Value of syndromic surveillance within the Armed Forces for early warning during a dengue fever outbreak in French Guiana in 2006

<p>Abstract</p> <p>Background</p> <p>A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response.</p> <p>Methods</p> <p>Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants.</p> <p>Results</p> <p>It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance.</p> <p>Conclusion</p> <p>Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future.</p

Mining local climate data to assess spatiotemporal dengue fever epidemic patterns in French Guiana

International audienceOBJECTIVE : To identify local meteorological drivers of dengue fever in French Guiana, we applied an original data mining method to the available epidemiological and climatic data. Through this work, we also assessed the contribution of the data mining method to the understanding of factors associated with the dissemination of infectious diseases and their spatiotemporal spread. METHODS : We applied contextual sequential pattern extraction techniques to epidemiological and meteorological data to identify the most significant climatic factors for dengue fever, and we investigated the relevance of the extracted patterns for the early warning of dengue outbreaks in French Guiana. RESULTS : The maximum temperature, minimum relative humidity, global brilliance, and cumulative rainfall were identified as determinants of dengue outbreaks, and the precise intervals of their values and variations were quantified according to the epidemiologic context. The strongest significant correlations were observed between dengue incidence and meteorological drivers after a 4-6-week lag. DISCUSSION : We demonstrated the use of contextual sequential patterns to better understand the determinants of the spatiotemporal spread of dengue fever in French Guiana. Future work should integrate additional variables and explore the notion of neighborhood for extracting sequential patterns. CONCLUSIONS : Dengue fever remains a major public health issue in French Guiana. The development of new methods to identify such specific characteristics becomes crucial in order to better understand and control spatiotemporal transmission

Blood lead levels and risk factors for lead exposure among pregnant women in western French Guiana: the role of manioc consumption

International audienceConcerns regarding lead (Pb) poisoning in French Guiana first arose in 2011 following the discovery of excessively high levels of the metal amongst children in a small neighborhood without any apparent source of Pb. Since 2012, blood lead level (BLL) measurement has been proposed for all pregnant women in western French Guiana. The aim of this study was to determine BLL in pregnant women in this region and identify factors associated with elevated BLL. An observational study of a consecutive sample of women who delivered in the maternity ward of the hospital was conducted. Risk factors were investigated using a questionnaire administered postdelivery by midwives (N = 531). Approximately 25 and 5% of women displayed BLL of ≥50 μg/L and ≥100 µg/L, respectively. The geometric mean was 32.6 μg/L. Factors that were significantly associated with an elevated BLL after modeling (multivariate linear regression) included place of residence along the Maroni river, low level of education, daily consumption of manioc derivatives, weekly and daily consumption or personal preparation of manioc flour during pregnancy, and weekly consumption of wild game. This study provides insight into the regional and social disparities in BLL in French Guiana and potential sources of exposure. Evidence indicates that foods that are primarily produced and consumed in the Guiana Shield significantly affect BLL levels. Taken together with existing data, our results demonstrate that specific actions in terms of prevention, screening, and care are required to be adapted and put into place in order to reduce exposure

A Data Mining Approach to Identify Climatic Determinants of Dengue Fever Patterns in French Guiana

We applied sequential pattern extraction to identify the most important climatic factors related to dengue fever in French Guiana.  Our findings suggest that the local climate has major effects on the occurrence of dengue epidemics in French Guiana and highlight the utility of the data mining approach to analyze disease surveillance data on a temporal and a spatial scale in relation to climatic, social and environmental variables.  This study is a first step of a data mining project which will help to better understand and accurately predict temporal dynamics of dengue fever in French Guiana.

Malaria on the Guiana Shield: a review of the situation in French Guiana.

International audienceIn a climate of growing concern that Plasmodium falciparum may be developing a drug resistance to artemisinin derivatives in the Guiana Shield, this review details our current knowledge of malaria and control strategy in one part of the Shield, French Guiana. Local epidemiology, test-treat-track strategy, the state of parasite drug resistance and vector control measures are summarised. Current issues in terms of mobile populations and legislative limitations are also discussed

First description of a dengue fever outbreak in the interior of French Guiana, February 2006.

International audienceThis is the first time that a dengue fever outbreak has been described beyond the coastal region of this French overseas Department

Recrudescence de paludisme à Saül, Guyane, 2008.

International audienceSur les 68 sujets interrogés, 48 ont totalisé 92 accès palustres. Le taux d’attaque du paludisme atteignait 71% et le pic épidémique observé au mois de novembre, correspondait aux données de la surveillance épidémiologique menée dans les Centres et postes de santé (Point épidémiologique n°1 du 23 janvier 2009 ; Cire Antilles-Guyane). P. falciparum était responsable de 60% des accès ce qui est conforme aux données de surveillance [2]. Le taux de densité d’incidence (7% personnes-semaine) était probablement surestimé du fait de possibles accès de reviviscence à P. vivax