Plasmodium vivax Malaria among military personnel, French Guiana, 1998-2008.

We obtained health surveillance epidemiologic data on malaria among French military personnel deployed to French Guiana during 1998-2008. Incidence of Plasmodium vivax malaria increased and that of P. falciparum remained stable. This new epidemiologic situation has led to modification of malaria treatment for deployed military personnel.

Advantages and limits of real-time epidemiological surveillance during military deployments: the experience of the French Armed Forces.

To perform epidemiological surveillance during deployments, the French military health service has developed a real-time surveillance approach. The objective was to identify the benefits and problems of this approach. A prototype of real-time surveillance has been set up in French Guiana since 2004. Its permanent evaluation has allowed identifying strengths and weaknesses. The experience has permitted expansion of the concept to French forces in Djibouti and also development of a global approach for the whole French armed forces. Real-time surveillance has shown its usefulness for early warning during different real and simulated situations. Functional and architectural choices have permitted interoperability with allied nations. However, the information produced was only the first step of the diagnostic epidemiological situation followed by other investigations. This first step of development has highlighted the required complementarity with traditional epidemiological surveillance.

Value of syndromic surveillance within the Armed Forces for early warning during a dengue fever outbreak in French Guiana in 2006.

BACKGROUND: A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response. METHODS: Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants. RESULTS: It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance. CONCLUSION: Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future.

Evaluation of a syndromic surveillance for the early detection of outbreaks among military personnel in a tropical country.

BACKGROUND: To evaluate a new military syndromic surveillance system (2SE FAG) set up in French Guiana. METHODS: The evaluation was made using the current framework published by the Centers for Disease Control and Prevention, Atlanta, USA. Two groups of system stakeholders, for data input and data analysis, were interviewed using semi-structured questionnaires to assess timeliness, data quality, acceptability, usefulness, stability, portability and flexibility of the system. Validity was assessed by comparing the syndromic system with the routine traditional weekly surveillance system. RESULTS: Qualitative data showed a degree of poor acceptability among people who have to enter data. Timeliness analysis showed excellent case processing time, hindered by delays in case reporting. Analysis of stability indicated a high level of technical problems. System flexibility was found to be high. Quantitative data analysis of validity indicated better agreement between syndromic and traditional surveillance when reporting on dengue fever cases as opposed to other diseases. CONCLUSIONS: The sophisticated technical design of 2SE FAG has resulted in a system which is able to carry out its role as an early warning system. Efforts must be concentrated on increasing its acceptance and use by people who have to enter data and decreasing the occurrence of the frequency of technical problems.