Evaluation des performances diagnostiques de marqueurs fongiques dans l'histoplasmose liée au VIH sur le plateau des Guyanes

International audienc

Prevalence, determinants and genetic diversity of hepatitis C virus in the multi-ethnic population living in Suriname

Little is known about the epidemiology of HCV in Suriname, a former Dutch colony in South America. To study the prevalence, determinants and genetic diversity of HCV, a one-month survey was conducted at the only Emergency Department in the capital Paramaribo. Participants (>= 18 years) completed an interviewer-led standardized HCV risk-factor questionnaire, were tested for HCV-antibodies, and if positive also for HCV RNA. The overall HCV prevalence was 1.0% (22/2128 participants; 95%CI 0.7-1.5). Male sex (OR=4.11; 95%CI 1.30-13.01), older age (OR=1.06 per year increase; 95%CI 1.04-1.09), Javanese ethnicity (OR=7.84; 95%CI 3.25-18.89) and cosmetic tattooing (OR=31.7; 95%CI 3.25-323.87) were independently associated with HCV-infection. Phylogenetic analysis revealed six distinct HCV subtypes, all HCV-geno-type 2 (HCV-2): subtype 2f (also circulating in Indonesia) plus five yet unassigned HCV-2 subtypes exclusively linked to Suriname. (C) 2016 Elsevier Inc. All rights reserve

Histoplasma capsulatum antigen detection tests as an essential diagnostic tool for patients with advanced HIV disease in low and middle income countries: A systematic review of diagnostic accuracy studies.

IntroductionDisseminated histoplasmosis, a disease that often resembles and is mistaken for tuberculosis, is a major cause of death in patients with advanced HIV disease. Histoplasma antigen detection tests are an important addition to the diagnostic arsenal for patients with advanced HIV disease and should be considered for inclusion on the World Health Organization Essential Diagnostics List.ObjectiveOur objective was to systematically review the literature to evaluate the diagnostic accuracy of Histoplasma antigen tests in the context of advanced HIV disease, with a focus on low- and middle-income countries.MethodsA systematic review of the published literature extracted data on comparator groups, type of histoplasmosis, HIV status, performance results, patient numbers, whether patients were consecutively enrolled or if the study used biobank samples. PubMed, Scopus, Lilacs and Scielo databases were searched for published articles between 1981 and 2018. There was no language restriction.ResultsOf 1327 screened abstracts we included a total of 16 studies in humans for further analysis. Most studies included used a heterogeneousgroup of patients, often without HIV or mixing HIV and non HIV patients, with disseminated or non-disseminated forms of histoplasmosis. Six studies did not systematically use mycologically confirmed cases as a gold standard but compared antigen detection tests against another antigen detection test. Patient numbers were generally small (19-65) in individual studies and, in most (7/10), no confidence intervals were given. The post test probability of a positive or negative test were good suggesting that this non invasive diagnostic tool would be very useful for HIV care givers at the level of reference hospitals or hospitals with the infrastructure to perform ELISA tests. The first results evaluating point of care antigen detection tests using a lateral flow assay were promising with high sensitivity and specificity.ConclusionsAntigen detection tests are promising tools to improve detection of and ultimately reduce the burden of histoplasmosis mortality in patients with advanced HIV disease

Histoplasmose disseminada na América do Sul, o elefante invisível Central e o ponto cego letal de organizações internacionais de saúde

Centre Hospitalier de Cayenne. Centre d Investigation Clinique Antilles. Guyane, Cayenne.Centre Hospitalier de Cayenne. Centre d Investigation Clinique Antilles. Guyane, Cayenne.Asociación de Salud Integral. Clínica Familiar "Luis Angel García". Guatemala.Asociación de Salud Integral. Clínica Familiar "Luis Angel García". Guatemala.Asociación de Salud Integral. Clínica Familiar "Luis Angel García". Guatemala.Universidad Rosario. School of Medicine and Health Sciences. Bogotá and Corporacion para Investigationnes Biologicas. Bogotá, Colombia.Universidad Rosario. School of Medicine and Health Sciences. Bogotá and Corporacion para Investigationnes Biologicas. Bogotá, ColombiaUniversidad Rosario. School of Medicine and Health Sciences. Bogotá and Corporacion para Investigationnes Biologicas. Bogotá, Colombia.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brazil.Federal University of Ceará. Fortaleza, CE, Brazil.Laboratório Central de Saúde Pública do Amapá. Macapá, AP, Brazil.Laboratório Central de Saúde Pública do Amapá. Macapá, AP, Brazil.Laboratório Central de Saúde Pública do Amapá. Macapá, AP, Brazil.Academic Hospital Paramaribo. Suriname.Diakonessenhuis. Utrecht, KE.Academic Hospital Paramaribo. Suriname.Academic Hospital Paramaribo. Suriname.Université de Guyane. Ecosystèmes Amazoniens et Pathologie Tropicale. French Guiana.Université de Guyane. Ecosystèmes Amazoniens et Pathologie Tropicale. French Guiana.Université de Guyane. Ecosystèmes Amazoniens et Pathologie Tropicale. French Guiana.Centre Hospitalier de l Ouest Guyanais. Service de Médecine. French Guiana.Instituto Nacional de Higiene Rafael Rangel. Departamento de Micología. Caracas, Venezuela.Instituto Nacional de Higiene Rafael Rangel. Departamento de Micología. Caracas, Venezuela.INEI-ANLIS "Dr Carlos G. Malbran". Buenos Aires, Argentina.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Rio de Janeiro, RJ, Brazil.Université de Guyane. Ecosystèmes Amazoniens et Pathologie Tropicale. French Guiana.Universidad Rosario. School of Medicine and Health Sciences. Bogotá and Corporacion para Investigationnes Biologicas. Bogotá, Colombia