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Background: Antibiotics are growth promotors used in animal farming. Doxycycline (DOXY) is a tetracycline antibiotic taken daily and continued 1 month after return to protect against malaria during travel and deployment in endemic areas. We evaluated DOXY impact on body weight in military international travelers., Materiel and Methods: A prospective cohort analysis was conducted in 2016-2018, recruiting 170 French soldiers before a 4-month assignment overseas. Many clinical data including anthropometric measures by an investigator were collected before and after deployment. Weight gain was defined by an increase of 2% from baseline. The study protocol was supported by the French Armed Forces Health Services and approved by the French ethics committee (IRB no. 2015-A01961-48, ref promoter 2015RC0). Written, informed consent was obtained with signature from each volunteer before inclusion., Results: After deployment, 84 soldiers were followed up. Overall, 38/84 (45%) were deployed to Mali with DOXY malaria prophylaxis, and others were deployed to Iraq or Lebanon without malaria prophylaxis according to international recommendations. Body weight increased in 24/84 (30%), of whom 14/24 (58%) were exposed to DOXY. In bivariate analysis, DOXY had a positive but not significant effect on weight gain (P-value = .4). In the final logistic regression model (Fig. 3), weight gain after deployment positively correlated with an increase in waist circumference (odds ratio [OR] 1.23 with 95% CI [1.06-1.47]) suggesting fat gain; with sedentary work (OR 5.34; 95% CI [1.07-31.90]); and with probiotic intake (OR 5.27; 95% CI [1.51-20.40]). Weight impact of probiotics was more important when associated with DOXY intake (OR 6.86; 95% CI [1.52-38.1]; P-value = .016)., Conclusions: Doxycycline (DOXY) malaria prophylaxis during several months did not cause significant weight gain in soldiers. Further studies are required in older and less sportive traveling populations, and to investigate a cumulative effect over time and recurrent DOXY exposure. Doxycycline (DOXY) may enhance other growth-promoting factors including fatty food, sedentariness, and strain-specific probiotics contained in fermented dairy products which are also used as growth promotors., (© The Association of Military Surgeons of the United States 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The prevalence of hepatitis B virus (HBV) infection varies geographically around the world. Yet, its underlying mechanisms are unknown. Using a nationally representative population-based sample from all 58 administrative divisions in Cameroon, we examined the association between median maternal age at first childbirth in a preceding generation, a proxy for the frequency of mother-to-child transmission (MTCT) of HBV in a region, and the risk of chronic HBV infection, defined as positive surface antigen (HBsAg), in the index generation., Methods: We estimated a division-specific median maternal age at first childbirth using Demographic Health Surveys (DHSs) conducted in 1991, 1998, 2004, and 2011. We tested HBsAg in 2011 DHS participants. We used maps to display spatial variation., Results: In 14 150 participants (median age, 27 years; 51% females), the overall weighted prevalence of HBsAg was 11.9% (95% confidence interval [CI], 11.0 to 12.8), with a wide geographical variation across the divisions (range, 6.3%-23.7%). After adjusting for confounders and spatial dependency, lower maternal age at first childbirth was significantly associated with positive HBsAg at the division level (β, 1.89; 95% CI, 1.26 to 2.52) and at the individual level (odds ratio, 1.20; 95% CI, 1.04 to 1.39). A similar ecological correlation was observed across other African countries., Conclusions: The significant association between the maternal age at first childbirth and HBsAg positivity suggests a crucial role of MTCT in maintaining high HBV endemicity in some areas in Cameroon. This underlines an urgent need to effectively prevent MTCT in sub-Saharan Africa., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

The Atlas of Genetics and Cytogenetics in Oncology and Haematology (http://AtlasGeneticsOncology.org) is a peer-reviewed internet journal/encyclopaedia/database focused on genes implicated in cancer, cytogenetics and clinical entities in cancer and cancer-prone hereditary diseases. The main goal of the Atlas is to provide review articles that describe complementary topics, namely, genes, genetic abnormalities, histopathology, clinical diagnoses and a large iconography. This description, which was historically based on karyotypic abnormalities and in situ hybridization (fluorescence in situ hybridization) techniques, now benefits from comparative genomic hybridization and massive sequencing, uncovering a tremendous amount of genetic rearrangements. As the Atlas combines different types of information (genes, genetic abnormalities, histopathology, clinical diagnoses and external links), its content is currently unique. The Atlas is a cognitive tool for fundamental and clinical research and has developed into an encyclopaedic work. In clinical practice, it contributes to the cytogenetic diagnosis and may guide treatment decision making, particularly regarding rare diseases (because they are numerous and are frequently encountered). Readers as well as the authors of the Atlas are researchers and/or clinicians.

To perform epidemiological surveillance during deployments, the French military health service has developed a real-time surveillance approach. The objective was to identify the benefits and problems of this approach. A prototype of real-time surveillance has been set up in French Guiana since 2004. Its permanent evaluation has allowed identifying strengths and weaknesses. The experience has permitted expansion of the concept to French forces in Djibouti and also development of a global approach for the whole French armed forces. Real-time surveillance has shown its usefulness for early warning during different real and simulated situations. Functional and architectural choices have permitted interoperability with allied nations. However, the information produced was only the first step of the diagnostic epidemiological situation followed by other investigations. This first step of development has highlighted the required complementarity with traditional epidemiological surveillance.

Background: To evaluate a new military syndromic surveillance system (2SE FAG) set up in French Guiana., Methods: The evaluation was made using the current framework published by the Centers for Disease Control and Prevention, Atlanta, USA. Two groups of system stakeholders, for data input and data analysis, were interviewed using semi-structured questionnaires to assess timeliness, data quality, acceptability, usefulness, stability, portability and flexibility of the system. Validity was assessed by comparing the syndromic system with the routine traditional weekly surveillance system., Results: Qualitative data showed a degree of poor acceptability among people who have to enter data. Timeliness analysis showed excellent case processing time, hindered by delays in case reporting. Analysis of stability indicated a high level of technical problems. System flexibility was found to be high. Quantitative data analysis of validity indicated better agreement between syndromic and traditional surveillance when reporting on dengue fever cases as opposed to other diseases., Conclusions: The sophisticated technical design of 2SE FAG has resulted in a system which is able to carry out its role as an early warning system. Efforts must be concentrated on increasing its acceptance and use by people who have to enter data and decreasing the occurrence of the frequency of technical problems.

Background: Nonimmune travelers in malaria-endemic areas are exposed to transmission and may experience clinical malaria attacks during or after their travel despite using antivectorial devices or chemoprophylaxis. Environment plays an essential role in the epidemiology of this disease. Remote-sensed environmental information had not yet been tested as an indicator of malaria risk among nonimmune travelers., Methods: A total of 1,189 personnel from 10 French military companies traveling for a short-duration mission (about 4 mo) in sub-Saharan Africa from February 2004 to February 2006 were enrolled in a prospective longitudinal cohort study. Incidence rate of clinical malaria attacks occurring during or after the mission was analyzed according to individual characteristics, compliance with antimalaria prophylactic measures, and environmental information obtained from earth observation satellites for all the locations visited during the missions., Results: Age, the lack of compliance with the chemoprophylaxis, and staying in areas with an average Normalized Difference Vegetation Index higher than 0.35 were risk factors for clinical malaria., Conclusions: Remotely sensed environmental data can provide important planning information on the likely level of malaria risk among nonimmune travelers who could be briefly exposed to malaria transmission and could be used to standardize for the risk of malaria transmission when evaluating the efficacy of antimalaria prophylactic measures.