A tropical forest is a hostile environment for humans. The military physician supporting these immersion activities must cope with varied clinical situations with limited resources to reduce operational unavailability. This article reports a prospective cross-sectional epidemiologic study conducted from January to May 2012, observing the daily activity at sick call during the rainy season at the tropical forest training center (CEFE) advanced jungle commando training, located in French Guyana. The aim was to observe the distribution of traumatic injuries and specific diseases in this tropical environment. In all, 9,221 army staff members participated in the training (mean age: 30.8 years) during the 120-day study period. There were 486 medical visits, for a mean daily incidence of 5.3% (trainees: 83.8%, trainers: 16.5%). Skin lesions were most frequent (39%), principally irritative dermatitis and skin maceration (moisture/dressing associated dermatitis). A third (34%) of these conditions were due to trauma, mainly limb contusions and ligament injuries. Tropical diseases accounted for 3% of the reasons for consultation, with rare problems related to equatorial fauna or flora. The remaining conditions (24%) were not specific to the environment or activity. Operational attrition averaged five days. Removal from the training course was necessary in 13.8% of the cases. In an isolated area with a demanding environment , edical practice in a tropical forest requires health prevention actions and close medical follow-up. The permanent presence of a physician provides both care and expertise and is an important asset for both trainees and trainers.
Keywords: French Guyana; advanced commando training; humidity; skin lesions; traumatic disorders; tropical forest.