title: Spectrum and impact of health problems during deployment: a prospective, multicenter study of French soldiers operating in Afghanistan, Lebanon and Côte d'Ivoire.
abstract: BACKGROUND
  More than 15 000 French soldiers are continuously deployed abroad. Along with combat-related injuries, they are exposed to non-combat-related diseases with an underestimated burden. Our objectives were to assess the incidence and impact of health problems on their operating capacity.
  
  
  METHODS
  A prospective multicenter study was conducted over more than three months in Lebanon, Côte d'Ivoire and Afghanistan including exclusively French soldiers.
  
  
  RESULTS
  We collected 4349 consultations (Afghanistan {n = 719}, Lebanon {n = 1401} and Côte d'Ivoire {n = 2229}) encompassing 4600 health problems. Injuries (21%), diarrhea (19%), dermatoses (17.5%) and respiratory tract infections (10.45%) were the most frequent health issues. Infectious diseases represented 41% of all health problems. Almost nine out of ten patients were managed as outpatients. Ten combat-related deaths were observed. We reported 68 (1.5%) medical repatriations of which 28 and 26 were psychiatric and trauma cases respectively. Partial or complete incapacity was estimated 724 days/1000 men/month. Etiological spectrum was similar in all three countries however, the incidence of diarrhea (p < 0.05) as well as inpatient management and medical evacuation rates were higher (p < 0.0001) in Afghanistan.
  
  
  CONCLUSIONS
  There was a wide spectrum of health problems occurring during military deployments with a predominance of common infections. Non-combat-related pathology represented an important burden for the loss of operating capacity.
authors.affiliation: Centre médical des armées de Colmar, 2 rue des Belges, 68000 Colmar, France. Electronic address: olivier.aoun@gmail.com.
authors.forename: Olivier
authors.initials: O
authors.lastname: Aoun
authors.affiliation: Antenne vétérinaire du centre médical des armées de Strasbourg, France. Electronic address: cedric.roqueplo@wanadoo.fr.
authors.forename: Cédric
authors.initials: C
authors.lastname: Roqueplo
authors.affiliation: Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, 69 avenue de Paris, 94160 Saint-Mandé, France; Ecole du Val de Grace, Paris, France. Electronic address: rappchristophe5@gmail.com.
authors.forename: Christophe
authors.initials: C
authors.lastname: Rapp
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D003141:Communicable Diseases / Q000453:epidemiology*; D007560:Cote d'Ivoire; D003967:Diarrhea / Q000453:epidemiology; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D008887:Military Medicine; D008889:Military Personnel / Q000706:statistics & numerical data*; D011446:Prospective Studies; D014195:Travel; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
keywords: Afghanistan; Côte d'Ivoire; Deployment; Lebanon; Military