49 results on '"Demar, Magalie"'
Search Results
2. Childhood lead exposure of Amerindian communities in French Guiana: an isotopic approach to tracing sources
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Maurice, Laurence, Barraza, Fiorella, Blondet, Isalyne, Ho-A-Chuck, Michèle, Tablon, Jessy, Brousse, Paul, Demar, Magalie, and Schreck, Eva
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- 2021
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3. Human Q Fever on the Guiana Shield and Brazil: Recent Findings and Remaining Questions
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Epelboin, Loïc, Eldin, Carole, Thill, Pauline, de Santi, Vincent Pommier, Abboud, Philippe, Walter, Gaëlle, Melzani, Alessia, Letertre-Gibert, Paule, Perez, Lucas, Demar, Magalie, Boutrou, Mathilde, Fernandes, Jorlan, Cermeño, Julman Rosiris, Panizo, Maria Mercedes, Vreden, Stephen GS, Djossou, Félix, Beillard, Emmanuel, de Waard, Jacobus H., and de Lemos, Elba Regina Sampaio
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- 2021
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4. Histoplasmosis in Non-HIV Infected Patients: Another Neglected Infection in French Guiana.
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Aissaoui, Houari, Bourne-Watrin, Morgane, Lemarie, Benoit, Guillot, Genevieve, Aboikoni, Alolia, Chhorn, Piseth, Gaudard, Dana, Hadj-Amara, Ghazi, Manasse, Ricardo, Ouedraogo, Mahamado, Salloum, Charles, Demar, Magalie, Epelboin, Loïc, Kallel, Hatem, Adenis, Antoine, Nacher, Mathieu, Drak Alsibai, Kinan, and Louvel, Dominique
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HISTOPLASMOSIS ,HOSPITAL patients ,DEATH rate ,SEX ratio ,IMMUNOSUPPRESSIVE agents - Abstract
(1) Background: Only a few studies on histoplasmosis in immunocompetent patients have been reported in French Guiana. Therefore, we conducted a detailed clinical description of hospitalized patients suffering with histoplasmosis among non-HIV patients. (2) Methods: This is a single-center, retrospective study conducted at Cayenne Hospital Center between 2008 and 2022. (3) Results: Our cohort was composed of 31 (91%) adults (>18 years of age) and 3 (9%) children, with a sex ratio, M:F, of 1:2. The median age was higher among the women than among the men (70 versus 54 years). The collection of respiratory samples constituted the majority of the performed examinations (38%). Fever (>37 °C) was found in 56% of patients. Surprisingly, the histoplasmosis was disseminated in 82% of patients with an overall case fatality rate of 14.7%. However, immunosuppressive conditions were found in 52% (16/31) of the adult patients, including lymphoid hemopathies, diabetes and immunosuppressive drugs. Conclusions: This disease, though rare and usually considered a mostly benign disease in non-HIV patients, presented a relatively high mortality rate in our cohort. Thus, histoplasmosis should be suspected, screened and investigated as a first line of defense in highly endemic areas, even in immunocompetent and non-HIV patients, especially those with fever or chronic respiratory symptoms. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Chromoblastomycosis in French Guiana: Epidemiology and Practices, 1955–2023.
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Valentin, Julie, Grotta, Geoffrey, Muller, Thibaut, Bourgeois, Pieter, Drak Alsibai, Kinan, Demar, Magalie, Couppie, Pierre, and Blaizot, Romain
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MYCOSES ,EPIDEMIOLOGY ,PARACOCCIDIOIDOMYCOSIS ,TERBINAFINE ,NEGLECTED diseases ,ITRACONAZOLE - Abstract
Chromoblastomycosis (CBM) is a chronic neglected fungal disease, usually met in tropical areas. French Guiana is a South American territory with limited epidemiological data. This retrospective study concerned all patients with CBM proven by at least one paraclinical examination and diagnosed in French Guiana between 1950 and 2023. In total, 23 patients were included, mostly males (87%) of Creole origin, living in the coastal region (87%) and involved in outdoor occupations (74%). Lesions were mostly observed on the lower limbs (78.3%), with a median time to diagnosis of four years. Laboratory tests included positive direct microscopic examinations (78.3%) and mycological cultures (69.6%), identifying 14 cases of Fonsecaea pedrosoi and one case of Exophiala janselmei. Various treatments were employed, including antifungals, surgery and combinations of both. In conclusion, CBM in French Guiana involves a different population than other subcutaneous mycoses such as Lobomycosis or Paracoccidioidomycosis, mostly found in the forest hinterland. Surgery should be recommended for recent and limited lesions. Itraconazole and terbinafine should systematically be proposed, either in monotherapy or in combination with surgery or cryotherapy. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Resurgence risk for malaria, and the characterization of a recent outbreak in an Amazonian border area between French Guiana and Brazil
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Mosnier, Emilie, Dusfour, Isabelle, Lacour, Guillaume, Saldanha, Raphael, Guidez, Amandine, Gomes, Margarete S., Sanna, Alice, Epelboin, Yanouk, Restrepo, Johana, Davy, Damien, Demar, Magalie, Djossou, Félix, Douine, Maylis, Ardillon, Vanessa, Nacher, Mathieu, Musset, Lise, and Roux, Emmanuel
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- 2020
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7. Human T-cell leukemia virus type 1 is associated with dysthyroidism in the French Amazon.
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Dugardin, Julia, Demar, Magalie, Hafsi, Nezha, Amroun, Hakim, Aurelus, Jean-Markens, Alsibai, Kinan Drak, Ntoutoum, André, Santa, Florin, Nacher, Mathieu, and Sabbah, Nadia
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HTLV-I ,ADULT T-cell leukemia ,THYROID diseases ,HYPERTHYROIDISM - Abstract
Background: Human T-cell leukemia virus type 1 (HTLV-1) is a retrovirus known to cause two major diseases: adult T-cell leukemia/lymphoma and a progressive neuromyelopathy—tropical spastic paraparesis. Many viruses may be involved in the pathogenesis of thyroiditis; however, few studies have focused on the role of HTLV-1. We aimed to investigate the association between HTLV-1 and biological thyroid dysfunction. Methods: We included 357 patients with a positive HTLV-1 serology and thyroidstimulating hormone assay data between 2012 and 2021 in a hospital in French Guiana; we compared the prevalence of hypothyroidism and hyperthyroidism in this group with that in an HTLV-1-negative control group (722 persons) matched for sex and age. Results: The prevalence of hypothyroidism and hyperthyroidism in patients with HTLV-1 infection was significantly higher than that in the control group (11% versus 3.2% and 11.3% versus 2.3%, respectively; p < 0.001). Conclusion: Our study shows, for the first time, the association between HTLV-1 and dysthyroidism in a large sample, suggesting that thyroid function exploration should be systematically implemented in this population as this may have an impact on therapeutic management. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Primaquine 30 mg/day versus 15 mg/day during 14 days for the prevention of Plasmodium vivax relapses in adults in French Guiana: a historical comparison
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Valdes, Audrey, Epelboin, Loic, Mosnier, Emilie, Walter, Gaelle, Vesin, Guillaume, Abboud, Philippe, Melzani, Alessia, Blanchet, Denis, Blaise, Nicaise, Nacher, Mathieu, Demar, Magalie, and Djossou, Felix
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- 2018
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9. Virulence of atypical Toxoplasma gondii strains isolated in French Guiana in a murine model
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Simon Stéphane, de Thoisy Benoit, Mercier Aurélien, Nacher Mathieu, and Demar Magalie
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Toxoplasmosis ,Amazonian ,French Guiana ,Virulence ,Mice ,Infectious and parasitic diseases ,RC109-216 - Abstract
Background. Toxoplasma gondii is an obligate intracellular protozoan parasite of warm-blooded vertebrates. Most infections in immunocompetent patients are asymptomatic. However, since 2000s, strains with particular genetic profiles that differ from the known clonal type (type I, II, III), have been described. In French Guiana, these strains are highly pathogenic in immunocompetent patients. They have defined a new clinical entity called Amazonian Toxoplasmosis. The present study aims to further improve our knowledge on the pathogenicity of these Amazonian T. gondii strains in comparison with three reference strains using Swiss strain mice. With these data, we tried to establish a predictive virulence score to classify these strains, but also to correlate this virulence with the severity of the disease in infected patients. Results. All the virulence indicators revealed that the Amazonian strains isolated in French Guiana presented a high virulence profile, but lower than the highly virulent type I reference RH strain. The findings reveal differences in virulence between human and animal strains, but also between anthropized and wild strains. Conclusion. In addition to being a clinically relevant animal model of Amazonian Toxoplasmosis, this model could also provide a solid experimental basis for future studies aiming to investigate the underlying mechanisms of Amazonian Toxoplasmosis disease.
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- 2019
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10. Symptomatic Chikungunya Virus Infection and Pregnancy Outcomes: A Nested Case-Control Study in French Guiana.
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Basurko, Célia, Hcini, Najeh, Demar, Magalie, Abboud, Philippe, Nacher, Mathieu, Carles, Gabriel, Lambert, Véronique, and Matheus, Séverine
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PREGNANCY outcomes ,CHIKUNGUNYA virus ,VIRUS diseases ,PREGNANT women ,PREGNANCY complications ,FEVER - Abstract
During the Chikungunya epidemic in the Caribbean and Latin America, pregnant women were affected by the virus in French Guiana. The question of the impact of the virus on pregnancy was raised because of the lack of scientific consensus and published data in the region. Thus, during the Chikungunya outbreak in French Guiana, a comparative study was set up using a cohort of pregnant women. The objective was to compare pregnancy and neonatal outcomes between pregnant women with Chikungunya virus (CHIKV) infection and pregnant women without CHIKV. Of 653 mothers included in the cohort, 246 mothers were included in the case-control study: 73 had CHIKV fever during pregnancy and 173 had neither fever nor CHIKV during pregnancy. The study did not observe any severe clinical presentation of CHIKV in the participating women. There were no intensive care unit admissions. In addition, the study showed no significant difference between the two groups with regard to pregnancy complications. However, the results showed a potential excess risk of neonatal ICU admission of the newborn when the maternal infection occurred within 7 days before delivery. These results suggest that special attention should be paid to neonates whose mothers were infected with CHIKV shortly before delivery. [ABSTRACT FROM AUTHOR]
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- 2022
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11. Prescription of Physical Activity by General Practitioners in Type 2 Diabetes: Practice and Barriers in French Guiana.
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Dranebois, Stephanie, Lalanne-Mistrih, Marie Laure, Nacher, Mathieu, Thelusme, Liliane, Deungoue, Sandra, Demar, Magalie, Dueymes, Maryvonne, Drak Alsibai, Kinan, and Sabbah, Nadia
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TYPE 2 diabetes ,PHYSICAL activity ,GENERAL practitioners ,MEDICAL prescriptions ,PEOPLE with diabetes - Abstract
Background: General practitioners (GPs) are the major primary healthcare players in the management of type 2 diabetes. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in the management of diabetic patients. However, GPs emphasize several obstacles to its prescription. The aim of this study is to evaluate the practices, barriers, and factors favoring the prescription of PA in type 2 diabetic patients by GPs in French Guiana. Method: We conducted a cross-sectional descriptive study using a questionnaire, designed to interview 152 French Guiana GPs and describe their practice in prescribing PA in type 2 diabetic patients. Results: Our results revealed that the prescription of PA as a non-medicinal therapeutic choice in the management of type 2 diabetes was practiced by 74% of the French Guiana GPs. However, only 37% of GPs responded that they implemented the recommendations; indeed, only one-third knew about them. The majority of GPs were interested in PA training, but only 11% were actually trained in this practice. The lack of structure adapted to the practice of PA and the lack of awareness of the benefits of PA in metabolic pathology appeared as the main obstacles to PA prescription. Conclusion: This study highlights the importance of improving the training of GPs in the prescription of PA, the development of adapted PA structures, and collaboration between the different actors within the framework of the sport-health system in type 2 diabetes in French Guiana. [ABSTRACT FROM AUTHOR]
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- 2022
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12. High incidence of acute Q fever among incarcerated people in Cayenne, French Guiana.
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Bonifay, Timothée, Beillard, Emmanuel, Daniel, Marie, Schiemsky, Vanessa, Vierendeels, Evelyn, Demar, Magalie, Pastre, Agathe, Hamiche, Karim, Nacher, Mathieu, and Epelboin, Loic
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Q fever ,COXIELLA burnetii ,PUBLIC health ,ZOONOSES ,EPIDEMIOLOGY ,PRISONS - Abstract
Q fever is a major public health problem in French Guiana. In recent years, a considerable number of cases has been reported in French Guiana's penitentiary center. The main objective of this study was to describe the epidemiology of these cases. A retrospective study was conducted at the prison to identify cases of acute Q fever in people incarcerated between 2010 and 2021. During the study period, 16 patients were diagnosed with acute Q fever. The positivity rate varied between 13 and 57%. The annual incidence rate in 2019, 2020 and 2021 was 269 (95% CI: 0-640) 1,120 (95% CI: 290-1950) and 1,931 (95% CI: 60-3810) per 100,000 person-years, respectively. While several vertebrate species have already been shown to play an important role in the transmission of Coxiella burnetii, the full epidemiology picture in the tropics is far from clear, and the prison context, with its controlled environment, could help provide answers. [ABSTRACT FROM AUTHOR]
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- 2022
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13. Review of diagnostic methods and results for HIV‐associated disseminated histoplasmosis: Pathologists are not sufficiently involved.
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Nacher, Mathieu, Valdes, Audrey, Adenis, Antoine, Blaizot, Romain, Ugo, Françoise, Abboud, Philippe, Demar, Magalie, Djossou, Félix, Epelboin, Loïc, Misslin, Caroline, Blanchet, Denis, Couppié, Pierre, and Alsibai, Kinan Drak
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HISTOPLASMOSIS ,PATHOLOGISTS ,CEREBROSPINAL fluid ,ALIMENTARY canal ,BONE marrow - Abstract
Objectives: Disseminated histoplasmosis is a major killer of HIV‐infected persons in Latin America. Antigen detection, fungal culture and Polymerase Chain Reaction are often not available, but cytology and histology are present in most hospitals and may offer a diagnostic alternative. In this study, we review 34 years of clinical experience to describe the roles of cytology and histology in diagnosing disseminated histoplasmosis. Methods: Retrospective multicentric study of 349 patients between 1 January 1981 and 1 October 2014 with confirmed disseminated histoplasmosis. Results: Around 32/214 (14.9%) of samples were screened using cytopathology, as were 10/101 (9.9%) bronchoalveolar lavage samples and 5/61 (8.2%) of spinal fluid samples. The samples most commonly sent to pathology were liver biopsies, lower digestive tract and lymphnode biopsies; the greatest proportion of positive results were found in lower digestive tract (43/59 (72.9%) positives), lymph node (39/63 (66.1%)), and liver (38/75 (50.7%)) samples. Overall, 97.2% of bone marrow and 97% of bronchoalveolar lavage samples were directly examined by a mycologist. Positive direct examination was independently associated with death (aHR = 1.5 (95%CI = 1–2.2)). Conclusions: Opportunities for a rapid diagnosis were regularly missed, notably for bone marrow samples, which could have been examined using staining methods complementary to those of the mycologist. [ABSTRACT FROM AUTHOR]
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- 2021
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14. Outbreak of Oropouche Virus in French Guiana.
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Gaillet, Mélanie, Pichard, Clara, Restrepo, Johana, Lavergne, Anne, Perez, Lucas, Enfissi, Antoine, Abboud, Philippe, Lambert, Yann, Ma, Laurence, Monot, Marc, Demar, Magalie, Djossou, Felix, Servas, Véronique, Nacher, Mathieu, Andrieu, Audrey, Prudhomme, Julie, Michaud, Céline, Rousseau, Cyril, Jeanne, Isabelle, and Duchemin, Jean-Bernard
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VIRUSES ,RAIN forests ,FEVER ,ARBOVIRUSES ,BUNYAVIRUSES - Abstract
Oropouche fever is a zoonotic dengue-like syndrome caused by Oropouche virus. In August-September 2020, dengue-like syndrome developed in 41 patients in a remote rainforest village in French Guiana. By PCR or microneutralization, 23 (82.1%) of 28 tested patients were positive for Oropouche virus, documenting its emergence in French Guiana. [ABSTRACT FROM AUTHOR]
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- 2021
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15. Breakthrough Infections of SARS-CoV-2 Gamma Variant in Fully Vaccinated Gold Miners, French Guiana, 2021.
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Vignier, Nicolas, Bérot, Vincent, Bonnave, Nathalie, Peugny, Sandrine, Ballet, Mathilde, Jacoud, Estelle, Michaud, Céline, Gaillet, Mélanie, Djossou, Félix, Blanchet, Denis, Lavergne, Anne, Demar, Magalie, Nacher, Mathieu, Rousset, Dominique, and Epelboin, Loïc
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GOLD miners ,SARS-CoV-2 ,VACCINATION ,GOLD mining ,COVID-19 - Abstract
An outbreak of severe acute respiratory syndrome coronavirus 2 caused by the Gamma variant of concern infected 24/44 (55%) employees of a gold mine in French Guiana (87% symptomatic, no severe forms). The attack rate was 60% (15/25) among fully vaccinated miners and 75% (3/4) among unvaccinated miners without a history of infection. [ABSTRACT FROM AUTHOR]
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- 2021
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16. Hyperparasitaemia during bouts of malaria in French Guiana
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Carme Bernard and Demar Magalie
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Malaria ,Plasmodium falciparum ,Plasmodium vivax ,Hyperparasitaemia ,Severe malaria ,French Guiana ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background High circulating parasite load is one of the WHO criteria for severe falciparum malaria. During a period of 11 years (2000–2010), the frequency of hyperparasitaemia (HP) (≥4% infected erythrocytes) during bouts of malaria due to Plasmodium falciparum, Plasmodium vivax and Plasmodium malariae in patients referred to Cayenne General Hospital (CGH) in French Guiana and the frequency of their admission to the Intensive Care Unit (ICU) were evaluated. Methods A mean of 1,150 malaria cases were referred to the Parasitology Laboratory of CGH each year over the last decade. During this period, malaria diagnostic (microscopy) and parasitaemia evaluation have remained unchanged: determination of the parasitized erythrocytes percentage with asexual forms on thin blood smears for all cases of parasitaemia exceeding 0.1%. Patients admitted to the ICU can be counted by origin of the request for malaria testing. All the data collected retrospectively were anonymized in a standardized case report form and in database. Results Between 2000 and 2010, 12,254 bouts of malaria were confirmed at the Parasitology Laboratory of CHG: P. vivax: 56.2%, P. falciparum: 39.5%, co-infection with both species: 3.4%, P. malariae: 0.9%. HP was observed in 262 cases, at a frequency of 4.9% for P. falciparum and only 0.041% for P. vivax, with no recorded cases for P. malariae. The need for intensive care was correlated with P. falciparum parasite load: 12.3% of cases for parasitaemia of 4-9%, 21.2% for parasitaemia 10-19%, 50% for parasitaemia 20-29% and 77.8% for parasitaemia ≥30% (n=9). The patient with the highest parasitaemia (75% infected erythrocytes with asexual form) presented a major concomitant lupus flare-up treated with corticoids. He survived without obvious sequelae. Conclusions In French Guiana during bouts of malaria, HP was observed at a frequency of ~ 5% for P. falciparum and two orders of magnitude less frequent for P. vivax. HP is a severity criterion for falciparum malaria in this endemic area. However, two of the patients with HP ≥30% were not admitted to the ICU and sequel-free cure in malaria patients with 75% parasitaemia is, therefore, possible.
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- 2013
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17. Comparison of Mycobacterium ulcerans (Buruli ulcer) and Leptospira sp. (Leptospirosis) dynamics in urban and rural settings
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Combe, Marine, Gozlan, Rodolphe Elie, Jagadesh, Soushieta, Velvin, Camilla Jensen, Ruffine, Rolland, Demar, Magalie Pierre, Couppié, Pierre, Djossou, Félix, Nacher, Mathieu, Epelboin, Loïc, Institut des Sciences de l'Evolution de Montpellier (UMR ISEM), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UR226, Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université de Montpellier (UM)-Institut de recherche pour le développement [IRD] : UR226-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and ANR-17-CE35-0006,PRIME,PRédire la niche écologique de souches Infectieuses de pathogènes humains comme un facteur déterminant dans l'éMErgence des maladies infectieuses(2017)
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Rural Population ,Bacterial Diseases ,Urban Population ,RC955-962 ,Pathology and Laboratory Medicine ,Microbiology ,Urban Environments ,Spatio-Temporal Analysis ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Arctic medicine. Tropical medicine ,Zoonoses ,Environmental Microbiology ,Medicine and Health Sciences ,Humans ,Leptospirosis ,Microbial Pathogens ,Petrology ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,Leptospira ,Sedimentary Geology ,Mycobacterium ulcerans ,Bacteria ,Ecology and Environmental Sciences ,Organisms ,Biology and Life Sciences ,Geology ,Tropical Diseases ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Terrestrial Environments ,French Guiana ,Bacterial Pathogens ,Actinobacteria ,Infectious Diseases ,Medical Microbiology ,Earth Sciences ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Sediment ,Seasons ,Public aspects of medicine ,RA1-1270 ,Pathogens ,Research Article ,Neglected Tropical Diseases - Abstract
Background Zoonotic pathogens respond to changes in host range and/or pathogen, vector and host ecology. Environmental changes (biodiversity, habitat changes, variability in climate), even at a local level, lead to variability in environmental pathogen dynamics and can facilitate their transmission from natural reservoirs to new susceptible hosts. Whilst the environmental dynamics of aquatic bacteria are directly linked to seasonal changes of their habitat they also rely on the ecological processes underpining their transmission. However data allowing the comparison of these ecological processes are lacking. Here we compared the environmental dynamics of generalist and vector-borne aquatic bacterial pathogens in the same unit of time and space, and across rural and urban habitats in French Guiana (South America). Principal findings Using Leptospira sp. and Mycobacterium ulcerans we performed an environmental survey that allowed the detection of both pathogens in urban vs. rural areas, and during rainy vs. dry weather conditions. All samples were subjected to qPCR amplifications of LipL32 (Leptospira sp.) and IS2404 and KR (M. ulcerans) genetic markers. We found (i) a greater presence of M. ulcerans in rural areas compared with Leptospira sp., (ii) that modified urban environments were more favourable to the establishment of both pathogens, (iii) that Leptospira sp. presence was enhanced during the rainy season and M. ulcerans during the dry period, and (iv) differences in the spatial distribution of both bacteria across urban sites, probably due to the mode of dissemination of each pathogen in the environment. Conclusions We propose that in French Guiana simplified and modified urban ecosystems might favour leptospirosis and Buruli ulcer emergence and transmission. Moreover, disease risk was also constrained by seasonality. We suggest that the prevention of aquatic bacterial disease emergence in impoverished urban areas of developing countries would benefit from seasonal diseases targeted surveys, which would maximise limited budgets from cash-strapped health agencies., Author summary Many emerging pathogens are zoonotic and transmit from their abiotic reservoir to wild animals, domesticated animals and humans. It is now well known that environmental changes lead to variability in their dynamics in the environment and contribute to changes in the infectious risk. Many aquatic bacteria are responsable for major public health concerns, and more importantly in developing countries where access to drinking-water and sanitation is often limited. Whilst their environmental dynamics are directly linked to seasonal changes of their habitat, they also rely on the ecological processes underpining their transmission, i.e. directly transmitted vs. vector-borne. However, few studies have compared such environmental dynamics despite the fact that it would help to better characterise the infectious risk in the environment, as well as to better monitor the emergence of infectious diseases. Our aim was to provide data on the prevalence of generalist vs. vector-borne aquatic bacterial pathogens in the environment that would further allow the comparison of their environmental dynamics in the same unit of time and space, and across rural and urban habitats. We showed that urbanization and seasonality are two important factors underlying Buruli ulcer and leptospirosis disease emergence in French Guiana (South America), and propose that the mode of transmission of such environmental pathogens might have a detrimental role in disseminating the infectious agent in the environment.
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- 2018
18. Primaquine 30 mg/day versus 15 mg/day during 14 days for the prevention of Plasmodium vivax relapses in adults in French Guiana: a historical comparison
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Epelboin, Loïc, Caumes, Eric, Guermonprez, Geraldine, Leturcq, France, Clarke, Peter, Nacher, Mathieu, Adenis, Antoine, Huber, Florence, Hallet, Edouard, Abboud, Philippe, Mosnier, Emilie, Bideau, Bastien, Marty, Christian, Lucarelli, Aude, Morel, Vanessa, Lacapère, François, Couppié, Pierre, Paraskevis, Dimitrios, Valdes, Audrey, Walter, Gaelle, Vesin, Guillaume, Melzani, Alessia, Blanchet, Denis, Blaise, Nicaise, Demar, Magalie Pierre, Djossou, Félix, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Fondation Maison des Champs, Biochimie et Génétique Moléculaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Croix-rouge française [Cayenne, Guyane Fraçaise], Service de Dermatologie, Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Service de Pharmacie [Cayenne, Guyane Française], Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne, Guyane] (COREVIH), and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424
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Adult ,Male ,medicine.medical_specialty ,lcsh:Arctic medicine. Tropical medicine ,Primaquine ,lcsh:RC955-962 ,030231 tropical medicine ,Plasmodium vivax ,Context (language use) ,World health ,lcsh:Infectious and parasitic diseases ,Antimalarials ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,parasitic diseases ,Epidemiology ,Malaria, Vivax ,Secondary Prevention ,Humans ,Medicine ,lcsh:RC109-216 ,030212 general & internal medicine ,Relapse ,ComputingMilieux_MISCELLANEOUS ,Survival analysis ,Dose-Response Relationship, Drug ,biology ,business.industry ,Research ,Middle Aged ,biology.organism_classification ,medicine.disease ,Malaria ,French Guiana ,3. Good health ,Infectious Diseases ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Tropical medicine ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Parasitology ,business ,medicine.drug - Abstract
International audience; BACKGROUND:The preventive treatment of Plasmodium vivax relapse recommended by the World Health Organization is primaquine at a dose of 15 mg/day for 14 days, except for malaria cases from Asia and Oceania. Since 2006, CDC recommends the use of primaquine at 30 mg/day for 14 days. In France, all cases of malaria due to P. vivax are treated with 30 mg of primaquine. This systematically increased dosage needs to be evaluated according to epidemiological context. The aim of the study was to compare relapses after 14 days of primaquine at 15 or 30 mg/day.METHODS:All patients treated with primaquine after a vivax malaria episode in French Guiana, between 1 January, 2007 and 1 August, 2016, were studied. Based on the compulsory hospital pharmacy forms for primaquine delivery, adult patients who received 15 or 30 mg of primaquine during 14 days for hypnozoite eradication were included. The recommended dose was initially 15 mg and was changed to 30 mg in 2011. Vivax malaria recurrences within 2 months after primaquine treatment, and vivax malaria recurrences 2-6 months after primaquine in each treatment group were analysed using survival analysis at 2, 3 and 6 months.RESULTS:Out of 544 patients included, 283 received 15 mg/day and 261 received 30 mg/day of primaquine. At 2 and 3 months after primaquine treatment, the number of recurrences was 7 (2.5%) and 19 (7.3%), and 9 (3.4%) and 15 (5.3%), in the 15 and 30 mg groups (p = 0.51 respectively 0.35), respectively. Within 3 months, the median time to recurrence was 2.05 months in the 15 and 30 mg groups. At 6 months after primaquine treatment, the number of recurrences was 25 (8.8%) and 31 (11.9%) at 15 and 30 mg, respectively (p = 0.24). The median time to recurrence was 2.38 months at 15 mg/day and of 2.64 months at 30 mg/day.CONCLUSIONS:There were no significant differences between primaquine at 15 or 30 mg/day for 14 days in the prevention of P. vivax relapses at 2, 3 and 6 months after primaquine treatment in French Guiana
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- 2018
19. HIV-Associated Disseminated Histoplasmosis and Rare Adrenal Involvement: Evidence of Absence or Absence of Evidence.
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Nacher, Mathieu, Alsibai, Kinan Drak, Valdes, Audrey, Abboud, Philippe, Adenis, Antoine, Blaizot, Romain, Blanchet, Denis, Demar, Magalie, Djossou, Félix, Epelboin, Loïc, Misslin, Caroline, Ntab, Balthazar, Sabbah, Nadia, and Couppié, Pierre
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HISTOPLASMOSIS ,COMPUTED tomography ,OPPORTUNISTIC infections ,ADRENAL glands ,HIV-positive persons ,AIDS-related opportunistic infections - Abstract
Adrenal histoplasmosis and primary adrenal insufficiency are mostly described in immunocompetent patients. This particular tropism is attributed to the presence of cortisol within the adrenal gland, a privileged niche for Histoplasma growth. In French Guiana, disseminated histoplasmosis is the main opportunistic infection in HIV patients. Our objective was to search in our HIV-histoplasmosis cohorts to determine how frequent adrenal insufficiency was among these patients. Between January 1, 1981 and October 1, 2014, a multicentric retrospective, observational study of histoplasmosis was conducted. Patients co-infected by HIV and histoplasmosis were enrolled in French Guiana's histoplasmosis and HIV database. Among 349 cases of disseminated histoplasmosis between 1981 and 2014, only 3 had adrenal insufficiency (0.85%). Their respective CD4 counts were 10, 14 and 43 per mm3. All patients had regular electrolyte measurements and 234/349 (67%) had abdominal ultrasonography and 98/349 (28%) had abdominopelvic CT scans. None of these explorations reported adrenal enlargement. Overall, these numbers are far from the 10% reports among living patients and 80-90% among histoplasmosis autopsy series. This suggests 2 conflicting hypotheses: First, apart from acute adrenal failure with high potassium and low sodium, less advanced functional deficiencies, which require specific explorations, may have remained undiagnosed. The second hypothesis is that immunosuppression leads to different tissular responses that are less likely to incapacitate the adrenal function. Furthermore, given the general immunosuppression, the adrenal glands no longer represent a particular niche for Histoplasma proliferation. [ABSTRACT FROM AUTHOR]
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- 2021
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20. Reduced Severity in Patients With HIV-Associated Disseminated Histoplasmosis With Deep Lymphadenopathies: A Trench War Remains Within the Lymph Nodes?
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Nacher, Mathieu, Alsibai, Kinan Drak, Adenis, Antoine, Blaizot, Romain, Abboud, Philippe, Demar, Magalie, Djossou, Félix, Epelboin, Loïc, Misslin, Caroline, Ntab, Balthazar, Valdes, Audrey, and Couppié, Pierre
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LYMPH nodes ,HISTOPLASMOSIS ,TRENCHES ,EARLY death ,CD4 lymphocyte count ,SYMPTOMS ,HELICOBACTER pylori ,PNEUMOCYSTIS jiroveci - Abstract
Background: Disseminated histoplasmosis is a major killer of patients with advanced HIV. It is proteiform and often hard to diagnose in the absence of diagnostic tests. We aimed to describe disseminated histoplasmosis with lymphadenopathies in French Guiana and to compare survival and severity of those patients to patients without lymphadenopathies. Methods: A retrospective cohort study was performed on data records collected between January 1, 1981 and October 1, 2014. Results: Among 349 cases of disseminated histoplasmosis 168 (48.3%) had superficial lymphadenopathies and 133(38.1%) had deep lymphadenopathies. The median LDH concentration, ferritin concentration, TGO concentration, and WHO performance status were lower among patients with deep lymphadenopathies than those without deep lymphadenopathies. There was a significant decrease in the risk of early death (<1 month) among those with deep lymphadenopathies relative to those without (OR=0.26 (95%CI=0.10–0.60), P=0.0006) and in the overall risk of death (OR=0.33 (95%CI=0.20-0.55), P<0.0001). These associations remained strongly significant after adjusting for time period, CD4 counts, age, delay between beginning of symptoms and hospital admission, antifungal and antiretroviral treatment. Conclusions: The present data show that in patients with advanced HIV and disseminated histoplasmosis, the presence of deep lymphadenopathies is associated with fewer markers of severity and a lower risk of death. To our knowledge it is the first study to show this. The presence of deep lymphadenopathies is hypothesized to reflect the patient's partially effective defense against H. capsulatum. [ABSTRACT FROM AUTHOR]
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- 2021
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21. Risk Factors for Mortality among HIV-Infected Patients with Disseminated Histoplasmosis.
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Nacher, Mathieu, Alsibai, Kinan Drak, Valdes, Audrey, Blaizot, Romain, Abboud, Philippe, Demar, Magalie, Djossou, Félix, Epelboin, Loïc, Misslin, Caroline, Ntab, Balthazar, Adenis, Antoine, and Couppié, Pierre
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HISTOPLASMOSIS ,SURVIVAL analysis (Biometry) ,SERUM ,CD4 antigen ,BIVARIATE analysis - Abstract
Identifying prognostic factors is important in order to guide the choice of first-line therapy for disseminated histoplasmosis. Our objective was to identify factors associated with death among a cohort of 330 patients compiled over 34 years of clinical practice in French Guiana. Survival analysis was performed with death as the failure event and date of symptom onset as the origin event. Incidence rates were and Cox proportional hazards models were computed. Overall, 330 HIV-infected patients with disseminated histoplasmosis were included in the analysis, with 126 deaths occurring. One-quarter of all patients died within 6 months of the first symptoms. Patients with dyspnea, renal failure, arterial blood pressure <90 mmHG, and a WHO performance score >2 had a greater incidence of death. Bivariate analyses showed that patients with increased LDH, low hemoglobin, low serum protein, low CD4 counts, and low platelets tended to have a greater incidence of death. After adjusting for potential confounders, patients with dyspnea, a WHO performance score >2, serum protein <60 g/L, and hemoglobin <8.9 g/dL had an increased risk of dying. The interaction terms showed that patients treated with liposomal amphotericin B had a marked reduction in death among patients with renal failure; among renal failure patients, the elevation of LDH was associated with a significant risk of death. [ABSTRACT FROM AUTHOR]
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- 2020
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22. Human leptospirosis in French Guiana: current knowledge and perspectives
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Epelboin, Loïc, Le Turnier, Paul, Picardeau, Mathieu, Schaub, Roxane, Petit-Sinturel, Marion, Villemant, Nicolas, Trombert-Paolantoni, Sabine, Berlioz-Arthaud, Alain, Bisser, Sylvie, Mosnier, Emilie, Ardillon, Vanessa, Jolivet, Anne, Demar, Magalie, Nacher, Mathieu, Bourhy, Pascale, Djossou , Felix, Université de Guyane (UG), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence de la Leptospirose - National Reference Center Leptospirosis (CNR), Institut Pasteur [Paris] (IP), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cellule Inter Régionale d'Epidémiologie des Antilles - Guyane, Institut de Veille Sanitaire (INVS), Université Paris 1 Panthéon-Sorbonne - UFR Géographie (UP1 UFR08), Université Paris 1 Panthéon-Sorbonne (UP1), Laboratoire CERBA [Saint Ouen l'Aumône], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Département des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de l'Ouest Guyanais, Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Institut Pasteur [Paris], and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
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Leptospira ,Epidemiology ,[SDV]Life Sciences [q-bio] ,Neglected tropical disease ,Leptospirose ,Maladie tropicale négligée ,French Guiana ,Épidémiologie ,Zoonosis ,Guyane française // Keywords: Leptospirosis ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Guyane française ,Zoonose ,Leptospirosis ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie - Abstract
Leptospirosis is a cosmopolitan zoonosis caused by the bacteria of the genus Leptospira. The warm and wet climate of the intertropical zone is particularly favorable with its expansion. In French Guiana, a French territory located at the North-East of the South American continent in Amazonian area, it seems to be rare. The objective of this article is to make the inventory of current knowledge on the epidemiology of human leptospirosis in French Guiana, and to discuss the prospects concerning this disease and improve its surveillance. Publications on leptospirosis in French Guiana are rare and old, and date from 1940 to 1995. The annual reports of the National Reference Centre of Leptospirosis (NRC, Pasteur Institute) show a quite stable annual number of cases, varying from 6 to 18 between 1996 and 2012, depending on the year, with a significant increase from 2013 to 2015, respectively 36, 92 and 67 cases a year. A retrospective study conducted recently on the cases which occurred between 2007 and 2014 with very strict inclusion criteria, identified 72 cases on the territory, among whom 12 (16.7%) severe cases and 3 (4.2%) deaths. The disease affects mainly men (86.1%) aged between 20 and 49 years (63.9%). It is probable that leptospirosis is a neglected disease in the region, due to the absence of quickly available diagnostic tools, the lack of awareness of clinicians on this pathology, and the existence of many other infectious agents with similar clinical presentations during acute episodes (such as malarias, arboviruses, Q fever and Amazonian toxoplasmosis). The implementation of larger studies is necessary to know the true burden of this disease in French Guiana., La leptospirose est une zoonose cosmopolite causée par les bactéries du genre Leptospira. Le climat chaud et humide de la zone intertropicale est particulièrement propice à son expansion. En Guyane, département français situé au nord-est du continent sud-américain, en région amazonienne, elle semble rare. L’objectif de cet article est de récapituler l’état des connaissances actuelles sur l’épidémiologie de leptospirose humaine en Guyane et de discuter les perspectives pour en améliorer la surveillance.Les publications sur la leptospirose en Guyane sont rares et anciennes, datant des années 1940-1995. Les rapports annuels du Centre national de référence de la leptospirose (CNR, Institut Pasteur de Paris) montrent un nombre annuel de cas assez stable entre 1996 et 2012, variant de 6 à 18 selon les années, avec une augmentation importante de 2013 à 2015 : respectivement 36, 92 et 67 cas par an. Une étude rétrospective menée récemment sur les cas survenus entre 2007 et 2014, identifiés avec des critères diagnostiques très stricts, a comptabilisé 72 cas sur le département, parmi lesquels 12 (16,7%) cas graves et 3 (4,2%) décès. La maladie touchait principalement des hommes (86,1%) âgés de 20 à 49 ans (63,9%).Il est probable que la leptospirose soit une maladie négligée dans la région, du fait de l’absence d’outils diagnostiques rapidement disponibles, de la méconnaissance des cliniciens de cette pathologie et de la présence de nombreuses autres pathologies à symptômes cliniques similaires en phase aiguë (paludismes, arboviroses, fièvre Q, toxoplasmose amazonienne). La mise en place d’études de plus grande ampleur est nécessaire pour connaître le véritable impact de cette maladie en Guyane.
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- 2017
23. Cytological and Histopathological Spectrum of Histoplasmosis: 15 Years of Experience in French Guiana.
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Drak Alsibai, Kinan, Couppié, Pierre, Blanchet, Denis, Adenis, Antoine, Epelboin, Loïc, Blaizot, Romain, Louvel, Dominique, Djossou, Félix, Demar, Magalie, and Nacher, Mathieu
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HISTOPLASMOSIS ,SMALL intestine ,ALIMENTARY canal ,COLON (Anatomy) ,BONE marrow - Abstract
Background: Disseminated histoplasmosis remains a major killer of immunocompromised patients in Latin America. Cytological and histological methods are usually present in most hospitals and may represent a precious diagnostic method. We report 15 years of experience of the department of pathology of the Centre Hospitalier de Cayenne Andrée Rosemon in French Guiana. Methods: Specimens from live patients from January 2005 to June 2020 with the presence of H. capsulatum on cytological and/or histological analysis were analyzed. All specimens were examined by an experienced pathologist. The analysis was descriptive. Results: Two hundred two cytological and histological samples were diagnosed with histoplasmosis between January 2005 and June 2020. The 202 samples included 153 (75.7%) histopathological formalin-fixed and paraffin-embedded tissues (biopsy or surgical specimens) and 49 (24.3%) cytological analysis from all organs. One hundred thirty-four patients (82.7%) were HIV-positive, 15 patients (9.3%) had immunosuppressant treatment, and 13 patients (8%) were immunocompetent. Seventy-eight of 202 (38.5%) were samples from the digestive tract, mostly the colon (53/78 cases, 70%) and small intestine (14/78 cases, 18%). Microorganisms were more numerous in digestive samples (notably the colon) than in other organs. Lymphocyte and histiocyte inflammation of moderate to marked intensity were observed in all positive specimens. Tuberculoid epithelioid granuloma were present in 16/78 (20,5%) specimens including 14 colon and 2 small intestine specimens. There were 11/202 cases of liver histoplasmosis, 26/202 (12,8%) cases of pulmonary histoplasmosis. Bone marrow involvement was diagnosed in 14 (2%) specimens (8 aspiration and 6 biopsies). Lymph nodes were positive in 42 specimens (31 histology and 11 cytology). Histopathological analysis of the 31 lymph nodes showed a variable histological appearance. Tuberculoid forms were most frequent (24/31, 77,4%). Conclusions: From the pathologist perspective, this is the largest series to date showing that digestive involvement was the most frequent, usually with a tuberculoid form and a greater load of Histoplasma. With awareness and expertise, cytology and pathology are widely available methods that can give life-saving results in a short time to help orient clinicians facing a potentially fatal infection requiring prompt treatment. [ABSTRACT FROM AUTHOR]
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- 2020
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24. Hemophagocytic Lymphohistiocytosis During HIV Infection in Cayenne Hospital 2012–2015: First Think Histoplasmosis.
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Nguyen, Duc, Nacher, Mathieu, Epelboin, Loic, Melzani, Alessia, Demar, Magalie, Blanchet, Denis, Blaizot, Romain, Drak Alsibai, Kinan, Abboud, Philippe, Djossou, Félix, Couppié, Pierre, and Adenis, Antoine
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HISTOPLASMOSIS ,HIV infections ,NOSOCOMIAL infections ,AMPHOTERICIN B ,ETIOLOGY of diseases ,VIRAL load - Abstract
Introduction: Haemophagocytic Lymphohistiocytosis (HLH), during HIV infection is a rare complication with a poor prognosis. There are few data on HLH within the Amazon region. The objective was to describe epidemiological, clinical and therapeutic features of HIV-related HLH in French Guiana. Methods: A retrospective analysis of adult HIV patients at Cayenne hospital with HLH between 2012 and 2015. A diagnosis of HLH was given if the patient presented at least 3 of 8 criteria of the HLH-2004 classification. Results: Fourteen cases of HLH were tallied during the study period. The mean age was 46 years with a sex ratio of 1.8. The most frequent etiology of HLH was an associated infection (12/14). Confirmed disseminated histoplasmosis, was found in 10 of 14 cases, and it was suspected in 2 other cases. The CD4 count was below 200/mm
3 in 13/14 cases. An HIV viral load >100,000 copies/ml was observed in 13/14 cases. An early treatment with liposomal amphotericin B was initiated in 12/14 cases. The outcome was favorable in 12/14 of all cases and in 10/12 cases involving histoplasmosis. Case fatality was 2/14 among all cases (14.3%) et 1/10 among confirmed disseminated histoplasmosis with HLH (10%). During the study period 1 in 5 cases of known HIV-associated disseminated histoplasmosis in French Guiana was HLH. Conclusion: Histoplasmosis was the most frequent etiology associated with HLH in HIV-infected patients in French Guiana. The prognosis of HLH remains severe. However, a probabilistic empirical first line treatment with liposomal amphotericin B seemed to have a favorable impact on patient survival. [ABSTRACT FROM AUTHOR]- Published
- 2020
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25. Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana.
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Nacher, Mathieu, Valdes, Audrey, Adenis, Antoine, Blaizot, Romain, Abboud, Philippe, Demar, Magalie, Djossou, Félix, Epelboin, Loïc, Alsibai, Kinan Drak, Misslin, Caroline, Ntab, Balthazar, and Couppié, Pierre
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HISTOPLASMOSIS ,MULTIPLE correspondence analysis (Statistics) ,EIGENVALUES - Abstract
We aimed to describe the ways patients with disseminated histoplasmosis—a multifaceted and often lethal disease—present themselves and are explored. A retrospective, observational, multicentric study spanned the period between 1 January 1981 and 1 October 2014. Principal component analysis was performed for the sampling sites and for the clinical signs and symptoms. The factor loadings of the principal components were selected for eigenvalues > 1. The most frequent signs and symptoms were an alteration of the WHO general performance status, fever, digestive tract, respiratory signs and symptoms and lymphadenopathies. The most common sites sampled were bone marrow, respiratory tract, blood, lymph node and liver biopsies, with significant variations in the number of sites from which samples were taken to try to identify the pathogen. The principal component analysis clinical signs and symptoms leading to the diagnosis showed four main lines of variation. The factor loadings of the four main components were compatible with four broad types of clinical presentations and four types of exploration strategies. Extracting simple algorithms was difficult, emphasizing the importance of clinical expertise when diagnosis depends on obtaining a sample where Histoplasma can be seen or grown. Histoplasma antigen detection tests will help simplifying the algorithms. [ABSTRACT FROM AUTHOR]
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- 2020
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26. Disseminated Histoplasmosis in HIV-Infected Patients: A Description of 34 Years of Clinical and Therapeutic Practice.
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Nacher, Mathieu, Valdes, Audrey, Adenis, Antoine, Blaizot, Romain, Abboud, Philippe, Demar, Magalie, Djossou, Félix, Epelboin, Loïc, Misslin, Caroline, Ntab, Balthazar, Alsibai, Kinan Drak, and Couppié, Pierre
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HISTOPLASMOSIS ,HIV-positive persons ,THERAPEUTICS ,AMPHOTERICIN B ,DEOXYCHOLIC acid - Abstract
Disseminated histoplasmosis is the main AIDS-defining infection of French Guiana. We aim to describe our therapeutic experience for 349 patients with disseminated histoplasmosis between 1 January 1981 and 10 January 2014 in French Guiana. Survival, delays for treatment initiation, duration of induction therapy, and associated initial treatments are described. The death rate was 14.9 per 100 person-years, with an early drop in survival. Among those who died, >1/3 died within a year of HIV diagnosis, and ¾ of all patients with histoplasmosis had been diagnosed for HIV within a year. As induction treatment, 29% received liposomal amphotericin B, 12.9% received deoxycholate amphotericin B, 54% received itraconazole alone, and 21.8% received liposomal amphotericin B and itraconazole. The median delay between symptoms-onset and hospitalization was 19.5 days (IQR = 5–105). Liposomal amphotericin B or itraconazole was initiated shortly after admission. Treatment initiation was often presumptive for liposomal amphotericin B (27%) and itraconazole (20%). The median duration of liposomal amphotericin B treatment was 7 days (IQR = 5–11 days). The present study shows that ¾ of the patients were profoundly immunocompromised and had been diagnosed for HIV within the past year. Antifungal treatment was often initiated presumptively on admission. Over time there was a significant gradual decline in early death. [ABSTRACT FROM AUTHOR]
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- 2020
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27. Comparison of Disseminated Histoplasmosis with and without Cutaneo-Mucous Lesions in Persons Living with HIV in French Guiana.
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Morote, Sophie, Nacher, Mathieu, Blaizot, Romain, Ntab, Balthazar, Blanchet, Denis, Alsibai, Kinan Drak, Demar, Magalie, Djossou, Félix, Couppié, Pierre, and Adenis, Antoine
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HISTOPLASMOSIS ,IMMUNODEFICIENCY ,HIV-positive persons ,IMMUNOSUPPRESSION - Abstract
Introduction: Histoplasmosis is the main opportunistic infection and cause of death in HIV-infected persons living with HIV in French Guiana and probably in most of Latin America. The objective of the present study was to compare cutaneomucous histoplasmosis to non-cutaneomucous histoplasmosis in French Guiana. Methods: Between 1981 and 2014 AIDS-related disseminated histoplasmosis patients followed in the three hospitals of French Guiana were retrospectively studied. Only proven incident cases of histoplasmosis, either by pathology and/or mycological analysis, were considered. Mucocutaneous histoplasmosis was ascertained by a positive mucosal or cutaneous biopsy. Results: Thirty-one patients had mucocutaneous lesions, and 318 had no mucocutaneous lesions. Patients with cutaneomucous lesions were more likely to have had prior opportunistic infections (35.5%) than those who did not have cutaneomucous lesions (19.5%). They were more likely to be very severely immunocompromised (CD4 count < 50) (90.3% versus 62.8%) and less likely to have digestive signs (32.3% versus 74.1%) and superficial adenopathies (29% versus 50.2%) than those without cutaneomucous lesions. In terms of simple biological examinations, patients with cutaneomucous lesions had fewer signs of cholestasis. The diagnosis was significantly more likely to be performed by direct examination and pathology in those with cutaneomucous lesions than in those without such lesions. On the contrary, patients with cutaneomucous lesions were less likely to be diagnosed by fungal culture than those without cutaneomucous lesions. There was a greater but non-significant risk of early death in those with cutaneomucous lesions relative to those without (OR = 2.28 (95%CI = 0.83–5.7), p = 0.056. Conclusions: Mucocutaneous forms were associated with more profound immunosuppression and perhaps risk of early death. They are easily accessible for diagnosis. [ABSTRACT FROM AUTHOR]
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- 2020
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28. Incidence and Trends in Immune Reconstitution Inflammatory Syndrome Associated With Histoplasma capsulatum Among People Living With Human Immunodeficiency Virus: A 20-Year Case Series and Literature Review.
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Melzani, Alessia, Michel, Regis de Reynal de Saint, Ntab, Balthazar, Djossou, Felix, Epelboin, Loic, Nacher, Mathieu, Blanchet, Denis, Demar, Magalie, Couppie, Pierre, and Adenis, Antoine
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DIAGNOSIS of fever ,HISTOPLASMOSIS diagnosis ,AIDS ,CONFIDENCE intervals ,DISEASES ,FUNGI ,HIV-positive persons ,INFORMED consent (Medical law) ,MEDICAL cooperation ,QUESTIONNAIRES ,RESEARCH ,ANTIRETROVIRAL agents ,DISEASE incidence ,RETROSPECTIVE studies ,CASE-control method ,IMMUNE reconstitution inflammatory syndrome ,DESCRIPTIVE statistics - Abstract
Background Histoplasmosis is among the main acquired immunodeficiency syndrome (AIDS)–defining conditions in endemic areas. Although histoplasmosis has a worldwide distribution, histoplasmosis-associated immune reconstitution inflammatory syndrome (IRIS) in people living with human immunodeficiency virus (PLHIV) is rarely reported. This study aimed to describe the incidence and features of histoplasmosis-associated IRIS in a cohort of PLHIV. Methods A retrospective multicenter study was conducted in French Guiana from 1 January 1997 to 30 September 2017. The target population was represented by PLHIV who presented an episode of histoplasmosis within 6 months after antiretroviral therapy initiation. We used a consensual IRIS case definition, submitted to the agreement of 2 experts. Each case was described using a standardized questionnaire, and all patients gave informed consent. Results Twenty-two cases of histoplasmosis-associated IRIS were included (14 infectious/unmasking and 8 paradoxical), with an overall incidence rate of 0.74 cases per 1000 HIV-infected person-years (95% confidence interval, 0.43–1.05). Mean age was 40.5 years. The ratio of males to females was 1:4. Median time to IRIS was 11 days (interquartile range 7–40 days) after antiretroviral therapy initiation. The main clinical presentation was fever, without any specific pattern, and disseminated disease. We reported 2 severe cases and partial or complete recovery at 1 month was the rule. Twenty-two cases were identified in the literature with similar characteristics. Conclusions Histoplasmosis-associated IRIS incidence was low but generated significant morbidity in PLHIV. In endemic areas, screening for latent or subclinical histoplasmosis should be implemented before antiretroviral therapy initiation. [ABSTRACT FROM AUTHOR]
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- 2020
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29. Pneumocystis jirovecii Diversity in Réunion, an Overseas French Island in Indian Ocean.
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Le Gal, Solène, Hoarau, Gautier, Bertolotti, Antoine, Negri, Steven, Le Nan, Nathan, Bouchara, Jean-Philippe, Papon, Nicolas, Blanchet, Denis, Demar, Magalie, and Nevez, Gilles
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CYTOCHROME b ,IMMUNOCOMPROMISED patients ,SUPEROXIDE dismutase ,NON-self-governing territories ,OCEAN - Abstract
Data on Pneumocystis jirovecii characteristics from the overseas French territories are still scarce whereas numerous data on P. jirovecii genotypes are available for metropolitan France. The main objective of the present study was to identify P. jirovecii multilocus genotypes in patients living in Réunion and to compare them with those identified using the same method in metropolitan France and in French Guiana. Archival P. jirovecii specimens from immunosuppressed patients, 16 living in Réunion (a French island of the Indian ocean), six living in French Guiana (a South-American French territory), and 24 living in Brest (Brittany, metropolitan France) were examined at the large subunit rRNA (mtLSUrRNA) genes, cytochrome b (CYB), and superoxide dismutase (SOD) genes using PCR assays and direct sequencing. A total of 23 multi-locus genotypes (MLG) were identified combining mtLSUrRNA, CYB , and SOD alleles, i.e., six in Reunionese patients, three in Guianese patients, and 15 in Brest patients. Only one MLG (mtLSU1- CYB 1- SOD 2) was shared by Reunionese and Guianese patients (one patient from each region) whereas none of the 22 remaining MLG were shared by the 3 patient groups. A total of eight MLG were newly identified, three in Réunion and five in Brest. These results that were obtained through a retrospective investigation of a relatively low number of P. jirovecii specimens, provides original and first data on genetic diversity of P. jirovecii in Réunion island. The results suggest that P. jirovecii organisms from Réunion present specific characteristics compared to other P. jirovecii organisms from metropolitan France and French Guiana. [ABSTRACT FROM AUTHOR]
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- 2020
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30. The Broad Clinical Spectrum of Disseminated Histoplasmosis in HIV-Infected Patients: A 30 Years' Experience in French Guiana.
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Couppié, Pierre, Herceg, Katarina, Bourne-Watrin, Morgane, Thomas, Vincent, Blanchet, Denis, Alsibai, Kinan Drak, Louvel, Dominique, Djossou, Felix, Demar, Magalie, Blaizot, Romain, and Adenis, Antoine
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HISTOPLASMOSIS ,HIV-positive persons ,HISTOPLASMA capsulatum ,MEDICAL mycology ,ANTIFUNGAL agents - Abstract
Histoplasmosis is a common but neglected AIDS-defining condition in endemic areas for Histoplasma capsulatum. At the advanced stage of HIV infection, the broad spectrum of clinical features may mimic other frequent opportunistic infections such as tuberculosis and makes it difficult for clinicians to diagnose histoplasmosis in a timely manner. Diagnosis of histoplasmosis is difficult and relies on a high index of clinical suspicion along with access to medical mycology facilities with the capacity to implement conventional diagnostic methods (direct examination and culture) in a biosafety level 3 laboratory as well as indirect diagnostic methods (molecular biology, antibody, and antigen detection tools in tissue and body fluids). Time to initiation of effective antifungals has an impact on the patient's prognosis. The initiation of empirical antifungal treatment should be considered in endemic areas for Histoplasma capsulatum and HIV. Here, we report on 30 years of experience in managing HIV-associated histoplasmosis based on a synthesis of clinical findings in French Guiana with considerations regarding the difficulties in determining its differential diagnosis with other opportunistic infections. [ABSTRACT FROM AUTHOR]
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- 2019
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31. Human leptospirosis in French Guiana: first multicentric transversal study (2007-2014)
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Le Turnier, P., Epelboin, Loïc, Mosnier, Emilie, Schaub, Roxane, Jolivet, A, Berlioz-Arthaud, Alain, Bourhy, Pascale, Picardeau, Mathieu, Demar, Magalie Pierre, Djossou, M, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Université de Guyane (UG), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose, Institut Pasteur [Paris] (IP), Centre National de Référence de la Leptospirose - National Reference Center Leptospirosis (CNR), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), and Institut Pasteur [Paris]
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french guiana ,[SDV]Life Sciences [q-bio] ,leptospirosis ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience
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- 2016
32. Dengue infection in sickle cell patients in French Guiana
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Mosnier, Emilie, Demar, Magalie Pierre, Bernit, Emmanuelle, Rousset, Dominique, Epelboin, Loïc, Nacher, Mathieu, Abboud, Philippe, Vantilke, Vincent, Djossou, Félix, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Département des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), Département de Médecine Interne (DMI - MARSEILLE), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, and CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG)
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[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,hemic and lymphatic diseases ,MESH: Dengue infection ,Sickle cell disease ,French Guiana ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie - Abstract
International audience; Reports on dengue morbidity in patients with sickle cell disease (SCD) are scarce. Dengue is arthropod-borne viroses due to dengue virus (DENV) and affects populations with a high prevalence of SCD; therefore, the risk of morbidity may be increased.To determine the impact of dengue infection in SCD patients, we reviewed medical records during a vast outbreak of dengue virus serotype-2 (DENV-2) in French Guiana in 2012-2013. We identified 10 cases of laboratory-confirmed dengue infection;these were classified into A, B and C categories based on levels of severity of dengue according to World Health Organisation (WHO). The average age of SCD patients was 18.2 years. 1, 6 and 3 cases were classified as A, B and C WHO severity criteria, respectively. All patients had an important decrease in haematocrit (while one of the WHO severity criteria is the increase of haematocrit). Only one patient had decreased platelet count. Seven cases had vaso-occlusive crisis (VOC), six patients developed acute hepatitis and eight had a simultaneous bacterial infection. Six of them needed a blood transfusion. The results suggested that the WHO severity laboratory criteria of hemoconcentration and platelet counts were not helpful in themanagement of SCD patients. The morbidity was mainly caused by specific complications of SCD, especially VOC, likely facilitated by vascular endothelial damages consecutive to dengue fever, severe haemolysis, hepatitis and bacterial co-infections.
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- 2015
33. HIV-Associated Histoplasmosis Early Mortality and Incidence Trends: From Neglect to Priority
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Adenis, Antoine, Nacher, Mathieu, Hanf, Matthieu, Vantilcke, Vincent, Boukhari, Rachida, Blanchet, Denis, Demar, Magalie Pierre, Aznar, Christine, Carme, Bernard, Couppié, Pierre, ADENIS, ANTOINE, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Epidémiologie des parasitoses et mycoses tropicales, Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Médecine Interne, Centre Hospitalier de l'Ouest Guyanais, Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Service de Dermatologie et Vénérologie
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AIDS ,Death ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,HIV ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Histoplasmosis ,Histoplasma capsulatum ,French Guiana - Abstract
International audience; BACKGROUND: Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved in this French overseas territory which offers an interesting model of Amazonian pathogen ecology. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. METHODS: A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated Histoplasma capsulatum var. capsulatum histoplasmosis admitted in one of the three main hospitals in French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. RESULTS: There were 124 deaths (45.3%) and 46 early deaths (16.8%) among 274 patients. Three time periods of particular interest were identified: 1992-1997, 1998-2004 and 2005-2011. The two main temporal trends were: the proportion of early deaths among annual incident histoplasmosis cases significantly declined four fold (χ2, p
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- 2014
34. Use of the intramuscular route to administer pentamidine isethionate in Leishmania guyanensis cutaneous leishmaniasis increases the risk of treatment failure.
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Christen, Jacques-Robert, Bourreau, Eliane, Demar, Magalie, Lightburn, Edward, Couppié, Pierre, Ginouvès, Marine, Prévot, Ghislaine, Gangneux, Jean-Pierre, Savini, Hélène, de Laval, Frank, Pommier de Santi, Vincent, and Briolant, Sébastien
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Background New world cutaneous leishmaniasis (NWCL) can be found in French Guiana as well as in several other parts of Central and South America. Leishmania guyanensis accounts for nearly 90% of cases in French Guiana and is treated with pentamidine isethionate, given by either intramuscular or intravenous injection. The military population is particularly exposed due to repeated missions in the rainforest. The purpose of the present study was to identify the factors associated with pentamidine isethionate treatment failure in a series of service members with L. guyanensis NWCL acquired in French Guiana. Method All the French service members reported as having acquired leishmaniasis in French Guiana from December 2013 to June 2016 were included. Results Seventy-three patients infected with L. guyanensis were included in the final analysis. Patients treated with IV pentamidine isethionate had better response rates than those treated with IM pentamidine isethionate (p = 0.002, adjusted odds ratio (AOR) = 0.15, 95% CI [0.04–0.50]). The rate of treatment success was 85.3% (95% CI [68.9–95.0]) for IV pentamidine isethionate and 51.3% (95% CI [34.8–67.6]) for IM pentamidine isethionate. Conclusions The use of intramuscular pentamidine isethionate in the treatment of Leishmania guyanensis cutaneous leishmaniasis is associated with more treatment failures than intravenous pentamidine isethionate. [ABSTRACT FROM AUTHOR]
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- 2018
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35. Paediatric Bone and Joint Infections in French Guiana: A 6 Year Retrospective Review.
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Osei, Lindsay, El Houmami, Nawal, Minodier, Philippe, Sika, Anicet, Basset, Thierry, Seligmann, Hervé, Terraz, Anne, Demar, Magalie, Pochard, Jacques, Clouzeau, Jérôme, Fournier, Pierre-Edouard, Elenga, Narcisse, and by
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PEDIATRIC epidemiology ,BONE diseases in children ,JOINT infections ,CHILDREN ,METHICILLIN-resistant staphylococcus aureus ,OSTEOARTHRITIS ,ANTIBIOTICS ,OSTEOMYELITIS diagnosis ,BACTERIAL toxins ,INFECTIOUS arthritis ,OSTEOMYELITIS ,STAPHYLOCOCCAL diseases ,STAPHYLOCOCCUS aureus ,TOXINS ,RETROSPECTIVE studies ,CYTOTOXINS ,DIAGNOSIS - Abstract
The epidemiology of paediatric bone and joint infections from South America is poorly known. We herein report a retrospective study conducted in whole French Guiana from January 2010 to December 2015. Medical charts of 55 previously healthy children were analysed, identifying 27 with osteomyelitis, 22 with septic arthritis and 6 with multifocal infections and/or osteoarthritis. The male:female ratio was 2.2:1, and the mean age was 7.5 years. Eighty percent children were ≥36 months old who had predominantly osteomyelitis related to methicillin-susceptible Staphylococcus aureus (p < 0.05) in the course of neglected skin infections. Five children presented with multi-systemic infections resulting in one fatality, mainly caused by S. aureus producing Panton-Valentine leucocidin (p < 0.01). In contrast, children aged 6-36 months had more likely culture-negative infections (p < 0.05), septic arthritis and mild clinical and biological features. Further prospective studies are required to better guide rational diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]
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- 2017
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36. Illegal gold miners in French Guiana: a neglected population with poor health.
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Douine, Maylis, Mosnier, Emilie, Le Hingrat, Quentin, Charpentier, Charlotte, Corlin, Florine, Hureau, Louise, Adenis, Antoine, Lazrek, Yassamine, Niemetsky, Florence, Aucouturier, Anne-Laure, Demar, Magalie, Musset, Lise, and Nacher, Mathieu
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GOLD miners ,GOLD mining ,SOCIODEMOGRAPHIC factors ,SEX ratio ,DIGESTIVE system diseases ,HEALTH ,HIV infection epidemiology ,ANEMIA ,ARBOVIRUS diseases ,PREVENTION of communicable diseases ,EMPLOYMENT ,GOLD ,INFECTION ,LEISHMANIASIS ,LONGITUDINAL method ,MALARIA ,MINERAL industries ,AT-risk people ,DISEASE prevalence ,CROSS-sectional method - Abstract
Background: In French Guiana, a French overseas territory in South America, 6 to 10 thousands undocumented persons work illegally in gold mining sites in the Amazonian forest. Precarious life conditions lead to poor health but few data exist on the health status of illegal gold miners in French Guiana. The objective of this article was to describe the sociodemographic and health status of this vulnerable population.Method: A prospective cross-sectional survey was conducted in 2015 on gold mine supply sites at the border between French Guiana and Suriname. Health status was assessed through medical examination, past medical history, haemoglobin concentration, and HIV and malaria testing. A questionnaire was used to collect data about the migration itinerary and life conditions on mining sites.Results: Among the 421 adults included in the study, 93.8% (395/421) were Brazilian, mainly from Maranhão (55.7%, 220/395), the poorest Brazilian state. The sex ratio was 2.4. Overall, 48% of persons never went to school or beyond the primary level. The median time spent in gold mining was quite long (10 years), with a high turn-over. One third of the surveyed population (37.1%, 156/421) had high blood pressure, and only two had a medical follow-up. Most persons had experienced malaria (89.3%, 376/421). They declared frequent arboviroses and digestive disorders. Active leishmaniasis was observed in 8.3% of gold miners. Among women, 28.5% were anemic. Concerning HIV, 36.6% (154/421) of persons, mainly men, never got tested before and 6 were tested positive, which represented an HIV prevalence of 1.43% (95%CI =0.29-2.5).Conclusion: These findings support the hypothesis that mining in remote areas is linked to several specific illnesses. Theoretically, gold miners would be presumed to start their economical migration to French Guiana as a healthy group. However, their strenuous working and living conditions there lead to poor health caused by infectious and non infectious diseases. This description of their health status is precious for health policy planners in French Guiana given the importance of controlling communicable disease, and the severity and range of specific illnesses acquired by this neglected population.Trial Registration: Clinical trial registration PRS N° NCT02903706 . Retrospectively registered 09/13/2016. [ABSTRACT FROM AUTHOR]- Published
- 2017
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37. A predictive score for hypotension in patients with confirmed dengue fever in Cayenne Hospital, French Guiana.
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Djossou, Félix, Vesin, Guillaume, Elenga, Narcisse, Demar, Magalie, Epelboin, Loïc, Walter, Gaëlle, Abboud, Philippe, Le-Guen, Thierry, Rousset, Dominique, Moreau, Brigitte, Mahamat, Aba, Malvy, Denis, and Nacher, Mathieu
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DENGUE ,HYPOTENSION ,RISK factors of epidemics ,HEALTH services administration ,DIAGNOSIS ,PATIENTS - Abstract
Background: Identifying patients at risk of developing severe dengue is challenging. The objective of the present study was to determine the incidence of hypotension and its predictive factors during the Dengue 2 epidemic in 2013. Methods: In 2013, a longitudinal study was performed using data from all confirmed cases of dengue seen in Cayenne General Hospital. The analysis used Cox proportional modeling to obtain adjusted hazards ratios for hypotension. Results: A total of 806 confirmed patients were included 78 (9.6%) of whom developed hypotension. Extensive purpura, cutaneomucous hemorrhage, serous effusion and age 1–15 years were associated with subsequent hypotension whereas ‘aches’ and a rash were associated with a lower incidence of hypotension. The biological variables independently associated with hypotension were: increase of hematocrit, low protein concentrations, low sodium concentration and lymphocytes over 1400/ml. A risk score was computed from the scaled Cox model coefficient. Conclusions: From a clinician’s perspective, extensive purpura, cutaneomucous hemorrhage, serous effusion, age 1–15 years, hematocrit increase, low protein, low sodium, lymphocytosis and the absence of aches or of a rash, may be important warning signs to predict subsequent hypotension and shock. Over half of the patients with the highest risk score subsequently developed hypotension. The prognostic score had a 48.2% sensitivity with less than 10% of false positives. This score requires external validation before its impact on clinical practice is evaluated. [ABSTRACT FROM AUTHOR]
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- 2016
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38. Prevalence of Plasmodium spp. in illegal gold miners in French Guiana in 2015: a hidden but critical malaria reservoir.
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Douine, Maylis, Musset, Lise, Corlin, Florine, Pelleau, Stéphane, Pasquier, Jérémie, Mutricy, Louise, Adenis, Antoine, Djossou, Felix, Brousse, Paul, Perotti, Frédérique, Hiwat, Helene, Vreden, Stephen, Demar, Magalie, and Nacher, Mathieu
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MALARIA transmission ,GOLD mining ,HEALTH of miners ,MOSQUITO vectors ,DRUG resistance ,ECOLOGY - Abstract
Background: Malaria is endemic in French Guiana, an overseas territory of France on the Guiana Shield. Since 2005, notified malaria cases are decreasing. However, new data show that malaria affects many Brazilian gold miners working illegally in French Guiana, the majority of whom are not counted in official data. In addition, one major concern is the usual practice of improper self-treatment in this mining population, raising fear of the development of antimalarial resistance. This prospective study, conducted in 2015, aimed to estimate the prevalence of Plasmodium spp. in illegal gold miners working in French Guiana. Methods: The recruitment of gold miners was carried out in resting sites along the French Guiana-Suriname border, where they go for supplies, medical care or leisure. After recording agreement, three malaria diagnostic methods were performed: rapid diagnostic test, microscopy and PCR. Results: Among 421 persons recruited in the study, malaria prevalence, detected by nested-PCR, was 22.3 % (CI [18.3-26.3], n = 94/421) of which 84 % were asymptomatic. Conclusions: This significant malaria reservoir in a mobile and illegal population with difficult access to a health care system raises the threat of artemisinin resistance and puts the population of the Guiana Shield at risk of new transmission foci while countries of the region aim at malaria elimination. Even though French legislation may hamper dealing with this population, France must face the reality of malaria in illegal gold miners in order to meet its commitment to malaria elimination. [ABSTRACT FROM AUTHOR]
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- 2016
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39. Frequency and distribution of mixed Plasmodium falciparum-vivax infections in French Guiana between 2000 and 2008.
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Ginouves, Marine, Veron, Vincent, Musset, Lise, Legrand, Eric, Stefani, Aurélia, Prevot, Ghislaine, Demar, Magalie, Djossou, Félix, Brousse, Paul, Nacher, Mathieu, and Carme, Bernard
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PLASMODIIDAE ,PLASMODIUM ,DIAGNOSIS ,INFECTION ,SENSITIVITY analysis ,POLYMERASE chain reaction - Abstract
Background: The two main plasmodial species in French Guiana are Plasmodium vivax and Plasmodium falciparum whose respective prevalence influences the frequency of mixed plasmodial infections. The accuracy of their diagnosis is influenced by the sensitivity of the method used, whereas neither microscopy nor rapid diagnostic tests allow a satisfactory evaluation of mixed plasmodial infections. Methods: In the present study, the frequency of mixed infections in different part of French Guiana was determined using real time PCR, a sensitive and specific technique. Results: From 400 cases of malaria initially diagnosed by microscopy, real time PCR showed that 10.75 % of the cases were mixed infections. Their prevalence varied considerably between geographical areas. The presence, in equivalent proportions, of the two plasmodial species in eastern French Guiana was associated with a much higher prevalence of mixed plasmodial infections than in western French Guiana, where the majority of the population was Duffy negative and thus resistant to vivax malaria. Conclusion: Clinicians must be more vigilant regarding mixed infections in co-endemic P. falciparum/P. vivax areas, in order to deliver optimal care for patients suffering from malaria. This may involve the use of rapid diagnostic tests capable of detecting mixed infections or low density single infections. This is important as French Guiana moves towards malaria elimination. [ABSTRACT FROM AUTHOR]
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- 2015
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40. Characteristics of Snakebite-Related Infection in French Guiana.
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Houcke, Stéphanie, Resiere, Dabor, Lontsingoula, Guy Roger, Cook, Fabrice, Lafouasse, Pierre, Pujo, Jean Marc, Demar, Magalie, Matheus, Severine, Hommel, Didier, and Kallel, Hatem
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NECROTIZING fasciitis ,WOUND infections ,INTENSIVE care units ,INFECTION ,FER-de-lance - Abstract
Wound infection is frequently reported following snakebite (SB). This study is retrospective. It was conducted in the emergency department and the Intensive Care Unit (ICU) of Cayenne General Hospital between 1 January 2016 and 31 July 2021. We included 172 consecutive patients hospitalized for SB envenoming. All patients were monitored for wound infection. Sixty-three patients received antibiotics at admission (36.6%). The main antibiotic used was amoxicillin–clavulanate (92.1%). Wound infection was recorded in 55 cases (32%). It was 19% in grade 1, 35% in grade 2, and 53% in grade 3. It included abscess (69.1%), necrotizing fasciitis (16.4%), and cellulitis (21.8%). The time from SB to wound infection was 6 days (IQR: 3–8). The main isolated microorganisms were A. hydrophila and M. morganii (37.5% and 18.8% of isolated organisms). Surgery was required in 48 patients (28.1%), and a necrosectomy was performed on 16 of them (33.3%). The independent factors associated with snakebite-associated infection were necrosis (p < 0.001, OR 13.15, 95% CI: 4.04–42.84), thrombocytopenia (p = 0.002, OR: 3.37, 95% CI: 1.59–7.16), and rhabdomyolysis (p = 0.046, OR: 2.29, 95% CI: 1.02–5.19). In conclusion, wound infection following SB is frequent, mainly in grade 2 and 3 envenomed patients, especially those with necrosis, thrombocytopenia, and rhabdomyolysis. The main involved bacteria are A. hydrophila and M. morganii. [ABSTRACT FROM AUTHOR]
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- 2022
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41. Vitamin D Deficiency in Patients with Diabetes in French Guiana: Epidemiology and Relation with Microvascular and Macrovascular Complications.
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Girard, Elise, Nacher, Mathieu, Bukasa-Kakamba, John, Fahrasmane, Aniza, Adenis, Antoine, Massicard, Mickael, Drak Alsibai, Kinan, De Toffol, Bertrand, Bekima, Raissa, Thelusme, Liliane, Okambabelle, Diana, Demar, Magalie, Aurelus, Jean M., and Sabbah, Nadia
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Vitamin D (VD) insufficiency is common among patients with diabetes in French Guiana. The study aimed to evaluate the prevalence of VD deficiency in the different type of diabetes encountered and to analyze the relationship between VD deficiency and diabetes complications. Methods: An observational study was conducted between May 2019 and May 2020 in French Guiana, based on data from the CODIAM study (Diabetes Cohort in French Amazonia), describing the characteristics of patients with diabetes mellitus. Among 600 patients enrolled with diabetes, 361 had an available VD assay. Results: The mean 25(OH)VD (hydroxycalciferol) level was 27.9 ng/mL. The level of VD was inversely proportional to the HbA1c (glycated hemoglobin) level. Patients with angina pectoris had a greater proportion of deficiencies VD < 20 ng/mL than those without angina. By contrast, patients with retinopathy had higher vitamin D concentrations than those without retinopathy. There was no association between vitamin D and arteriopathy, stroke, nephropathy and polyneuropathy. VD deficiency was more frequent in women, and in patients with a high school education. Conclusion: The prevalence of VD deficiency was high in patients with diabetes in French Guiana, emphasizing the importance of VD supplementation. [ABSTRACT FROM AUTHOR]
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- 2021
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42. La toxoplasmose ≪ guyanaise ≫.
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Ajzenberg, Daniel, Carme, Bernard, Demar, Magalie, Boukhari, Rachida, and a, Marie-Laure
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TOXOPLASMA ,PREGNANCY ,SHEEP ,LIVESTOCK ,MEAT industry - Abstract
Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2007
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43. The predictive value of a maculopapular rash in children hospitalized for dengue fever in Cayenne, French Guiana
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Basurko, Célia, Alvarez, Emma Cuadro, Djossou, Félix, Ardillon, Vanessa, Demar, Magalie, Villeneuve, Chantal, Elenga, Narcisse, Bonnet, Philippe, Carme, Bernard, and Nacher, Mathieu
- Subjects
DENGUE ,HOSPITAL care of children ,THERAPEUTICS ,COHORT analysis ,EPIDEMICS - Abstract
Abstract: In order to determine the predictive value of a rash during dengue fever, a cohort study was conducted in children hospitalized for dengue during an epidemic in French Guiana. A rash was predictive of uncomplicated dengue: the HR of developing a severe form of disease was 0.43 (95% CI 0.21–0.88; p-value=0.021) for patients with rash. [Copyright &y& Elsevier]
- Published
- 2012
- Full Text
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44. Clinical Features and Management of Snakebite Envenoming in French Guiana.
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Resiere, Dabor, Houcke, Stéphanie, Pujo, Jean Marc, Mayence, Claire, Mathien, Cyrille, NkontCho, Flaubert, Blaise, Nicaise, Demar, Magalie Pierre, Hommel, Didier, and Kallel, Hatem
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SNAKEBITES ,INTERNATIONAL normalized ratio ,PARTIAL thromboplastin time ,PROTHROMBIN ,INTENSIVE care units - Abstract
The management of snakebite (SB) envenoming in French Guiana (FG) is based on symptomatic measures and antivenom (AV) administration (Antivipmyn Tri
® ; Instituto Bioclon—Mexico). Our study aimed to assess clinical manifestations, the efficacy, and safety of Antivipmyn Tri® in the management of SB. Our study is a prospective observational work. It was conducted in the Intensive Care Unit (ICU) of Cayenne General Hospital between 1 January 2016 and 31 December 2019. We included all patients hospitalized for SB envenoming. Our study contained three groups (without AV, three vials, and six vials Antivipmyn Tri® ). During the study period, 133 patients were included. The main clinical symptoms were edema (98.5%), pain (97.7%), systemic hemorrhage (18%), blister (14.3%), and local hemorrhage (14.3%). AV was prescribed for 83 patients (62.3%), and 17 of them (20%) developed early adverse reactions. Biological parameters at admission showed defibrinogenation in 124 cases (93.2%), International Normalized Ratio (INR) > 2 in 104 cases (78.2%), and partial thromboplastin time (PTT) > 1.5 in 74 cases (55.6%). The time from SB to AV was 9:00 (5:22–20:40). The median time from SB to achieve a normal dosage of fibrinogen was 47:00 vs. 25:30, that of Factor II was 24:55 vs. 15:10, that of Factor V was 31:42 vs. 19:42, and that of Factor VIII was 21:30 vs. 10:20 in patients without and with AV, respectively, (p < 0.001 for all factors). Patients receiving Antivipmyn Tri® showed a reduction in the time to return to normal clotting tests, as compared to those who did not. We suggest assessing other antivenoms available in the region to compare their efficacy and safety with Antivipmyn Tri® in FG. [ABSTRACT FROM AUTHOR]- Published
- 2020
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45. Usefulness of C-Reactive Protein in Differentiating Acute Leptospirosis and Dengue Fever in French Guiana.
- Author
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Turnier, Paul Le, Bonifay, Timothée, Mosnier, Emilie, Schaub, Roxane, Jolivet, Anne, Demar, Magalie, Bourhy, Pascale, Nacher, Mathieu, Djossou, Félix, and Epelboin, Loïc
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DENGUE ,LEPTOSPIROSIS ,C-reactive protein ,CREATINE kinase ,BIVARIATE analysis ,DENGUE hemorrhagic fever - Abstract
Objective Leptospirosis and dengue fever (DF) are hard-to-differentiate diseases in cocirculating areas, especially during DF epidemics. Misdiagnosis and ensuing lack of antibiotic therapy can be detrimental in leptospirosis. The objective of this study was to identify factors that help differentiate acute leptospirosis from dengue fever on admission. Method Patients with leptospirosis (positive serology or polymerase chain reaction) were compared with patients with DF (positive nonstructural 1 [NS1] antigen) in a case-control study with age matching. Data on admission were compared using bivariate analysis and multivariate analysis. Results Seventy-two patients with leptospirosis were compared to 216 patients with DF. In bivariate analysis, the factors associated with leptospirosis were male gender, cough, anemia, and elevated blood levels of C-reactive protein (CRP), leukocytes, creatinine, bilirubin, and creatine phosphokinase. Exanthema, purpura, myalgia, headache, and neutropenia were associated with DF. In multivariate analysis, elevated blood levels of leukocytes, bilirubin, and CRP were associated with leptospirosis. The CRP threshold of 50 mg/L taken alone had elevated sensitivity and specificity. Conclusions The CRP level, an easy-to-obtain biomarker, was a powerful tool to differentiate on admission leptospirosis and DF. Facing a dengue-like syndrome in cocirculating areas and awaiting new specific rapid diagnostic tests, CRP dosing could help the clinician to promptly consider the diagnosis of leptospirosis and initiate antibiotic therapy early. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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46. Primaquine 30 mg/day versus 15 mg/day during 14 days for the prevention of <italic>Plasmodium vivax</italic> relapses in adults in French Guiana: a historical comparison.
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Valdes, Audrey, Epelboin, Loic, Mosnier, Emilie, Walter, Gaelle, Vesin, Guillaume, Abboud, Philippe, Melzani, Alessia, Blanchet, Denis, Blaise, Nicaise, Nacher, Mathieu, Demar, Magalie, and Djossou, Felix
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PLASMODIUM vivax ,PREVENTIVE medicine ,PRIMAQUINE ,MALARIA treatment ,THERAPEUTICS - Abstract
Background: The preventive treatment of
Plasmodium vivax relapse recommended by the World Health Organization is primaquine at a dose of 15 mg/day for 14 days, except for malaria cases from Asia and Oceania. Since 2006, CDC recommends the use of primaquine at 30 mg/day for 14 days. In France, all cases of malaria due toP. vivax are treated with 30 mg of primaquine. This systematically increased dosage needs to be evaluated according to epidemiological context. The aim of the study was to compare relapses after 14 days of primaquine at 15 or 30 mg/day. Methods: All patients treated with primaquine after a vivax malaria episode in French Guiana, between 1 January, 2007 and 1 August, 2016, were studied. Based on the compulsory hospital pharmacy forms for primaquine delivery, adult patients who received 15 or 30 mg of primaquine during 14 days for hypnozoite eradication were included. The recommended dose was initially 15 mg and was changed to 30 mg in 2011. Vivax malaria recurrences within 2 months after primaquine treatment, and vivax malaria recurrences 2–6 months after primaquine in each treatment group were analysed using survival analysis at 2, 3 and 6 months. Results: Out of 544 patients included, 283 received 15 mg/day and 261 received 30 mg/day of primaquine. At 2 and 3 months after primaquine treatment, the number of recurrences was 7 (2.5%) and 19 (7.3%), and 9 (3.4%) and 15 (5.3%), in the 15 and 30 mg groups (p = 0.51 respectively 0.35), respectively. Within 3 months, the median time to recurrence was 2.05 months in the 15 and 30 mg groups. At 6 months after primaquine treatment, the number of recurrences was 25 (8.8%) and 31 (11.9%) at 15 and 30 mg, respectively (p = 0.24). The median time to recurrence was 2.38 months at 15 mg/day and of 2.64 months at 30 mg/day. Conclusions: There were no significant differences between primaquine at 15 or 30 mg/day for 14 days in the prevention ofP. vivax relapses at 2, 3 and 6 months after primaquine treatment in French Guiana. [ABSTRACT FROM AUTHOR]- Published
- 2018
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47. Ecologic Correlates of Toxoplasma gondii Exposure in Free-ranging Neotropical Mammals
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de Thois, Benoit, Demar, Magalie, Aznar, Christine, and Carme, Bernard
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- 2003
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48. Dynamics of SARS-CoV-2 lineages in French Guiana in 2020–2021: 4 epidemic waves with cross-influences from Europe and South America.
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Miliu, Alexandra, Lavergne, Anne, Succo, Tiphanie, Laizé, Claire, Andrieu, Audrey, Enfissi, Antoine, Enouf, Vincent, Van der Werf, Sylvie, Blanchet, Denis, Demar, Magalie, Carod, Jean-François, Carage, Thierry, Flamand, Claude, Tirera, Sourakhata, Simon-Lorière, Etienne, Rousseau, Cyril, and Rousset, Dominique
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COVID-19 , *SARS-CoV-2 , *WHOLE genome sequencing , *EPIDEMICS , *COVID-19 pandemic , *RNA viruses - Abstract
Since the first cases of SARS-CoV-2 infection in Wuhan in December 2019, this RNA virus gave rise to different viral lineages with different virological, epidemiological and immunological properties. Here we describe the dynamics of circulation of SARS-CoV-2 lineages in an Amazonian South American French overseas territory, French Guiana (FG). The data analyzed are based on the general epidemic course, and genomic surveillance data come from whole genome sequencing (WGS) as well as typing PCRs. From March 2020 to October 2021, four COVID-19 epidemic waves were observed in FG with an evolution of viral lineages influenced by virus introductions from continental France and above all by land-based introductions from neighbouring countries. The third epidemic wave from March to June 2021 was driven by a predominant Gamma introduced from Brazil and a less frequent Alpha introduced from France. This coexistence was completely substituted by Delta that initiated the fourth epidemic wave. • France and South America cross-influenced SARS-CoV-2 lineages in French Guiana • High resolution tracking by typing PCRs and NGS • Epidemic waves dynamics 2020–2021 [ABSTRACT FROM AUTHOR]
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- 2022
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49. Ecology, evolution, and epidemiology of zoonotic and vector-borne infectious diseases in French Guiana: Transdisciplinarity does matter to tackle new emerging threats.
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de Thoisy, Benoît, Duron, Olivier, Epelboin, Loïc, Musset, Lise, Quénel, Philippe, Roche, Benjamin, Binetruy, Florian, Briolant, Sébastien, Carvalho, Luisiane, Chavy, Agathe, Couppié, Pierre, Demar, Magalie, Douine, Maylis, Dusfour, Isabelle, Epelboin, Yanouk, Flamand, Claude, Franc, Alain, Ginouvès, Marine, Gourbière, Sébastien, and Houël, Emeline
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VECTOR-borne diseases , *COMMUNICABLE diseases , *EMERGING infectious diseases , *DISEASE vectors , *DISEASE outbreaks , *EPIDEMIOLOGY , *MEDICAL research - Abstract
French Guiana is a European ultraperipheric region located on the northern Atlantic coast of South America. It constitutes an important forested region for biological conservation in the Neotropics. Although very sparsely populated, with its inhabitants mainly concentrated on the Atlantic coastal strip and along the two main rivers, it is marked by the presence and development of old and new epidemic disease outbreaks, both research and health priorities. In this review paper, we synthetize 15 years of multidisciplinary and integrative research at the interface between wildlife, ecosystem modification, human activities and sociodemographic development, and human health. This study reveals a complex epidemiological landscape marked by important transitional changes, facilitated by increased interconnections between wildlife, land-use change and human occupation and activity, human and trade transportation, demography with substantial immigration, and identified vector and parasite pharmacological resistance. Among other French Guianese characteristics, we demonstrate herein the existence of more complex multi-host disease life cycles than previously described for several disease systems in Central and South America, which clearly indicates that today the greater promiscuity between wildlife and humans due to demographic and economic pressures may offer novel settings for microbes and their hosts to circulate and spread. French Guiana is a microcosm that crystallizes all the current global environmental, demographic and socioeconomic change conditions, which may favor the development of ancient and future infectious diseases. • Both scientific and biomedical research tends to work in silos, what the OneHealth and Ecohealth concepts keep hammering. • Zoonotic and vector-borne (ZVBID) infectious diseases form an important group of diseases emerging and reemerging worldwide. • 15 years of research in French Guiana (South America) on ZVBID reveals new insights onto the wildlife-ecosystem-disease nexus. • Environmental, demographic, socioeconomic changes in French Guiana favor the development of ancient and new ZVBID. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
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