Contagious conditions are associated with major pitfalls because of their high prevalence, implicit inflexibility, and significant impact on functional capacity.

The operation zones of the French fortified forces are frequently aboriginal for contagious conditions because of multiple factors low socio- profitable status of countries, tropical countries, lack of health installations. Some of these infections are particularly frequent because of poor hygiene due to community living conditions, functional situation, and faecal pollution. Other infections are favoured by the tropical climate similar as malaria, schistosomiasis, or leishmaniasis. Some contagious pitfalls are specific to the fortified forces because of war crack infections and exposure to natural munitions [1, 2].

Besides their frequence, these contagious conditions may be severe and potentially fatal. French fortified forces have decreasingly been transferred to tropical countries over the once 10 times, and severe. Falciparum malaria accounts for one death every two times on average among fortified forces labor force.

Medical evacuation of fortified forces labor force infected during an operation may be justified in colourful situations incapability to conduct the charge, need of fresh individual examinations, inauguration of a specific treatment, or monitoring of a specific treatment. The French army health service makes a distinction between “politic medical evacuations” and “strategic medical evacuations”. Tactical medical evacuations correspond in transferring the dogface to the nearest acceptable health installation in the theatre of operations, while strategic medical evacuations correspond in repatriating the dogface to a health installation in metropolitan France. An aggregate of 718 strategic medical evacuations were carried out in 2015. It's associated with high cost and strong functional impact. Similar evacuations bear mortal coffers and means, and may disrupt the military charge. Specific measures may also need to be enforced as similar infections are potentially contagious, and cases may bear to be insulated for case.

We aimed to estimate the characteristics of strategic medical evacuations of French fortified forces labor force between 2011 and 2016 for contagious conditions. We aimed to identify “critical” situations taking extradition to metropolitan France [3, 4].

Materials and Methods

Type of study

We performed a register- grounded retrospective study of French fortified forces labor force serving overseas who served from a strategic medical evacuation to metropolitan France between January 1, 2011 and December 31, 2016.

Data sources

Epidemiological data of French fortified forces labor force serving overseas between January 1, 2011 and December 31, 2016, with the position of the operations, were collected from the registers of the French functional service staff for health (French acronym EMO- S).

All requests for strategic medical evacuations of French fortified forces labor force are consolidated at the M3/ MEDEVAC unit of the EMO- S. A regulating croaker is in charge of organizing the evacuation. Data of the medical evacuation is proved in a specific database. The present study is grounded on the analysis of this database. Collected data included the case, the theatre of operations, and the contagious complaint taking evacuation, the transportation characteristics, and the destination [5].

Within the French center for epidemiology and public health of the fortified forces (French acronym CESPA), the functional unit known as “Epidemiological surveillance and intervention” monitors the health of fortified forces labor force. The surveillance is grounded on monitoring roughly 60 diseases or conditions declared through daily epidemiological dispatches by the unit's croakers. We assessed the data from this epidemiological surveillance and compared it with strategic medical evacuations of French fortified forces labor force for contagious conditions over the same period of time.

Addition criteria and anatomized data

All French fortified forces labor force repatriated from a geographical area outside of metropolitan France via strategic medical evacuation organized by the EMO- S between January 1, 2011 and December 31, 2016 were included in the analysis. Lines with missing data similar as the date of birth, nation, opinion, and country of origin were barred from the analysis. Cases who failed before being vacated were also barred [6].

Discussion

Surveillance of similar medical evacuations should contribute to assessing the effectiveness of contagious threat forestalment strategies during military operations, as well as treatment effectiveness within the healthcare chain on the field.

Over the study period6.5 of strategic medical evacuations were decided because of contagious situations. One should add the13.6 of medical evacuations for potentially contagious situations that haven't been assessed for lack of data. Similar results are analogous to those published in other studies reporting that contagious conditions were responsible for 10 to 20 of medical evacuations of French fortified forces members in operations abroad. This data confirms that infections are a major threat for members of the fortified forces transferred abroad. Infections are associated with high morbidity in theatres of operations, and may compromise the military charge. Contagious conditions contracted by members of the fortified forces depend on the functional environment, and our study results feel to confirm the increased threat of contagious conditions in theatres with high functional involvement, especially at the launch of a new charge. This may be explained by living conditions and precarious hygiene at the launch of a new charge, which are latterly bettered once architectures and living areas have been set up. Changes in functional operations as well as their variety may also have dropped the fortified forces’ experience related to country living in tropical areas [7, 8].

Conclusion

Contagious conditions contracted in operations by French fortified forces members and medical evacuations decided for similar reasons are major epidemiological pointers that should be covered. Similar pointers help acclimatize forestalment measures, training, and remedial and individual tools used by frontal- line military croakers.

Prevention and operation of contagious conditions in military operations are still grueling. The Ebola outbreak lately reminded the scientific community that extradition of largely contagious cases is still problematic. The emergence and presence of multidrug- resistant bacteria in countries where French fortified forces are being transferred, and the high frequence of carriage of multidrug- resistant bacteria among members of the fortified forces also raise issues of evacuation conditions, insulation measures, and choice of antibiotic remedy [9, 10].

Acknowledgement

The authors would like to thank all people involved in the operation of cases included in the study, as well as the EMO Health for supporting the French fortified forces abroad.

Conflict of Interest

The authors declare that they've no contending interest.

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