Spectrum and impact of health problems during deployment: A prospective, multicenter study of French soldiers operating in Afghanistan, Lebanon and Cote d'Ivoire

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, Cote d'Ivoire and Afghanistan including exclusively French soldiers. Results: We collected 4349 consultations (Afghanistan {n = 719), Lebanon {n = 1401) and Cote 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. (C) 2014 Elsevier Ltd. All rights reserved.