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Article Dans Une Revue Journal of Travel Medicine Année : 2017

Infection burden among medical events onboard cargo ships: a four-year study

Résumé

Background. Cargo ships are medically isolated, yet neglected environments. We aimed to know about medical events onboard cargo ships. Methods. We reviewed all the medical events onboard a large commercial 471-cargo ship company for 4 years. Medical events were recorded within 20 categories as routinely used by Medical Maritime Consulting Centers, using a 4-level medical gravity score. The chi(2) test and logistic regression and correspondence analyses were used for the analysis of qualitative variables. Results. Excluding wounds and burns, a total of 322 illness events were notified by onboard health officers for 471 ships totalizing 46 navigation/months. 250 non-infectious events and 72 cases of infection yielded an incidence of 7.75 medical events for 1000 person-years. Infections comprised 25 digestive tract infections, 17 skin infections, 8 urinary tract infections, 5 dental infections, 4 isolated fevers, 3 Ear-Nose-Throat and respiratory tract infections, 2 ocular infections, myalgia and orchitis and 1 case of mediastinal infection. The mean age for sailors diagnosed with infection (37.7 +/- 10.5 years) was significantly younger than the mean age of sailors diagnosed with non-infectious disease (40.8 +/- 11.2 years) (P = 0.04). In affected sailors, the proportion of death and hospitalization among infectious disease cases (26/69, 37.7%) was significantly higher than the proportion of death and hospitalization for non-infectious disease cases (48/242, 19.8%) (P = 0.02). The correspondence analysis showed that the routes may be classified according to two main independent risks, digestive infections and skin infections. We observed a statistically significant correlation between the severity of medical events and the maritime route ``North Europe-OI- Australia-India-North Europe''. Conclusions. These data illustrate a previously underreported variability of the medical risks in various maritime routes; and help promoting targeted medical interventions including the implementation of onboard point-of-care laboratories, to further increase the rapidity of the diagnosis and the medical management onboard cargo ships.

Dates et versions

hal-01521251 , version 1 (11-05-2017)

Identifiants

Citer

Cyril Marimoutou, Davide Tufo, Hervé Chaudet, Marc Abdul Samad, Gaetan Gentile, et al.. Infection burden among medical events onboard cargo ships: a four-year study. Journal of Travel Medicine, 2017, 24 (3), ⟨10.1093/jtm/tax010⟩. ⟨hal-01521251⟩

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