Infectious diseases during the European Union training mission Mali (EUTM MLI) \u2013 a four-year experience

Hagen Frickmann,Ralf Matthias Hagen,Florian Geiselbrechtinger,Nagpal Hoysal

doi:10.1186/s40779-018-0166-5

Abstract

BackgroundThe European Union Training Mission Mali (EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury surveillance data, this study quantifies the true impact of infectious diseases for this tropical mission and potential seasonal variations in infectious disease threats.MethodsCategorized health events during the EUTM MLI mission and associated lost working days were reported using the EpiNATO-2 report. Infection-related health events were descriptively analyzed for a 4-year period from the 12th week in 2013 to the 13th week in 2017. Aggregated EpiNATO-2 data collected from all missions other than EUTM MLI were used as a comparator.ResultsAmong the infectious diseases reported by EUTM MLI, non-severe upper respiratory infections and gastrointestinal diseases dominated quantitatively, accounting for 1.65 and 1.42 consultations per 100 person-weeks, respectively. The number of recorded infectious disease-associated lost working days during the whole study interval was 723. Seasonal changes in disease frequency were detectable. More gastrointestinal infections were seen in the rainy season, and more respiratory infections occurred in the dry season; these were associated with peaks of more than 2.5 consultations per 100 person-weeks for both categories.ConclusionsDespite initial concerns focused on tropical infectious diseases during this mission in tropical Mali, upper respiratory tract and gastrointestinal infections predominate. The relatively low number of reported lost working days may indicate that these infections are at the milder end of the spectrum of infectious diseases despite a likely reporting bias.

Highlights

The European Union Training Mission Mali (EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali
In collaboration with the Deployment Health Surveillance Capability (DHSC) of the North Atlantic Treaty Organization (NATO) Centre of Excellence for Military Medicine, the health of the force deployed to EUTM MLI has been monitored continuously by using the EpiNATO-2 weekly
We describe the patterns of infectious disease threats reported in EUTM MLI and relate this to a microbiological assessment of routinely collected food samples

Summary

Introduction

The European Union Training Mission Mali (EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. In 2013, the European Training Mission in Mali (EUTM MLI) was initiated to support the military training of the Malian Armed Forces. General assumptions about the threat to the deployed force from tropical diseases and the general lack of reliable surveillance data in conflict areas led to the deployment of experts in tropical medicine and infectious diseases as part of the in-theatre medical support package at the beginning of the mission. In collaboration with the Deployment Health Surveillance Capability (DHSC) of the NATO Centre of Excellence for Military Medicine, the health of the force deployed to EUTM MLI has been monitored continuously by using the EpiNATO-2 weekly. All diagnoses consistent with upper or lower digestive tract infection. Excludes noninfectious intestinal diagnoses such as hemorrhoids, ulcers, hernias, etc., and chronic conditions such as irritable bowel syndrome

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