On August 23, 2011 the physician of Role 1 informs the Medical Doctor Adele 2 Operation European Training Mission (EUTM) Somalia that the "quick test" performed on one of the Role's nurses
This is why the Nakasero Hospital in Kampala is to be moved urgently at approximately 400 km from roads in very bad conditions.
The decision on how to carry out the transfer does not depend on EUTM-Somalia, Role 2 can decide independently on being hired by EUTM-Somalia.
Role-2 personnel have their own health insurance.
This means that they can face their own evacuations and hospital admissions.
As they always count on the help and collaboration of the EUTM-Somalia General Headquarters.
The alarming symptoms that lead their partners to perform the Quik test is an acute pseudo-confusional syndrome associated with fatigue, headache, and fever of more than 38oC.
Apparently, in the hours after the confirmation of the diagnosis there is a history that the patient had not revealed up to that time: asthenia in the last fifteen days, headaches, diarrhea and amoxicillin an apparently infectious condition that the patient had started with clavulanic acid.
As a medical history the patient suffered from migraines.
The staff of this Rooxi-affiliated pharmacy in an area for long periods of more than one year (with one month of rest each six months of stay approximately), which has led in many cases to the voluntary cessation of prophylaxis).
It was decided to carry out the patient's transfer by road with ambulance from Kampala, and the Medical Adjustment at the Nakasero Hospital in Kampala was informed.
At approximately 12 hours after diagnosis, the patient was admitted to the hospital and a few hours later she became comatose.
The aero-evacuation of Italy was already being implemented.
Given the advanced stage of the disease, the patient was assessed by the company of "Flying Doctors" to Nairobi two days later.
After his admission to the hospital of Nairobi his evolution persists very unfavorablely dying a few hours after the fourth day of his initial diagnosis.
It can be thought that one of the causes of the rapid and poor evolution of the disease of our partner was due to a late diagnosis and initiation of treatment, lack of immunity acquired from the patient chemoprophylaxis and rapid abandonment of prophylaxis.
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Medical Admission
Throughout this process, as is customary, the Medical Addict at every moment informs the Head of the Military Staff and keeps informed to the Head of Mission, who in turn transmits everything that happens in our Mission.
The concern of Brussels is evident.
In addition, the Medical Adjustment Reports to the Defense Preventive Medicine Institute (IMPDEF) and to the Emergency Medical Service (EMCDDA) to inform the patient as soon as possible.
After highlighting the training and instructional measures, it becomes necessary to prevent diseases whose functions are to remind the whole contingent deployed in the mission of risky diseases in the area,
In relation to malaria, it is important to take chemoprophylaxis, in addition to carrying out defensive measures we all know to prevent mosquito bites, such as:
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Use diethyltoluamide insect repellents, applicable in zones above all from 18 p.m. to 05 a.m.
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Outside use long handle clothing and long pants.
Even impregnate the uniform with permethrin.
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Have flies in the rooms windows.
Mosquiter mackerel impregnated in permethrin in bed, which remains well tensed and plunged below the mattress, and never leans on the ground.
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Use insecticides for the room inside.
They are informed and reminded that in order to avoid a fatal outcome with malaria treatment is essential, and for this reason it is essential that they find themselves adhering to Role 1 (continuously present as a "malign" symptom).
It is said that when fever appears in malaria-endemic area "we must think as a first option in this disease".
It is very important to take this principle into account, but we must not forget all the symptoms that may appear in malaria: headache, sore throat, severe asthenia, chills, sweating, nausea, diarrhoea and vomiting.
These are common symptoms to other common conditions in the area, such as gastroenteritis, so the patient may not give them importance.
The need to consult with a doctor about the presence of any of them is imperative.
During the mission, the Medical Adjustment via benefits to the capital of Kenya to inform about the services and services of the hospitals that are there.
The protocol for the diagnosis and treatment of malaria is also reported.
All of them involve early treatment of the disease, and the presence of clinical symptoms is sufficient even if microscopic diagnosis is negative.
In most cases Artemether 20mg/Lumefant 120mg is used four units every 12 hours for 3 days.
Two cases of malaria were treated in the Kampala General Ward, without a clear diagnosis of malaria.
The evolution was very good.
Another preventive measure considered was the fight against the vector.
Several companies specialized in combating the malaria vector were visited and a study for the disinfection of the Bishop Campaign was requested.
The Kampala General Headquarters are disinfected once a month in rooms and in the nearest exterior, including all vegetation found there.
The complete disinfection of the military Campaign involves the most complicated plan, because it is surrounded by very extensive green zones and a life expectancy of the Uganda military and their families who do not meet the necessary sanitary conditions.
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A study was carried out by the expert company for disinfection, measures to prevent mosquitoes from entering the interior, to promote drying of vegetation drains, and to promote water elimination by the house.
All this in a radius of at least one kilometre.
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The Medical Addiction Uganda mission ended without deciding on many of the above measures.
As no European country has put in place a Medical Adjusting Studies replacing the former, all these issues remain open and pending a decision by the new Head of Mission, assisted by the Head of State
Figures 1 and 2 show the housing conditions of Ugandeses military families very close to the Europeans' living area.
windows and doors should be treated and closed with mosquito nets for proper disinfection and elimination of the vector.
Figure 3 gives us a clear idea of the proximity of the European military houses (with roofs) and the military houses (blue roofs of the zone).
