Determination of the Plasmodium vivax relapse pattern in Camopi, French Guiana

<p>Abstract</p> <p>Background</p> <p>Malaria is a major public health problem in French Guiana, where <it>Plasmodium vivax </it>has become the dominant malaria species since 2000. As in others endemic areas, it is important to specify the pattern of vivax malaria relapses and to try to discriminate efficiently re-infections from relapses.</p> <p>Methods</p> <p>This study was conducted in children born between January 1, 2001 and December 31, 2008 in Camopi, an Amerindian village located in the Amazon forest (n = 325), using an open cohort design. Primary and secondary attack rates of <it>P. vivax </it>were calculated using survival analysis. With the difference between the primary and secondary rates, this study aimed to estimate indirectly <it>P. vivax </it>relapse rate and evaluate its time evolution.</p> <p>Results</p> <p>Of the 1042 malaria attacks recorded, 689 (66%) were due to <it>P. vivax </it>(without mixed infection). One hundred and fifty one children had their primary attack with <it>P. vivax </it>and 106 had their two first attacks with <it>P. vivax</it>. In the absence of primaquine treatment, it was shown that <it>P. vivax </it>relapses mainly occurred during the first three months after the first attack. Thirty percent of children never had a relapse, 42% had a relapse before the first month after primary attack, 59% before the second month and 63% before the third month.</p> <p>Conclusion</p> <p>This study confirmed that the relapse pattern in Camopi was compatible with the pattern described for the <it>P. vivax </it>Chesson (tropical) strain. In addition, due to the relapse rate time evolution, a simple arbitrary classification rule could be constructed: before 90 days after the primary attack, the secondary attack is a relapse; after 90 days, it is a re-infection. Adapted management of malaria cases based on these results could be devised.</p

Influence of climate and river level on the incidence of malaria in Cacao, French Guiana

<p>Abstract</p> <p>Background</p> <p>The epidemiological profiles of vector-borne diseases, such as malaria, are strongly associated with environmental conditions. An understanding of the effect of the climate on the occurrence of malaria may provide indirect insight into the anopheles mosquito vectors endemic to a particular region. The association between meteorological and hydrographical factors and the occurrence of malaria was studied in a village in French Guiana during an epidemic caused essentially by <it>Plasmodium vivax</it>.</p> <p>Methods</p> <p>A cohort of confirmed cases of <it>P. vivax </it>malaria occurring between 2002 and 2007 was studied to search for an association between the number of new infection episodes occurring each month, mean, maximum and minimum monthly temperatures, cumulative rainfall for the month and the mean monthly height of the river bordering the village, with the aid of time series. Cross-correlation analysis revealed that these meteorological factors had large effects on the number of episodes, over a study period of 12 months.</p> <p>Results</p> <p>Climatic factors supporting the continuance of the epidemic were identified in the short-term (low minimum temperatures during the month), medium-term (low maximum temperatures two months before) and long-term (low maximum temperatures nine months before and high lowest level of the river 12 months before). Cross-correlation analysis showed that the effects of these factors were greatest at the beginning of the short rainy season.</p> <p>Conclusion</p> <p>The association between the river level and the number of malaria attacks provides clues to better understand the environment of malaria transmission and the ecological characteristics of the vectors in the region.</p

Symptomatic Chikungunya Virus Infection and Pregnancy Outcomes: A Nested Case-Control Study in French Guiana

During the Chikungunya epidemic in the Caribbean and Latin America, pregnant women were affected by the virus in French Guiana. The question of the impact of the virus on pregnancy was raised because of the lack of scientific consensus and published data in the region. Thus, during the Chikungunya outbreak in French Guiana, a comparative study was set up using a cohort of pregnant women. The objective was to compare pregnancy and neonatal outcomes between pregnant women with Chikungunya virus (CHIKV) infection and pregnant women without CHIKV. Of 653 mothers included in the cohort, 246 mothers were included in the case-control study: 73 had CHIKV fever during pregnancy and 173 had neither fever nor CHIKV during pregnancy. The study did not observe any severe clinical presentation of CHIKV in the participating women. There were no intensive care unit admissions. In addition, the study showed no significant difference between the two groups with regard to pregnancy complications. However, the results showed a potential excess risk of neonatal ICU admission of the newborn when the maternal infection occurred within 7 days before delivery. These results suggest that special attention should be paid to neonates whose mothers were infected with CHIKV shortly before delivery

Le paludisme à plasmodium vivax dans la région de Cacao (Guyane) de 2002 à 2007 (incidence des accès palustres et facteurs environnementaux)

MONTPELLIER-BU Médecine UPM (341722108) / SudocMONTPELLIER-BU Médecine (341722104) / SudocSudocFranceF

Connaissances et perceptions de parents avec enfants avec des troubles du spectre d’autistique en Guyane française

International audienceFrance Résumé Contexte. – La Guyane française a un retard structurel important par rapport à la France métropolitaine. L’absence de données concernant lestroubles du spectre autistique complique le choix des priorités des décideurs en termes d’actions à prendre et de création de centres spécialisés.L’objectif de cette étude transversale était d’obtenir le point de vue (sonder la perception) des parents d’enfants ayant des troubles du spectre autistique (TSA) en ce qui concerne le soin, l’éducation de leur enfant et leurs difficultés et leur fac¸on de s’adapter à la situation.Méthodes. – Entre juin 2012 et juillet 2013, cent quatre-vingt-un parents de 101 enfants ayant des TSA ont été interrogés face à face.L’échantillonnage a utilisé la méthode de la boule de neige et la collecte d’information fut réalisée à l’aide d’un questionnaire structuré avec quelques questions ouvertes, et l’échelle WCC-R pour mesurer les types de « coping ».Résultats. – L’âge moyen au diagnostic de TSA était de 4,5 ans (±1,8 ans), et le processus de diagnostic semblait long pour 75 % des parents.Presque la moitié des enfants n’étaient pas scolarisés, et les parents signalaient des problèmes pour les faire inscrire. Cependant 90 % des parents étaient satisfaits des soins et 75 % de l’éducation de leurs enfants. Le niveau de satisfaction s’améliorait avec la connaissance/compréhension des troubles de l’autisme. Le coping était plus centré sur le problème lorsque les parents étaient plus informés sur l’autisme, habitaient en couple ou avaient un travail. L’analyse des réponses des mères, montrait qu’après 4 ans écoulés depuis les premières inquiétudes, elles avaient plus fréquemment un coping centré sur le problème que dans les 4 premières années.Conclusions. – Malgré les retards structuraux en Guyane française, les parents exprimaient globalement une satisfaction et une confiance dans la prise en charge médico-sociale et éducative de leurs enfants et, avec le temps, semblaient s’adapter à la vie avec un enfant autiste. L’amélioration de la connaissance de l’autisme et des structures locales impliquées semble importante pour aider les parents à faire face à l’autisme

Le Trouble de Stress Post-traumatique parmi les Détenus en Centre Pénitentiaire en Guyane Française

International audienceDespite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p < 0.005).The prevalence of PTSD is very high in this study, about 24 times higher than in a general population survey using the same screening tool.A large number of comorbidities have been identified, which corresponds to those described in the literature. The specific issues of psychiatry in prison lead us to examine more specifically the significance of the results about suicide risk. A comprehensive suicide risk (sum of medium and high risk screened by the M.I.N.I.) was found in significantly more PTSD+ inmates (17% versus 7%, p = 0.005). This study supports the need for routine screening of PTSD among incomers in detention. This disease is both worrying and common in this population but the real issues are the comorbidities. Suicidal potential is among the most important issues in detention. Its evaluation should be completed by an early recognition of a PTSD.Soumis à des mouvements de population importants, la Guyane Française et son centre pénitentiaire abritentune population métissée chez qui l’histoire récente a laissé une empreinte forte (tremblement de terre en Haïti,guerre civile au Suriname, violence liée à l’orpaillage et au trafic de stupéfiants). Ces événements de vienégatifs apparaissent comme autant de vecteurs potentiels de psychotraumatismes. Dans ces conditions, il nous a paru essentiel de mettre l’accent sur le repérage du TSPT (Trouble de Stress Post-traumatique) dans cette population sensible. A l'aide d’entretiens d’accueil dédiés nous nous sommes proposé de repérer les TSPT, de décrire sur un plan sociodémographique la population étudiée et de rechercher les comorbidités psychiatriques. Le résultat principal de cette étude était une prévalence du TSPT de 17% chez les arrivants en détention. Le MINI 5.0 a montré une prévalence plus élevée des pathologies psychiatriques dans le groupe présentant un TSPT avec un lien très fort (p<0.005) pour l’épisode dépressif majeur actuel, l’épisode (hypo)maniaque actuel et le risque suicidaire. Cette étude appuie la nécessité d’avoir un dépistage systématique du TSPT chez les arrivants en détention. Cette pathologie est à la fois fréquente dans cette population et invalidante mais ce sont ses comorbidités, dont le potentiel suicidaire, qui font tout l’enjeu d’un repérage précoce

Le trouble de stress post-traumatique parmi les détenus en centre pénitentiaire en Guyane française

Soumis à des mouvements de population importants, la Guyane française et son centre pénitentiaire abritent une population métissée chez qui l’histoire récente a laissé une empreinte forte (tremblement de terre en Haïti, guerre civile au Suriname, violence liée à l’orpaillage et au trafic de stupéfiants). Ces événements de vie négatifs apparaissent comme autant de vecteurs potentiels de psychotraumatismes. Dans ces conditions, il nous a paru essentiel de mettre l’accent sur le repérage du trouble de stress post-traumatique (TSPT) dans cette population sensible. À l’aide d’entretiens d’accueil dédiés, nous nous sommes proposé de repérer les TSPT, de décrire sur un plan sociodémographique la population étudiée et de rechercher les comorbidités psychiatriques. Le résultat principal de cette étude était une prévalence du TSPT de 17 % chez les arrivants en détention. Le MINI 5.0 a montré une prévalence plus élevée des pathologies psychiatriques dans le groupe présentant un TSPT avec un lien très fort (p < 0,005) pour l’épisode dépressif majeur actuel, l’épisode maniaque ou hypomaniaque actuel et le risque suicidaire. Cette étude appuie la nécessité d’avoir un dépistage systématique du TSPT chez les arrivants en détention. Cette pathologie est à la fois fréquente dans cette population et invalidante, mais ce sont ses comorbidités, dont le potentiel suicidaire, qui font tout l’enjeu d’un repérage précoce.Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p < 0.005).The prevalence of PTSD is very high in this study, about 24 times higher than in a general population survey using the same screening tool.A large number of comorbidities have been identified, which corresponds to those described in the literature. The specific issues of psychiatry in prison lead us to examine more specifically the significance of the results about suicide risk. A comprehensive suicide risk (sum of medium and high risk screened by the M.I.N.I.) was found in significantly more PTSD+ inmates (17% versus 7%, p = 0.005). This study supports the need for routine screening of PTSD among incomers in detention. This disease is both worrying and common in this population but the real issues are the comorbidities. Suicidal potential is among the most important issues in detention. Its evaluation should be completed by an early recognition of a PTSD