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1. Materno-fetal Consequences of Symptomatic Dengue in Pregnant Wowen in French Guiana (CMFdeng)

Author: Centre Hospitalier de Kourou, Centre Hospitalier de l'Ouest Guyanais, Centres de Protection Maternelle Infantile Cayenne, Kourou et Saint-Laurent du Maroni, Private physicians Cayenne, Kourou et Saint-Laurent du Maroni, and Private midwife Cayenne, Kourou et Saint-Laurent du Maroni
Published: 2021

2. Suicide Prevention Algorithm in the French Overseas Territories (APSOM)

Author: Centre Hospitalier de Monteran, Guadeloupe, Centre Hospitalier Universitaire de Pointe-a-Pitre, Centre Hospitalier de Cayenne, Centre Hospitalier de Ouest Guyanais Franck Joly, Centre d Accueil Psychiatrique Ouest-Centre, La Réunion, Centre d Accueil d Urgences Médico Psychologique, La Réunion, Centre d Accueil Psychiatrique Nord, La Réunion, and Etablissement Publique de Santé Mentale de la Réunion
Published: 2021

3. ZIKA Virus infection in pregnant women in French Guiana: More precarious-more at risk

Author: Claude Flamand, Timothée Bonifay, Maryvonne Dueymes, Mathieu Nacher, Edouard Hallet, Camille Fritzell, Dominique Rousset, Balthazar Ntab, Séverine Matheus, Université de Guyane (UG), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais, 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), 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], and ROUSSET, Dominique
Subjects: European People, Economics, Cross-sectional study, Maternal Health, RC955-962, Social Sciences, Pathology and Laboratory Medicine, MESH: Risk Assessment, Zika virus, MESH: French Guiana / epidemiology, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Arctic medicine. Tropical medicine, MESH: Child, Ethnicities, Public and Occupational Health, Chikungunya, Young adult, Child, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, Zika Virus Infection, Socioeconomic Aspects of Health, French Guiana, 3. Good health, Medical Microbiology, MESH: Young Adult, Viral Pathogens, Public aspects of medicine, Alphaviruses, Microbiology, Risk Assessment, 03 medical and health sciences, Health Economics, MESH: Zika Virus Infection, MESH: Cross-Sectional Studies, Health insurance, Humans, Microbial Pathogens, MESH: Prevalence, MESH: Adolescent, MESH: Humans, Flaviviruses, Organisms, Public Health, Environmental and Occupational Health, Chikungunya Infection, MESH: Adult, Tropical Diseases, medicine.disease, Health Care, Cross-Sectional Studies, 030104 developmental biology, Population Groupings, MESH: Female, Health Insurance, Demography, RNA viruses, 0301 basic medicine, Viral Diseases, medicine.disease_cause, Medicine and Health Sciences, Prevalence, French People, Pregnancy Complications, Infectious, Chikungunya Virus, biology, Transmission (medicine), Obstetrics and Gynecology, Middle Aged, Serology, Infectious Diseases, Viruses, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Pathogens, RA1-1270, Risk assessment, Research Article, Neglected Tropical Diseases, Adult, MESH: Socioeconomic Factors, Adolescent, 030231 tropical medicine, MESH: Insurance, Health, Togaviruses, Young Adult, medicine, MESH: Pregnancy Complications, Infectious, Insurance, Health, Biology and life sciences, business.industry, Zika Virus, biology.organism_classification, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, People and Places, Women's Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: Background A recent study in French Guiana suggested that populations living in precarious neighborhoods were more at risk for Chikungunya CHIKV than those living in more privileged areas. The objective of the present study was to test the hypothesis that Zika virus (ZIKV) infection was more frequent in precarious pregnant women than in non-precarious pregnant women, as reflected by their health insurance status. Methods A multicentric cross-sectional study was conducted in Cayenne hospital including ZIKV pregnant women with serological or molecular proof of ZIKV during their pregnancy between January and December 2016. Health insurance information was recorded at delivery, which allowed separating women in: undocumented foreigners, precarious but with residence permit, and non-precarious. Results A total of 6654 women were included. Among them 1509 (22,7%) had confirmed ZIKV infection. Most women were precarious (2275/3439) but the proportion of precarious women was significantly greater in ZIKV-confirmed 728/906 (80.4%) than the ZIKV-negatives 1747/2533 (69.0%), p, Author summary A recent study in French Guiana suggested that populations living in precarious neighborhoods were more at risk for chikungunya CHIKV than those living in more privileged areas. The objective of the present study was to test the hypothesis that Zika virus (ZIKV) infection was more frequent in precarious pregnant women than in non-precarious pregnant women as reflected by their health insurance status. A multicenter cross-sectional study was conducted including ZIKV pregnant women with serological or molecular proof of ZIKV during their pregnancy between January and December 2016. Health insurance information was recorded at delivery, which allowed separating women into: undocumented foreigners, precarious but with residence permit, and non-precarious. Overall 6654 women were included. Among them, 1509 (22,7%) had confirmed ZIKV infection. The majority of women were precarious, but the proportion of precarious women was significantly greater in ZIKV-confirmed 728/906 (80.4%) than the ZIKV-negatives 1747/2533 (69.0%). Precariousness and undocumented status were associated with a higher prevalence of ZIKV acquisition during pregnancy. The present results illustrate that in French Guiana, as elsewhere, ZIKV transmission disproportionately affected the socially vulnerable pregnant women, presumably because of poorer housing conditions, and lack of vector control measures in poor neighborhoods.
Published: 2020
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4. Maternal-fetal transmission and adverse perinatal outcomes in pregnant women infected with Zika virus: prospective cohort study in French Guiana

Author: Najeh Hcini, Véronique Lambert, Anne Jolivet, David Baud, C. Pomar, Manon Vouga, Alice Panchaud, Léo Pomar, Guillaume Benoist, Gustavo Malinger, Dominique Rousset, Séverine Matheus, Gabriel Carles, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Université de Lausanne (UNIL), Centre Hospitalier de l'Ouest Guyanais, Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Tel Aviv University [Tel Aviv], University of Geneva [Switzerland], Gestionnaire, Hal Sorbonne Université, Université de Lausanne = University of Lausanne (UNIL), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Tel Aviv University (TAU), Tel Aviv Sourasky Medical Center [Te Aviv], Université de Genève = University of Geneva (UNIGE), Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), We thank all involved personnel at the Centre Hospitalier de l'Ouest Guyannais (CHOG)., and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Pregnancy Complications, Infectious* / epidemiology, MESH: Risk Assessment, MESH: Zika Virus Infection / congenital, Zika virus, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 030219 obstetrics & reproductive medicine, biology, Obstetrics, Zika Virus Infection, MESH: Infant, Newborn, MESH: Infectious Disease Transmission, Vertical, Pregnancy Outcome, General Medicine, MESH: Zika Virus Infection / transmission, 3. Good health, French Guiana, MESH: Young Adult, Cohort, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, medicine.symptom, Cohort study, Adult, medicine.medical_specialty, Population, Prenatal diagnosis, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Asymptomatic, Risk Assessment, 03 medical and health sciences, Young Adult, MESH: French Guiana, medicine, Humans, education, Epidemics, MESH: Epidemics, MESH: Humans, business.industry, Research, Infant, Newborn, MESH: Adult, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, biology.organism_classification, medicine.disease, MESH: Pregnancy Outcome, MESH: Prospective Studies, Infectious Disease Transmission, Vertical, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Zika Virus Infection / epidemiology, MESH: Female
Abstract: ObjectivesTo estimate the rates of maternal-fetal transmission of Zika virus, adverse fetal/neonatal outcomes, and subsequent rates of asymptomatic/symptomatic congenital Zika virus infections up to the first week of life.DesignCohort study with prospective data collection and subsequent review of fetal/neonatal outcomes.SettingsReferral centre for prenatal diagnosis of the French Guiana Western Hospital.ParticipantsPregnant women at any stage of pregnancy with a laboratory confirmed symptomatic or asymptomatic Zika virus infection during the epidemic period in western French Guiana. The cohort enrolled 300 participants and prospectively followed their 305 fetuses/newborns.Main outcome measuresRate of maternal-fetal transmission of Zika virus (amniotic fluid, fetal and neonatal blood, urine, cerebrospinal fluid, and placentas); clinical, biological, and radiological outcomes (blindly reviewed); and adverse outcomes defined as moderate signs potentially related to congenital Zika syndrome (CZS), severe complications compatible with CZS, or fetal loss. Associations between a laboratory confirmed congenital Zika virus infection and adverse fetal/neonatal outcomes were evaluated.ResultsMaternal-fetal transmission was documented in 26% (76/291) of fetuses/newborns with complete data. Among the Zika virus positive fetuses/newborns, 45% (34/76) presented with no signs/complications at birth, 20% (15/76) with moderate signs potentially related to CZS, 21% (16/76) with severe complications compatible with CZS, and 14% (11/76) with fetal loss. Compared with the Zika virus positive fetuses/neonates, those that were identified as negative for Zika virus (215/291) were less likely to present with severe complications (5%; 10/215) or fetal loss (0.5%; 1/215; relative risk 6.9, 95% confidence interval 3.6 to 13.3). Association between a positive Zika virus test and any adverse fetal/neonatal outcome was also significant (relative risk 4.4, 2.9 to 6.6). The population attributable fraction estimates that a confirmed congenital Zika virus infection contributes to 47% of adverse outcomes and 61% of severe adverse outcomes observed.ConclusionIn cases of a known maternal Zika virus infection, approximately a quarter of fetuses will become congenitally infected, of which a third will have severe complications at birth or fetal loss. The burden of CZS might be lower than initially described in South America and may not differ from other congenital infections.
Published: 2018
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5. High mortality due to snakebites in French Guiana: Time has come to re-evaluate medical management protocols

Author: R. Mutricy, Frédérique Perotti, Véronique Lambert, Mathieu Nacher, Christian Marty, Jean-Philippe Chippaux, Xavier Heckmann, Maylis Douine, Anne Jolivet, David Boels, Sébastien Larréché, Loïc Epelboin, 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], Service d’Accueil des Urgences/SAMU/SMUR [Cayenne, Guyane Fraçaise], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Croix-rouge française [Cayenne, Guyane Fraçaise], Département de Santé Publique [Saint-Laurent-du-Maroni, Guyane Française], Service de gynécologie et d’obstétrique [Saint Laurent du Maroni, Guyanne Française], Pharmacy, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, France, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Centre Antipoison et Toxicovigilance du Grand Ouest (Angers) (CAPTV Angers), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Hôpital d'Instruction des Armées Begin, Service de Santé des Armées, Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et l’Enfance [Cotonou, Bénin] (CERPAGE), Université d’Abomey-Calavi = University of Abomey Calavi (UAC), Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique (MERIT - UMR_D 216), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), PRES Sorbonne Paris Cité, Université Paris Descartes - Faculté de Pharmacie de Paris (UPD5 Pharmacie), Université Paris Descartes - Paris 5 (UPD5), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne, Guyane] (COREVIH), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centres antipoison et de toxicovigilance (CAPTV Angers), Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et l’Enfance (CERPAGE), University of Abomey Calavi (UAC), Université des Antilles et de la Guyane - UFR des sciences médicales (UAG UFR SM), Université des Antilles et de la Guyane (UAG), 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), Service d'Oto-Rhino-Laryngologie [CH Briançon], Centre Hospitalier des Escartons de Briançon (CH Briançon), Université de Guyane (UG), and Latour, Marie
Subjects: 0301 basic medicine, [SDV]Life Sciences [q-bio], Snake Bites, Toxicology, Pathology and Laboratory Medicine, Geographical locations, 0302 clinical medicine, Medicine and Health Sciences, Medicine, Toxins, Snakebite, ComputingMilieux_MISCELLANEOUS, Mortality rate, lcsh:Public aspects of medicine, High mortality, Eukaryota, Snakes, Squamates, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], Viewpoints, Infectious Diseases, Research Design, Vertebrates, Brazil, Neglected Tropical Diseases, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Death Rates, Clinical Research Design, 030231 tropical medicine, Toxic Agents, Colombia, Research and Analysis Methods, 03 medical and health sciences, Population Metrics, Environmental health, Animals, Humans, Adverse effect, Population Biology, business.industry, Venoms, Public Health, Environmental and Occupational Health, Organisms, Biology and Life Sciences, Reptiles, lcsh:RA1-1270, South America, Tropical Diseases, Health Care, 030104 developmental biology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Amniotes, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Adverse Events, People and places, Health Statistics, Morbidity, business
Abstract: International audience; no abstract
Published: 2018
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6. Absence of Zika virus among pregnant women in Vietnam in 2008

Author: Y.-C. Chiu, D. Baud, A. Fahmi, B. Zumkehr, M. Vouga, L. Pomar, D. Musso, B. C. Thuong, M.P. Alves, M. Stojanov, Materno-Fetal and Obstetrics Research Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland., University of Bern, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), and Université de Lausanne = University of Lausanne (UNIL)
Subjects: [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Infectious Diseases, 630 Agriculture, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Public Health, Environmental and Occupational Health, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Abstract: Background Despite being first identified in 1947, Zika virus-related outbreaks were first described starting from 2007 culminating with the 2015 Latin American outbreak. Hypotheses indicate that the virus has been circulating in Asia for decades, but reports are scarce. Methods We performed serological analysis and screened placental samples isolated in 2008 for the presence of Zika virus from pregnant women in Ho Chi Minh City (Vietnam). Results None of the placental samples was positive for Zika virus. Four serum samples out of 176 (2.3%) specifically inhibited Zika virus, with variable degrees of cross-reactivity with other flaviviruses. While one of the four samples inhibited only Zika virus, cross-reactivity with other flaviviruses not included in the study could not be ruled out. Conclusion Our results support the conclusion that the virus was not present among pregnant women in the Vietnamese largest city during the initial phases of the epidemic wave.
Published: 2023
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7. Clinical features and prognosis of paraquat poisoning in French Guiana

Author: Elenga, Narcisse, Merlin, Caroline, Le Guern, Rémi, Kom-Tchameni, Rémi, Ducrot, Yves-Marie, Pradier, Maxime, Ntab, Balthazar, Dinh-Van, Kim-Anh, Sobesky, Milko, Mathieu, Daniel, Dueymes, Jean-Marc, Egmann, Gérald, Kallel, Hathem, Mathieu-Nolf, Monique, Service de Pédiatrie [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut de Microbiologie [CHRU Lille], Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Tourcoing, Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais, Centre médico-chirurgical de Kourou [Guyane française], Département de l'information médicale, Centre Hospitalier de Cayenne, Intensive Care Unit and Hyperbaric Center, Lille University Hospital, F-59037, Lille, CH Cayenne, and Centres antipoison et de toxicovigilance (CAPTV Lille)
Subjects: [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018
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8. A prospective matched study on symptomatic dengue in pregnancy

Author: Jean-Pierre Duvernois, Sibille Everhard, Célia Basurko, Hélène Hilderal, Gabriel Carles, Marion Restrepo, Larissa Valmy, Rachida Boukhari, Séverine Matheus, Anne Favre, Mathieu Nacher, Véronique Lambert, 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], Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier de l'Ouest Guyanais, Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Service de gynécologie et d’obstétrique [Kourou, Guyane française] (Croix Rouge Française), Centre médico-chirurgical de Kourou [Guyane française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Mathématiques Informatique et Applications (LAMIA), Université des Antilles (UA), 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]
Subjects: 0301 basic medicine, Viral Diseases, Physiology, Maternal Health, lcsh:Medicine, Blood Pressure, Dengue virus, medicine.disease_cause, Pathology and Laboratory Medicine, Vascular Medicine, Dengue fever, Dengue Fever, Cohort Studies, Dengue, Labor and Delivery, 0302 clinical medicine, Pregnancy, Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine and Health Sciences, Birth Weight, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, lcsh:Science, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Multidisciplinary, Obstetrics, Obstetrics and Gynecology, 3. Good health, French Guiana, Infectious Diseases, Physiological Parameters, Hypertension, Female, Cohort study, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, 030106 microbiology, Hemorrhage, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Preterm Birth, 03 medical and health sciences, Young Adult, Signs and Symptoms, Diagnostic Medicine, Hypertensive Disorders in Pregnancy, medicine, Humans, Seroconversion, business.industry, Cesarean Section, lcsh:R, Body Weight, Infant, Newborn, Infant, Biology and Life Sciences, Dengue Virus, Infant, Low Birth Weight, medicine.disease, Tropical Diseases, Preeclampsia, Infectious Disease Transmission, Vertical, Pregnancy Complications, Relative risk, Birth, Small for gestational age, Women's Health, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; Dengue fever is an increasing problem worldwide, but consequences during pregnancy remain unclear. Much of the available literature suffers from methodological biases that compromise the validity of clinical recommendations. We conducted a matched cohort study during an epidemic in French Guiana to compare events and pregnancy outcomes between two paired groups of pregnant women: women having presented with symptomatic dengue during pregnancy (n = 73) and women having had neither fever nor dengue during pregnancy (n = 219). Women in each arm were matched by place of follow up, gestation weeks at inclusion, and place of residence. Dengue infection was considered to be confirmed if viral RNA, N S1 antigen, the seroconversion of IgM antibodies or the presence of IgM was detected in collected samples. According to the 2009 WHO classification, 27% of the women with symptomatic dengue had at least one clinical or biological warning sign. These complications occurred after the 28th week of gestation in 55% of cases. The medical history, socioeconomic status and demographic characteristics were included in multivariate analysis. Exposure to dengue during pregnancy was not significantly associated with pre-maturity, small for gestational age infants, hypertension or emergency caesarian section. Maternal dengue with warning signs was a risk factor for peripartum hemorrhage with adjusted relative risk = 8.6(95% CI = 1.2-62). There was a near significant association between dengue and in utero death (p = 0.09). This prospective comparative study underlined the importance of taking into account potential confounders between exposure to den-gue and the occurrence of obstetrical events. It also confirms the need for increased vigilance for pregnant women with dengue, particularly for women who present with severe dengue. PLOS ONE | https://doi.org/10.1371/journal.pone.
Published: 2018
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9. Epidemiological assessment of the severity of dengue epidemics in French Guiana

Author: Narcisse Elenga, Philippe Quénel, Séverine Matheus, Christelle Prince, Philippe Abboud, Magalie Demar, Martine Papaix-Puech, Félix Djossou, Dominique Rousset, Luisiane Carvalho, Rachida Boukhari, Mathieu Nacher, Vanessa Ardillon, Camille Fritzell, Claude Flamand, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cellule Inter Régionale d'Epidémiologie des Antilles - Guyane, Institut de Veille Sanitaire (INVS), Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Service de Médecine Interne Centre Médico-Chirurgical, Kourou, Guyane Française, Service de Pédiatrie [Cayenne, Guyanne Française], 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), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), 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], Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Réseau International des Instituts Pasteur ( RIIP ), Unité des Maladies Infectieuses et Tropicales ( UMIT ), Institut de Veille Sanitaire, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Service de Pédiatrie, 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], Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Unité des Maladies Infectieuses et Tropicales (UMIT), Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Cellule Interrégionale d'Epidémiologie Antilles-Guyane, Département de Biologie Clinique [Saint-Laurent-du-Maroni, Guyane Française], EA 3593 Université des Antilles et de la Guyane, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut pluridisciplinaire de recherche appliquée dans le domaine du génie pétrolier (IPRADDGP), Université de Pau et des Pays de l'Adour (UPPA)-Centre National de la Recherche Scientifique (CNRS), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane), Institut National de Veille Sanitaire, Institut national de veille sanitaire, and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424
Subjects: Male, Viral Diseases, Serum Proteins, Future studies, Physiology, Epidemiology, lcsh:Medicine, Biochemistry, Severity of Illness Index, Dengue Fever, Hospitalization rate, Dengue fever, Dengue, 0302 clinical medicine, Animal Cells, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Medicine and Health Sciences, Ethnicities, Medicine, Mental health and psychiatry, French People, 030212 general & internal medicine, Fluid accumulation, Child, lcsh:Science, Children, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Multidisciplinary, Schools, Death rates, Mortality rate, Hematology, Fear, Middle Aged, Hospitals, Body Fluids, French Guiana, 3. Good health, Hospitalization, Infectious Diseases, Blood, Hematocrit, Italy, Warning signs, Child, Preschool, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, Anatomy, Cellular Types, Research Article, Neglected Tropical Diseases, Platelets, Adult, medicine.medical_specialty, Infectious Disease Control, Adolescent, 030231 tropical medicine, Mothers, Disease Surveillance, Infectious Disease Epidemiology, [ SDV.EE ] Life Sciences [q-bio]/Ecology, environment, 03 medical and health sciences, Internal medicine, Humans, Aspartate Aminotransferases, Hospitalizations, Blood Cells, Platelet Count, business.industry, lcsh:R, Biology and Life Sciences, Proteins, Infant, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Lithuania, Cell Biology, Tropical Diseases, Serum samples, medicine.disease, Blood Counts, Health Care, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Health Care Facilities, Infectious Disease Surveillance, People and Places, Immunology, Population Groupings, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; BACKGROUND: Dengue fever is the most important arboviral infection that affects humans, particularly in tropical and subtropical regions. Here, we provide the first comprehensive overview of the severity of dengue epidemics in French Guiana. METHODOLOGY/PRINCIPAL FINDINGS: We monitored hospitalized cases between 2008 and 2013. Detailed clinical features and biological parameters were collected on a daily basis from all cases. Among the 1,356 cases, 216 (16%) were classified according to the WHO 2009 classification as dengue without warning signs (WS), 926 (68%) were classified as dengue with WS and 214 (16%) were classified as severe dengue. The severity rates were similar between the three major epidemics that occurred during the study period, whereas the hospitalization rate was highest in 2013. Fluid accumulation, aspartate aminotransferase (ASAT) counts>193 IU/L and platelet counts
Published: 2017
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10. Prevalence of Plasmodium spp. in illegal gold miners in French Guiana in 2015: a hidden but critical malaria reservoir

Author: Helene Hiwat, Frédérique Perotti, Antoine Adenis, Félix Djossou, Mathieu Nacher, Stephen Vreden, Magalie Demar, Florine Corlin, Paul Brousse, Maylis Douine, Stéphane Pelleau, Jérémie Pasquier, Louise Mutricy, Lise Musset, 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], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Stem cell and microenvironment laboratory, Weill Cornell Medicine [Qatar], Department Genetic Medicine, Corneil University-Weill Medical College of Cornell University [New York], Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Direction Interarmées du Service de Santé en Guyane, Département des Centres Délocalisés de Prévention et de Soins, Pharmacy, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, France, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Medical Mission, Academisch Ziekenhuis, Paramaribo Hospital, Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), funded by European Funds for Regional Development (Feder), N° Presage 32078 and the Institut Veille Sanitaire (French Ministry of Health), European Project: 32078,OrPal, 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), Service d'Immunologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), ADENIS, ANTOINE, and European Funds for Regional Development (Feder), N° Presage 32078 - OrPal - 32078 - INCOMING
Subjects: Male, Plasmodium, Cross-sectional study, artemisinin resistance, Polymerase Chain Reaction, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Health care, Prevalence, 030212 general & internal medicine, Immunoassay, Microscopy, Rapid diagnostic test, education.field_of_study, Malaria reservoir, Ecology, Transmission (medicine), Illegal gold mining, Middle Aged, French Guiana, 3. Good health, Infectious Diseases, Geography, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Adult, medicine.medical_specialty, 030231 tropical medicine, Population, Miners, 03 medical and health sciences, Environmental health, parasitic diseases, medicine, Humans, education, Diagnostic Tests, Routine, business.industry, Research, Public health, medicine.disease, Malaria, Cross-Sectional Studies, Guiana Shield, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Asymptomatic Diseases, Tropical medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Parasitology, Gold, business
Abstract: International audience; BackgroundMalaria 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. MethodsThe 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,ResultsAmong 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. ConclusionThis 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.
Published: 2016
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11. PADS 2-07 - La leptospirose en Guyane française : 1re étude transversale multicentrique 2007-2014

Author: F. Djossou, Emilie Mosnier, Alain Berlioz-Arthaud, P. Le Turnier, Loïc Epelboin, Rachida Boukhari, Pascale Bourhy, Roxane Schaub, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), 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 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), Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Biologie des Spirochètes / Biology of Spirochetes, Institut Pasteur [Paris], ADENIS, ANTOINE, 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], and Institut Pasteur [Paris] (IP)
Subjects: 0303 health sciences, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, 030306 microbiology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine
Abstract: National audience; Introduction La leptospirose est une zoonose de répartition mondiale avec une incidence en augmentation. Elle représente un problème de santé publique en zone tropicale. L’objectif de notre étude était de faire un état des lieux de la leptospirose en Guyane Française afin d’en améliorer la prise en charge.
Published: 2016

12. Performance Testing of PCR Assay in Blood Samples for the Diagnosis of Toxoplasmic Encephalitis in AIDS Patients from the French Departments of America and Genetic Diversity of Toxoplasma gondii: A Prospective and Multicentric Study

Author: Cyrille Vautrin, Magalie Demar, Daniel Ajzenberg, Isabelle Lamaury, Rachida Boukhari, Marie-Laure Dardé, André Cabié, Muriel Nicolas, Patrice Massip, Homayoun Riahi, Michel Dupon, Nicole Desbois-Nogard, Anaïs Labrunie, Pierre-Marie Preux, Stéphane Simon, Marie-Paule Boncoeur, Université de Limoges ( UNILIM ), Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC) ( CNR Toxoplasmose-Toxoplasma BRC ), CHU Limoges, Neuroépidémiologie Tropicale ( NET ), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ) -CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale ( EPat ), Université de Guyane ( UG ) -Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Guyane ( UG ) -Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Médecine, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), 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], CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Laboratoire de Biostatistique et d'Informatique Médicale, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] ( SIME ), Unité Fonctionnelle de Recherche Clinique et de Biostatistique ( UFRCB ), Service de Radiologie et Imagerie Médicale [CHU Limoges], Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Université de Limoges (UNILIM), Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC) (CNR Toxoplasmose-Toxoplasma BRC), 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), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], 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], Laboratoire de Microbiologie, Laboratoire de Biologie Médicale, Service de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais, Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Service de Neuroradiologie interventionnelle [CHU Limoges], French Ministry of Health (PHRC R 2007- R-04), ClinicalTrials.gov NCT00803621, Douady, Claire, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], 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), Service des maladies infectieuses et tropicales [Toulouse], Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], and CHU Toulouse [Toulouse]
Subjects: 0301 basic medicine, Toxoplasmic encephalitis, Male, Viral Diseases, Artificial Gene Amplification and Extension, Polymerase Chain Reaction, Geographical locations, law.invention, Toxoplasma Gondii, law, Genotype, Medicine and Health Sciences, Medicine, Ethnicities, Cluster Analysis, French People, Prospective Studies, Prospective cohort study, Polymerase chain reaction, Protozoans, biology, lcsh:Public aspects of medicine, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, 3. Good health, French Guiana, AIDS, Infectious Diseases, Toxoplasmosis, Cerebral, Female, Toxoplasma, Toxoplasmosis, Brazil, Research Article, Adult, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, 030106 microbiology, Research and Analysis Methods, Sensitivity and Specificity, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Diagnostic Medicine, Parasitic Diseases, Humans, Molecular Biology Techniques, Genotyping, Molecular Biology, Caribbean, Genetic diversity, Acquired Immunodeficiency Syndrome, Protozoan Infections, business.industry, Public Health, Environmental and Occupational Health, Organisms, Toxoplasma gondii, Biology and Life Sciences, Genetic Variation, lcsh:RA1-1270, South America, medicine.disease, biology.organism_classification, Virology, Parasitic Protozoans, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, People and Places, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Population Groupings, business, Microsatellite Repeats
Abstract: Background Toxoplasmic encephalitis in patients with AIDS is a life-threatening disease mostly due to reactivation of Toxoplasma gondii cysts in the brain. The main objective of this study was to evaluate the performance of real-time PCR assay in peripheral blood samples for the diagnosis of toxoplasmic encephalitis in AIDS patients in the French West Indies and Guiana. Methodology/Principal Findings Adult patients with HIV and suspicion of toxoplasmic encephalitis with start of specific antitoxoplasmic therapy were included in this study during 40 months. The real-time PCR assay targeting the 529 bp repeat region of T. gondii was performed in two different centers for all blood samples. A Neighbor-Joining tree was reconstructed from microsatellite data to examine the relationships between strains from human cases of toxoplasmosis in South America and the Caribbean. A total of 44 cases were validated by a committee of experts, including 36 cases with toxoplasmic encephalitis. The specificity of the PCR assay in blood samples was 100% but the sensitivity was only 25% with moderate agreement between the two centers. Altered level of consciousness and being born in the French West Indies and Guiana were the only two variables that were associated with significantly decreased risk of false negative results with the PCR assay. Conclusion/Significance Our results showed that PCR sensitivity in blood samples increased with severity of toxoplasmic encephalitis in AIDS patients. Geographic origin of patients was likely to influence PCR sensitivity but there was little evidence that it was caused by differences in T. gondii strains. Trial Registration ClinicalTrials.gov NCT00803621, Author Summary Diagnosis of toxoplasmic encephalitis (TE) in patients with AIDS is not straightforward because clinicians rely initially on an empiric diagnosis based on clinical and radiographic improvement to specific anti-Toxoplasma gondii therapy. There is therefore a need for biological tools to improve the diagnosis of TE, especially in tropical areas where this diagnosis is likely to be underestimated. The use of PCR testing in blood samples for the diagnosis of TE has been limited by its poor sensitivity in the studies conducted in Europe. In tropical South America, the results of PCR sensitivity in blood samples were controversial. Considering that T. gondii strains from tropical South America have substantial genetic and pathogenic differences with those from USA and Europe, it is therefore important to re-evaluate the performance of the PCR assay in blood samples for the diagnosis of TE in AIDS patients from this region. Our results showed that the only interest of PCR would be in the most severe forms of TE with altered consciousness because PCR is more likely to be positive. We also provided important genotyping data on T. gondii strains isolated in human cases of toxoplasmosis in the Caribbean and in South America.
Published: 2016
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13. La leptospirose en Guyane française : 1ère étude transversale multicentrique 2007-2014

Author: Le Turnier, P., Epelboin, Loïc, Mosnier, Emilie, Schaub, Roxane, Boukhari, R., Berlioz-Arthaud, Alain, Bourhy, Pascale, Djossou, Félix, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), Université de Guyane (UG), Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose, Institut Pasteur [Paris], Centre National de Référence de la Leptospirose - National Reference Center Leptospirosis (CNR), Centre National de Référence de la Leptospirose-Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose-Biologie des Spirochètes, Unité de Maladie Infectieuses et Tropicales, Centre hospitalier Andrée Rosemon, Cayenne, and Institut Pasteur [Paris] (IP)
Subjects: [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2016

14. Rôle des intégrines dans la fibrose cardiaque

Author: Jean-Sébastien Hulot, Clément DELACROIX, Sciences, EDP, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], CIC - HEGP (CIC 1418), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], General Medicine, General Biochemistry, Genetics and Molecular Biology
Abstract: International audience; Ces vingt dernières années, l’intérêt pour les intégrines n’a cessé de grandir et les découvertes ont ouvert de nouvelles perspectives thérapeutiques, notamment dans le cadre de la fibrose, particulièrement pour les intégrines de la famille aV. Après les revers de la thérapie anti-angiogénique utilisée contre le cancer, de nouvelles molécules inhibitrices de ces intégrines se sont révélées intéressantes pour le traitement de la fibrose tissulaire de différents organes, notamment le cœur. La fibrose cardiaque conduit à terme à l’insuffisance cardiaque, une des premières causes de mortalité dans le monde. La compréhension des déterminants de la fibrose cardiaque et l’implication des intégrines dans son développement représentent un enjeu majeur de santé publique. Dans cette revue, nous présentons les différents types de fibrose cardiaque et leurs étiologies. Nous évoquons ensuite les premières applications de stratégies anti-fibrosantes reposant sur l’inhibition d’intégrines spécifiques, comme traitement futur contre le développement de la fibrose cardiaque.
Published: 2022
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15. Tonate Virus and Fetal Abnormalities, French Guiana, 2019

Author: Veronique Lambert, Antoine Enfissi, Mathilde Lefebvre, Leo Pomar, Sobhi Kedous, Fabien Guimiot, Gabriel Carles, Anne Lavergne, Dominique Rousset, Najeh Hcini, 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), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Guyane (UG), Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], and Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)
Subjects: fetal abnormalities, Microbiology (medical), brain diseases, Epidemiology, Alphavirus, Infectious and parasitic diseases, RC109-216, MESH: Brain, MESH: Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: French Guiana, Humans, viruses, reproductive and urinary physiology, vertical disease transmission, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, prenatal diagnosis, MESH: Humans, MESH: Alphavirus, [SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE], tonate virus, Dispatch, Brain, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Infectious Disease Transmission, Vertical, French Guiana, MESH: Infectious Disease Transmission, Vertical, Venezuelan equine encephalitis, Infectious Diseases, arboviruses, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Medicine, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Tonate Virus and Fetal Abnormalities, French Guiana, 2019, meningitis/encephalitis, pregnancy, MESH: Female
Abstract: International audience; V enezuelan equine encephalomyelitis (VEE) complex viruses consist of antigenically related arboviruses widely distributed throughout the Americas (1). Only subtype I varieties AB and C cause severe equine epizootics and human outbreaks marked by the occurrence of encephalitis and fetal damage (2). The other subtypes are endemic in small areas of South America (3). In 1973, subtype III-B, the Tonate virus (TONV), was isolated in birds from French Guiana (4). It has since been found in neighboring countries and in South Dakota and Colorado in the United States (5,6). The wild cycle of TONV is still poorly understood. Transmission by Culicidae insects has been observed during the rainy season (4). Birds and bats are the only identifi ed vertebrate hosts (7). In humans in French Guiana, TONV seroprevalence suggests endemic transmission, particularly along the coast of the Bas Maroni region (8). However, clinical descriptions remain scarce, and no adverse pregnancy outcomes or vertical transmission have been reported (9,10). We report a case of vertical transmission of TONV from a pregnant woman to her fetus and describe ultrasonographic and fetopathological fi ndings. The Study During the 2019 rainy season, a 33-year-old woman living in the Bas Maroni region of French Guiana was referred to the prenatal diagnosis unit at West French Guiana Hospital Center (Saint-Laurent-du-Maroni, French Guiana) for fetal anomalies. This healthy G8P7 woman had no history of genetic disorders or birth defects from previous pregnancies. She was asymptomatic during the fi rst trimester of pregnancy and tested negative for syphilis, toxoplasmosis, rubella, cytomegalovirus, chikungunya, and Zika. An ultrasound screening performed at 20 weeks of gestation showed a hydropic fetus with microcephaly. The atrophic cerebral mantle exhibited calcifi cations and moderate ventriculomegaly. The corpus callosum, the cerebellum, and the brain stem were dysplastic. The fetus manifested limb malformations and an absence of swallowing at the time of the serially performed sonograms (Appendix Figure, https:// wwwnc.cdc.gov/EID/article/28/2/21-0884-App1. pdf). Therefore, we performed amniocentesis for etiological investigation. Because of the poor prognosis, the mother elected to terminate the pregnancy. After approval by the multidisciplinary center for prenatal diagnosis, the pregnancy was terminated without complication. The patient gave written informed consent for the publication of her case. Karyotype and array comparative genomic hybridization were normal. Results of screening for metabolic diseases were negative. All PCR and reverse transcription PCR (RT-PCR) for toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, and common arboviruses from the Amazon were negative. However, we reproducibly detected the presence of a VEE complex virus in the amniotic fl uid with a real-time RT-PCR test yielding cycle threshold values of 30. Furthermore, although maternal serum samples collected 2 months before pregnancy were negative for TONV IgM, the test was positive at the time of pregnancy termination.
Published: 2022
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16. HIV-Associated Histoplasmosis Early Mortality and Incidence Trends: From Neglect to Priority.: HIV - associated histoplasmosis early mortality

Author: Matthieu Hanf, Magalie Demar, Christine Aznar, Antoine Adenis, Rachida Boukhari, Vincent Vantilcke, Denis Blachet, Bernard Carme, Pierre Couppié, Mathieu Nacher, 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], 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, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Service de Dermatologie et Vénérologie
Subjects: Male, Viral Diseases, Antifungal Agents, Epidemiology, Medicine and Health Sciences, Young adult, Histoplasmosis, 0303 health sciences, lcsh:Public aspects of medicine, Incidence (epidemiology), Mortality rate, Incidence, Fungal Diseases, Middle Aged, 3. Good health, Histoplasma capsulatum, French Guiana, Death, AIDS, Infectious Diseases, Female, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Infectious Disease Control, lcsh:RC955-962, Sexually Transmitted Diseases, 03 medical and health sciences, Young Adult, Acquired immunodeficiency syndrome (AIDS), medicine, Humans, 030304 developmental biology, Retrospective Studies, AIDS-Related Opportunistic Infections, 030306 microbiology, business.industry, Public health, Public Health, Environmental and Occupational Health, HIV, lcsh:RA1-1270, Retrospective cohort study, medicine.disease, Tropical Diseases, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract: 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, Author Summary 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. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated histoplasmosis admitted in one of the three main hospitals of 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. Among 274 patients there were 46 early deaths (16.8%). The two main temporal trends were: the proportion of early deaths significantly divided four fold and the number of annual incident histoplasmosis cases increased three fold. The present example testifies that rapid progress could be at reach if awareness increases and leads to clinical and laboratory capacity building in order to diagnose and treat this curable disease.
Published: 2014
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17. Dynamics of SARS-CoV-2 lineages in French Guiana in 2020–2021: 4 epidemic waves with cross-influences from Europe and South America

Author: Alexandra Miliu, Anne Lavergne, Tiphanie Succo, Claire Laizé, Audrey Andrieu, Antoine Enfissi, Vincent Enouf, Sylvie Van der Werf, Denis Blanchet, Magalie Demar, Jean-François Carod, Thierry Carage, Claude Flamand, Sourakhata Tirera, Etienne Simon-Lorière, Cyril Rousseau, Dominique Rousset, Santé publique France Guyane, Santé publique France - French National Public Health Agency [Saint-Maurice, France], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Agence Régionale de Santé Guyane (ARS Guyane), Agence Régionale de la Santé (ARS), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Centre Hospitalier de Kourou (CHK), Génomique évolutive des virus à ARN - Evolutionary genomics of RNA viruses, Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), ESL acknowledges funding from the INCEPTION programme (Investissements d’Avenir grant ANR-16-CONV-0005)., and ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016)
Subjects: Microbiology (medical), SARS-CoV2 variants, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Microbiology, French Guiana, Variant of concern, Infectious Diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Genomic surveillance, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Genetics, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Molecular Biology, Dynamics of circulation, Ecology, Evolution, Behavior and Systematics
Abstract: International audience; 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.
Published: 2022
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18. HIV-Associated Histoplasmosis Early Mortality and Incidence Trends: From Neglect to Priority

Author: 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
Subjects: 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
Published: 2014
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19. Acute toxoplasmoses in immunocompetent patients hospitalized in an intensive care unit in French Guiana

Author: Bernard Carme, Anne Marie Bourbigot, Magalie Demar, Daniel Ajzenberg, Marie-Laure Dardé, C. Peneau, Didier Hommel, Dominique Louvel, Rachida Boukhari, Félix Djossou, Valéry Nasser, 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 Réanimation, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicale, Centre Hospitalier de Cayenne, Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais, Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC) (CNR Toxoplasmose-Toxoplasma BRC), CHU Limoges, Université de Limoges (UNILIM), Neuroépidémiologie Tropicale et Comparée (NETEC), and Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM)
Subjects: Microbiology (medical), Adult, Male, medicine.medical_specialty, Adolescent, Genotype, Pneumonia severity index, 030231 tropical medicine, Severity of Illness Index, law.invention, 03 medical and health sciences, Young Adult, 0302 clinical medicine, law, Risk Factors, Internal medicine, Surveys and Questionnaires, Epidemiology, Severity of illness, medicine, Amazonian toxoplasmosis, Humans, atypical Toxoplasma gondii, Prospective Studies, Simplified Acute Physiology Score, Intensive care medicine, disseminated infection, 030304 developmental biology, 0303 health sciences, business.industry, life-threatening pneumonia, General Medicine, Toxoplasmoses, DNA, Protozoan, medicine.disease, Intensive care unit, Survival Analysis, Toxoplasmosis, 3. Good health, French Guiana, Pneumonia, Intensive Care Units, Infectious Diseases, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, business, Toxoplasma, Microsatellite Repeats
Abstract: International audience; Clin Microbiol Infect ABSTRACT: Atypical Toxoplasma gondii strains, unrelated to archetypal clonal lineages (I, II, III), have been reported more frequently over the last decade in areas other than Europe and North America. A newly described form of toxoplasmosis, 'Amazonian toxoplasmosis' (AT), has been reported since 2002 in French Guiana. It is characterized by severe cases and atypical strains linked to a neotropical forest-based cycle. We report on the cases of AT that required intensive care management. We performed a prospective observational study on hospitalized adults in the Intensive Care Unit (ICU) from 2002 to 2008. Clinical and laboratory data, microbiological findings and outcomes were recorded. Data, including the ICU simplified acute physiology score and the pneumonia severity index, were calculated. Epidemiological risk factors for AT were assessed through questionnaires. Eleven non-immunodeficient patients were admitted to the ICU in Cayenne for life-threatening pneumonia associated with disseminated toxoplasmosis. Mechanical ventilation was necessary in seven patients, four of whom required immediate orotracheal intubation. Cardiac and ophthalmological abnormalities were found in five and four patients, respectively. One patient died from multiple organ failure. The genetic characterization of Toxoplasma DNA using six microsatellite markers revealed unique and atypical genotypes in eight patients. All patients presented epidemiological risk factors for AT. In French Guiana, significant T. gondii-related infectious syndrome associated with the lungs, a high level of LDH activity and the reported risk factors for AT was strongly suggestive of disseminated toxoplasmosis with a possible trend toward life-threatening pneumonia.
Published: 2011
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20. Human impact on genetic diversity of Toxoplasma gondii: example of the anthropized environment from French Guiana

Author: D. Blanchet, Sébastien Devillard, Marie-Laure Dardé, Henri Bonnabau, Daniel Ajzenberg, B. de Thoisy, Stéphane Simon, Frédéric Collinet, Magalie Demar, Rachida Boukhari, Bernard Carme, Aurélien Mercier, Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC) (CNR Toxoplasmose-Toxoplasma BRC), CHU Limoges, Ecologie et évolution des populations, Département écologie évolutive [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), 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), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Unité Fonctionnelle de Recherche Clinique et de Biostatistique (UFRCB), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Laboratoire de Biologie Médicale, Centre Hospitalier de l'Ouest Guyanais (CHOG), CHOG-Centre Hospitalier de l'Ouest Guyanais-CHOG-Centre Hospitalier de l'Ouest Guyanais, Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Genotype, Mice, 0302 clinical medicine, Genotype, Cluster Analysis, MESH: Animals, MESH: Genetic Variation, MESH: Models, Genetic, MESH: Phylogeny, Phylogeny, Genetics, 0303 health sciences, Principal Component Analysis, MESH: Toxoplasmosis, Animal, biology, MESH: Toxoplasma, 3. Good health, French Guiana, Phylogeography, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Phylogeography, MESH: Toxoplasmosis, Microsatellite, Inbreeding, Toxoplasma, Toxoplasmosis, Microbiology (medical), MESH: Bayes Theorem, 030231 tropical medicine, Zoology, Microbiology, 03 medical and health sciences, parasitic diseases, MESH: French Guiana, MESH: Polymorphism, Genetic, Animals, Humans, Molecular Biology, Genotyping, MESH: Mice, Ecology, Evolution, Behavior and Systematics, 030304 developmental biology, MESH: Principal Component Analysis, Genetic diversity, Polymorphism, Genetic, MESH: Humans, Molecular epidemiology, Models, Genetic, Toxoplasma gondii, Genetic Variation, Bayes Theorem, Anthropization, biology.organism_classification, MESH: Cluster Analysis, MESH: Wilderness, Toxoplasmosis, Animal, Wilderness, MESH: Microsatellite Repeats, Microsatellite Repeats
Abstract: International audience; In French Guiana, severe cases of toxoplasmosis in immunocompetent patients are associated with atypical strains of Toxoplasma gondii linked to a wild neotropical rainforest cycle and a higher genetic diversity than usually observed for T. gondii isolates from anthropized environment. This raises the question of the impact of anthropization of the natural environment, on genetic diversity and on the population structure of T. gondii. However, few data are available on strains circulating in the anthropized areas from French Guiana. Seropositive animals originating mainly from anthropized sub-urban areas and punctually from wild environment in French Guiana were analyzed for T. gondii isolation and genotyping. Thirty-three strains were obtained by bioassay in mice and compared with 18 previously reported isolates chiefly originating from the Amazon rainforest. The genotyping analysis performed with 15 microsatellite markers located on 12 different chromosomes revealed a lower genetic diversity in the anthropized environment. Results were analyzed in terms of population structure by clustering methods, Neighbor-joining trees reconstruction based on genetic distances, F(ST,) Mantel's tests and linkage disequilibrium. They clearly showed a genetic differentiation between strains associated to the anthropized environment and those associated to the wild, but with some inbreeding between them. The majority of strains from the anthropized environment were clustered into additional lineages of T. gondii that are common in the Caribbean. In conclusion the two environmental populations "wild" and "anthropized" were genetically well differentiated. The anthropization of the environment seems to be accompanied with a decreased diversity of T. gondii associated with a greater structure of the populations. We detected potential interpenetration and genetic exchanges between these two environmental populations. As a higher pathogenicity in human of "wild" genotypes has been described, the interpenetration of both environments leads to hybridization between strains that may be at risk for human health.
Published: 2011
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21. Prolonged Maternal Zika Viremia as a Marker of Adverse Perinatal Outcomes

Author: Séverine Matheus, Manon Vouga, Dominique Rousset, C. Pomar, Najeh Hcini, Gabriel Carles, Léo Pomar, Alice Panchaud, David Baud, Véronique Lambert, Lausanne University Hospital, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Institut Pasteur [Paris] (IP), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), University of Bern, and Institut Pasteur [Paris]
Subjects: congenital Zika syndrome, Epidemiology, vector-borne infections, lcsh:Medicine, Zika virus, Serology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pregnancy, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, mosquitoborne diseases, biology, Transmission (medicine), Obstetrics, Zika Virus Infection, Prolonged Maternal Zika Viremia as a Marker of Adverse Perinatal Outcomes, 3. Good health, French Guiana, prolonged viremia, Infectious Diseases, Female, Microbiology (medical), medicine.medical_specialty, 030231 tropical medicine, 610 Medicine & health, Viremia, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Zika, 360 Social problems & social services, medicine, Humans, viruses, lcsh:RC109-216, Risk factor, ZIKV, Fetus, business.industry, Research, lcsh:R, Infant, Newborn, Zika Virus, biology.organism_classification, medicine.disease, congenital infection, Relative risk, business
Abstract: International audience; Whether prolonged maternal viremia after Zika virus infection represents a risk factor for maternal-fetal transmission and subsequent adverse outcomes remains unclear. In this prospective cohort study in French Guiana, we enrolled Zika virus-infected pregnant women with a positive PCR result at inclusion and noninfected pregnant women; both groups underwent serologic testing in each trimester and at delivery during January-July 2016. Prolonged viremia was defined as ongoing virus detection >30 days postinfection. Adverse outcomes (fetal loss or neurologic anomalies) were more common in fetuses and neonates from mothers with prolonged viremia (40.0%) compared with those from infected mothers without prolonged viremia (5.3%, adjusted relative risk [aRR] 7.2 [95% CI 0.9-57.6]) or those from noninfected mothers (6.6%, aRR 6.7 [95% CI 3.0-15.1]). Congenital infections were confirmed more often in fetuses and neonates from mothers with prolonged viremia compared with the other 2 groups (60.0% vs. 26.3% vs. 0.0%, aRR 2.3 [95% CI 0.9-5.5]).
Published: 2021
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22. COVID-19 epidemic in remote areas of the French Amazon, March 2020 to May 2021: Another reality

Author: Loïc Epelboin, Tiphanie Succo, Céline Michaud, Margot Oberlis, Bastien Bidaud, Pauline Naudion, Lise Dudognon, Clara Fernandes, Charlène Cochet, Cécile Caspar, Estelle Jacoud, Sébastien Teissier, Maylis Douine, Dominique Rousset, Claude Flamand, Félix Djossou, Mathieu Nacher, Cyril Rousseau, Nicolas Vignier, Mélanie Gaillet, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], 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], Santé publique France Guyane, Santé publique France - French National Public Health Agency [Saint-Maurice, France], Croix rouge 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), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and FEDER European funding for the « AMAZCOV’N FEVER» project: FEADER /2020/AAP-FLASH COVID-19 /N°18 - GY0028034.
Subjects: Microbiology (medical), Adolescent, COVID-19 vaccines, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, parasitic diseases, MESH: French Guiana, Humans, MESH: COVID-19, Epidemics, MESH: Epidemics, MESH: Adolescent, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Humans, SARS-CoV-2, COVID-19, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, French Guiana, Europe, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Health promotion, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Parasitology, MESH: Europe, MESH: Brazil, Brazil
Abstract: International audience; Background:French Guiana (FG) is an ultra-peripheral European region in the Amazon, and the COVID-19 epidemic has had very different kinetics from both its giant neighbors, Brazil or mainland France.Methods:This study summarized the epidemics of COVID-19 in FG.Results:The tropical climate, multiethnicity, and remoteness of the population forced healthcare providers to accordingly adapt the management of the epidemic. Incidence and mortality have been lower than that in Europe and Latin America due to a combination of prevalence of the youth in the population and highly developed healthcare system.Conclusions:Currently, vaccine hesitancy hinders the rapid expansion of vaccine coverage.
Published: 2022
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23. Seroprevalence of anti-SARS-CoV-2 IgG at the first epidemic peak in French Guiana, July 2020

Author: Anais Perilhou, Elodie Boizon, Dominique Rousset, Nathalie Clement, Antoine Enfissi, Véronique Servas, Didier Musso, Thierry Carage, Félix Djossou, Céline Michaud, E. Beillard, Christelle Alves Sarmento, Stephanie Eustache, Sarah Bailly, Simon Cauchemez, Jean-François Carod, Samantha James, Mélanie Gaillet, Claude Flamand, Henrik Salje, Celine Tourbillon, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre de Recherche Translationnelle - Center for Translational Science (CRT), Institut Pasteur [Paris], Laboratoire d'Analyses Médicales [Kourou], Eurofins Labazur, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), University of Cambridge [UK] (CAM), Johns Hopkins Bloomberg School of Public Health [Baltimore], Johns Hopkins University (JHU), This study was supported by the National Research Agency to CF, the 'European Regional Development Fund' (GY0027257) to CF, the 'Regional Health Agency of French Guiana' to CF and the « URGENCE COVID-19 » fundraising campaign of Institut Pasteur to CF., Unité d'Epidémiologie [Cayenne, Guyane française], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Laboratoire de virologie [Cayenne, Guyane française], Laboratoire de biologie médicale [Cayenne, Guyane française] (LBM), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), This study was supported by the National Research Agency to CF, the 'European Regional Development Fund' (GY0027257) to CF, the 'Regional Health Agency of French Guiana' to CF and the « URGENCE COVID-19 » fundraising campaign of Institut Pasteur to CF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript, We are grateful to all field workers, collaborators, technical and medical staff from Health Centers Department of Cayenne Hospital Center and biological laboratories and health centers involved in the EPI-COVID-19 project. We thank Bhety LABEAU, David MOUA, Laetitia BREMAND, Sylvie ALOEPOE, Elisabeth CHAN from Institut Pasteur in French Guiana, Nathalie JOLLY from Clinical Core of the Center for Translational Research of Institut Pasteur. We also thank Sophie GAULIN, Lysiane ROMAIN, Véronique TOGNERI and Tadens MPWENE from La Liberté., ANR-20-COVI-0014,EPI-COVID-19,Étude de la transmission intra-ménage autour des cas confirmés de COVID-19 en Guyane(2020), Flamand, Claude [0000-0002-8064-445X], Beillard, Emmanuel [0000-0002-2546-7614], Michaud, Céline [0000-0001-5410-6298], Cauchemez, Simon [0000-0001-9186-4549], Apollo - University of Cambridge Repository, and Salje, Henrik [0000-0003-3626-4254]
Subjects: RNA viruses, Viral Diseases, Pulmonology, Coronaviruses, Physiology, RC955-962, 030204 cardiovascular system & hematology, Antibodies, Viral, Serology, MESH: Aged, 80 and over, Medical Conditions, 0302 clinical medicine, Seroepidemiologic Studies, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Arctic medicine. Tropical medicine, MESH: Child, Pandemic, MESH: COVID-19, Medicine, 030212 general & internal medicine, [MATH]Mathematics [math], Enzyme-Linked Immunoassays, Child, Pathology and laboratory medicine, Virus Testing, MESH: Immunoglobulin G, MESH: Aged, Aged, 80 and over, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, Medical microbiology, Middle Aged, MESH: Infant, French Guiana, 3. Good health, Bioassays and Physiological Analysis, Infectious Diseases, Physiological Parameters, MESH: Young Adult, Child, Preschool, Viruses, Public aspects of medicine, RA1-1270, SARS CoV 2, Pathogens, Research Article, Adult, SARS coronavirus, Adolescent, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Research and Analysis Methods, Microbiology, Respiratory Disorders, Young Adult, 03 medical and health sciences, MESH: Cross-Sectional Studies, Diagnostic Medicine, MESH: French Guiana, Humans, Seroprevalence, MESH: SARS-CoV-2, Immunoassays, Enzyme Assays, Aged, MESH: Adolescent, Medicine and health sciences, MESH: Humans, MESH: Seroepidemiologic Studies, Routine screening, Biology and life sciences, SARS-CoV-2, business.industry, MESH: Child, Preschool, Body Weight, Organisms, Viral pathogens, Public Health, Environmental and Occupational Health, COVID-19, Infant, Spike Protein, MESH: Adult, Covid 19, Microbial pathogens, Cross-Sectional Studies, Young population, Immunoglobulin G, Respiratory Infections, Immunologic Techniques, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biochemical Analysis, business, MESH: Antibodies, Viral, Demography
Abstract: Background While Latin America has been heavily affected by the pandemic, only a few seroprevalence studies have been conducted there during the first epidemic wave in the first half of 2020. Methodology/Principal findings A cross-sectional survey was performed between 15 July 2020 and 23 July 2020 among individuals who visited 4 medical laboratories or 5 health centers for routine screening or clinical management, with the exception of symptomatic suggestive cases of covid-19. Samples were screened for the presence of anti-SARS-CoV-2 IgG directed against domain S1 of the SARS-CoV-2 spike protein using the anti-SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) from Euroimmun. Conclusions/Significance The overall seroprevalence was 15.4% [9.3%-24.4%] among 480 participants, ranging from 4.0% to 25.5% across the different municipalities. The seroprevalence did not differ according to gender (p = 0.19) or age (p = 0.51). Among SARS-CoV-2 positive individuals, we found that 24.6% [11.5%-45.2%] reported symptoms consistent with COVID-19. Our findings revealed high levels of infection across the territory but a low number of resulting deaths, which can be explained by French Guiana’s young population structure., Author summary While Latin America has been heavily affected by the pandemic, only a few seroprevalence studies have been conducted there during the first epidemic wave in the first half of 2020. A cross-sectional survey was performed between 15 July 2020 and 23 July 2020 among individuals who visited 4 medical laboratories or 5 health centers for routine screening or clinical management, with the exception of symptomatic suggestive cases of covid-19. Samples were screened for the presence of anti-SARS-CoV-2 IgG using the anti-SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) from Euroimmun. The overall seroprevalence was 15.4% [9.3%-24.4%] among 480 participants, ranging from 4.0% to 25.5% across the different municipalities. The seroprevalence did not differ according to gender (p = 0.19) or age (p = 0.51). Among SARS-CoV-2 positive individuals, we found that 24.6% [11.5%-45.2%] reported symptoms consistent with COVID-19. Our findings revealed high levels of infection across the territory but a low number of resulting deaths, which can be explained by French Guiana’s young population structure.
Published: 2021
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24. Levers and Barriers to Vaccinate against COVID-19 in the Multicultural Context of French Guiana: A Qualitative Cross-Sectional Survey among Health Care Workers

Author: Nicolas Vignier, Mélanie Gaillet, Antoine Adenis, Mathieu Nacher, Audrey Valdes, Philippe Abboud, Kepha Brureau, Loïc Epelboin, Jacques Breton, Sibylle Granier, Félix Djossou, Camille Agostini, Mathilde Ballet, Céline Michaud, Maylis Douine, 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], Biome Tropical et Immuno-Pathophysiologie = Tropical Biome and ImmunoPhysiopathology [Lille] (TBIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG), Université de Montpellier (UM), Université des Antilles (UA), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Agence Régionale de la Santé [Cayenne, Guyane française] (ARS), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Sorbonne Paris Nord, This study received logistical support from the Centre Hospitalier de Cayenne (Centre d’investigation Clinique Antilles Guyane, CIC Inserm 1424)., 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), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, and Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Guyane (UG)
Subjects: medicine.medical_specialty, Cross-sectional study, media_common.quotation_subject, barriers, Immunology, Population, education, Context (language use), multiculturalism, Article, Grounded theory, information, 03 medical and health sciences, 0302 clinical medicine, Political science, Drug Discovery, Health care, medicine, Pharmacology (medical), 030212 general & internal medicine, 030304 developmental biology, media_common, Pharmacology, 0303 health sciences, education.field_of_study, business.industry, COVID-19, vaccination, 3. Good health, French Guiana, Vaccination, Infectious Diseases, Multiculturalism, Family medicine, Medicine, willingness, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, qualitative research, Qualitative research
Abstract: International audience; In French Guiana, a French overseas territory in South America facing a fourth wave of COVID-19, vaccination coverage is very low, both in the population and among health care workers (HCWs). Vaccine hesitancy concerned 35.7% of the latter in early 2021. The objective of this complementary study is to understand barriers and levers and to adapt messages to increase vaccination coverage among HCWs. We conducted a regional cross-sectional survey of HCWs with a questionnaire containing open-ended questions exploring factors associated with vaccine hesitancy and the needs to adapt the vaccination campaign in French Guiana. The discourses were analyzed using a qualitative approach based on grounded theory, with open coding of data by themes and construction of abstract categories. The analysis of the 357 responses collected from January to March 2021 reveals several trends. The ethical aspect of the HCWs’ role emphasizes the importance of getting vaccinated themselves (to protect patients, to set an example...) and of vaccinating as many people as possible, including the most geographically or socially distant, such as undocumented migrants. However, some HCWs remain suspicious of the vaccine with concerns over the efficacy and side effects, of health institutions, and of the pharmaceutical industry. The role of fake news circulating on social networks has been widely discussed. Efforts to explain and convince HCWs must be continued in French Guiana using the identified levers to improve the acceptability of vaccination.
Published: 2021
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25. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group

Author: Olivier Hermine, Xavier Mariette, Raphael Porcher, Felix Djossou, Yann Nguyen, Jean-Benoît Arlet, Laurent Savale, Jean Luc Diehl, Sophie Georgin-Lavialle, Jacques Cadranel, Gilles Pialoux, Karine Lacombe, Arsène Mekinian, Hélène Gros, Xavier Lescure, Jade Ghosn, Elisabeth Coupez, Kevin Grapin, Christophe Rapp, Marc Michel, Anne Lise Lecapitaine, Jean Marie Michot, Nathalie Costedoat-Chalumeau, Liem Binh Luong Nguyen, Luca Semerano, François Raffi, Claire Aguillar, Claire Rouzaud, Jacques Eric Gottenberg, Yves Hansmann, Boris Bienvenu, Jonathan London, Franklin Samou Fantchou, Felix Ackermann, Antoine Gros, Alexandre Morel, Nicolas Gambier, Damien Sène, Bruno Mégarbane, Elie Azoulay, Serge Bureau, Maxime Dougados, Joseph Emmerich, Muriel Fartoukh, Bertrand Guidet, Marc Humbert, Mathieu Mahevas, Frédéric Pène, Frédéric Schlemmer, Valérie Pourcher-Martinez, Annick Tibi, Gabriel Baron, Elodie Perrodeau, Stéphanie Baron, Gabriel Steg, Yazdan Yazdapanah, Tabassome Simon, Matthieu Resche-Rigon, Pierre-Louis Tharaux, Philippe Ravaud, Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Bicêtre, Université Paris-Saclay, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Hôtel-Dieu [Paris], Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Hôpital Beaujon [AP-HP], Université Paris Cité (UPCité), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Sorbonne Paris Cité (USPC), Université Sorbonne Paris Nord, CHU Saint-Antoine [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Robert Ballanger [Aulnay-sous-Bois], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Hôpital Américain de Paris, Hôpital Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Compiègne-Noyon (CHCN), Centre Hospitalier Compiègne-Noyon, Institut Gustave Roussy (IGR), Département d'hématologie [Gustave Roussy], Hôpital Cochin [AP-HP], Sorbonne Université (SU), CIC Cochin Pasteur (CIC 1417), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Groupe hospitalier Broca-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Avicenne [AP-HP], Hôtel-Dieu de Nantes, Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université Paris Descartes - Paris 5 (UPD5), Centre hospitalier Saint-Joseph [Paris], Les Hôpitaux Universitaires de Strasbourg (HUS), Université de Strasbourg (UNISTRA), Hôpital Saint-Joseph [Marseille], Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Hôpital Foch [Suresnes], Centre Hospitalier de Versailles André Mignot (CHV), Hôpital privé d'Antony - Ramsay Santé (HPA-RS), Hôpital Delafontaine, Centre Hospitalier de Saint-Denis [Ile-de-France], Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7), Optimisation thérapeutique en Neuropsychopharmacologie (OPTeN (UMR_S_1144 / U1144)), Hopital Saint-Louis [AP-HP] (AP-HP), Université Paris-Est (UPE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [AP-HP], Agence Générale des Equipements et Produits de Santé [Paris] (AGEPS), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Service de médecine interne [CHU Saint-Antoine], and Tharaux, Pierre-Louis
Subjects: [SDV] Life Sciences [q-bio], [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, [SDV]Life Sciences [q-bio], COVID-19, General Medicine, Randomized clinical trial, Tocilizumab+Dexamethasone, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background: In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial.Methods: From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979.Findings: A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively.Interpretation: Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn.Funding: Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche.
Published: 2021
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26. Spatial Distribution and Burden of Emerging Arboviruses in French Guiana

Author: Anne Lavergne, Jean-François Carod, Camille Fritzell, Léna Berthelot, Sarah Bailly, Claude Flamand, Sandrine Fernandes-Pellerin, Antoine Enfissi, Dominique Rousset, Jean-Claude Manuguerra, Sarrah Ben Achour, Simon Cauchemez, Félix Djossou, Jessica Vanhomwegen, Nathanaël Hozé, Mona Saout, Henrik Salje, Unité d'Epidémiologie [Cayenne, Guyane française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Institut Pasteur [Paris], University of Cambridge [UK] (CAM), Centre de Recherche Translationnelle - Center for Translational Science (CRT), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], This study was supported by the European Regional Development Fund under EPI-ARBO grant agreement GY0008695, the Regional Health Agency of French Guiana, and the National Center of Spatial Studies. C.F. (Claude Flamand) acknowledges financial support from the Centre National d’Etudes Spatiales-Terre solide, Océan, Surfaces Continentales, Atmosphère fund (grant number CNES-TOSCA-4800000720) and funding from Calmette and Yersin allocated by the Pasteur Institut Department of International Affairs. S.C. acknowledges financial support from the AXA Research Fund, the Investissement d’Avenir program, the Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases program (grant number ANR-10-LABX-62-IBEID), the Models of Infectious Disease Agent Study of the National Institute of General Medical Sciences, the INCEPTION project (PIA/ANR-16-CONV-0005), and the European Union’s Horizon 2020 research and innovation program under ZIKAlliance grant agreement number 734548., We thank Laure Garancher from the Ink Link Association, the coordination department of Health centers and all health centers, collaborators and field workers involved in the Arbovirus Epidemiologic Survey (EPI-ARBO) project. We also thank all biological and technical staff from the Arbovirus National Reference Center for their valuable contributions to the laboratory analyses., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), European Project: 734548,ZIKAlliance(2016), Rousset, Dominique [0000-0002-1473-3147], Fritzell, Camille [0000-0002-4324-1109], Hozé, Nathanaël [0000-0002-3977-8966], Vanhomwegen, Jessica [0000-0002-7879-1485], Salje, Henrik [0000-0003-3626-4254], Lavergne, Anne [0000-0002-5304-5574], Djossou, Félix [0000-0002-6761-0511], Cauchemez, Simon [0000-0001-9186-4549], Flamand, Claude [0000-0002-8064-445X], Apollo - University of Cambridge Repository, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), and Institut Pasteur [Paris] (IP)
Subjects: Male, 0301 basic medicine, Serotype, Recombinant antigen, viruses, Antibodies, Viral, medicine.disease_cause, Serology, Dengue fever, Dengue, 0302 clinical medicine, Cost of Illness, Seroepidemiologic Studies, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Prevalence, Chikungunya, Child, education.field_of_study, prevalence studies, virus diseases, Middle Aged, arboviruses, Zika, Mayaro, French Guiana, QR1-502, 3. Good health, Infectious Diseases, Child, Preschool, Female, Adult, Adolescent, 030231 tropical medicine, Population, Arbovirus Infections, Biology, Microbiology, Article, Young Adult, 03 medical and health sciences, Virology, medicine, Humans, Seroprevalence, education, Aged, Demography, medicine.disease, Serum samples, Cross-Sectional Studies, 030104 developmental biology, Immunoglobulin G
Abstract: International audience; Despite the health, social and economic impact of arboviruses in French Guiana, very little is known about the extent to which infection burden is shared between individuals. We conducted a large multiplexed serological survey among 2697 individuals from June to October 2017. All serum samples were tested for IgG antibodies against DENV, CHIKV, ZIKV and MAYV using a recombinant antigen-based microsphere immunoassay with a subset further evaluated through anti-ZIKV microneutralization tests. The overall DENV seroprevalence was estimated at 73.1% (70.6–75.4) in the whole territory with estimations by serotype at 68.9% for DENV-1, 38.8% for DENV-2, 42.3% for DENV-3, and 56.1% for DENV-4. The overall seroprevalence of CHIKV, ZIKV and MAYV antibodies was 20.3% (17.7–23.1), 23.3% (20.9–25.9) and 3.3% (2.7–4.1), respectively. We provide a consistent overview of the burden of emerging arboviruses in French Guiana, with useful findings for risk mapping, future prevention and control programs. The majority of the population remains susceptible to CHIKV and ZIKV, which could potentially facilitate the risk of further re-emergences. Our results underscore the need to strengthen MAYV surveillance in order to rapidly detect any substantial changes in MAYV circulation patterns.
Published: 2021
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27. Mayaro virus infection in French Guiana, a cross sectional study 2003-2019

Author: Rémi Mutricy, Séverine Matheus, Émilie Mosnier, Enguerrane Martinez-Lorenzi, Franck De Laval, Mathieu Nacher, Florence Niemetzky, Pauline Naudion, Félix Djossou, Dominique Rousset, Loïc Epelboin, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Institut Pasteur [Paris] (IP), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre d'épidémiologie et de santé publique des armées [Marseille] (CESPA), Service de Santé des Armées, Centre Médical Interarmées de Cayenne, 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], and ROUSSET, Dominique
Subjects: Microbiology (medical), viruses, MESH: Zika Virus, MESH: Chikungunya Fever, Mosquito Vectors, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Microbiology, MESH: Arthralgia, MESH: Zika Virus Infection, MESH: Cross-Sectional Studies, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Aedes, MESH: Arboviruses, parasitic diseases, MESH: French Guiana, Genetics, Animals, Humans, MESH: Animals, Molecular Biology, Ecology, Evolution, Behavior and Systematics, Retrospective Studies, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Humans, Zika Virus Infection, virus diseases, MESH: Retrospective Studies, MESH: Chikungunya virus, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, MESH: Aedes, Zika Virus, Arthralgia, French Guiana, Infectious Diseases, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Chikungunya Fever, MESH: Mosquito Vectors, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Chikungunya virus, Arboviruses
Abstract: International audience; Mayaro Virus is an emerging arbovirus which can be responsible of important outbreaks in tropical regions. A retrospective study was performed in French Guiana, an ultraperipheral region of Europe in Amazonia. We identified 17 human cases between 2003 and 2019. The clinical and biological picture was close to Chikungunya with fever and arthralgia. One patient had acute meningo-encephalitis, and 4 had persistent arthralgia. Physicians should be aware of this virus, as imported cases in Europe have already occurred. AUTHOR SUMMARY: Latin America has experienced several epidemics of arboviruses in recent years, some known for a long time, such as the dengue virus, and others of more recent introduction such as the chikungunya or Zika viruses. There are other arboviruses for the moment more discreet which are rife with low noise in several countries of the continent, such as the Mayaro virus. This alphavirus, with a presentation similar to that of the chikungunya virus, is currently confined to transmission by forest mosquitoes, but its potential to be transmitted by coastal mosquitoes such as Aedes aegypti, make it a potential candidate for a continent-wide epidemic. It therefore seems necessary to know this virus as well as possible in order to anticipate the occurrence of a possible new epidemic. We present here a both demographic and clinical study of this endemic arbovirus disease in French Guiana.
Published: 2021
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28. Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin

Author: Kepha Brureau, Nicolas Vignier, Félix Djossou, Philippe Abboud, Céline Michaud, Antoine Adenis, Jacques Breton, Mathieu Nacher, Audrey Valdes, Mélanie Gaillet, Loïc Epelboin, Maylis Douine, Camille Agostini, Mathilde Ballet, Sybille Granier, 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], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), UFR Santé, Médecine et Biologie Humaine (UFR SMBH), Université Sorbonne Paris Nord, Université des Antilles (UA), Université de Montpellier (UM), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], and Université de Guyane (UG)
Subjects: 0301 basic medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], Immunology, COVID-19 vaccines, Context (language use), health personnel, Article, 03 medical and health sciences, 0302 clinical medicine, Drug Discovery, Health care, Pandemic, medicine, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, Government, business.industry, Public health, South America, 3. Good health, French Guiana, 030104 developmental biology, Infectious Diseases, Family medicine, Vaccine refusal, Medicine, vaccine hesitancy, Ordered logit, willingness to get vaccinated, business
Abstract: Background: In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (Gamma) variant of concern (VOC), mRNA vaccines have been made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimed to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods: A cross-sectional survey was conducted from January 22 to March 26, 2021 among a sample of HCWs in French Guiana. They were asked about their willingness to get vaccinated against COVID-19 and vaccine hesitancy, vaccine uptake and vaccines attitudes. Factors associated with willingness to get vaccinated have been analyzed with ordinal logistic regression, using Stata software. Results: A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. HCWs were more willing to get vaccine if they were older, were worried about COVID-19 and were confident in the management of epidemic. Conversely, participants were less likely to have been vaccinated or willing to if they were nurses or of another non-medical profession, born in French Guiana, feared adverse effects, or if they did not trust pharmaceutical companies and management of the epidemic by authorities. Conclusion: Negative attitudes towards vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with Gamma VOC. General vaccine hesitancy and concerns about future side effects in particular represent important barriers. Low confidence in government and science are significant in COVID-19 vaccine refusal among non-medical staffs. Public health messaging with information on vaccine safety should be tailored to address these concerns. The specific challenges of HCWs from French Guiana must be taken into account.
Published: 2021
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29. Simultaneous dengue and COVID-19 epidemics: Difficult days ahead?

Author: Stanley Carroll, Audrey Valdes, Maylis Douine, Mélanie Gaillet, Mathieu Nacher, Dominique Rousset, Cyril Rousseau, Nathalie Passard, Chedli Mahdaoui, Félix Djossou, Magalie Demar, Claude Flamand, Loïc Epelboin, Gabriel Carles, 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], Université de Guyane (UG), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité d'Epidémiologie [Cayenne, Guyane française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Réseau de médecins sentinelles, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], The authors received no specific funding for this work., Flamand, Claude, 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)
Subjects: RNA viruses, Viral Diseases, MESH: Coronavirus Infections, Epidemiology, [SDV]Life Sciences [q-bio], RC955-962, [MATH] Mathematics [math], MESH: Dengue, MESH: Hospitalization, Pathology and Laboratory Medicine, Social Distancing, Geographical locations, Dengue fever, Dengue Fever, Dengue, 0302 clinical medicine, Medical Conditions, Arctic medicine. Tropical medicine, Medicine and Health Sciences, 030212 general & internal medicine, [MATH]Mathematics [math], ComputingMilieux_MISCELLANEOUS, Coinfection, [SDV] Life Sciences [q-bio], [STAT]Statistics [stat], Viewpoints, Hospitalization, Infectious Diseases, Medical Microbiology, Viral Pathogens, Viruses, MESH: Betacoronavirus, Public aspects of medicine, RA1-1270, Pathogens, Coronavirus Infections, Brazil, Neglected Tropical Diseases, 2019-20 coronavirus outbreak, MESH: Pandemics, Coronavirus disease 2019 (COVID-19), Infectious Disease Control, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030231 tropical medicine, Physical Distancing, Pneumonia, Viral, Microbiology, Diagnosis, Differential, 03 medical and health sciences, Betacoronavirus, MESH: Diagnosis, Differential, Diagnostic Medicine, medicine, Humans, Microbial Pathogens, Pandemics, MESH: Humans, Biology and life sciences, Flaviviruses, business.industry, SARS-CoV-2, Public Health, Environmental and Occupational Health, Organisms, COVID-19, Covid 19, Dengue Virus, South America, medicine.disease, Tropical Diseases, [STAT] Statistics [stat], MESH: Coinfection, MESH: Pneumonia, Viral, Co-Infections, Medical Risk Factors, MESH: Social Distance, People and places, business, Co infection
Abstract: International audience
Published: 2020
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30. High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in Western French Guiana

Author: Laurence Rochat-Stettler, Maria-Francesca Manca, Anne Jolivet, Jean-François Carod, Camille Agostini, Equipe de Recherche en Epidémiologie Sociale [iPLesp] (ERES), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and CCSD, Accord Elsevier
Subjects: Microbiology (medical), Adult, Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Unprotected sex, lcsh:QR1-502, Chlamydia trachomatis, Urine, medicine.disease_cause, lcsh:Microbiology, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Gonorrhea, Throat, medicine, Prevalence, Humans, lcsh:RC109-216, Risk factor, Retrospective Studies, 0303 health sciences, High prevalence, 030306 microbiology, business.industry, Obstetrics, Retrospective cohort study, Chlamydia Infections, Neisseria gonorrhoeae, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], Infectious Diseases, medicine.anatomical_structure, Female, business
Abstract: International audience; The purpose of this study was to estimate the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in western French Guiana and to analyze associated factors with both infections. A retrospective study was conducted in a sexually transmitted infections clinic in 2017. Women (n=338) were tested by real-time polymerase chain reaction for vaginal, anal and throat CT and NG infections. Men (n=192) were evaluated using urine specimens. Socio-demographic and sexual behaviour data were collected by nurses with a structured questionnaire. The prevalence of CT and NG infections among women were 24.3% and 13.3%, respectively, and 12.0% and 7.3% among men. Women aged under 25 years had a higher risk of CT and NG infections than women aged 35 years or more. Another risk factor for CT infection was low educational level, and occasional unprotected sex for NG infection. CT and NG infections were associated with reporting symptoms among men. Very high prevalences of CT and NG infections among women and men were found, which suggest that a large-scale screening strategy should be implemented in French Guiana.
Published: 2020
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31. Guidelines for pregnant women with suspected SARS-CoV-2 infection

Author: Guillaume Favre, Léo Pomar, Karin Nielsen-Saines, David Baud, Didier Musso, Xiaolong Qi, Lausanne University Hospital, The First Hospital of Lanzhou University, University of California (UC), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Lausanne university hospital, University of California, Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Laboratoire Interdisciplinaire Solidarités, Sociétés, Territoires (LISST), École des hautes études en sciences sociales (EHESS)-Université Toulouse - Jean Jaurès (UT2J)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure de Formation de l'Enseignement Agricole de Toulouse-Auzeville (ENSFEA), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), École des hautes études en sciences sociales (EHESS)-Université Toulouse - Jean Jaurès (UT2J), and Université de Toulouse (UT)-Université de Toulouse (UT)-École Nationale Supérieure de Formation de l'Enseignement Agricole de Toulouse-Auzeville (ENSFEA)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Pregnancy, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pandemic, medicine, Humans, Viral therapy, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, Pregnancy Complications, Infectious, Algorithms, Coronavirus Infections/diagnosis, Coronavirus Infections/therapy, Female, Pandemics, Pneumonia, Viral/diagnosis, Pneumonia, Viral/therapy, Pregnancy Complications, Infectious/diagnosis, Pregnancy Complications, Infectious/therapy, Pregnancy Complications, Infectious/virology, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 030219 obstetrics & reproductive medicine, biology, SARS-CoV-2, business.industry, COVID-19, medicine.disease, biology.organism_classification, Virology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Pneumonia, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Coronavirus Infections, business
Abstract: International audience
Published: 2020
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32. COVID-19 in pregnant women – Authors' reply

Author: Léo Pomar, Guillaume Favre, Didier Musso, David Baud, Xiaolong Qi, Eric Giannoni, Karin Nielsen-Saines, Université de Lausanne (UNIL), University Hospital and University of Lausanne, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Lausanne University Hospital, Lausanne university hospital, The First Hospital of Lanzhou University, University of California, Vecteurs - Infections tropicales et méditerranéennes (VITROME), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA)
Subjects: 2019-20 coronavirus outbreak, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Coronavirus disease 2019 (COVID-19), biology, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), biology.organism_classification, medicine.disease, Virology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Betacoronavirus, Coronavirus Infections, Female, Humans, Pandemics, Pneumonia, Viral, Pregnancy, Pneumonia, Infectious Diseases, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pandemic, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Medicine, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2020
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33. Ultrasound features of fetal toxoplasmosis: A contemporary multicenter survey in 88 fetuses

Author: Nicole Ferret, Catherine Noel, Alexandra Benachi, Anne-Hélène Saliou, Olivier Picone, Léo Pomar, Estelle Cateau, Camille Codaccioni, Fabrice Cuillier, Laurent Mandelbrot, Dorothée Quinio, Norbert Winer, Denis Filisetti, Isabelle Villena, Martine Wallon, A. S. Weingertner, Valérie Vequeau-Goua, Christelle Pomares, Paul Maurice, Guillaume Benoist, Yves Ville, Rose-Anne Lavergne, Laurent Guibaud, Marc Dommergues, Véronique Lambert, Service de gynécologie et obstétrique [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Louis Mourrier, Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Service de Médecine Fœtale [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire de parasitologie et de mycologie médicale [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Département de Radiologie [HCL, Lyon], Hospices civils de Lyon (HCL), Service de Gynécologie-Obstétrique (BREST - Gynéco-Obs), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Laboratoire de Parasitologie et Mycologiede [CHRU Brest], Service de gynécologie-obstétrique, médecine de la reproduction [Béclère], Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gynécologie-Obstétrique [CH Renée Dubos, Pontoise], Centre Hospitalier Renée Dubos [Pontoise], Université Paris Descartes - Paris 5 (UPD5), Service de Gynécologie Obstétrique [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), Laboratoire de Parasitologie-Mycologie, Nice, COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), Laboratoire de parasitologie et mycologie médicale [CHU Strasbourg], CHU Strasbourg, Département de Gynécologie-Obstétrique [CHU Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Service de gynécologie et obstétrique [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Laboratoire de Parasitologie-Mycologie (CHU de Poitiers), Université de Lausanne (UNIL), Hospices Civils de Lyon (HCL), Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle (ESCAPE), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Reims Champagne-Ardenne (URCA), Dupuis, Christine, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Université Nice Sophia Antipolis (1965 - 2019) (UNS), Université de Lausanne = University of Lausanne (UNIL), Université de Reims Champagne-Ardenne (URCA)-Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)
Subjects: 0301 basic medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030105 genetics & heredity, Toxoplasmosis, Congenital, Ultrasonography, Prenatal, Serology, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Ascites, medicine, Humans, Seroconversion, Pregnancy Complications, Infectious, Genetics (clinical), Retrospective Studies, Fetus, 030219 obstetrics & reproductive medicine, business.industry, Ultrasound, Obstetrics and Gynecology, medicine.disease, Toxoplasmosis, 3. Good health, [SDV] Life Sciences [q-bio], Fetal Diseases, Multicenter survey, Small for gestational age, Female, Radiology, medicine.symptom, business
Abstract: Objective: To describe the lesions detected by prenatal ultrasound examination in congenital toxoplasmosis (CT). Methods: We retrospectively analyzed all cases of fetal infection with T. gondii with ultrasound anomalies described by fetal medicine experts in 2009-2019 in 30 French centers. Results: Eighty-eight cases of CT were included. Forty-five (51.1%) had one or more cerebral signs only, 35 (39.8%) had cerebral plus extra-cerebral signs and 8 (9.1%) had extra-cerebral signs only. The main cerebral signs were intracranial hyperechogenic nodular foci (n=60) of which 20 were isolated, ventriculomegalies (n=44) which generally increased during follow-up, and periventricular abscesses (n=12). The main extra-cerebral signs were hepatomegaly and/or splenomegaly (n=14), small for gestational age (n=14), ascites (n=14, including 2 with hydrops), and hyperechogenic bowel (n=11). Maternal infection occurred mostly in the first or second trimester (81 cases), periconceptionally in 1 and in the third trimester in 6 cases. The first ultrasound signs were detected after a median of 7 weeks [range: 1.4; 24.0] following maternal toxoplasmosis seroconversion. Conclusion: While no sign was specific of CT, there were typical associations of cerebral signs with or without extracerebral signs. Detailed ultrasound examination could improve prognostic evaluation, as well as diagnosis of CT in settings lacking serological screening. This article is protected by copyright. All rights reserved.
Published: 2020
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34. Risk factors for premature birth in French Guiana: the importance of reducing health inequalities

Author: Malika Leneuve-Dorilas, Anne Favre, Gabriel Carles, Mathieu Nacher, Alphonse Louis, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais, and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424
Subjects: Adult, Pediatrics, medicine.medical_specialty, Adolescent, Inequality, media_common.quotation_subject, Scarred uterus, Birth rate, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Humans, risk factors, Medicine, Registries, 030212 general & internal medicine, Retrospective Studies, media_common, 030219 obstetrics & reproductive medicine, Perinatal mortality, business.industry, prematurity, Infant, Newborn, Obstetrics and Gynecology, Prenatal Care, Retrospective cohort study, Health Status Disparities, Odds ratio, Middle Aged, medicine.disease, French Guiana, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Premature birth, Pediatrics, Perinatology and Child Health, Premature Birth, Gestation, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Live Birth, Demography
Abstract: International audience; Objectives: French Guiana has the highest birth rate in South America. This French territory alsohas the highest premature birth rate and perinatal mortality rate of all French territories. Theobjective was to determine the premature birth rate and to identify the prevalence of risk factorsof premature birth in French Guiana.Methods: A retrospective study of all births in French Guiana was conducted between January2013 and December 2014 using the computerized registry compiling all live births over 22weeks of gestation on the territory.Results: During this period 12 983 live births were reported on the territory. 13.5% of newbornswere born before 37 (1755/12 983). The study of the registry revealed that common sociodemographicrisk factors of prematurity were present. In addition, past obstetrical history was alsoimportant: a scarred uterus increased the risk of prematurity adjusted odds ratio ¼1.4, 95%CI(1.2–1.6). Similarly, obstetrical surveillance, the absence of preparation for birth or of prenatalinterview increased the risk of prematurity by 2.4 and 2.3, the excess fraction in the populationwas 69% and 72.2%, respectively.Conclusions: Known classical risk factors are important. In the present study excess fractionswere calculated in order to prioritize interventions to reduce the prematurity rate.
Published: 2017
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35. Paid HIV rapid testing in general medicine private practice in French Guiana: a pilot project

Author: Leila Adriouch, Levy-Loeb M, Pierre Couppié, Christian Marty, Mathieu Nacher, S Dimanche, Vincent Vantilcke, Anne Jolivet, Antoine Adenis, Issa Sangare, Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Réseau Kikiwi, Réseau Ville-hôpital VIH, Cayenne, Guyane française, Maison des réseaux de la Guyane, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), 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], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre de dépistage du VIH et des IST, Croix Rouge française, Guyane française, and Croix rouge française
Subjects: 0301 basic medicine, medicine.medical_specialty, Pediatrics, Health professionals, business.industry, 030106 microbiology, Public Health, Environmental and Occupational Health, Human immunodeficiency virus (HIV), virus diseases, General Medicine, medicine.disease_cause, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Hiv test, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Private practice, Family medicine, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Christian ministry, 030212 general & internal medicine, business, Rapid testing
Abstract: International audience; French Guiana has long been the French territory most affected by HIV (Ministry of Health, 2010). Persons unaware of their HIV infection have a preponderant role in the infection of new sexual partners.1 Too often, HIV-infected persons unaware of their infections repeatedly come in contact with physicians without being offered an HIV test.2 In French Guiana, private practitioners perform 70% of all HIV tests and diagnose 45% of new HIV patients.3 Following the national recommendations to do an HIV test each year for every one having sexual relations in French Guiana,4,5 a pilot project using rapid HIV tests in the private practice was developed by the Réseau Kikiwi, a network of health professionals involved in HIV care and testing. The objective here is to present this experience and its evaluation.
Published: 2017
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36. The singular epidemiology of HPV infection among French Guianese women with normal cytology

Author: Vincent Lacoste, Jean Luc Deshayes, Fatiha Najioullah, Hatem Ben Amor, Paul Brousse, Maylis Douine, Vincent Molinie, Raymond Césaire, Odile Kilié, Nadia Thomas, Valentin Dufit, Gabriel Carles, Remy Pignoux, Dominique Catherine, Antoine Adenis, Claire Grenier, Mathieu Nacher, 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), Laboratoire de Virologie [Fort-de-France, Martinique], CHU de la Martinique [Fort de France], Service d'anatomopathologie [Fort de France, Martinique], CHU Fort de France, Service de Gynecologie Obstétrique [Cayenne], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Association de Dépistage Organisé des Cancers de Guyane (AGDOC), Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais, Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), The Study was funded by the European Regional Development Fund (FEDER) Presage number 30814., We wish to thank all study participants and the staff from the health centers of French Guiana., Lacoste, Vincent, Centre d'investigation clinique Antilles-Guyane ( CIC - Antilles Guyane ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU de la Martinique-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Virologie-Immunologie [Fort de France, Martinique], Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Association guyanaise de dépistage organisé des cancers ( AGDOC ), Service de gynécologie-obstétrique [Saint Laurent du Maroni, Guyane Française], Réseau International des Instituts Pasteur ( RIIP ), and Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine ( COREVIH Guyane )
Subjects: MESH: Cervix Uteri/cytology, MESH: Uterine Cervical Neoplasms/pathology, [SDV]Life Sciences [q-bio], MESH: Uterine Cervical Neoplasms/epidemiology, Uterine Cervical Neoplasms, Cervix Uteri, 0302 clinical medicine, Informed consent, Surveys and Questionnaires, Epidemiology, Prevalence, MESH: DNA, Viral/genetics, Medicine, 030212 general & internal medicine, Papillomaviridae, MESH: Aged, MESH: Papillomavirus Infections/epidemiology, Cervical cancer, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Obstetrics, lcsh:Public aspects of medicine, HPV infection, virus diseases, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Uterine Cervical Neoplasms/diagnosis, Middle Aged, female genital diseases and pregnancy complications, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], MESH: Papillomaviridae/genetics, Women's Health Services, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Papillomaviridae/isolation & purification, MESH: Young Adult, 030220 oncology & carcinogenesis, Female, Normal cytology, Research Article, Papanicolaou Test, Adult, medicine.medical_specialty, Human papillomavirus, MESH: French Guiana/epidemiology, Genotype, MESH: Papillomavirus Infections/prevention & control, MESH: Women's Health Services, MESH: Papanicolaou Test, Young Adult, 03 medical and health sciences, MESH: Cross-Sectional Studies, Humans, MESH: Papillomaviridae/classification, MESH: Surveys and Questionnaires, MESH: Uterine Cervical Neoplasms/prevention & control, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Prevalence, MESH: Papillomavirus Infections/pathology, Aged, Gynecology, MESH: Humans, business.industry, Public health, Papillomavirus Infections, Public Health, Environmental and Occupational Health, Cancer, MESH: Adult, lcsh:RA1-1270, medicine.disease, MESH: Papillomavirus Infections/diagnosis, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Concomitant, DNA, Viral, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biostatistics, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND:In French Guiana, cervical cancer is the second most frequent cancer in females. The objective of the present study was to describe the prevalence of HPV infections in women with normal cervical cytology living in the remote villages of French Guiana.METHODS:Before the study, the study team communicated in the remote villages on the importance of screening. All women from the target population were offered to participate. They signed informed consent during inclusion and then had a concomitant HPV-test and cervical smear. Only women with normal cytology and a good quality smear were analyzed. The detection of HPV-DNA was performed using the GREINER-BIO-ONE kit.RESULTS:Overall, 27.2% of women with normal cervical cytology had a positive HPV-test. There was a U-shaped evolution of prevalence with women over 50 years having the highest HPV prevalence, followed by the 20 to 29 years group. The most prevalent HPV genotypes were HPV 53(3.52%), 68(3.33%), 52(2.59%), 31(2.22%) and 16 (1.85%). The proportion of HPV 16 among HPV-infected women was 6.8%.CONCLUSIONS:HPV prevalence in cytologically normal women was very high. The most prevalent genotypes were very different from what is usually described in the world, and notably in South America.
Published: 2017
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37. Authors' reply

Author: David Baud, Karin Nielsen-Saines, Xiaolong Qi, Didier Musso, Léo Pomar, Guillaume Favre, University of California, The First Hospital of Lanzhou University, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française]
Subjects: [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, SARS-CoV-2, Pneumonia, Viral, COVID-19, Infections, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Article, Betacoronavirus, Infectious Diseases, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Humans, Coronavirus Infections, Pandemics, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2020
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38. Épidémiologie des infections à mycobactéries non tuberculeuses d'expression respiratoire en Guyane française, étude rétrospective 2008-2018

Author: Sabine Trombert-Paolantoni, Stéphanie Thomas, M. Chaptal, Timothée Bonifay, S. Guyomard, A. Lucarelli, Félix Djossou, Fabrice Flament, Véronique Jiacomo, Vincent Vantilke, Geneviève Guillot, Claire Andrejak, Emilie Mosnier, Balthazar Ntab, V. Travers, Tania Vaz, E. Beillard, Hatem Kallel, Loïc Epelboin, Nicolas Veziris, M. Boutrou, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Université de Pau et des Pays de l'Adour (UPPA), Immunobiologie des Cellules dendritiques, Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité des Maladies Virales Emergentes (UMVE), Centre International de Recherches Médicales de Franceville (CIRMF), Pôle des urgences [CH Andrée Rosemon, Guyane Française], Institut Pasteur de la Guadeloupe, Réseau International des Instituts Pasteur (RIIP), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité des Maladies Infectieuses et Tropicales [Cayenne, Guyane Française], Université de Guyane (UG), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Amiens-Picardie, Unité de Soins et de Consultations Ambulatoires [Cayenne, Guyane Française] (UCSA), Département de Médecine Interne [Cayenne, Guyane Française], Centre Intégré de drépanocytose [Cayenne, Guyane Française], Direction des informations médicales [Saint-Laurent Du Maroni, Guyane française] (DIM), Service de réanimation [Cayenne, Guyane française], Croix-rouge française [Cayenne, Guyane Fraçaise], Cabinet libéral de médecine générale [Cayenne, Guyane française], Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Hôpital de Jour Adultes [Cayenne, Guyane Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Cayenne General Hospital, Direction des informations médicales [Kourou, Guyane française], Institut Pasteur de la Guyane, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire CERBA [Saint Ouen l'Aumône], Eurofins Biomnis, Matillon, Mirlène, Université des Antilles - UFR des sciences médicales Hyacinthe Bastaraud (UA UFR SM), Université des Antilles (UA), Dupuis, Christine, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: [SDV] Life Sciences [q-bio], Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, 030220 oncology & carcinogenesis, [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS, 3. Good health
Abstract: International audience; IntroductionL’épidémiologie des infections causées par les mycobactéries non tuberculeuses d’expression respiratoire (MBNTER) est mal connue en Amérique latine, et en Guyane française en particulier. L’objectif principal de cette étude était de déterminer les caractéristiques de ces infections en Guyane. Les objectifs secondaires étaient de déterminer l’incidence des maladies pulmonaires liées aux MBNTER (MBNT-MP), et les caractéristiques spécifiques des malades infectés à Mycobacterium avium complexe (MAC) ou M. abscessus et de ceux infectés par le VIH.MéthodesIl s’agit d’une étude rétrospective observationnelle multicentrique entre 2008 et 2018, réalisée sur tous les hôpitaux de Guyane. Étaient inclus les patients ayant eu au moins une culture positive à MBNTER sur prélèvement respiratoire. Les cas étaient classés en 2 catégories : porteurs non malades et malades dues à une atteinte pulmonaire liée à MBNTER selon les critères définis par l’American Thoracic Society/Infectious Disease Society of America (ATS/IDSA) en 2007.RésultatsSur la période d’étude, 178 cas ont été inclus, parmi lesquels 147 étaient porteurs non malades et 31 malades. Les patients étaient plutôt des hommes (61 %), jeunes (âge médian 49 ans), vivant dans la précarité (64 %) avec des comorbidités respiratoires (33 %) ou une immunodépression avec des CD4 ≤ 50/mm3 dans 39 % des 46 % de patients séropositifs pour le VIH. Les MAC suivies de M. fortuitum puis M. abscessus étaient les plus fréquentes (38 %, 19 % et 6 % respectivement). Le taux d’incidence annuel moyen de MBNT-MP était à 1,07/100 000 habitants par an. La MBNT-MP était significativement associée à l’infection par le VIH, à la dénutrition, et aux espèces MAC et M. abscessus qui représentaient respectivement 81 % et 16 % des maladies pulmonaires à MBNT. La mortalité à un an toutes causes confondues était de 29 % chez les malades.ConclusionIl s’agit de la première étude réalisée sur les infections à MBNTER en Guyane. L’épidémiologie des MBNTER y est spécifique avec une population différente de celle de France métropolitaine. MAC et M. abscessus sont les espèces responsables de maladies respiratoires favorisées par une infection par le VIH, ou par des comorbidités respiratoires et la dénutrition, respectivement. Les caractéristiques chez le séropositif pour le VIH sont différentes et les critères ATS/IDSA n’y sont pas extrapolables rendant le diagnostic difficile. La mortalité est plus élevée en Guyane qu’en France métropolitaine.
Published: 2020
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39. A critical analysis of the neurodevelopmental and neurosensory outcomes after 2 years for children with in utero Zika virus exposure

Author: Manon Vouga, David Baud, Léo Pomar, Didier Musso, Alice Panchaud, Université de Lausanne = University of Lausanne (UNIL), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Université de Lausanne (UNIL), and Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
Subjects: Pediatrics, medicine.medical_specialty, General Biochemistry, Genetics and Molecular Biology, Article, Zika virus, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pregnancy, Medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, Child, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, 0303 health sciences, biology, business.industry, Zika Virus Infection, General Medicine, Zika Virus, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, In utero, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, business
Abstract: International audience
Published: 2019
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40. Usefulness of C-Reactive Protein in Differentiating Acute Leptospirosis and Dengue Fever in French Guiana

Author: Mathieu Nacher, Loïc Epelboin, Timothée Bonifay, Pascale Bourhy, Magalie Demar, Félix Djossou, Anne Jolivet, Emilie Mosnier, Paul Le Turnier, Roxane Schaub, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université des Antilles (UA), 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 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), 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), Centre National de Référence de la Leptospirose - National Reference Center Leptospirosis (CNR), Institut Pasteur [Paris], The authors acknowledge Rachida Boukhari (Hopital Franck Joly, Saint-Laurent du Maroni, French Guiana), Anne Terraz (Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana), Denis Blanchet (Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana), and Mathieu Picardeau (Institut Pasteur, Centre National de Référence de la Leptospirose, Paris, France) for their help in the data collection., 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], Institut Pasteur [Paris] (IP), and Matillon, Mirlène
Subjects: 0301 basic medicine, myalgia, medicine.medical_specialty, Anemia, diagnosis, [SDV]Life Sciences [q-bio], 030106 microbiology, 030231 tropical medicine, Neutropenia, Dengue fever, Major Articles, C-reactive protein, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, dengue fever, leptospirosis, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, Creatinine, biology, business.industry, medicine.disease, Leptospirosis, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Oncology, chemistry, biology.protein, Biomarker (medicine), medicine.symptom, business
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., Leptospirosis and dengue fever are hard-to-differentiate diseases in the tropics. In this case-control study, their presentation on admission was compared. A C-reactive protein (CRP) level >50 mg/L was associated with leptospirosis. 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.
Published: 2019
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41. Placental infection by Zika virus in French Guiana

Author: Yoann Madec, C. Pomar, Léo Pomar, Arnaud Fontanet, Alice Panchaud, Manon Vouga, Séverine Matheus, David Baud, Véronique Lambert, Gabriel Carles, Université de Lausanne = University of Lausanne (UNIL), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Institut Pasteur [Paris] (IP), Université de Genève = University of Geneva (UNIGE), Université de Lausanne (UNIL), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut Pasteur [Paris], Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), and University of Geneva [Switzerland]
Subjects: placental pathology, Placenta Diseases, Placenta, Zika virus, 0302 clinical medicine, Pregnancy, Medicine, 030212 general & internal medicine, Prospective Studies, Pregnancy Complications, Infectious, 030219 obstetrics & reproductive medicine, Radiological and Ultrasound Technology, biology, ultrasound, Zika Virus Infection, Hazard ratio, Obstetrics and Gynecology, Gestational age, General Medicine, 3. Good health, French Guiana, Fetal Diseases, Uterine Artery, medicine.anatomical_structure, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, medicine.symptom, Adult, medicine.medical_specialty, Asymptomatic, Ultrasonography, Prenatal, 03 medical and health sciences, Zika, placentomegaly, Humans, Radiology, Nuclear Medicine and imaging, Epidemics, Fetal Death, Gynecology, Fetus, business.industry, Ultrasonography, Doppler, Zika Virus, biology.organism_classification, medicine.disease, congenital infection, Reproductive Medicine, Relative risk, business
Abstract: To describe placental findings on prenatal ultrasound and anatomopathological examination in women with Zika virus (ZIKV) infection, and to assess their association with congenital ZIKV infection and severe adverse outcome, defined as fetal loss or congenital Zika syndrome (CZS).This was a prospective study of pregnancies undergoing testing for maternal ZIKV infection at a center in French Guiana during the ZIKV epidemic. In ZIKV-positive women, congenital infection was defined as either a positive reverse transcription polymerase chain reaction result or identification of ZIKV-specific immunoglobulin-M in at least one placental, fetal or neonatal sample. Placental ZIKV-infection status was classified as non-exposed (placentae from non-infected women), exposed (placentae from ZIKV-infected women without congenital infection) or infected (placentae from ZIKV-infected women with proven congenital infection). Placentae were assessed by monthly prenatal ultrasound examinations, measuring placental thickness and umbilical artery Doppler parameters, and by anatomopathological examination after live birth or intrauterine death in women with ZIKV infection. The association of placental thickness during pregnancy and anatomopathological findings with the ZIKV status of the placenta was assessed. The association between placental findings and severe adverse outcome (CZS or fetal loss) in the infected group was also assessed.Among 291 fetuses/neonates/placentae from women with proven ZIKV infection, congenital infection was confirmed in 76 cases, of which 16 resulted in CZS and 11 resulted in fetal loss. The 215 remaining placentae from ZIKV-positive women without evidence of congenital ZIKV infection represented the exposed group. A total of 334 placentae from ZIKV-negative pregnant women represented the non-exposed control group. Placentomegaly (placental thickness 40 mm) was observed more frequently in infected placentae (39.5%) than in exposed placentae (17.2%) or controls (7.2%), even when adjusting for gestational age at diagnosis and comorbidities (adjusted hazard ratio (aHR), 2.02 (95% CI, 1.22-3.36) and aHR, 3.23 (95% CI, 1.86-5.61), respectively), and appeared earlier in infected placentae. In the infected group, placentomegaly was observed more frequently in cases of CZS (62.5%) or fetal loss (45.5%) than in those with asymptomatic congenital infection (30.6%) (aHR, 5.43 (95% CI, 2.17-13.56) and aHR, 4.95 (95% CI, 1.65-14.83), respectively). Abnormal umbilical artery Doppler was observed more frequently in cases of congenital infection resulting in fetal loss than in those with asymptomatic congenital infection (30.0% vs 6.1%; adjusted relative risk (aRR), 4.83 (95% CI, 1.09-20.64)). Infected placentae also exhibited a higher risk for any pathological anomaly than did exposed placentae (62.8% vs 21.6%; aRR, 2.60 (95% CI, 1.40-4.83)).Early placentomegaly may represent the first sign of congenital infection in ZIKV-infected women, and should prompt enhanced follow-up of these pregnancies. Copyright © 2019 ISUOG. Published by John WileySons Ltd.
Published: 2019
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42. Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management

Author: Manon Vouga, David Baud, Sophie Masmejan, Sara V de Meyer, Milos Stojanov, Yen-Chi Chiu, Didier Musso, Blaise Genton, Léo Pomar, Université de Lausanne (UNIL), Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Swiss Tropical and Public Health Institute [Basel], Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Division of Molecular Genome Analysis, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Université de Lausanne = University of Lausanne (UNIL), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
Subjects: medicine.medical_specialty, 030231 tropical medicine, Review, Dengue virus, medicine.disease_cause, Zika virus, Dengue fever, Dengue, 03 medical and health sciences, 0302 clinical medicine, Zika, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pregnancy, Medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, Chikungunya, Pregnancy Complications, Infectious, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, Aedes, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Travel, biology, business.industry, Epidemiological Factors, Transmission (medicine), Zika Virus Infection, General Medicine, biology.organism_classification, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Chikungunya Fever, Female, business
Abstract: Rationale for reviewYoung adults of childbearing age and pregnant women are travelling more frequently to tropical areas, exposing them to specific arboviral infections such as dengue, zika and chikungunya viruses, which may impact ongoing and future pregnancies. In this narrative review, we analyse their potential consequences on pregnancy outcomes and discuss current travel recommendations.Main findingsDengue virus may be associated with severe maternal complications, particularly post-partum haemorrhage. Its association with adverse fetal outcomes remains unclear, but prematurity, growth retardation and stillbirths may occur, particularly in cases of severe maternal infection. Zika virus is a teratogenic infectious agent associated with severe brain lesions, with similar risks to other well-known TORCH pathogens. Implications of chikungunya virus in pregnancy are mostly related to intrapartum transmission that may be associated with severe neonatal infections and long-term morbidity.Travel recommendationsFew agencies provide specific travel recommendations for travelling pregnant patients or couples trying to conceive and discrepancies exist, particularly regarding Zika virus prevention. The risks significantly depend on epidemiological factors that may be difficult to predict. Prevention relies principally on mosquito control measures. Couples trying to conceive and pregnant women should receive adequate information about the potential risks. It seems reasonable to advise pregnant women to avoid unnecessary travel to Aedes spp. endemic regions. The current rationale to avoid travel and delay conception is debatable in the absence of any epidemic. Post-travel laboratory testing should be reserved for symptomatic patients.
Published: 2019
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43. Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research

Author: Elsa Kermorvant-Duchemin, Guillaume Binson, Cécile Desbruyeres, Roselyne Brat, Evelyne Jacqz-Aigrain, Anne-Sophie Pages, Guillaume Escourrou, Duksha Ramful, Séverine Martin-Mons, Gaël Mazeiras, Amélie Moussy-Durandy, Julien Mourdie, Ceneric Alexandre, Francesco Bonsante, Marine Dorsi, Florence Le Bail Dantec, Laurence Caeymaex, Yaovi Kugbe, Olivier Flechelles, Soumeth Abasse, Béatrice Gouyon, Anaelle Pignolet, Massimo Di Maio, Abdellah ElGellab, Yvan Couringa, Mohamed-Amine Yangui, Elodie Marie Garnier, Alexandre Lapillonne, Karine Norbert, Catherine Lafon, Jean-Bernard Gouyon, Hasinirina Razafimahefa, Simon Lorrain, Silvia Iacobelli, Florence Flamein, Delphine Mitanchez, Léila Karaoui, Olivier Girard, Jean-Marc Rosenthal, Centre d'Études Périnatales de l'Océan Indien (CEPOI), Université de La Réunion (UR)-Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Centre Hospitalier Sud Francilien, CH Evry-Corbeil, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional d'Orléans (CHRO), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Groupe Hospitalier Artois-Ternois Centre Hospitalier d’Arras, Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Lille, centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier Métropole Savoie [Chambéry], Groupe Hospitalier du Havre Hôpital Jacques Monod (MONTIVILLIERS) (GHH), Centre Hospitalier Intercommunal André Grégoire [Montreuil] (CHI André Gregoire), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre Hospitalier de Mayotte, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier Public du Cotentin (CHPC), Centre hospitalier territorial Gaston-Bourret [Nouméa], Grand Hôpital de l'Est Francilien (GHEF), Centre Hospitalier de Lens, Centre hospitalier Saint-Brieuc, Centre Hospitalier René Dubos [Pontoise], Centre hospitalier de Pau, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Robert Debré, and Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)
Subjects: Male, Pediatrics, Databases, Factual, Organic chemistry, Medication prescription, Neonatal Care, 0302 clinical medicine, Antibiotics, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Summary of Product Characteristics, Practice Patterns, Physicians', Vitamin D, Routes of Administration, Multidisciplinary, Antimicrobials, Gestational age, Drugs, Vitamins, 3. Good health, Chemistry, Physical Sciences, Female, Infant, Premature, Cohort study, Research Article, medicine.medical_specialty, Prescription Drugs, Science, Cardiology, Gestational Age, Drug Prescriptions, Microbiology, 03 medical and health sciences, Alkaloids, 030225 pediatrics, Caffeine, Microbial Control, Patients' Rooms, Organic compounds, Humans, Medical prescription, Retrospective Studies, Polypharmacy, Pharmacology, business.industry, Infant, Newborn, Chemical Compounds, Biology and Life Sciences, Neonates, Retrospective cohort study, Environmental Exposure, Health Care, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Observational study, Neonatology, business, Developmental Biology
Abstract: ObjectivesThe primary objective of this study is to determine the current level of patient medication exposure in Level 3 Neonatal Wards (L3NW). The secondary objective is to evaluate in the first month of life the rate of medication prescription not cited in the Summary of Product Characteristics (SmPC). A database containing all the medication prescriptions is collected as part of a prescription benchmarking program in the L3NW.Material and methodsThe research is a two-year observational cohort study (2017-2018) with retrospective analysis of medications prescribed in 29 French L3NW. Seventeen L3NW are present since the beginning of the study and 12 have been progressively included. All neonatal units used the same computerized system of prescription, and all prescription data were completely de-identified within each hospital before being stored in a common data warehouse.ResultsThe study population includes 27,382 newborns. Two hundred and sixty-one different medications (International Nonproprietary Names, INN) were prescribed. Twelve INN (including paracetamol) were prescribed for at least 10% of patients, 55 for less than 10% but at least 1% and 194 to less than 1%. The lowest gestational ages (GA) were exposed to the greatest number of medications (18.0 below 28 weeks of gestation (WG) to 4.1 above 36 WG) (pConclusionNeonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.
Published: 2019
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44. Impact of Zika Virus Emergence in French Guiana: A Large General Population Seroprevalence Survey

Author: Dominique Rousset, Juliette Paireau, Sarah Bailly, Félix Djossou, Antoine Enfissi, Jean-François Carod, Claude Flamand, Mirdad Kazanji, Séverine Matheus, Camille Fritzell, Henrik Salje, Léna Berthelot, J.-C. Manuguerra, Sandrine Fernandes-Pellerin, Simon Cauchemez, Sébastien Linares, Jessica Vanhomwegen, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Cellule d'Intervention Biologique d'Urgence - Laboratory for Urgent Response to Biological Threats (CIBU), Institut Pasteur [Paris] (IP), Environnement et Risques infectieux - Environment and Infectious Risks (ERI), Modélisation mathématique des maladies infectieuses - Mathematical modelling of Infectious Diseases, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche Translationnelle - Center for Translational Science (CRT), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], This study was supported by the European Regional Development Fund under EPI-ARBO grant agreement GY0008695, the Regional Health Agency of French Guiana, and the National Center of Spatial Studies. C. Fl. acknowledges financial support from the Centre National d’Etudes Spatiales-Terre solide, Océan, Surfaces Continentales, Atmosphère fund (grant number CNES-TOSCA-4800000720) and funding from Calmette and Yersin allocated by the Pasteur Institut Department of International Affairs. S. C. acknowledges financial support from the AXA Research Fund, the Investissement d’Avenir program, the Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases program (grant number ANR-10-LABX-62-IBEID), the Models of Infectious Disease Agent Study of the National Institute of General Medical Sciences, the INCEPTION project (PIA/ANR-16-CONV-0005), and the European Union’s Horizon 2020 research and innovation program under ZIKAlliance grant agreement number 734548., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), ANR-16-CONV-0005,INCEPTION,Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs(2016), European Project: 734548,ZIKAlliance(2016), Salje, Henrik [0000-0003-3626-4254], Apollo - University of Cambridge Repository, Institut Pasteur [Paris], Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), ROUSSET, Dominique, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Institut Convergences pour l'étude de l'Emergence des Pathologies au Travers des Individus et des populatiONs - - INCEPTION2016 - ANR-16-CONV-0005 - CONV - VALID, and A global alliance for Zika virus control and prevention - ZIKAlliance - 2016-10-01 - 2019-09-30 - 734548 - VALID
Subjects: 0301 basic medicine, Male, Recombinant antigen, Communicable Diseases, Emerging, Serology, Zika virus, 0302 clinical medicine, Seroepidemiologic Studies, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, Immunology and Allergy, MESH: Communicable Diseases, Emerging, Geography, Medical, Child, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Aged, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, MESH: Middle Aged, Zika Virus Infection, Middle Aged, 3. Good health, French Guiana, Infectious Diseases, MESH: Young Adult, Child, Preschool, Population Surveillance, Viruses, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Adult, Adolescent, 030231 tropical medicine, Population, Biology, Virus, MESH: Population Surveillance, Major Articles and Brief Reports, 03 medical and health sciences, Young Adult, MESH: Zika Virus Infection, MESH: Cross-Sectional Studies, MESH: Geography, Medical, MESH: French Guiana, Seroprevalence, Humans, Serologic Tests, General population survey, education, Aged, MESH: Adolescent, MESH: Humans, MESH: Seroepidemiologic Studies, seroprevalence study, general population survey, MESH: Serologic Tests, MESH: Child, Preschool, MESH: Adult, Serum samples, biology.organism_classification, MESH: Male, 030104 developmental biology, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female, Demography
Abstract: Background Since the identification of Zika virus (ZIKV) in Brazil in May 2015, the virus has spread throughout the Americas. However, ZIKV burden in the general population in affected countries remains unknown. Methods We conducted a general population survey in the different communities of French Guiana through individual interviews and serologic survey during June–October 2017. All serum samples were tested for anti-ZIKV immunoglobulin G antibodies using a recombinant antigen-based SGERPAxMap microsphere immunoassay, and some of them were further evaluated through anti-ZIKV microneutralization tests. Results The overall seroprevalence was estimated at 23.3% (95% confidence interval [CI], 20.9%–25.9%) among 2697 participants, varying from 0% to 45.6% according to municipalities. ZIKV circulated in a large majority of French Guiana but not in the most isolated forest areas. The proportion of reported symptomatic Zika infection was estimated at 25.5% (95% CI, 20.3%–31.4%) in individuals who tested positive for ZIKV. Conclusions This study described a large-scale representative ZIKV seroprevalence study in South America from the recent 2015–2016 Zika epidemic. Our findings reveal that the majority of the population remains susceptible to ZIKV, which could potentially allow future reintroductions of the virus., This study provides a consistent overview of a large-scale representative Zika virus (ZIKV) seroprevalence study in French Guiana, revealing that the majority of the population remains susceptible to ZIKV, which could potentially allow future reintroductions of the virus.
Published: 2019
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45. High mortality due to congenital malformations in children aged < 1 year in French Guiana

Author: Narcisse Elenga, Mathieu Nacher, Anne Favre, Véronique Lambert, Gabriel Carles, 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], Centre Hospitalier de l'Ouest Guyanais, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de Gynécologie Obstétrique, Service de Pédiatrie [Cayenne, Guyanne Française], and Bodescot, Myriam
Subjects: Male, Pediatrics, medicine.medical_specialty, Cardiovascular Abnormalities, 030231 tropical medicine, Chromosome Disorders, Disease, Nervous System Malformations, Congenital Abnormalities, Circulatory apparatus, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, parasitic diseases, Humans, Medicine, 030212 general & internal medicine, Mortality, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Incidence, Incidence (epidemiology), Mortality rate, High mortality, Infant, Newborn, lcsh:RJ1-570, Absolute risk reduction, Infant, lcsh:Pediatrics, Congenital malformations, 3. Good health, French Guiana, Relative risk, Pediatrics, Perinatology and Child Health, Neurological, Malformations, Female, France, business, Research Article
Abstract: International audience; BACKGROUND: In French Guiana, pregnant women may be exposed to infectious, environmental, and social risks leading to congenital malformation. The objective of the study was to study mortality rates from congenital malformations among infants
Published: 2018
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46. Modeling of the HIV epidemic and continuum of care in French Guiana

Author: Leila Adriouch, Félix Djossou, Florence Huber, Pierre Couppié, Antoine Adenis, Narcisse Elenga, Vincent Vantilcke, Mathieu Nacher, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne, Guyane] (COREVIH), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], 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), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Service de Médecine [CH de l'Ouest Guyanais], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Service des maladies infectieuses et tropicales [Cayenne, Guyane Française], Service de Pédiatrie [Cayenne, Guyanne Française], Service de Dermatologie et Vénérologie [Cayenne, French Guiana], and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424
Subjects: RNA viruses, Male, European People, Epidemiology, Hiv epidemic, Human immunodeficiency virus (HIV), lcsh:Medicine, HIV Infections, medicine.disease_cause, Pathology and Laboratory Medicine, Geographical locations, 0302 clinical medicine, Immunodeficiency Viruses, Risk Factors, Epidemiological Statistics, Medicine, Ethnicities, 030212 general & internal medicine, French People, Continuum of care, lcsh:Science, education.field_of_study, Multidisciplinary, Antimicrobials, Incidence (epidemiology), Incidence, Drugs, Antiretrovirals, HIV diagnosis and management, Continuity of Patient Care, Antivirals, 3. Good health, French Guiana, Europe, HIV epidemiology, Medical Microbiology, Viral Pathogens, Cohort, Viruses, Infectious diseases, Epidemiological Methods and Statistics, Female, France, Pathogens, Research Article, Adult, 030231 tropical medicine, Population, Viral diseases, Microbiology, 03 medical and health sciences, Microbial Control, Virology, Retroviruses, Population growth, Humans, European Union, education, Epidemics, Microbial Pathogens, Medicine and health sciences, Pharmacology, Models, Statistical, business.industry, lcsh:R, Lentivirus, Organisms, Biology and Life Sciences, HIV, Diagnostic medicine, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, People and Places, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Population Groupings, business, Demography
Abstract: International audience; BACKGROUND:In order to compute the continuum of care for French Guiana, it is necessary to estimate the total number of persons living with HIV. The main objective was to determine how many persons were infected with HIV and how many were unaware of it.METHODS:We used 2 different models to calculate the total number of persons infected with HIV: Spectrum's AIM module using CSAVR to compute incidence from case registration and vital statistics; and the ECDC model from the French Guiana HIV cohort data.RESULT:The present results show that both models led to similar results regarding the incident number of cases (i.e. for 2016 174 versus 161) and the total HIV population (in 2016 3206 versus 3539) respectively. The ECDC modeling tool showed that the proportion of undiagnosed HIV infections declined from 50% in 1990 to 15% in 2015. This amounted to a stable or slightly increasing total number of undiagnosed patients of 520.CONCLUSIONS:The estimations of the total HIV population by both models show that the HIV population is still growing. The incidence rate declined in 2000 and the decline of the number of newly acquired HIV infections, after a decline after 2003 is offset by population growth. The proportion of undiagnosed infections has declined to 15% but the number of undiagnosed infections remains stable. The HIV cascade shows that despite good results for treatment in care, reaching the 90*90*90 UNAIDS target may be difficult because a significant proportion of patients are lost to follow-up.
Published: 2018
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47. Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas

Author: Yoann Madec, Cécile Herrmann-Storck, Arnaud Fontanet, Bruno Hoen, Caroline Callier, Raymond Césaire, Dominique Rousset, Alice Monthieux, Cédric Laouénan, Manon Boullard, Anna L. Funk, Maylis Douine, S. Stegmann-Planchard, Benoit Tressières, Bruno Schaub, Fatiha Najioullah, Jean-Luc Voluménie, Eustase Janky, André Cabié, Gabriel Carles, Kinda Schepers, Samson Yassinguezo, Sylvie Cassadou, Vanessa Ardillon, Philippe Kadhel, Mathieu Nacher, Catherine Ryan, CHU Pointe-à-Pitre/Abymes [Guadeloupe], 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], Université des Antilles et de la Guyane (UAG), Maison de la Femme de la Mère et de l'Enfant [CHU de la Martinique] (MFME [Fort de France]), CHU de la Martinique [Fort de France], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université des Antilles et de la Guyane - UFR des sciences médicales (UAG UFR SM), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre Hospitalier Louis Constant Fleming, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale (CGH), Institut Pasteur [Paris] (IP)-Réseau International des Instituts Pasteur (RIIP), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Supported by the French Ministry of Health (Soutien Exceptionnel à la Recherche et à l’Innovation), by a grant (ANR-10-LABX-62-IBEID) from Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases project, by the ZIKAlliance consortium (the European Union’s Horizon 2020 Research and Innovation Program), and by INSERM. This study is part of the ZIKAlliance consortium project., We thank the women who participated in this study, all the physicians, midwives, clinical research assistants, health officers, and epidemiologists who helped conduct this study in each of the French territories in the Americas: Myriam Atine, Lyderic Aubert, Marie Barrau, Kebe Beavogui, Christelle Celeste, Joelle Colat-Peyron, Elvire Couchy, Véronique Davidas, Lucetta Delver, Jacqueline Dubois, Stanie Gaete, Dorothée Harrois, Marie-Laure Lalanne-Mistrih, Mathilde Melin, Marie-France Mirane, Francelise Nadessein, Marie-Josée Pelczar, Véronique Plantier, Céline Rocquet, Magdalena Saint-Marc, Patrick Saint-Martin, Valérie Soter, Ingrid Soubdhan, Jennifer Taillefond, Lambo Velonasy, and Véronique Walter (Guadeloupe), Nicole Ambroisine, Gilda Belrose, Alain Blateau, Patricia Blondel, Isabelle Calmont, Valérie Decatrelle, Michèle Gueneret, Eugénie Jolivet, Isabelle Komla-Soukha, Corinne Plavonil, Marie-andrée Pyram, and Jean-Luc Voluménie (Martinique), Antoine Adenis, Audrey Andrieu, Luisiane Carvalho, Sandy Dabrowski, Céline Delorme, Maryvonne Dueymes, Aniza Fahrasmane, Arthur Felix, Hélène Hilderal, Anne Jolivet, Justine Krajewsky, Véronique Lambert, Thomas Lemaitre, Myriam Livain, Jérémie Pasquier, Marion Petit-Sinturel, Céline Pomar, Léo Pomar, and Stéphanie Rogier (French Guiana), and David Baud (University of Lausanne, Switzerland) and Rebecca Grant (Institut Pasteur de Paris, France) for their critical review of an earlier version of the manuscript., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), Jonchère, Laurent, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, 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], Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-CHU de la Martinique [Fort de France], and Réseau International des Instituts Pasteur (RIIP)-Institut Pasteur [Paris]
Subjects: 0301 basic medicine, Microcephaly, [SDV]Life Sciences [q-bio], Chromosome Disorders, MESH: Amniotic Fluid, Zika virus, Cohort Studies, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, MESH: Martinique, ZikV Infection, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, Prospective cohort study, Guadeloupe, MESH: Cohort Studies, MESH: Chromosome Disorders, MESH: Middle Aged, biology, Zika Virus Infection, Obstetrics, MESH: Infant, Newborn, Pregnancy Outcome, Gestational age, MESH: Congenital Abnormalities, General Medicine, Middle Aged, French Guiana, 3. Good health, [SDV] Life Sciences [q-bio], Fetal Diseases, MESH: Fetal Diseases, MESH: Young Adult, Cohort, Female, Pregnancy Trimesters, Adult, medicine.medical_specialty, Adolescent, MESH: Zika Virus, Article, MESH: Microcephaly, Congenital Abnormalities, Young Adult, 03 medical and health sciences, MESH: Zika Virus Infection, MESH: French Guiana, Humans, MESH: Guadeloupe, Martinique, MESH: Pregnancy Complications, Infectious, Pregnancy outcomes, MESH: Adolescent, Fetus, MESH: Humans, business.industry, Infant, Newborn, MESH: Adult, Zika Virus, Amniotic Fluid, medicine.disease, biology.organism_classification, MESH: Pregnancy Outcome, Confidence interval, 030104 developmental biology, business, MESH: Female, MESH: Pregnancy Trimesters
Abstract: International audience; BACKGROUND:The risk of congenital neurologic defects related to Zika virus (ZIKV) infection has ranged from 6 to 42% in various reports. The aim of this study was to estimate this risk among pregnant women with symptomatic ZIKV infection in French territories in the Americas.METHODS:From March 2016 through November 2016, we enrolled in this prospective cohort study pregnant women with symptomatic ZIKV infection that was confirmed by polymerase-chain-reaction (PCR) assay. The analysis included all data collected up to April 27, 2017, the date of the last delivery in the cohort.RESULTS:Among the 555 fetuses and infants in the 546 pregnancies included in the analysis, 28 (5.0%) were not carried to term or were stillborn, and 527 were born alive. Neurologic and ocular defects possibly associated with ZIKV infection were seen in 39 fetuses and infants (7.0%; 95% confidence interval, 5.0 to 9.5); of these, 10 were not carried to term because of termination of pregnancy for medical reasons, 1 was stillborn, and 28 were live-born. Microcephaly (defined as head circumference more than 2 SD below the mean for sex and gestational age) was detected in 32 fetuses and infants (5.8%), of whom 9 (1.6%) had severe microcephaly (more than 3 SD below the mean). Neurologic and ocular defects were more common when ZIKV infection occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001).CONCLUSIONS:Among pregnant women with symptomatic, PCR-confirmed ZIKV infection, birth defects possibly associated with ZIKV infection were present in 7% of fetuses and infants. Defects occurred more frequently in fetuses and infants whose mothers had been infected early in pregnancy. Longer-term follow-up of infants is required to assess any manifestations not detected at birth. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT02916732 .).
Published: 2018
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48. Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection

Author: Dominique Rousset, Bhety Labeau, Mirdad Kazanji, Séverine Matheus, Laetitia Bremand, Rachida Boukhari, Valérie Ernault, Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), and Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française]
Subjects: 0301 basic medicine, Letter, cross-reactivity, Epidemiology, viruses, specificity, lcsh:Medicine, NS1 antigen, Viral Nonstructural Proteins, Dengue virus, medicine.disease_cause, Serology, Zika virus, Dengue fever, Dengue, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, differential diagnosis, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, Zika Virus Infection, Transmission (medicine), Yellow fever, virus diseases, French Guiana, 3. Good health, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Saint Louis encephalitis, Microbiology (medical), 030231 tropical medicine, 030106 microbiology, Enzyme-Linked Immunosorbent Assay, Cross Reactions, Sensitivity and Specificity, Virus, NS1 protein, lcsh:Infectious and parasitic diseases, Diagnosis, Differential, 03 medical and health sciences, Zika, medicine, Humans, lcsh:RC109-216, Letters to the Editor, Specificity of Dengue NS1 Antigen in Differential Diagnosis of Dengue and Zika Virus Infection, lcsh:R, Zika Virus, Dengue Virus, biochemical phenomena, metabolism, and nutrition, medicine.disease, biology.organism_classification, Virology, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, nonstructural protein
Abstract: To the Editor: Circulation of new arboviruses of the genus Flavivirus poses a major problem for differential diagnosis. Zika virus, a mosquitoborne virus of the family Flaviviridae, is closely related to other arboviruses circulating in the Americas, including dengue, yellow fever, Saint Louis encephalitis, and West Nile viruses (1,2). Serologic cross-reactivity between these arboviruses is common; thus, to ensure optimal patient care and accurate epidemiologic surveillance, an effective differential diagnosis is required in regions with active transmission of dengue virus and circulation of Zika virus (2–4).
Published: 2016
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49. Predictors of abnormal cytology among HPV-infected women in remote territories of French Guiana

Author: Jerome Ponty, Raymond Césaire, Nadia Thomas, Vincent Molinie, Claire Grenier, Valentin Dufit, Maylis Douine, Laure Bianco, Mathieu Nacher, Paul Brousse, Antoine Adenis, Dominique Catherine, Gabriel Carles, Fatiha Najioullah, Odile Kilié, Jean Luc Deshayes, Vincent Lacoste, 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], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Service d'anatomopathologie [Fort de France, Martinique], CHU Fort de France, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Association Guyanaise Dépistage Organisé des Cancers [Cayenne] (A.G.D.O.C), Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), The present study was funded by the European Regional Development Funds (FEDER) N° Presage 30,814., 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]
Subjects: Rural Population, [SDV]Life Sciences [q-bio], Uterine Cervical Neoplasms, MESH: Genotype, 0302 clinical medicine, MESH: Rural Population, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Cytology, Genotype, Medicine, 030212 general & internal medicine, Life history, Papillomaviridae, Anamnesis, MESH: Aged, MESH: Middle Aged, lcsh:Public aspects of medicine, Obstetrics and Gynecology, virus diseases, General Medicine, MESH: Papillomavirus Vaccines, Middle Aged, Abnormal cytology, female genital diseases and pregnancy complications, MESH: Predictive Value of Tests, 3. Good health, French Guiana, Vaccination, MESH: Young Adult, 030220 oncology & carcinogenesis, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, MESH: Papillomavirus Infections/complications, MESH: DNA, Viral/analysis, Research Article, Adult, medicine.medical_specialty, Cytodiagnosis, Reproductive medicine, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Papillomavirus Infections/prevention & control, lcsh:Gynecology and obstetrics, MESH: Papillomaviridae/isolation & purification, MESH: Cytodiagnosis/statistics & numerical data, 03 medical and health sciences, Young Adult, Predictive Value of Tests, Internal medicine, MESH: French Guiana, Humans, Papillomavirus Vaccines, MESH: Papillomaviridae/genetics, Normal cytology, lcsh:RG1-991, Aged, MESH: Uterine Cervical Neoplasms/virology, MESH: Humans, business.industry, Papillomavirus Infections, MESH: Papillomavirus Infections/virology, lcsh:RA1-1270, MESH: Adult, Reproductive Medicine, DNA, Viral, MESH: Uterine Cervical Neoplasms/prevention & control, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; BACKGROUND: Cervical cancer prevention using cervical cytology is insufficiently sensitive, a significant proportion of HPV-infected women having normal cytology. The objective of the present study was to try to identify factors associated with abnormal cytology in HPV-infected women living in remote areas of French Guiana.METHODS: A study was conducted in women aged 20-65 years having HPV infections confirmed by HPV DNA detection using the GREINER-BIO-ONE kit. In addition to HPV testing, cytology was performed and classified as normal or abnormal. Demographic and life history variables, and infecting genotypes were compared between the normal and abnormal cytology groups.RESULTS: None of the demographic and life history variables were associated with cytology results. HPV genotype 53 was significantly associated with absence of cytological abnormalities whereas HPV 52, 58, 16 and perhaps 33 and 66 were independently associated with a greater risk of cytological abnormalities. When grouping HPV genotypes in different species, only species 9 (HPV 16, 31, 33, 35, 52, 58, 67) was significantly associated with abnormal cytology AOR = 5.1 (95% CI = 2.3-11.2), P
Published: 2018
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50. Estimating the Risk of Vertical Transmission of Dengue: A Prospective Study

Author: Mathieu Nacher, Véronique Lambert, Jean-Pierre Duvernois, Anne Favre, Emma Cuadro-Alvarez, Hélène Hilderal, Marion Restrepo, Séverine Matheus, Sibille Everhard, Rachida Boukhari, Gabriel Carles, Célia Basurko, Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, 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], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Service de gynécologie et d’obstétrique [Saint Laurent du Maroni, Guyanne Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Pôle de Santé Publique [Saint Laurent du Maroni, Guyanne Française], Service de Pédiatrie [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service d’analyses médicales [Saint Laurent du Maroni, Guyanne Française], Service de gynécologie et d’obstétrique [Kourou, Guyane française] (Croix Rouge Française), Centre médico-chirurgical de Kourou [Guyane française], Réseau Périnat de Guyane [Cayenne, Guyanne Française], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne, Guyane] (COREVIH), This study was funded by European public funds (PO-FEDER 2007-2013 program, presage number 31257), by the Pasteur Institute, and by Cayenne General Hospital, 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)
Subjects: Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Fever, Placenta, 030106 microbiology, Dengue fever, law.invention, Cohort Studies, Dengue, 03 medical and health sciences, Pregnancy, law, Virology, medicine, Humans, Prospective Studies, Pregnancy Complications, Infectious, Epidemics, Prospective cohort study, business.industry, Incidence (epidemiology), Infant, Newborn, Articles, Dengue Virus, medicine.disease, Infectious Disease Transmission, Vertical, Confidence interval, French Guiana, 3. Good health, Infectious Diseases, Transmission (mechanics), [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Postpartum period, Cohort study
Abstract: International audience; The incidence of dengue worldwide is increasing rapidly. A better understanding of dengue transmission may help improve interventions against this major public health problem. The virus is mostly transmitted by vectors. There are, however, other modes of transmission, notably mother-to-child transmission or vertical transmission. We studied a prospective cohort of 54 women who had dengue while pregnant during the 2012–2013 epidemic in French Guiana to estimate the mother-to-child transmission rate and assess the clinical and biological presentation of neonatal dengue. The rate of vertical transmission was between 18.5% (95% confidence interval [CI]: 9.25–31.4) and 22.7% (95% CI: 11.5–37.8), depending on the calculation method used. Mother-to-child transmission occurred both in early and late pregnancy. There were 52 births, including three newborns who presented neonatal dengue with warning signs requiring platelet transfusion. This quantification of the mother-to-child transmission of dengue highlights three points: first, vertical transmission of dengue is not negligible; second, it is more frequent when maternal dengue occurs late during pregnancy near delivery; and third, reliable diagnostic tests must be used to allow the diagnosis of vertical transmission. Our findings indicate that if there is a known history of maternal dengue during pregnancy, or if there is fever during the 15 days before term, cord blood and placenta should be sampled after delivery and tested for the virus, and the newborn should be closely monitored during the postpartum period.
Published: 2018
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