T he Republic of Djibouti, bordered by Eritrea, Ethiopia, and Somalia, is a semiarid country in the Horn of Africa. The population comprises <900,000 persons, 70% of whom live in Djibouti, the capital city. Before 2013, malaria was hypoendemic to the country, with low levels of transmission in periruban and rural areas during December-May. Localized outbreaks occurred regularly, possibly caused by migration from surrounding countries. Most cases were caused by infection with Plasmodium falciparum (>80%) or P. vivax. Before 2013, researchers considered the Anopheles arabiensis mosquito to be the primary vector (1).The incidence of malaria had drastically decreased in the country since 2008; by 2012, this transmission level was compatible with preelimination goals (2,3). In 2013, an autochthonous outbreak of malaria occurred in Djibouti; fi eld entomologic investigations identifi ed An. stephensi mosquitoes as a new malaria vector (4). This species, a known vector of urban malaria in India and the Arabian Peninsula, has changed the epidemiologic profi le of malaria in Djibouti (5). In 2018, malaria incidence increased to 25,319 confi rmed cases (64% caused by P. falciparum and 36% by P. vivax) and >100,000 suspected cases (Appendix Figure 1, https://wwwnc.cdc.gov/EID/ article/27/6/20-4557-App1.pdf).The French Armed Forces (FAF) have served in Djibouti for decades. Service members and their families (≈2,700 persons) live in the capital. Despite malaria prevention and treatment measures described elsewhere (6), an outbreak among French military personnel occurred in February 2019; failure of early artemisinin combined therapy was documented in 1 patient. The StudyWe collated FAF epidemiologic surveillance data on malaria cases among service members in Djibouti during 1993Djibouti during -2019; the 2019 data included cases among family members. We defi ned a malaria case as an illness resulting in a positive result on a rapid diagnostic test or thin blood smear.We conducted the fi eld investigation in the capital during February 28-March 22, 2019. We obtained a dried blood spot on fi lter paper from each patient and stored the samples in a sealed plastic pouch until processing. We extracted DNA from the samples and

BACKGROUND: The practice of self-medication among military fighter aircrew could compromise flight safety because of the adverse effects that can occur in flight. However, data on this subject is scarce. The aim of this study was to identify the determinants of the practice in this population.METHODS: A cross-sectional study was carried out among the French Air Force fighter aircrew based on an anonymous questionnaire distributed electronically. The questions included personal characteristics, opinions, and relations with the healthcare domain as well as the use of self-medication in general and before a flight.RESULTS: Between March and November 2020, 170 questionnaires were reviewed for an overall return rate of approximately 34%. Our data showed an absolute self-medication rate of 97.6%, but the frequency of its use was rare or nonexistent in 53.5% of cases. Factors associated with a more frequent use of self-medication were the function of pilot, age under 35, having a regular prescription, lacking intentionality toward getting enough sleep, having confidence in the medical profession, and some specific clinical situations. The consumption of 97 medications was recorded and 49 before a flight.DISCUSSION: Despite the limitations due to the design of this survey, results suggest that the use of self-medication in fighter aircrews is a reality, but that the frequency of its use is less common. This practice is probably the result of a complex interaction between many personal factors. However, its impact on flight safety remains uncertain.du Baret de Limé M, Monin J, Leschiera J, Duquet J, Manen O, Chiniard T. Self-medication among military fighter aircrews. Aerosp Med Hum Perform. 2022; 93(7):571–580.

BACKGROUND The epidemiology of French military severe trauma patients injured during recent military operations remains poorly described, even if French operations, casualties sustained, and care rendered in a different trauma system are distinct from others. This study aimed at describing the characteristics of these patients upon arrival at hospital in France and during hospital stay. METHODS This 5-year retrospective cohort study included all French military servicemen injured during military operations and admitted to the intensive care unit. Data on the characteristics upon arrival at the Percy hospital in France and during hospital stay were obtained from a national civilian trauma registry. RESULTS Of 1,990 military trauma patients injured in military operations, 39 were finally admitted to the intensive care unit of the Percy hospital and included in the analysis. Traumas were related to battle injuries and nonbattle injuries in 27 and 12 patients, respectively. Ninety-eight wounds were described: torso (n = 32), limbs (n = 32), head and neck (n = 25), and spine (n = 9). The mechanism of injury was explosion in 19 patients, gunshot wound in 8 patients, motor vehicular crash in 7 patients, or other mechanisms in 5 patients. The median Injury Severity Score was 25.5 (interquartile range, 14–34). CONCLUSION This study highlights the small number of military severe trauma patients injured in recent warfare and their characteristics. The use of dedicated systemic military trauma registries could improve the specific epidemiological knowledge on recent warfare and help better prepare for future conflicts that may include major engagements and large-scale combat operations. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level V.