ABSTRACT
We report the case of a French soldier deployed in Chad, who developed disabling pollakiuria after starting antimalarial prophylaxis by doxycycline. This rare secondary effect is not mentioned in reference books.
Subject(s)
Antimalarials/adverse effects , Doxycycline/adverse effects , Urination Disorders/chemically induced , Humans , Malaria/prevention & control , Male , Military Personnel , Pelvic Pain/chemically induced , Pre-Exposure Prophylaxis , Young AdultABSTRACT
A problem of community-acquired Staphylococcus aureus skin infections emerged in the French armed forces in 2004, in a malaria-endemic areas. The high incidence rate led us to evaluate military staff practices. This was a cross-sectional survey of doctors and nurses deployed as officers in French Guyana since 2006. The definition of skin and soft-tissue infection came from the criteria for epidemiological surveillance of the armed forces. We studied the management of antibiotic therapy and its related difficulties. In all, 47 officers responded. At the Military Medical Center (MMC), 23.4% of respondents routinely prescribed antibiotics, compared with 36.2% when stationed in the jungle (p<0.05%). Complication led 68.1 of staff to prescribe antibiotic prescriptions at the MMC, compared with 46.8% in the jungle (p<0.05%). Finally, 22.5% of those at MMC prescribed antibiotic coverage of surgical drainage, compared with 14.8% in the jungle (p<0.05%). Pristinamycin and fusidic acid were the preferred antibiotics. Two-thirds of the staff reported difficulties in jungle management. This first study indicates the need for an update of military medical recommendations. Personnel training must continue to enable them to provide appropriate aggressive management in the current endemic context.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Staphylococcal Skin Infections/drug therapy , Staphylococcus aureus , Adult , Cross-Sectional Studies , Female , Guyana/epidemiology , Health Care Surveys , Humans , Malaria/epidemiology , Male , Military Personnel , Practice Guidelines as Topic , Practice Patterns, Nurses' , Practice Patterns, Physicians'ABSTRACT
A tropical forest is a hostile environment for humans. The military physician supporting these immersion activities must cope with varied clinical situations with limited resources to reduce operational unavailability. This article reports a prospective cross-sectional epidemiologic study conducted from January to May 2012, observing the daily activity at sick call during the rainy season at the tropical forest training center (CEFE) advanced jungle commando training, located in French Guyana. The aim was to observe the distribution of traumatic injuries and specific diseases in this tropical environment. In all, 9,221 army staff members participated in the training (mean age: 30.8 years) during the 120-day study period. There were 486 medical visits, for a mean daily incidence of 5.3% (trainees: 83.8%, trainers: 16.5%). Skin lesions were most frequent (39%), principally irritative dermatitis and skin maceration (moisture/dressing associated dermatitis). A third (34%) of these conditions were due to trauma, mainly limb contusions and ligament injuries. Tropical diseases accounted for 3% of the reasons for consultation, with rare problems related to equatorial fauna or flora. The remaining conditions (24%) were not specific to the environment or activity. Operational attrition averaged five days. Removal from the training course was necessary in 13.8% of the cases. In an isolated area with a demanding environment , edical practice in a tropical forest requires health prevention actions and close medical follow-up. The permanent presence of a physician provides both care and expertise and is an important asset for both trainees and trainers.
