Health monitoring during water scarcity in Mayotte, France, 2017

Abstract Background During the 2016–2017 austral summer, unprecedented water scarcity was observed in the south of Mayotte, French island in the Indian Ocean. Therefore, authorities introduced restrictive measures to save the water of this part of the island. The rationing system affected over 65,000 people, for four months. In order to detect a possible deterioration of the health situation, a strengthened epidemiological surveillance system was set up. Methods Surveillance focused on intestinal and skin diseases, which are often associated with a lack of hygiene or poor-quality drinking and bathing water. Three pathologies were monitored: acute diarrhoea, acute gastroenteritis and skin diseases and also, proportion of antidiarrhoeal and rehydration solutions sales in pharmacies. Cases of leptospirosis were also under surveillance. The analyses consisted of comparing the collected data according to the areas that were either affected or not affected by the water restrictions. Comparisons with historical data were also made. Results Although none of the surveillance systems were able to demonstrate any impact on skin diseases, they revealed a very sharp increase in the proportion of consultations for acute diarrhoea and gastro-enteritis in the southern area. This was corroborated by a high increase in the sales of antidiarrhoeals and oral rehydration solutions via the sentinel pharmacists in the south of the island compared with those of the north. Comparison with historical data highlighted the occurrence of an unusual situation. Conclusion These water restrictions caused a real deterioration in the health status of the inhabitants who were deprived of water

Développer l’éducation thérapeutique du patient à Mayotte en tenant compte de l’hétérogénéité des personnes et du contexte social: Premiers enseignements à partir des données récoltées auprès de personnes diabétiques ou obèses

International audienceIn 2011, a research combined to action development aimed to question the conditions of operationalizing and the effects of the implementation of therapeutic patient education (TPE) intervention in Mayotte (Indian Ocean). In a socially and economically deprived context, 30 persons with diabetes and/or obesity beneficiated from learning sessions conceived at the University (Reunion island) and implemented in the health management network REDIAB-YLANG (Mayotte). Interviews conducted before and after TPE sessions showed that the individual and familial inscription of the work realized during TPE succeeded, even for the most deprived, but also that the social context is of great influence on the relations to illness and health of individuals.En 2011, un travail de recherche lié à un projet de développement a permis d’interroger les conditions d’opérationnalisation et les effets d’une intervention en éducation thérapeutique du patient (ETP) à Mayotte (Océan Indien). Dans un contexte fortement fragilisé sur les plans social et économique, une trentaine de personnes diabétiques et/ou obèses ont bénéficié de situations d’apprentissage conçues à l’université de La Réunion et développées par le réseau de santé REDIAB-YLANG (Mayotte). Les résultats des entretiens menés avant et après l’intervention éducative montrent que si l’inscription individuelle et familiale du travail mené en ETP est réussie – y compris pour les personnes en situation précaire -, le contexte social exerce également une influence importante sur les rapports à la maladie et à la santé des personnes

Seroprevalence and risk factors of chikungunya virus infection in Mayotte, Indian Ocean, 2005-2006: a population-based survey.

BackgroundSince 2006, Chikungunya virus (CHIKV) has re-emerged as an important pathogen of global concern. However, individual and household factors associated with the acquisition and the magnitude of clinically silent CHIKV infections remain poorly understood. In this present study, we aimed to investigate the seroprevalence, estimate the proportion of symptomatic illness and identify the risk factors for CHIKV infection in the primo-exposed population of Mayotte. METHODS/ PRINCIPAL FINDINGS: We conducted a household-based cross sectional serosurvey in Mayotte in November and December 2006 using complex multistage cluster sampling. To produce the results representative of the island population aged 2 years or older, sample data were adjusted with sample weights. Explanatory and multiple logistic regression analyses were performed to investigate associations between CHIKV infection seropositivity (presence of IgM and/or IgG to CHIKV by enzyme-linked immunoabsorbent assay) and risk factors. A total of 1154 individuals were analyzed. The overall seroprevalence of CHIKV infection was 37.2% (95% CI = 33.9-40.5), 318 (72.3%) of the seropositive participants reported symptoms consistent with a CHIKV infection during the epidemic period. Risk factors for CHIKV seropositivity among adults (aged 15 years and older) were male gender, low socioeconomic index, schooling ConclusionsOur findings indicate that roughly one out of four CHIKV infections is asymptomatic. Conditions associated with poverty may be considered as critical in CHIKV acquisition. Thus, these conditions should be taken into account in the development of future prevention strategies of CHIKV disease

Adjusted odds-ratios for the presence of any CHIK virus antibody according to household features of individuals aged ≥15 years, Mayotte, 2005–2006.

*<p>This asset index included following the parameters: electricity, flush toilet within the household, piped water as source of drinking water, possession of a television set, radio, refrigerator.</p

Comparison of self-reported symptoms consistent with CHIKV infection according to the presence of any CHIKV-specific antibody, Mayotte, 2005–2006.

*<p>Positive.</p>†<p>Negative.</p

Adjusted odds-ratios for the presence of any CHIK virus antibody according to demographic characteristics of individuals aged ≥15 years, Mayotte, 2005–2006.

<p>Adjusted odds-ratios for the presence of any CHIK virus antibody according to demographic characteristics of individuals aged ≥15 years, Mayotte, 2005–2006.</p

Weighted seroprevalence of anti-CHIK virus antibodies according to demographic characteristics in individuals aged ≥2 years, Mayotte, 2005–2006.

<p>^* Probabilities were calculated using an adjusted Wald <i>X²</i> test within subgroups; ^† Only for adults ; ^‡ For those born outside of Mayotte.</p