Article Text

Download PDFPDF
OP TRENTON 3: An analysis of primary care presentations to a deployed role 1 in support of a United Nation peacekeeping operation
  1. Christopher Thomas Bonham1,
  2. S J C Pallett1 and
  3. T J Holland2
  1. 1 AMS Sp Unit, Army Medical Services, Camberley, UK
  2. 2 RAF Centre of Aviation Medicine, Henlow, UK
  1. Correspondence to Major Christopher Thomas Bonham, AMS Sp Unit, Army Medical Services, Camberley GU15 4NP, UK; christopherbonham{at}


Objectives Health data of operational relevance from South Sudan are lacking, outdated and non-representative. This study sets out to record and analyse primary healthcare (PHC) presentations to a deployed UK Level 1 Primary Healthcare Centre (L1 PHC) facility in Bentiu, South Sudan, to inform on disease prevalence for UK Military Personnel in a sub-Saharan Operational environment.

Methods A prospective single-centre cohort study was completed for all PHC presentations to a UK L1 PHC facility while deployed on the United Nations Mission to South Sudan from June 2017 to November 2017.

Results 861 episodes of clinical care were recorded at Bentiu Camp during the 6-month period. 82% were from disease; 18% non-battle injuries and no battle injuries were seen. As per EPINATO2 categorisation, the top three presentations were acute gastrointestinal disease, dermatological disease and routine clinical care. Differences were noted for June–August and September–November, as a proportion of total cases seen. It was noted that gastrointestinal illnesses were three times more likely in the first half of the operation and bites and sting almost twice as likely.

Conclusions Gastrointestinal disease results in a significant burden on humanitarian operations where an extended Relief-in-Place is a key area of risk. The EPINATO2 reporting tool provides insufficient detail for planning purposes and an improved method of data collection is required. Targeting the diagnosis and management of infectious diseases during predeployment training should prepare L1 PHC for the most common cases encountered. Delivery of targeted Force Health Protection training for all personnel with early deployment of L1 PHC forward could improve support to commanders during the highest risk periods.

  • primary care
  • epidemiology
  • public health
  • health services administration & management
  • infectious diseases
  • occupational & industrial medicine

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors CTB, SJCP and TJH designed the study methodology. SJCP collected the data from June-Aug, CTB and TJH collected the data from Sep-Nov. All authors reviewed the data analysis and decided on themes. CTB and SJCP drafted the initial document. All authors have contributed significantly to revision. All authors have agreed on the final version for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.