Determinants of compliance with malaria chemoprophylaxis among French soldiers during missions in inter-tropical Africa

International audienc

Novel Virus Influenza A (H1N1sw) in South-Eastern France, April-August 2009

BACKGROUND: In April 2009, the first cases of pandemic (H1N1)-2009 influenza [H1N1sw] virus were detected in France. Virological surveillance was undertaken in reference laboratories of the seven French Defence Zones. METHODOLOGY/PRINCIPAL FINDINGS: We report results of virological analyses performed in the Public Hospitals of Marseille during the first months of the outbreak. (i) Nasal swabs were tested using rapid influenza diagnostic test (RIDT) and two RT-PCR assays. Epidemiological characteristics of the 99 first suspected cases were analyzed, including detection of influenza virus and 18 other respiratory viruses. During three months, a total of 1,815 patients were tested (including 236 patients infected H1N1sw virus) and distribution in age groups and results of RIDT were analyzed. (ii) 600 sera received before April 2009 and randomly selected from in-patients were tested by a standard hemagglutination inhibition assay for antibody to the novel H1N1sw virus. (iii) One early (May 2009) and one late (July 2009) viral isolates were characterized by sequencing the complete hemagglutinine and neuraminidase genes. (iiii) Epidemiological characteristics of a cluster of cases that occurred in July 2009 in a summer camp were analyzed. CONCLUSIONS/SIGNIFICANCE: This study presents new virological and epidemiological data regarding infection by the pandemic A/H1N1 virus in Europe. Distribution in age groups was found to be similar to that previously reported for seasonal H1N1. The first seroprevalence data made available for a European population suggest a previous exposure of individuals over 40 years old to influenza viruses antigenically related to the pandemic (H1N1)-2009 virus. Genomic analysis indicates that strains harbouring a new amino-acid pattern in the neuraminidase gene appeared secondarily and tended to supplant the first strains. Finally, in contrast with previous reports, our data support the use of RIDT for the detection of infection in children, especially in the context of the investigation of grouped cases

Determinants of compliance with anti-vectorial protective measures among non-immune travellers during missions to tropical Africa

International audienceThe effectiveness of anti-vectorial malaria protective measures in travellers and expatriates is hampered by incorrect compliance. The objective of the present study was to identify the determinants of compliance with anti-vectorial protective measures (AVPMs) in this population that is particularly at risk because of their lack of immunity

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Methods for handling missing data in epidemiology : application in oncology

La problématique de la gestion des données manquantes dans les études épidémiologiques est un sujet qui intéressera tous les chercheurs impliqués dans l’analyse des données recueillies et dans l’interprétation des résultats issus de ces analyses. Et même si la question de la gestion des données manquantes et de leur impact sur la validité des résultats obtenus est souvent discutée, cesont souvent les méthodes de traitement des données manquantes les plus simples mais pas toujours les plus valides qui sont utilisées en pratique. L’utilisation de chacune de ces méthodes suppose un certain nombre d’hypothèses sous lesquelles les résultats obtenus sont valides, mais il n’est pas toujours possible de tester ces hypothèses. L’objectif de ce travail était (i) de proposer une revue des différentes méthodes de traitement des données manquantes utilisées en épidémiologie en discutant les avantages et les limites de chacune de ces méthodes, (ii) de proposer une stratégie d’analyse afin d’étudier la robustesse des résultats obtenues via les méthodes classiques de traitement des données manquantes à l’écart aux hypothèses qui, bien que non testables, sont nécessaires à la validité de ces résultats, et (iii) de proposer quelques applications sur des données réelles des différents point discutés dans les deux premières parties.The issue of how to deal with missing data in epidemiological studies is a topic which concerns every researcher involved in the analysis of collected data and in the interpretation of the results produced by these analyses. And even if the issue of the handling of missing data and of their impact on the validity of the results is often discussed, simple, but not always appropriate methods to deal with missing data are commonly used. The use of each of these methods is based on some hypotheses under which the obtained results are valid, but it is not always possible to test these hypotheses. The objective of this work was (i) to propose a review of various methods to handle missing data used in the field of epidemiology, and to discuss the advantages and disadvantages of each of these methods, (ii) to propose a strategy of analysis in order to study the robustness of the results obtained via classical methods to handle missing data to the departure from hypotheses which are required for the validity of these results, although they are not testable, and (iii) to propose some applications on real data of the issues discussed in the first two sections

Preliminary results of synergy between norepinephrine and terlipressin during septic shock

International audienc

The hidden side of oral thrombin inhibitors

International audienc

In Vitro Co Exposure to CeO2 Nanomaterials from Diesel Engine Exhaust and Benzo(a)Pyrene Induces Additive DNA Damage in Sperm and Cumulus Cells but not in Oocytes

International audienceBenzo(a)pyrene (BaP) is a recognized reprotoxic compound and the most widely investigated polycyclic aromatic hydrocarbon in ambient air; it is widespread by the incomplete combustion of fossil fuels along with cerium dioxide nanomaterials (CeO2 NMs), which are used in nano based diesel additives to decrease the emission of toxic compounds and to increase fuel economy. The toxicity of CeO2 NMs on reproductive organs and cells has also been shown. However, the effect of the combined interactions of BaP and CeO2 NMs on reproduction has not been investigated. Herein, human and rat gametes were exposed in vitro to combusted CeO2 NMs or BaP or CeO2 NMs and BaP in combination. CeO2 NMs were burned at 850 °C prior to mimicking their release after combustion in a diesel engine. We demonstrated significantly higher amounts of DNA damage after exposure to combusted CeO2 NMs (1 g L 1) or BaP (1.13 mol L 1) in all cell types considered compared to unexposed cells. Co exposure to the CeO2 NMs BaP mixture induced additive DNA damage in sperm and cumulus cells, whereas no additive effect was observed in rat oocytes. This result could be related to the structural protection of the oocyte by cumulus cells and to the oocyte's efficient system to repair DNA damage compared to that of cumulus and sperm cells