Éditeur(s) : HAL CCSD
Résumé : International audience
Ann Soc Belg Med Trop

hal-00717098
https://hal.univ-antilles.fr/hal-00717098
PUBMED : 6456703

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
ISSN: 0002-9637

hal-00717068
https://hal.univ-antilles.fr/hal-00717068
PUBMED : 6154427

Éditeur(s) : HAL CCSD American Society of Hematology
Résumé : International audience
Human immunodeficiency virus (HIV)-associated disseminated Histoplasma capsulatum capsulatum infection often mimics tuberculosis. This disease is well know in the United States but is dramatically underdiagnosed in Central and South America. In the Amazon region, given the available incidence data and the regional HIV prevalence, it is expected that, every year, 1,500 cases of histoplasmosis affect HIV patients in that region alone. Given the mortality in undiagnosed patients, at least 600 patients would be expected to die from an undiagnosed but treatable disease. The lack of a simple diagnostic tool and the lack of awareness by clinicians spiral in a vicious cycle and made a major problem invisible for 30 years. The HIV/acquired immunodeficiency syndrome community should tackle this problem now to prevent numerous avoidable deaths from HIV-associated histoplasmosis in the region and elsewhere.
ISSN: 0006-4971

inserm-00913874
http://www.hal.inserm.fr/inserm-00913874
http://www.hal.inserm.fr/inserm-00913874/document
http://www.hal.inserm.fr/inserm-00913874/file/2013_Nacher_-_How_many_have_died_from_undiagnosed_histoplasmosis.pdf
DOI : 10.4269/ajtmh.13-0226

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Histoplasmosis is an endemic fungal infection in French Guiana. It is the most common AIDS-defining illness and the leading cause of AIDS-related deaths. Diagnosis is difficult, but in the past 2 decades, it has improved in this French overseas territory which offers an interesting model of Amazonian pathogen ecology. The objectives of the present study were to describe the temporal trends of incidence and mortality indicators for HIV-associated histoplasmosis in French Guiana. METHODS: A retrospective study was conducted to describe early mortality rates observed in persons diagnosed with incident cases of HIV-associated Histoplasma capsulatum var. capsulatum histoplasmosis admitted in one of the three main hospitals in French Guiana between 1992 and 2011. Early mortality was defined by death occurring within 30 days after antifungal treatment initiation. Data were collected on standardized case report forms and analysed using standard statistical methods. RESULTS: There were 124 deaths (45.3%) and 46 early deaths (16.8%) among 274 patients. Three time periods of particular interest were identified: 1992-1997, 1998-2004 and 2005-2011. The two main temporal trends were: the proportion of early deaths among annual incident histoplasmosis cases significantly declined four fold (χ2, p<0.0001) and the number of annual incident histoplasmosis cases increased three fold between 1992-1997 and 1998-2004, and subsequently stabilized. CONCLUSION: From an occasional exotic diagnosis, AIDS-related histoplasmosis became the top AIDS-defining event in French Guiana. This was accompanied by a spectacular decrease of early mortality related to histoplasmosis, consistent with North American reference center mortality rates. The present example testifies that rapid progress could be at reach if awareness increases and leads to clinical and laboratory capacity building in order to diagnose and treat this curable disease.
ISSN: 1935-2727

inserm-01065109
http://www.hal.inserm.fr/inserm-01065109
http://www.hal.inserm.fr/inserm-01065109/document
http://www.hal.inserm.fr/inserm-01065109/file/PLOS_Neglected_Tropical_Dis_2014.pdf
http://www.hal.inserm.fr/inserm-01065109/file/2014_Adenis_-_HIV-associated_histoplasmosis_early_mor.pdf

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
In disease-endemic areas, histoplasmosis is the main differential diagnosis for tuberculosis among human immunodeficiency virus (HIV)-infected patients. However, no study has compared the two diseases. Thus, the objective of this study was to compare tuberculosis and histoplasmosis in HIV-infected patients. A population of 205 HIV-infected patients (99 with tuberculosis and 106 with histoplasmosis) hospitalized in Cayenne, French Guiana during January 1, 1997-December 31, 2008 were selected retrospectively from the French Hospital Database on HIV. Multivariate analysis showed that tuberculosis was associated with cough (adjusted odds ratio [AOR] = 0.20, 95% confidence interval [CI] = 0.05-0.73) and a C-reactive protein level > 70 mg/L (AOR = 0.98, 95% CI = 0.97-0.99). Variables associated with disseminated histoplasmosis were a γ-glutamyl transferase level > 72 IU/L (AOR = 4.99, 95% CI = 1.31-18.99), origin from French Guiana (AOR = 5.20, 95% CI = 1.30-20.73), disseminated localization (AOR = 6.40, 95% CI = 1.44-28.45), a concomitant opportunistic infection (AOR = 6.71, 95% CI = 1.50-29.96), a neutrophil count < 2,750 cells/mm(3) (AOR = 10.54, 95% CI = 2.83-39.24), a CD4 cell count < 60 cells/mm(3) (AOR = 11.62, 95% CI = 2.30-58.63), and a platelet count < 150,000/mm(3) (AOR = 19.20, 95% CI = 3.35-110.14). Tuberculosis and histoplasmosis have similarities, but some factors show a greater association with one of these diseases. Thus, adapted therapeutic choices can be made by using simple clinical and paraclinical criteria.
ISSN: 0002-9637

inserm-01065027
http://www.hal.inserm.fr/inserm-01065027
http://www.hal.inserm.fr/inserm-01065027/document
http://www.hal.inserm.fr/inserm-01065027/file/2014_Adenis_-_Tuberculosis_and_Histoplasmosis_among_HIV.pdf
DOI : 10.4269/ajtmh.13-0084

Éditeur(s) : HAL CCSD
Résumé : International audience
Objective: In order to determine how risk factors of death among HIV-infected patients in French Guiana interact with one another and to define high risk population segments, an alternative statistical method to Cox proportional hazards models was used. Patients and methods: Data from HIV+ patients followed in the three main hospitals of French Guiana were used. Data were extracted from the prospective French Hospital Database for HIV (FHDH). To examine the nature of the relationships between time of death since the first consultation and a set of predictor variables (age at enrolment, gender, nationality, CD4 count at enrolment, presence or absence of HAART at enrolment, a declared addiction, and mode of acquisition of the virus) a survival tree analysis was used. Survival rates at 5 years and 10 years and their 95% confidence interval were also calculated. Results: This analysis permitted to reveal a new specific subgroup of HIV+ patients particularly at risk in French Guiana not already mentioned in the literature: the HIV+ female patients with a declared addiction. Conclusions: Prevention and care in this vulnerable segment of the HIV+ population identified by this methodology should be reinforced.
J AIDS Clinic Res

Droits : info:eu-repo/semantics/OpenAccess
inserm-00914956
http://www.hal.inserm.fr/inserm-00914956
http://www.hal.inserm.fr/inserm-00914956/document
http://www.hal.inserm.fr/inserm-00914956/file/2012_Hanf_-_Hierarchysur Determinants_Underlying_Death_among_HIV-Infected_patients_in_French_Guiana.pdf
DOI : 10.4172/2155-6113.1000172

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
Histoplasmosis is the first cause of acquired immunodeficiency syndrome (AIDS) and AIDS-related deaths in French Guiana. Cohort data were used to determine whether primary prophylaxis with 100 mg itraconazole for patients with CD4 counts < 150/mm(3) was cost-effective with different scenarios. For a scenario where 12% of patients died, 60% were aware of their human immunodeficiency virus (HIV) infection and adherence was only 50%, primary prophylaxis would prevent 1 death and 9 cases of histoplasmosis for a cost of 36,792 Euros per averted death, 1,533 per life-year saved, 4,415 Euros per averted case, when only counting the costs of itraconazole prophylaxis. Taking into account the total costs of hospitalization showed that primary prophylaxis would allow a savings of 185,178 Euros per year. Even in a scenario of low adherence, primary prophylaxis would be cost-effective in French Guiana, and presumably in the rest of the Guianas and the Amazon.
ISSN: 0002-9637

inserm-00913886
http://www.hal.inserm.fr/inserm-00913886
http://www.hal.inserm.fr/inserm-00913886/document
http://www.hal.inserm.fr/inserm-00913886/file/2013_Nacher_-_Primary_prophylaxissur disseminated_histoplasmosis_in_HIV_patients_in_French_Guiana_a_cost_effectiveness_study.pdf
DOI : 10.4269/ajtmh.13-0082

Éditeur(s) : HAL CCSD
Résumé : National audience
Introduction Le chikungunya (CHIKV) est un alphavirus ré-émergent depuis 10 ans responsable de nombreuses épidémies. Chez certains patients, il est à l'origine de troubles musculo-squelettiques et de polyarthropathies inva-lidants et persistants plus de 3 mois, définissant la forme chronique du chikun-gunya (CHIKC). Afin de déterminer la prévalence du CHIKC, nous avons mené une cohorte prospective de patients ambulatoires lors de la dernière épi-démie en outre-mer. Secondairement, nous avons recherché les facteurs de risques associés.
Médecine et maladies infectieuses 46 (2016) 15-16
Lille, France

inserm-01413489
http://www.hal.inserm.fr/inserm-01413489
http://www.hal.inserm.fr/inserm-01413489/document
http://www.hal.inserm.fr/inserm-01413489/file/2016%2C%20Thioune%20-%20COL%207-01%20%281%29.pdf
http://www.hal.inserm.fr/inserm-01413489/file/2016%2C%20Thioune%20-%20COL%207-01.pdf

Éditeur(s) : HAL CCSD
Résumé : International audience
Studying the ecology of Leishmania parasites is essential for understanding and controlling the epidemiology of the diseases they cause. Despite their abundance and diversity in neotropical forests, few studies have been conducted to investigate the potential involvement of Chiroptera in the Leishmania pathogenic complexes. However, phlebotomine sand flies are known to colonize the same anthropized habitat, are attracted to bats, and are able to transmit trypanosomatids. Thus, 216 bats representing 29 species were sampled in the field in different primary and secondary forests of French Guiana where human cutaneous leishmaniases have been reported, together with 62 non-volant mammals. A series of 411 tissue samples representing 47 mammalian species were cultured and screened for the presence of Leishmania spp. by a genus-specific polymerase chain reaction. All 278 individuals surveyed were negative. Thus, bats do not appear to be involved in the Lishmania parasitic cycles in the Guyanas.
The American journal of tropical medicine and hygiene

halsde-00339305
https://hal.archives-ouvertes.fr/halsde-00339305

Éditeur(s) : HAL CCSD
Résumé : International audience
Lewis blood group specificities are detected in the liver Fluke: Fasciola hepatica. Such specificities had never been reported in nature, other than in the human body. The investigation of this phenomenon might contribute to a better understanding of the mechanisms involved in parasite-host relationship.
C R Seances Acad Sci D

hal-00715437
https://hal.univ-antilles.fr/hal-00715437
PUBMED : 120793

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
UNLABELLED: ABSTRACT: BACKGROUND: High circulating parasite load is one of the WHO criteria for severe falciparum malaria. During a period of 11 years (2000-2010), the frequency of hyperparasitaemia (HP) (≥4% infected erythrocytes) during bouts of malaria due to Plasmodium falciparum, Plasmodium vivax and Plasmodium malariae in patients referred to Cayenne General Hospital (CGH) in French Guiana and the frequency of their admission to the Intensive Care Unit (ICU) were evaluated. METHODS: A mean of 1,150 malaria cases were referred to the Parasitology Laboratory of CGH each year over the last decade. During this period, malaria diagnostic (microscopy) and parasitaemia evaluation have remained unchanged: determination of the parasitized erythrocytes percentage with asexual forms on thin blood smears for all cases of parasitaemia exceeding 0.1%. Patients admitted to the ICU can be counted by origin of the request for malaria testing. All the data collected retrospectively were anonymized in a standardized case report form and in database. RESULTS: Between 2000 and 2010, 12,254 bouts of malaria were confirmed at the Parasitology Laboratory of CHG: P. vivax: 56.2%, P. falciparum: 39.5%, co-infection with both species: 3.4%, P. malariae: 0.9%. HP was observed in 262 cases, at a frequency of 4.9% for P. falciparum and only 0.041% for P. vivax, with no recorded cases for P. malariae. The need for intensive care was correlated with P. falciparum parasite load: 12.3% of cases for parasitaemia of 4-9%, 21.2% for parasitaemia 10-19%, 50% for parasitaemia 20-29% and 77.8% for parasitaemia ≥30% (n=9). The patient with the highest parasitaemia (75% infected erythrocytes with asexual form) presented a major concomitant lupus flare-up treated with corticoids. He survived without obvious sequelae. CONCLUSIONS: In French Guiana during bouts of malaria, HP was observed at a frequency of ~ 5% for P. falciparum and two orders of magnitude less frequent for P. vivax. HP is a severity criterion for falciparum malaria in this endemic area. However, two of the patients with HP ≥30% were not admitted to the ICU and sequel-free cure in malaria patients with 75% parasitaemia is, therefore, possible.
ISSN: 1475-2875

inserm-00780740
http://www.hal.inserm.fr/inserm-00780740
http://www.hal.inserm.fr/inserm-00780740/document
http://www.hal.inserm.fr/inserm-00780740/file/1475-2875-12-20.pdf
DOI : 10.1186/1475-2875-12-20

Résumé : Les études écologiques sont maintenant considérées comme prometteuses en raison de leur capacité à intégrer dans un même modèle autant des facteurs individuels que populationnels. Le mouvement récent de l’open data pourrait jouer un rôle important dans la pérennisation des démarches multidisciplinaires. Cette thèse montre que l’association des méthodes écologiques aux données publiques permet d’éclairer sous un angle nouveau des problématiques des maladies infectieuses.En Guyane Française, des méthodes écologiques dites de séries temporelles couplées aux données climatiques libres ont contribué à une meilleure compréhension du rôle du climat sur la dynamique de la transmission du paludisme, de la leishmaniose cutanée ainsi que de l’histoplasmose disséminée. L’utilisation de méthodes écologiques sur des données libres de la littérature scientifique concernant la séroprévalence toxoplasmose dans les populations humaines a permis d’identifier les principaux facteurs influençant le niveau de séroprévalence globale et indirectement du risque de toxoplasmose congénital associé. L’association de données onusiennes à des méthodes écologiques a permis de montrer qu’une prévalence importante d’ascaridiose est associée à une réduction par 10 de l’incidence du paludisme et l’impact significatif de la corruption sur la mortalité juvéno-infantile et sur les résistances aux anti-tuberculeux. Ces études montrent que l’association des méthodes écologiques aux données publiques permet d’éclairer sous un angle nouveau des problématiques des maladies infectieuses. Ce type d‘étude fournit la flexibilité nécessaire à l’étude des interactions complexes des nombreux déterminants de la santé.
Ecological studies are now considered promising because of their ability to integrate as well as individual factors than populational ones in the same model. The recent open data movement could play an important role in the sustainability of multidisciplinary approaches. The studies developed in this thesis show that the combination of ecological methods with open data could give original results in the issues of infectious diseases.In French Guiana, ecological methods called time series, coupled with open climate data, have contributed to a better understanding of the role of climate on the dynamics of malaria, cutaneous leishmaniasis and disseminated histoplasmosis. The use of ecological methods with open data from the scientific literature concerning toxoplasmosis seroprevalence in human populations has permitted to identify the main factors influencing the level of overall seroprevalence and indirectly to estimate the associated risk of congenital toxoplasmosis.The combination of UN data to ecological methods has shown that a high prevalence of ascariasis is associated with a reduction from 10 in the incidence of malaria and that corruption has a significant impact on child mortality and resistance to TB.The various studies developed in this thesis show that the combination of ecological methods to public data sheds a new light on the issues of infectious diseases. This type of study provides the flexibility to study the complex interactions of many determinants of health.

http://www.theses.fr/2011AGUY0482/document

Éditeur(s) : HAL CCSD
Résumé : International audience
Background: In French Guiana, a recent study has shown that a major part of the histoplasmosis incidence temporal fluctuations could be explained by climatic factors and thus postulated that disseminated histoplasmosis cases could be in a large proportion due to new infections. The description of the seasonal pattern of histoplasmosis could potentially help to test this new hypothesis. Patients and methods: A study using prospective data from the French Hospital Database for HIV was conducted in order to determine seasonal variations of the incidence of first cases of disseminated histoplasmosis in HIV persons in Cayenne, French Guiana. Single failure Cox proportional hazards models were used. Results: After adjusting for CD4 counts and antiretroviral treatment, the incidence of disseminated histoplasmosis was significantly higher during the Short Wet Season-Long Dry Season than during the Short Dry Season-Long Wet Season (Adjusted Hazard ratio 1.7 (1.1-2.5), P= 0.01). Conclusion: This result gives both valuable epidemiologic information to clinicians and a supplementary argument in favour of the hypothesis that an important proportion of cases were due to recent exposure. Therefore, the use of a primary prophylaxis must be discussed in French Guiana.
J AIDS Clinic Res

Droits : info:eu-repo/semantics/OpenAccess
inserm-00915009
http://www.hal.inserm.fr/inserm-00915009
http://www.hal.inserm.fr/inserm-00915009/document
http://www.hal.inserm.fr/inserm-00915009/file/2012_Hanf_-_Disseminated_Histoplasmosis_seasonal_incidence_variations_a_supplementary_argument_for_recent_infection.pdf
DOI : 10.4172/2155-6113.1000175

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Four lyophilizated liver flüke antigens and one of hydatid fluid were examined for the presence of blood group like antigens P1, A, B, M and N by an hemagglutination inhibition test with hyperimmune and natural hemagglutinating sera. P1 or P1-like substance was found in the extracts of "Fasciola hepatica" and "F. gigantica" in a lower concentration than in echinoccocal fluid. This presence may explain the occurrence of anti-P1 antibodies in patients infected with liver flüke and belonging to the P2 blood group. However biochemical studies will be necessary to determine if the P1 activity is due to the blood group P1 substance of the red cell itself or due to a P1 like substance.
ISSN: 0369-8114

hal-00715431
https://hal.univ-antilles.fr/hal-00715431
PUBMED : 392420

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Reliable molecular typing tools are required for a better understanding of the molecular epidemiology of Plasmodium vivax. The genes msp3a and msp1_block5 are highly polymorphic and have been used as markers in many P. vivax population studies. These markers were used to assess the genetic diversity of P. vivax strains from French Guiana (South America) and to develop a molecular typing protocol. METHODS: A total of 120 blood samples from 109 patients (including 10 patients suffered from more than one malaria episode, samples were collected during each episode) with P. vivax infection were genotyped. All samples were analysed by msp3a PCR-RFLP and msp1_b5 gene sequencing was performed on 57 samples. Genotyping protocol applied to distinguish between new infection or relapse from heterologus hypnozoites and treatment failure or relapse from homologus hypnozoites was based on analysing first msp3a by PCR-RFLP and secondly, only if the genotypes of the two samples are identical, on sequencing the msp1_b5 gene. RESULTS: msp3a alleles of three sizes were amplified by PCR: types A, B and C. Eleven different genotypes were identified among the 109 samples analysed by msp3a PCR-RFLP. In 13.8% of cases, a mixed genotype infection was observed. The sequence of msp1_b5 gene revealed 22 unique genotypes and 12.3% of cases with mixed infection. In the 57 samples analysed by both methods, 45 genotypes were found and 21% were mixed. Among ten patients with two or three malaria episodes, the protocol allowed to identify five new infections or relapses from heterologous hypnozoites and six treatment failures of relapses from homologous hypnozoites. CONCLUSION: The study showed a high diversity of msp3a and msp1_b5 genetic markers among P. vivax strains in French Guiana with a low polyclonal infection rate. These results indicated that the P. vivax genotyping protocol presented has a good discrimination power and can be used in clinical drug trials or epidemiological studies.
ISSN: 1475-2875

pasteur-00590981
https://hal-riip.archives-ouvertes.fr/pasteur-00590981
DOI : 10.1186/1475-2875-8-40
PUBMED : 19284592

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Malaria is a major public health problem in French Guiana, where Plasmodium vivax has become the dominant malaria species since 2000. As in others endemic areas, it is important to specify the pattern of vivax malaria relapses and to try to discriminate efficiently re-infections from relapses. METHODS: This study was conducted in children born between January 1, 2001 and December 31, 2008 in Camopi, an Amerindian village located in the Amazon forest (n = 325), using an open cohort design. Primary and secondary attack rates of P. vivax were calculated using survival analysis. With the difference between the primary and secondary rates, this study aimed to estimate indirectly P. vivax relapse rate and evaluate its time evolution. RESULTS: Of the 1042 malaria attacks recorded, 689 (66%) were due to P. vivax (without mixed infection). One hundred and fifty one children had their primary attack with P. vivax and 106 had their two first attacks with P. vivax. In the absence of primaquine treatment, it was shown that P. vivax relapses mainly occurred during the first three months after the first attack. Thirty percent of children never had a relapse, 42% had a relapse before the first month after primary attack, 59% before the second month and 63% before the third month. CONCLUSION: This study confirmed that the relapse pattern in Camopi was compatible with the pattern described for the P. vivax Chesson (tropical) strain. In addition, due to the relapse rate time evolution, a simple arbitrary classification rule could be constructed: before 90 days after the primary attack, the secondary attack is a relapse; after 90 days, it is a re-infection. Adapted management of malaria cases based on these results could be devised.
ISSN: 1475-2875

inserm-00663913
http://www.hal.inserm.fr/inserm-00663913
http://www.hal.inserm.fr/inserm-00663913/document
http://www.hal.inserm.fr/inserm-00663913/file/1475-2875-8-278.pdf
DOI : 10.1186/1475-2875-8-278

Éditeur(s) : HAL CCSD Centers for Disease Control and Prevention
Résumé : International audience
From 1998 through 2006, 44 cases of severe primary toxoplasmosis were observed in French Guiana in immunocompetent adults. Toxoplasma gondii isolates exhibited an atypical multilocus genotype. Severe disease in humans may result from poor host adaptation to neotropical zoonotic strains of T. gondii circulating in a forest-based cycle.
ISSN: 1080-6040

hal-00406549
https://hal.archives-ouvertes.fr/hal-00406549
PUBMED : 19331765

Résumé : Notre étude s’est proposée d’analyser l’incidence du paludisme et son évolution dans le temps et dans l’espace, ainsi que de rechercher les facteurs de risque d’accès palustres chez les enfants d’un village du Moyen-Oyapock (Camopi), peuplé d’Amérindiens wayampi et émerillon, d’une part, et d’un village du Haut-Maroni (Antecume Pata), peuplé d’Amérindiens wayana, d’autre part. L’approche a été multiple avec, pour chacun des deux sites d’étude :- Une analyse de survie (modèle de Cox) à partir des accès palustres confirmés biologiquement dans une cohorte d’enfants de moins de sept ans régulièrement suivis, ainsi qu’un questionnaire de type Connaissances, Attitudes et Pratiques (CAP), puis les caractéristiques des habitats et la description de leur environnement immédiat.- Une analyse spatiale avec une classification de l’occupation du sol à partir d’images satellites SPOT 5, l’extraction de variables environnementales d’intérêt, l’étude de leur effet sur la transmission du paludisme et la mise au point d’une méthode objective de sélection d’un rayon d’observation autour des habitations pour la caractérisation de l’environnement.- Une étude de séries temporelles (ARIMA) afin de déterminer l’effet des évènements climatiques et hydrologiques sur le paludisme, aux niveaux local et plus global (El Niño).Les taux d’incidence d’accès palustres sur la période 2001-2009 se sont révélés particulièrement élevés chez les jeunes enfants, notamment à Camopi avec une moyenne de 773‰ par année. Une diminution brutale de l’incidence a eue lieu en 2007 sur le Haut-Maroni et ce phénomène est observé à Camopi depuis 2010. Une prémunition se développe assez rapidement au cours de la vie (2-3 ans), surtout contre les reviviscences à Plasmodium vivax. Les facteurs environnementaux se sont avérés être les plus nombreux et les plus fortement liés à l’incidence palustre. En effet, le dégagement des alentours du carbet de toute végétation et une certaine distance de celui-ci à la forêt sont des facteurs protecteurs. La composante géographique est également apparue essentielle à Camopi avec une incidence qui variait selon le fleuve d’habitation et en fonction de la distance au hameau principal. Les facteurs météorologiques locaux (température et niveau du fleuve) se sont également révélés être liés à l’incidence du paludisme à court terme (0-3 mois). Par ailleurs, nos résultats ont permis d’émettre un certain nombre d’hypothèses quant à la transmission et au(x) vecteur(s) local(ux), et notamment de suggérer la participation d’un vecteur autre qu’An. darlingi dans la transmission du paludisme à Camopi. Nous avons également prouvé par ce travail que la télédétection et les systèmes d’information géographique sont très prometteurs pour la prise en compte de la dimension spatiale et environnementale dans l’étude des maladies transmissibles, notamment dans les zones d’accès difficile de Guyane.
The aim of our study was to analyze the incidence of malaria in children and its evolution through time and space, as well as to search for risk factors in a village in Mid-Oyapock (Camopi), populated by Amerindians Wayampi and Emerillon, on the one hand, and a village in Upper-Maroni (Antecume Pata), populated by Amerindians Wayana, on the other hand. The approach was multiple with, for both study sites:- A survival analysis (Cox modelling) completed out of biologically confirmed malaria attacks in a cohort of children under seven, as well as a Knowledge, Attitudes, Practices and Behavior (KAPB) questionnaire, and also the characteristics of the houses and the description of their immediate environment.- A spatial analysis with a land cover classification from SPOT 5 satellite images, the extraction of environmental variables, the study of their effect on malaria transmission and the development of an objective method for picking the proper observation horizon around houses in order to characterize the environment.- A time series study (ARIMA) to determine the effect of climatic and hydrological events on malaria at local and global (El Niño) scales.The incidence rates of malaria attacks during the period 2001-2009 were particularly high among young children, especially in Camopi with an average of 773‰ by year. A sharp decline in incidence occurred in 2007 on the Upper Maroni and this phenomenon has been observed in Camopi since 2010. An acquired immunity develops quite rapidly during the life (2-3 years old), especially against P. vivax relapses. Environmental factors were found to be the most strongly associated with malaria incidence. Indeed, living in a hut cleared from the surrounding vegetation and at a larger distance from the forest are protective factors. The geographic component also appeared essential in Camopi with an incidence which varied with the river of living and with the distance from the main hamlet. The local meteorological factors (temperature and river level) also proved to be linked to malaria incidence in the short term (0-3 months). Moreover, our results have allowed issuing a number of assumptions about the transmission and the local vector(s), in particular to suggest the involvement of another vector than An. darlingi in the malaria transmission in Camopi. We also proved by this work that remote sensing and geographic information systems hold great promise for the inclusion of the spatial and environmental dimensions in the study of transmitted diseases, especially in areas of difficult access in French Guiana.

http://www.theses.fr/2011AGUY0448/document

Éditeur(s) : HAL CCSD
Résumé : International audience
Some of the immunologic mechanisms involved in malaria physiopathology remain unclear. In animals, the spleen seems to play a key role in protecting the host against malaria. However, little is known about the effect of spleen dysfunction on human malaria. We report two severe cases of Plasmodium falciparum infection with unusual clinical and parasitologic features in two splenectomized men living in French Guiana. The peripheral blood of these cases showed hyperparasitemia, with a high proportion of mature parasites and leukocytes with malaria pigment. Despite appropriate treatment and adequate absorption, hyperparasitemia persisted. Parasite clearance was delayed and one patient died. Only the patient who died had the merozoite surface protein 1 allele B-K1 and the varD gene genotype, which is considered to be a probable parasite virulence factor. These uncommon cases differ from most of those described in the literature, illustrating the complexity of the mechanisms underlying the protective function of the spleen in human malaria.
The American journal of tropical medicine and hygiene

pasteur-00590993
https://hal-riip.archives-ouvertes.fr/pasteur-00590993
PUBMED : 15381808

Éditeur(s) : HAL CCSD
Résumé : International audience
An important hypereosinophilia is usually regarded as an interesting argument of presumption in lymphatic filariasis. This present report concerns 278 Polynesians people infected with Wuchereria bancrofti pacifica. Six kinds of patients were analysed: carriers of microfilarias, patients with elephantiasis, with lymphangitis attacks, new infections, carriers of microfilariasis recently treated with Diethylcarbamazine and, at least, 100 fellows without filariasis. The results which were observed differ, in some aspects, from the usually admitted ideas.
Bull Soc Pathol Exot Filiales

hal-00715417
https://hal.univ-antilles.fr/hal-00715417
PUBMED : 1037617