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1. Missed opportunities of HIV pre-exposure prophylaxis in France: a retrospective analysis in the French DAT’AIDS cohort

Author

Lions, C., Cabras, O., Cotte, L., Huleux, T., Gagneux-Brugnon, A., Makinson, A., Cabié, A., Bonnet, B., Duvivier, C., Hocqueloux, L., Cua, E., Cheret, A., Hustache-Mathieu, L., Obry-Roguet, V., Jacomet, C., Poizot-Martin, I., Bouiller, K., Chirouze, Catherine, Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Services des maladies infectieuses [Tourcoing], Centre Hospitalier de Tourcoing, Service des maladies infectieuses [Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Service de maladies infectieuses et tropicales [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service des Maladies infectieuses et tropicales [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327), Université Paris Descartes - Paris 5 (UPD5), Service des maladies infectieuses [CHR Orléans], Centre Hospitalier Régional d'Orléans (CHRO), Service d'infectiologie [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Médecine interne [CHU Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), service de maladies infectieuses CHU J Minjoz Besancon, Service des maladies infectieuses [Clermont-Ferrand], CHU Clermont-Ferrand, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Etienne, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), COMBE, Isabelle, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre Hospitalier Tourcoing, 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], Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Hôpital Jean Minjoz, Laboratoire Chrono-environnement - CNRS - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)

Subjects
0301 basic medicine, Male, Delayed Diagnosis, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Cohort Studies, Pre-exposure prophylaxis, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Epidemiology, Transgender, Retrospective analysis, 030212 general & internal medicine, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, virus diseases, AIDS Serodiagnosis, Middle Aged, PrEP, 3. Good health, HIV testing, Africa, Western, Infectious Diseases, Sexual Partners, 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, France, Research Article, Adult, medicine.medical_specialty, Anti-HIV Agents, Sexual Behavior, 030106 microbiology, Context (language use), Transgender Persons, lcsh:Infectious and parasitic diseases, Missed opportunities, 03 medical and health sciences, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Humans, lcsh:RC109-216, Homosexuality, Male, Retrospective Studies, Unsafe Sex, business.industry, HIV, medicine.disease, HIV-1, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; BackgroundHIV pre-exposure prophylaxis (PrEP) was implemented in France in November 2015 based on individual-level risk factors for HIV infection. We evaluated the proportion of missed opportunities for PrEP among newly HIV-diagnosed people entering the Dat’AIDS cohort in 2016.MethodsMulticenter retrospective analysis in 15 French HIV clinical centers of patients with a new diagnosis of HIV infection. Among them we differentiated patients according to the estimated date of infection: those occurring in the PrEP area (a previous negative HIV test in the last 12 months or those with an incomplete HIV-1 western blot (WB) with no HIV-1 anti-Pol-antibody at time of HIV diagnosis) and those in the pre-PrEP area (older infections). Epidemiological, biological and clinical data at HIV diagnosis were collected. Clinicians retrospectively identified potential eligibility for PrEP based on individual-level risk factors for HIV infection among those infected in the PrEP area.ResultsAmong 966 patients with a new HIV diagnosis, 225 (23.3%) were infected in the PrEP area and 121 (53.8%) had complete data allowing evaluation of PrEP eligibility. Among them, 110 (91%) would have been eligible for PrEP, median age 31 years, with 68 (75.6%) born in France and 10 (11.1%) in Central/West Africa, with more than one previous STI in 19 (15.7%). The main eligibility criteria for PrEP were being a man who had sex with men or transgender 91 (82.7%) with at least one of the following criteria: unprotected anal sex with ≥2 partners in the last 6 months: 67 (60.9%); bacterial sexually transmitted infection in the last 12 months: 33 (30%); Use of psychoactive substances in a sexual context (chemsex): 16 (14.5%). PrEP was indicated for other HIV risk factors in 25 (22.7%).ConclusionWith 91% (110/121) of patients infected in the PrEP area eligible for PrEP, this study highlights the high potential of PrEP in avoiding new infection in France but also shows a persistent delay in HIV testing. Thus, an important limit on PrEP implementation in France could be insufficient screening and care access.

Published
2019

2. Patients’ high acceptability of a future therapeutic HIV vaccine in France: a French paradox?

Author

Christophe Lalanne, Thierry Prazuck, Olivier Chassany, Pierre Verger, S. Dimi, Isabelle Aubin-Auger, Martin Duracinsky, C. Majerholc, David Zucman, Emmanuel Mortier, Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), COMBE, Isabelle, Hôpital Foch [Suresnes], Recherche Clinique ville-hôpital, Méthodologies et Société (REMES), Université Paris Diderot - Paris 7 (UPD7), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des maladies infectieuses [CHR Orléans], Centre Hospitalier Régional d'Orléans (CHRO), Service de Médecine Interne (LOUIS MOURIER - Med Int), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Médecine interne-Immunologie clinique [Kremlin-Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)

Subjects
Male, 0301 basic medicine, HIV Infections, Confidence, Disease, 0302 clinical medicine, Medical microbiology, Acceptability, Quality of life, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, 030212 general & internal medicine, HIV vaccine, AIDS Vaccines, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [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, education.field_of_study, Middle Aged, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Infectious Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Research Article, Adult, medicine.medical_specialty, Adolescent, Visual analogue scale, 030106 microbiology, Population, lcsh:Infectious and parasitic diseases, Young Adult, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Humans, lcsh:RC109-216, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, education, Aged, business.industry, HIV, Patient Acceptance of Health Care, Therapeutic vaccine, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Confidence interval, Acceptance, Cross-Sectional Studies, Family medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business, Forecasting
Abstract

International audience; Background: France is the European country with the lowest level of confidence in vaccines. Measurement of patients' acceptability towards a future therapeutic HIV vaccine is critically important. Thus, the aim of this study was to evaluate patients' acceptability of a future therapeutic HIV vaccine in a representative cohort of French patients living with HIV-AIDS (PLWHs). Methods: This multicentre study used quantitative and qualitative methods to assess PLWHs' opinions and their potential acceptance of a future therapeutic HIV vaccine. Cross-sectional study on 220 HIV-1 infected outpatients, aged 18-75 years. Results: The participants' characteristics were similar to those of the overall French PLWH population. Responses from the questionnaires showed high indices of acceptance: the mean score for acceptability on the Visual Analog Scale VAS was 8.4 of 10, and 92% of patients agreed to be vaccinated if a therapeutic vaccine became available. Acceptability depended on the expected characteristics of the vaccine, notably the duration of its effectiveness: 44% of participants expected it to be effective for life. This acceptance was not associated with socio-demographic, clinical (mode of contamination, duration of disease), quality of life, or illness-perception parameters. Acceptability was also strongly correlated with confidence in the treating physician. Conclusion: The PLWHs within our cohort had high indices of acceptance to a future therapeutic HIV vaccine. Trial registration: This study was retroactively registered on ClinicalTrials.gov with ID: NCT02077101 in February 21, 2014.

Published
2019

3. Patient Preference and Adherence Dovepress evaluating patient preference and satisfaction for human immunodeficiency virus therapy in France

Author

Brégigeon-Ronot, Sylvie, Cheret, Antoine, Cabié, André, Prazuck, Thierry, Volny-Anne, Alain, Ali, Shehzad, Bottomley, Catherine, Finkielsztejn, Laurent, Philippe, Caroline, Parienti, Jean-Jacques, Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier Tourcoing, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), 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 Hospitalier Régional d'Orléans (CHRO), Independent patient representative [Paris], Université Paris Descartes - Paris 5 (UPD5), ICON Contract Research Organisation, Viiv Healthcare France, ViiV Healthcare [Brentford, UK], Qualees Contract Research Organisation, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Services des maladies infectieuses [CH Turcoing], Centre Hospitalier de Tourcoing, Service de médecine interne, Université Paris Descartes - Paris 5 ( UPD5 ) -AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), 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-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service des maladies infectieuses [CHR Orléans], Centre Hospitalier Régional d'Orléans ( CHR ), Université Paris Descartes - Paris 5 ( UPD5 ), Viiv Healthcare, Groupe de Recherche sur l'Adaptation Microbienne ( GRAM 2.0 ), Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ), 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], Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Université de Caen Normandie (UNICAEN)

Subjects
preference elicitation, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, antiretroviral therapy, satisfaction, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, adherence, HIV infection, ARV treatments
Abstract

International audience; Objectives: The objectives were 1) to elicit relative preferences for attributes of antiretroviral therapies (ART) in people living with HIV (PLWH) and 2) to explore satisfaction and adherence with current ART. Patients and methods: We conducted a multicenter cross-sectional study, consecutively enrolling PLWH receiving an ART. The quantitative part estimated the strength of preference for different attributes using an online discrete choice experiment (DCE). DCE data were analyzed using a mixed logit regression model. Qualitative data were collected through individual interviews. A preliminary coding framework was developed which was then further refined and applied during thematic analysis of factors influencing satisfaction and adherence. Results: A total of 101 PLWH took part in the quantitative part and 31 in the qualitative part. Over 90% had an undetectable viral load. Quantitative data revealed a strong preference for a treatment with limited drug–drug interactions, diarrhea and long-term health problems (P,0.0001), and that did not need to be taken on an empty stomach (P,0.0001). Patients also preferred to avoid problems associated with treatment failure (P,0.0001) or one that left them with a higher viral load after the first weeks of treatment (P=0.044). Differences in CD4 cell count, and pills that must be taken with food were not significant drivers of treatment choice. The strength of these attributes was reflected in the qualitative data, highlighting the importance patients place on treatment efficacy, and also suggesting that some of these attributes may impact adherence. Many factors influencing adherence and satisfaction with treatment were identified, including pill size, worry about sexual transmission and impact on social life. Conclusion: Most of the attributes included in this survey were important to participants when choosing an ART, in particular those related to quality of life, and these should be taken into account in order to optimize adherence and satisfaction.

Published
2017

4. Cytogaligin, one of the proteins produced by the proapoptotic GALIG gene, interacts with autophagy and proteasome molecules

Author

Serrano, A, Haddad, S El, Normand, T, Dubois, M, Guery, T, Hocqueloux, L, Charpentier, Stéphane, Brulé-Morabito, Fabienne, Schoenwald, M, Carp, D, Prazuck, T, Legac, E, Legrand, Alain, Mollet, Lucile, Frapart, Isabelle, Centre de biophysique moléculaire (CBM), Université d'Orléans (UO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Service des maladies infectieuses [CHR Orléans], Centre Hospitalier Régional d'Orléans (CHRO), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2016

5. Bioavailability of dissolved and crushed single tablets of bictegravir, emtricitabine, tenofovir alafenamide in healthy adults: the SOLUBIC randomized crossover study.

Author

Hocqueloux L, Lefeuvre S, Bois J, Brucato S, Alix A, Valentin C, Peyro-Saint-Paul L, Got L, Fournel F, Dargere S, Prazuck T, Fournier A, Gregoire N, McNicholl I, and Parienti JJ

Subjects
Humans, Adult, Emtricitabine therapeutic use, Tenofovir therapeutic use, Biological Availability, Cross-Over Studies, Adenine pharmacokinetics, Tablets, Alanine therapeutic use, HIV Infections drug therapy, Anti-HIV Agents therapeutic use
Abstract

Background: Crushing or dissolving bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) tablets is not recommended because there are no data supporting this practice., Methods: A crossover, randomized trial in healthy adults (NCT04244448) investigated the bioavailability of two off-label uses of BIC/TAF/FTC (50/200/25 mg), dissolved in water or crushed in apple compote, compared with the solid tablet. Pharmacokinetic (PK) parameters were estimated from sequential intensive plasma antiretroviral concentrations over a 72 h period post dose. Bioequivalence was met if the 90% CIs of the geometric least-squares means ratios comparing BIC/TAF/FTC exposures (AUC and Cmax) from the experimental phases were within 80%-125% of the reference., Results: Eighteen subjects participated in each of the three phases. Dissolved tablet Cmax geometric mean ratio (90% CI) for BIC/TAF/FTC was 105% (93-119)/97% (87-108)/96% (74-124), respectively. Dissolved tablet AUC geometric mean ratio (90% CI) for BIC/TAF/FTC was 111% (100-122)/100% (94 to 105)/99% (81 to 120), respectively. Crushed tablet Cmax geometric mean ratio (90%) CI for BIC/TAF/FTC was 110% (97 to 124)/70% (63-78)/66% (51-85), respectively. Crushed tablet AUC geometric mean ratio (90%) CI for BIC/TAF/FTC was 107% (96-118)/86% (82-91)/84% (69-103), respectively., Conclusions: Crushing BIC/TAF/FTC tablets may lead to suboptimal emtricitabine and tenofovir alafenamide drug exposures. Dissolving BIC/TAF/FTC in water may be acceptable if the tablet cannot be swallowed whole., (© The Author(s) 2022. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Published
2022
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6. Reliability of the INSTI® rapid test for the diagnosis of HIV-1 non-B subtypes and recombinant variants.

Author

Goupil de Bouillé J, Le Moal G, Hocqueloux L, Guigon A, Plainchamp D, Giraudeau G, Theillay A, Languille A, Bélec L, and Prazuck T

Subjects
Adult, Female, HIV-1 classification, Humans, Male, Middle Aged, Sensitivity and Specificity, Genotype, HIV Antibodies blood, HIV Infections diagnosis, HIV-1 immunology, HIV-1 isolation & purification, Recombination, Genetic, Serologic Tests methods
Abstract

Data regarding the efficacy of Rapid HIV tests (RHTs) in detecting non-B subtype HIV-1 are limited. We evaluated the sensitivity of the INSTI® test for the detection of HIV-1 antibodies for the diagnosis of HIV-1 non-B subtypes and recombinant variants. We identified adults with HIV-1 infection due to non-B subtypes and recombinant variants. The participants were re-tested with INSTI® test. We included 258 patients. Overall, the INSTI® test sensitivity was 98.4% (95%CI: 96.9-99.9%). For the major CRF_02AG subtype, the sensitivity was 99.0% (95%CI: 97.1-100%). The HIV INSTI® test is reliable for the detection of various non-B HIV-1 antibodies., (© 2015 Wiley Periodicals, Inc.)

Published
2016
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7. Reducing gastroenteritis occurrences and their consequences in elementary schools with alcohol-based hand sanitizers.

Author

Prazuck T, Compte-Nguyen G, Pelat C, Sunder S, and Blanchon T

Subjects
Administration, Cutaneous, Alcohols adverse effects, Ambulatory Care statistics & numerical data, Anti-Infective Agents, Local adverse effects, Antiviral Agents adverse effects, Chi-Square Distribution, Child, Child, Preschool, Female, Gastroenteritis epidemiology, Humans, Kaplan-Meier Estimate, Male, Proportional Hazards Models, Schools statistics & numerical data, Statistics, Nonparametric, Students statistics & numerical data, Surveys and Questionnaires, Alcohols administration & dosage, Anti-Infective Agents, Local administration & dosage, Antiviral Agents administration & dosage, Disease Outbreaks prevention & control, Gastroenteritis prevention & control, Hand Disinfection methods
Abstract

Background: Schools are a source of epidemic seasonal dissemination-in particular gastroenteritis among children and the general population. We assessed the impact of an alcohol-based sanitizer on gastroenteritis and its subsequent consequences., Methods: A study was conducted in 2 primary schools over a 17-week period, before and throughout the seasonal gastroenteritis period. The intervention, under strict teacher supervision and in a realistic and long lasting manner, consisted of 1 school rubbing an alcohol-based sanitizer into the hands of the school children. The primary outcome was the proportion of children without any occurrence of gastroenteritis during the study period both in the treated group and the control group, which were 2 separate schools. A Cox proportional hazards model was used to assess the hazard ratio. Secondary outcomes were the number of gastroenteritis episodes, doctor appointments, absenteeism, and working days lost by a parent., Results: Four thousand six hundred fifty-four weekly questionnaires were collected. One hundred fifty-five children presented with at least 1 occurrence of gastroenteritis during the study period: 64 of 259 in the treatment group and 91 of 217 in the control group (χ2 = 16.4, P < 0.0001). The instantaneous risk of primary infection, at any time of the study, for children receiving the treatment was multiplied by 0.52 (95% CI: [0.37,0.71]) compared with children not receiving the treatment. The average number of gastroenteritis episodes was 0.31 in the treatment group and 0.53 in the control group (P < 0.001)., Conclusions: Systematic and controlled use of alcohol-based sanitizers during the epidemic season could significantly reduce the incidence of gastroenteritis in primary school children.

Published
2010

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