International Maritime Health最新文献

Background: First, this analysis was conducted to study a coronavirus disease 2019 (COVID-19) cluster dynamic on a cruise ship in order to allow the ship physician to anticipate the duration and importance of the contaminations. Secondly, the author tries to find out if the closed environment on board allows specific conclusions about epidemic dynamics and preventative measures.

Materials and methods: From a personal epidemiological compendium done by himself on board the author analysed different epidemic curves identified on board other ships and compared them to the epidemiologic data from the different COVID-19 contamination waves in France since 2020. All crew members were submitted to polymerase chain reaction tests on D2, D5, D8 and D15 and symptomatic cases were tested on on-board devices in the meantime. An excel file called "Log Covid" allowed for daily reporting to the ship-owner on the epidemic dynamics and the prospects on the end of crises in order to anticipate the resumption of the business in the best conditions. The jobs on board, age and geographic origin of the contaminated people were analysed, as well as their vaccination status.

Results: Out of a total of 118 crew members, 61 (52%) sailors were contaminated in 8 days. The symptoms were benign (pharyngitis, headaches, feverish state); no serious form of illness were reported. The passengers were repatriated to France at the earliest stage. The epidemic phase occurred in a 15-day window. The first 8 days corresponded to the ascending phase, then a faster phase of epidemic decrease of 7 days. Similarities emerged between the epidemic dynamics of this virus and other contaminations on cruise ships and epidemic phases on land in spite of important differences in numbers.

Conclusions: This study can allow a ship's doctor to better understand the viral dynamics in case of a COVID- 19 cluster and to anticipate the exit of the crisis. Repeated tests during the active phase of the epidemic are necessary in case of a large cluster to know where to place oneself on a typical epidemic curve. Isolation and barrier measures advised by the ship's doctor remain the only weapons that can limit its magnitude.

Background: The fixed regimen and strict dietary habits of seafarers and trainee sailors, make them susceptible to several oral diseases. The aim of the study was to assess prevalence of dental caries, oral hygiene status and treatment needs among seafarers and trainee sailors in the state of Goa.

Materials and methods: This descriptive, cross-sectional study was carried out from January 2023 to March 2023. After a pilot study, convenience sampling technique was employed to recruit 261 participants. The investigators were standardized and calibrated to record World Health Organization Oral Health Assessment Form (1997) and Oral Hygiene Index-Simplified (OHI-S) which were instrumented in the study. Intra-examiner and inter-examiner reliability scores were recorded using kappa statistics (0.81, 0.83) and (0.83, 0.85), respectively. The data was analysed using descriptive analysis, chi-square test, Mann- -Whitney U test and multivariate linear regression analysis at statistical significance (p ≤ 0.05).

Results: The mean ages of seafarers (n = 133) and trainee sailors (n = 128) were 36.41 ± 6.40, and 25.36 ± 7.39, respectively. The prevalence of dental caries among seafarers and trainee sailors was determined to be 59% and 78%, respectively (p = 0.01). The mean OHI-S score of seafarers (1.31 ± 0.68) and trainee sailors (1.53 ± 0.82) was statistically significant (p = 0.015).

Conclusions: Seafarers and trainee sailors demonstrated high caries prevalence and poor oral hygiene status due to their distinctive lifestyle, representing a vulnerable community in terms of oral health.

A unique report of Schönlein-Henoch purpura (SHP) associated with a recent Giardia lamblia enteric infection is described and discussed on the ground of the available literature. Tinidazole plus an appropriate probiotic therapy, including Lactobacillus reuteri and vitamin D, proved to be effective in the condition. SHP is an immunocomplex-mediated disorder characterised by a number of differently associated signs and symptoms, leading to the possible involvement of the skin, joints, abdomen and kidneys. Recent bacterial, viral, or protozoan infections may trigger the disease onset in patients of all ages. The paper describes the first case of SHP triggered by a giardiasis. Tinidazole plus an appropriate probiotic therapy, i.e. L. reuteri and vitamin D proved to be effective in this condition. To our knowledge, this is the first reported case of lambliasis-associated SHP described in an international traveller.

Background: Coastal fishermen are particularly affected by occupational stress and burnout because they are exposed to high psychosocial factors at work and organizational constraints related to difficult working conditions.

Materials and methods: This survey aimed to assess the prevalence of burnout syndrome (BOS) of fishermen and its relationship with sociodemographic and occupational parameters. This cross-sectional study involved a representative sample of 761 fishermen. We used an individual questionnaire including socio-demographic and occupational parameters, the Karasek's Job Content Questionnaire, and Maslach BO Inventory. BOS includes three dimensions: emotional exhaustion, depersonalisation, and loss of self-efficacy. The positive diagnosis of BOS is retained if the scores of the three dimensions are abnormal (high for the first two and low for the third).

Results: Five hundred and twenty-six people agreed to answer the questionnaire. Of these, 16.1% had a high emotional exhaustion, 13.9% high depersonalisation, and 11.2% low personal accomplishment. Furthermore, 37.1% had at least one abnormal dimension of BOS: 16.9% had one abnormal dimension, 12.2% two, and 8% three (BOS). The prevalence of abnormal dimensions of BOS was significantly higher in pilots-copilots (67.9%), and in mechanics (63.5%) than in sailors (27.8%). It was higher in fishermen living alone (44.4%), having seasonal job (57.9%), suffering of job strain (42.1%) or isostrain (57.9%), and sleep disorders (55.4%). The multivariate logistic regression showed that job strain, isostrain, fatigue, sleep disorders, seasonal job and daily working > 14 h constituted a major risk factor of abnormal dimension of BOS.

Conclusions: It is imperative to identify priority actions to improve the working conditions of fishermen, and to develop a genuine prevention policy.

An enclosed space is an area with poor or no natural ventilation which is not designed for continuous occupancy, where access is limited and which may contain a dangerous atmosphere. Enclosed space atmospheres can be hazardous due to one or a combination of the conditions which includes oxygen deficiency; presence of toxic and/or flammable gases. When it is intended that personnel should enter or work in an enclosed space, care should be taken to create and maintain safe working conditions. The case report describes an incident on board an oil rig where the rig workers were exposed to noxious gases resulting in multiple fatalities. Work involved gas sampling/monitoring at various locations inside the "spud tanks" of the rig and certifying it free of noxious gases for marine surveyor's inspection. Contributory factors that have been frequently identified following enclosed space accident investigations are non-compliance with procedures, inappropriate equipment, poor supervision, complacency and over familiarity leading to short cuts being taken, detection and monitoring equipment not used or not working properly and improper action in an emergency. Preventive measures to avoid such accidents and create a safe working area are discussed.

Background: Seafarers, confronted with unique health challenges, occasionally necessitate medical repatriation. This study examines the trends in medical repatriation cases among Filipino seafarers employed by a Maritime shipping company over a 10-year period from 2013 to 2022.

Materials and methods: Medical records of seafarers a shipping company were reviewed, obtaining causes for and dates of medical repatriation. International Classification of Diseases (ICD-11) was utilised to classify repatriation cases. Proportion of repatriation cases were calculated and their annual trends were analysed.

Results: Our findings reveal that the majority of repatriation cases are attributed to injury/trauma (19.91%), musculoskeletal (18.40%), gastrointestinal (16.56%), cardiovascular (8.77%), infectious (6.82%), and genitourinary conditions (5.30%). Significantly, the study identifies a declining trend in the proportion of cardiovascular, gastrointestinal, and genitourinary conditions in annual repatriation cases, particularly in ischaemic heart conditions, cholelithiasis, cholecystitis, and urinary calculus.

Conclusions: These results emphasize the critical need for multisectoral collaboration to enhance seafarers' health and well-being. Prioritizing comprehensive care programmes, ensuring safe working conditions, and exploring holistic healthcare initiatives are essential steps to enhance seafarers' occupational health.

Background: The armed aggression of the Russian Federation against Ukraine resulted in the destruction of the country's infrastructure and a decline in the standard of living for many citizens (e.g. shortages of electricity and safe drinking water, limited access to healthcare, living in unsuitable cold basements). A lot of Ukrainians living in the eastern, southern and central parts of the country were forced to flee their homes. The aim of this study was to assess the prevalence of intestinal parasite infections among internal war refugees and residents of Ternopil, a city in Western Ukraine, in response to the worsening of the epidemiological situation in the country.

Materials and methods: Parasitological diagnostics was carried out in June 2023 and involved 127 adult Ukrainian citizens aged 19-80 years old, including 80 internal war refugees (most of the participants came from Donetsk, Luhansk, Dnipro, Kherson regions) and 47 residents of Ternopil region, Western Ukraine. Surveys and parasitological examination of stool samples by three different light microscopy testing methods (direct smear, decantation, flotation) were performed. The samples were then tested for the presence of Giardia intestinalis intestinal protozoa by molecular tests (reverse transcription polymerase chain reaction [RT-PCR]) and immunochromatographic rapid diagnostic tests (RDTs).

Results: All RT-PCR and RDT tests to detect Giardia intestinalis were found to be negative. The examination of faecal samples taken from 127 patients showed no infections with nematodes, cestodes or trematodes. The examinations only revealed infections with potentially pathogenic Blastocystis spp.: 18/80 infections in the population of internal war refugees (22.5%) and 7/47 infections among residents of the Ternopil region (14.9%). Survey results demonstrated frequent use of antibiotics and antiparasitic drugs without physician advise or prescription: 43.9% of the study participants (n = 127) were taking antibiotics, and 25.2% were taking antiparasitic drugs during the period of 3 months prior to the study.

Conclusions: An absence of intestinal parasite pathogens was detected in the studied population. The authors may explain it by the fact, that many Ukrainian patients have unlimited access to antimicrobial drugs (drugs sold without a valid prescription and taken without consultation with a physician), which could have contributed to the low incidence of intestinal parasite infections.