Examinations regarding the prevalence of intestinal parasitic diseases in Polish soldiers contingents assigned to missions abroad

The aim of this paper is to present the program of diagnostic examinations regarding the detection and following treatment of intestinal parasitic diseases in the population of Polish soldiers serving in different climatic and sanitary conditions. Intestinal parasitoses remain one of the health problems of soldiers participating in contemporary military operations. This fact mainly results from unsatisfactory sanitary and hygienic standards in the regions where troops are deployed, contamination of water and soil, inappropriate processes of purifying drinking water, and the terrible condition of sewage systems, water purification plants, or sewage treatment facilities. The occurrence of such diseases is further facilitated by disregard of some basic principles of food and feeding hygiene. Mass examinations of Polish troops to find the prevalence of intestinal parasitoses will cause a decrease in the morbidity rate of parasitic diseases among Polish soldiers deployed in military operations. They can also lead to a decrease in expenditure on medical treatment of disease-related complications and on damages awarded to soldiers who have developed a serious disease while being engaged in a mission abroad. (Int Marit Health 2011; 62, 1: 31–36

Travel health prevention

All around the world there has been a rapid growth in the number of international travels. According to the World Tourism Organisation the number of international tourist arrivals reached 1,235 billion in 2016 and continues to grow at a high rate. This has been much due to the development of air transport (including low-cost airlines), increasingly common economic migration, a growing number of travellers visiting friends and relatives, and an increase in medical tourism. With tropical destinations becoming increasingly popular among travellers, doctors have seen a rising number of patients who seek medical advice on health risks prevalent in hot countries and health prevention measures to be taken in tropical destinations, especially where sanitation is poor. The risk for developing a medical condition while staying abroad depends on a variety of factors, including the traveller’s general health condition, health prevention measures taken before or during travel (vaccinations, antimalarial chemoprophylaxis, health precautions during air, road and sea travel, proper acclimatisation, prevention of heat injuries, protection against local flora and fauna, personal hygiene, water, food and feeding hygiene), as well as the prevalence of health risk factors in a given location. Health prevention is a precondition for safe travel and maintaining good physical health; in the era of a rapid growth in international tourism it has become of key importance for all travellers

The pregnant traveller

Travelling during pregnancy has become increasingly common. Many pregnant women travel for pleasureand recreation and a lot of them continue to work and therefore often travel on business, sometimes to areas with poor standards of sanitation and limited access to health care providers. During pregnancy, it is extremely important that a woman has a regular access to maternal health care, also in temporary destinations, especially in areas characterised by harsh environmental conditions, and places where the prevalence of infectious diseases is high. It must be remembered that the course of contagious or parasitic illnesses, such as hepatitis E and malaria, is generally more severe in pregnant travellers, due to pregnancy-related immunosuppression. The assessment of indications and contraindications for the use of mandatory/recommended vaccinations and antimalarial drugs is also very important in pregnant travellers. When pregnant women travel for long term, it is absolutely necessary that they receive prenatal care in a new place of residence. Scheduled maternity care usually begins in week 10–12 of pregnancy, and continues once a month until the 7 month of pregnancy, next every second week until week 36 and then once a week until the delivery.  

Post-travel screening of symptomatic and asymptomatic travelers

Until last year, terrorism, economic instability, poverty and natural disasters were considered the major threats to humans globally. Infectious diseases were seen as a minor problem. This, however, changed in 2020 when the global COVID-19 pandemic broke out and a new danger emerged. The latest events generated a lot of discussion on health hazards associated with international tourism and uncontrolled spread of pathogens across the borders. The major health problems of travelers to developing countries with harsh environmental conditions and endemic infectious diseases include gastrointestinal disorders, dermatoses, respiratory infections and fevers of unknown origin. A medical interview by an experienced physician is the foundation of the post-travel screening process both in symptomatic and asymptomatic travelers; the interview should focus on identifying exposure to risk factors (endemic infectious diseases, failure to adopt disease prevention measures, consumption of food or water from unsafe sources, insect bites, animal bites, travelling in large groups, unsafe sex with casual partners). While physical examination (identification of abnormalities) and diagnostic tests (identification of pathogens) can be useful for detecting illnesses and asymptomatic infections as well as assessing the general health condition of a patient, including his immune system. The aim of the article is to provide information on the post-travel screening process in symptomatic and asymptomatic travelers who have returned from areas with harsh climate conditions and low sanitation standards

The paediatric traveller

International travel with children, which is the opportunity for the family to see the world together, has become commonplace. If you are travelling with children the journey needs to be carefully planned, especially in cases of visiting a region with harsh environment or poor sanitation. It is particularly important in terms of thermoregulation (hot climate) and the immune system (protection against pathogens causing infectious and invasive diseases) as these are not fully developed in small children. In addition, it is important to maintain appropriate safety and security measures in the destination area (e.g. using child car seats during drive, supervising children during recreational activities in water and on land, avoiding contact with undomesticated animals). Moreover, it is essential to prepare a travel health kit containing drugs appropriate for young travellers — matched for their age and body weight, and to purchase personal prevention products for everyday use (sunscreen with a high sun protection factor, insect repellents, etc.)

Health hazards in areas of military operations conducted in different climatic and sanitary conditions

This paper reviews the most common health hazards occurring among personnel of peacekeeping and stabilization missions functioning within armed conflicts in the contemporary world. Military operations have been executed in diverse climatic and sanitary conditions, which are frequently unfamiliar for their participants. Some of them, e.g. the UN peacekeeping missions in the Middle East (Lebanon, the Golan Heights), have been carried out in a relatively stable geopolitical environment; whereas, stabilization missions in Iraq and Afghanistan, which are actually combat activities, undoubtedly fall into the group of the most perilous military operations in the world. Hot or cold climate, poor sanitary and hygienic conditions along with warfare facilitate the occurrence of numerous diseases and body injuries not only among the local people but also among peacekeepers, who represent the population of immigrants. Health hazards which pose major epidemiological threats in combat zones are arthropod-borne, food and water-borne, respiratory tract diseases, sexually transmitted diseases, enzootic diseases, battle injuries, and non- -battle injuries, e.g. traffic accidents. Another considerable health problem are psychiatric disorders, which can either appear directly after the occurrence of a traumatic event in a combat zone or indirectly, after some time had elapsed. In addition to the health hazards listed above, environmental factors such as changeable weather conditions and local fauna may also be life threatening. (Int Marit Health 2011; 62, 1: 41–62

Health problems of peacekeepers carrying out mandatory tasks in Chad, Central Africa

Background. The article presents the results of the author’s own studies concerning the morbidity profile in the group of soldiers serving in the Polish Military Contingent (PMC) deployed to Chad in the period May 2008–April 2009 within the framework of a European Union operation (EUFOR) and a United Nations peacekeeping mission (MINURCAT). Material and methods. The conducted analysis was based on medical records of soldiers (n = 540) treated at Level 1 (FOB Iriba) and Level 2 (HQ Abeche) medical centres located in the operational zone where the PMC was stationed. Irrespective of the evaluation of diseases of particular organs and systems, parasitological examination for the presence of intestinal parasitic diseases using a light microscopy were carried out. Results. The research has demonstrated that the most serious health problems occurring in the group of Polish soldiers in the given period included: skin diseases (22.7%), respiratory tract diseases (18.9%), digestive tract diseases (12.9%), and non-battle injuries (9.2%). Conclusions. Parasitological examinations toward intestinal parasitic diseases, conducted among Polish soldiers (n = 247) in the mission area in April 2009, revealed the occurrence of protozoan pathogens (55 cases of Giardia intestinalis, 2 cases of Entamoeba histolytica/dispar). (Int Marit Health 2011; 62, 1: 37–40

Eye diseases in travelers

Travelling has been growing in popularity over the last several decades. Eye diseases, e.g. decreased visual acuity, inflammatory or degenerative lesions, chronic diseases or eye trauma, affect all groups of travelers. The main risk factors contributing to the manifestation or exacerbation of common ocular diseases include exposure to dry air (inside the airplane cabin or in air-conditioned hotel rooms), exposure to chlorinated or salty water (swimming/bathing in swimming pools or in the sea), and sudden changes in the weather conditions. In addition, travelers to tropical destinations are at risk of ocular diseases which are rarely seen in temperate climate, e.g. onchocerciasis, loiasis, gnatostomosis, African trypanosomosis, or trachoma. The most common condition of the eye seen in travelers is conjunctivitis; it may be either of cosmopolitan (bacterial or viral infections, allergic inflammation) or tropical etiology, e.g. arboviral infections (zika, chikungunya). Given the fact that a large proportion of the general population have decreased visual acuity and many of them wear contact lenses rather than glasses, keratitis has become a common health problem among travelers as well; the major risk factors in such cases include sleeping in contact lenses, prolonged exposure to air-conditioning, working with a computer or swimming/bathing in microbiologically contaminated water (e.g. Acanthoamoeba protozoa). Conditions affecting the cornea, conjunctiva or lens may also occur due to excessive exposure to solar radiation, especially if travelers wear glasses without a UV protection

Reasons for medical evacuations of soldiers serving in International Security Assistance Force (ISAF) operation in Afghanistan

Background: The article presents the results of a research study into the reasons for medical evacuations of Polish military personnel taking part in the International Security Assistance Force (ISAF) operation in Afghanistan from 2007 to 2013. Materials and methods: The authors have analysed medical records of 485 soldiers who were medically evacuated out of a combat zone in Afghanistan for battle injuries, non-battle injuries and diseases. Each medically evacuated Polish soldier was subjected to statistical analysis. The study population comprised 25,974 soldiers assigned to the Polish Military Contingent Afghanistan in the given period. Results: From 2007 to 2013, 1.9% of the Polish military personnel (n = 485) participating in the ISAF operation in Afghanistan were evacuated for medical reasons before the scheduled termination of their contract. 40.6% of all medical evacuations were due to battle injuries, 32.4% due to non-battle injuries, and 27.0% due to diseases. Conclusions: ISAF is an example of a combat operation, in which battle injuries remain the leading health problem in mission participants. 3 of 4 Polish soldiers who were medically evacuated from Afghanistan were no longer fit for military service in the area of operations due to the traumas they had suffered