Increasing Role of Roof Gutters as Aedes aegypti (Diptera: Culicidae) Breeding Sites in Guadeloupe (French West Indies) and Consequences on Dengue Transmission and Vector Control

During the past ten years, the islands of Guadeloupe (French West Indies) are facing dengue epidemics with increasing numbers of cases and fatal occurrences. The vector Aedes aegypti is submitted to intensive control, with little effect on mosquito populations. The hypothesis that important Ae. aegypti breeding sites are not controlled is investigated herein. For that purpose, the roof gutters of 123 houses were systematically investigated, and the percentage of gutters positive for Ae. aegypti varied from 17.2% to 37.5%, from humid to dry locations. In the dryer location, most of houses had no other breeding sites. The results show that roof gutters are becoming the most important Ae. aegypti breeding sites in some locations in Guadeloupe, with consequences on dengue transmission and vector control

The Relation Between Temperature, Ozone, and Mortality in Nine French Cities During the Heat Wave of 2003

BACKGROUND: During August 2003, record high temperatures were observed across Europe, and France was the country most affected. During this period, elevated ozone concentrations were measured all over the country. Questions were raised concerning the contribution of O(3) to the health impact of the summer 2003 heat wave. METHODS: We used a time-series design to analyze short-term effects of temperature and O(3) pollution on mortality. Counts of deaths were regressed on temperatures and O(3) levels, controlling for possible confounders: long-term trends, season, influenza outbreaks, day of the week, and bank holiday effects. For comparison with previous results of the nine cities, we calculated pooled excess risk using a random effect approach and an empirical Bayes approach. FINDINGS: For the nine cities, the excess risk of death is significant (1.01%; 95% confidence interval, 0.58–1.44) for an increase of 10 μg/m(3) in O(3) level. For the 3–17 August 2003 period, the excess risk of deaths linked to O(3) and temperatures together ranged from 10.6% in Le Havre to 174.7% in Paris. When we compared the relative contributions of O(3) and temperature to this joint excess risk, the contribution of O(3) varied according to the city, ranging from 2.5% in Bordeaux to 85.3% in Toulouse. INTERPRETATION: We observed heterogeneity among the nine cities not only for the joint effect of O(3) and temperatures, but also for the relative contribution of each factor. These results confirmed that in urban areas O(3) levels have a non-negligible impact in terms of public health

Time series analysis of dengue incidence in Guadeloupe, French West Indies: Forecasting models using climate variables as predictors

BACKGROUND: During the last decades, dengue viruses have spread throughout the Americas region, with an increase in the number of severe forms of dengue. The surveillance system in Guadeloupe (French West Indies) is currently operational for the detection of early outbreaks of dengue. The goal of the study was to improve this surveillance system by assessing a modelling tool to predict the occurrence of dengue epidemics few months ahead and thus to help an efficient dengue control. METHODS: The Box-Jenkins approach allowed us to fit a Seasonal Autoregressive Integrated Moving Average (SARIMA) model of dengue incidence from 2000 to 2006 using clinical suspected cases. Then, this model was used for calculating dengue incidence for the year 2007 compared with observed data, using three different approaches: 1 year-ahead, 3 months-ahead and 1 month-ahead. Finally, we assessed the impact of meteorological variables (rainfall, temperature and relative humidity) on the prediction of dengue incidence and outbreaks, incorporating them in the model fitting the best. RESULTS: The 3 months-ahead approach was the most appropriate for an effective and operational public health response, and the most accurate (Root Mean Square Error, RMSE = 0.85). Relative humidity at lag-7 weeks, minimum temperature at lag-5 weeks and average temperature at lag-11 weeks were variables the most positively correlated to dengue incidence in Guadeloupe, meanwhile rainfall was not. The predictive power of SARIMA models was enhanced by the inclusion of climatic variables as external regressors to forecast the year 2007. Temperature significantly affected the model for better dengue incidence forecasting (p-value = 0.03 for minimum temperature lag-5, p-value = 0.02 for average temperature lag-11) but not humidity. Minimum temperature at lag-5 weeks was the best climatic variable for predicting dengue outbreaks (RMSE = 0.72). CONCLUSION: Temperature improves dengue outbreaks forecasts better than humidity and rainfall. SARIMA models using climatic data as independent variables could be easily incorporated into an early (3 months-ahead) and reliably monitoring system of dengue outbreaks. This approach which is practicable for a surveillance system has public health implications in helping the prediction of dengue epidemic and therefore the timely appropriate and efficient implementation of prevention activities

Émergence du chikungunya dans les Départements Français d’Amérique : résultats de la surveillance épidémiologique mise en œuvre en avril 2014

National audienc

Analysing Ambulatory Blood Pressure Monitoring Data with Multivariate Sliced Inverse Regression.

This paper proposes to use a semi parametric regression method, named Sliced Inverse Regression (SIR hereafter), to analyse ambulatory blood pressure monitoring data.ECONOMETRICS;EVALUATION;HEALTH;MATHEMATICS

Increased resting heart rate with pollutants in a population based study

Background: Air pollution is associated with cardiovascular mortality. Changes in the autonomic nervous system may contribute to cardiac arrhythmias and cardiovascular mortality. This study investigated the relations between air pollutant concentrations of sulphur dioxide (SO(2)), ozone (O(3)), nitric dioxide (NO(2)), and resting heart rate (RHR) in a population based study. Methods: A sample of 863 middle aged men and women, living in Toulouse (MONICA centre) area, was randomly recruited. A cross sectional survey on cardiovascular risk factors was carried. RHR was measured twice in a sitting position after a five minute rest. Multivariate analyses with quintiles of RHR were performed using polytomous logistic regression. Models were adjusted for temperature, season, relative humidity, sex, physical activity, blood pressure, C reactive protein, and cardiovascular drugs. Results: For NO(2), the OR (odds ratio) (95% CI) associated with an increase of 5 µg/m(3) in the current day of medical examination was 1.14 (1.03 to 1.25) in quintile Q5 of RHR compared with Q1, p for trend = 0.003. For SO(2), OR was 1.16 (0.94 to 1.44) in Q5 compared with Q1, p for trend = 0.05, and for O(3), OR was 0.96 (0.91 to 1.01) in Q5 compared with Q1, p for trend = 0.11. No significant association was seen when the daily mean concentration of NO(2), SO(2), and O(3) was considered during the previous day as well as when day lag 2 or 3 was considered. The cumulative concentration (three consecutive days) of O(3) is negatively associated with RHR (p for trend = 0.02). Conclusion: Changes in pulse rate could reflect cardiac rhythm changes and may be part of the pathophysiological link between pollution and cardiovascular mortality