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Master Thesis

État des lieux de la biologie délocalisée en rôle 1 terrestre

Abstract : Introduction: In their feedback, French military physicians deployed in role 1 (NATO taxonomy) have increasingly reported the need of bioassay tests for the primary management of military patients. The implementation of portable analyzers in roles 1 could improve the medical management of deployed soldiers and thus contribute to maintain operationality. The main objective of this study was to identify the current needs for biological analyses and diagnostic tests on the field. To provide optimal support to French military doctors deployed in role 1 and adapt diagnostic and therapeutic tools, we also interested in their medical activities by operational theatres. Methods: We conducted a survey based on self-administrated questionnaires among French military doctors deployed in roles 1 between January 2013 and December 2018. They were asked about the frequency of main syndromes and grouped cases they had to manage during their last mission; and they also were interviewed on their estimate of usefulness and frequency of use concerning a list of biological analyses and diagnostic tests. Result: Participation was 30% (139/466). The majority of physicians was deployed in Mali (57/139 or 41%). The pathologies reported as the most frequently treated were traumatisms (89%), dermatology (84%) and diarrhea (81%). The main bioassays requested in terms of usefulness were C-Reactive Protein (83%), hemoglobin (80%), creatinine (76%), troponin (74%) and white blood cells (73%); and in terms of frequency (i.e. for a regular use) were: la C-Reactive Proteine (42%), white blood cells (36%), glycemia (32%), hemoglobin (27%) and complete blood count (26%). Implementation of rapid diagnostic tests or point-of-care technologies were considered the most helpful for the diagnosis of malaria (83%), streptococcus (65%), bacteriological (64%) and parasitological (63%) stool pathogens and HIV (60%). Conclusion: This study confirms the spectrum and the priorities of medical support in roles 1. We also identified specificities per theatre, particularly in Mali. Our results will help to optimize resources available for medical cares at the closest to the fighter. We proposed a classification of bioassays that would be most and/or frequently useful in roles 1. However, the reliability of portable analyzers in adverse weather conditions is of concern and must be monitored.
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Submitted on : Tuesday, March 24, 2020 - 11:45:11 AM
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Oksana Fauconnier. État des lieux de la biologie délocalisée en rôle 1 terrestre. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02517037⟩



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