Éditeur(s) : UNDP Guyana UNDP Guyana ( Guyana )
Résumé : (Funding) Support for the development of the technical infrastructure and partner training provided by the United States Department of Education TICFIA program.
While the global response to HIV and AIDS has realized several successes in achieving universal access to prevention, care and treatment to date, challenges persist in ensuring equal access to these services for most at risk populations. The epidemiology of HIV reflects a stark disparity in access to prevention and treatment services for neglected most-at risk populations, such as men who have sex with men (MSM). World-wide, MSM often experience higher rates of HIV relative to the total population. The reasons for this dynamic are multi-faceted and include high risk behaviors, and cultural as well as structural barriers. For MSM in developing countries, for example, basic services for prevention and treatment of HIV infection have yet to reach the large majority of men. Homophobia and discrimination limit access of MSM to prevention services and markedly increase vulnerability, as do criminalization of same-sex behavior. Decriminalization of same-sex behavior is a structural intervention for prevention of HIV infection and has recently been embraced by a nonbinding statement from the United Nations (Beyrer C,Clin Infect Dis. 2010 May 15;50 Suppl 3:S108-13) In the Caribbean, all of the above mentioned barriers exist. In fact, recent evidence demonstrates that there is a correlation between the decriminalization of homosexuality and lower rates of HIV (UNAIDS). This correlation is attributed to improved access to services. Therefore, The United Nations Development Program (UNDP) has recently launched an initiative to address the current situation regarding men who have sex with men in Guyana where the HIV prevalence in this population is 19.4% in contrast to 1.8% in the total population. This rapid assessment has been commissioned to supplement two previous studies that were conducted in Guyana in informing the design of upcoming activities to support local capacity building to enhance access to services and respect for the human rights protections for MSM. Unfortunately, in Guyana, like much of the Caribbean, MSM tend to be a hard to reach population, perhaps due to elevated levels of stigma and discrimination and difficulty in accessing men who might participate in high risk same sex behaviors yet do not self-identify as an MSM. As a result, there is a relative paucity of data concerning the knowledge, attitudes and behaviors of this total population in Guyana. (i.e. those who self –identify and those who do not) The baseline report is organized as follows: the methodology is explained followed by the study limitations, the review (literature and desk). The report then proceeds with describing the reality of work and working with sexual and gender minorities in Guyana, the status quo and entry points. The main findings of the capacity assessment and focus groups are then discussed. Issues relating to the uniformed forces and health services providers are then presented followed by discussions and conclusions.

Droits : All rights reserved by the source institution.

Éditeur(s) : HAL CCSD
Résumé : International audience
Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive episode, current manic or hypomanic episode and suicidal risk (p < 0.005).The prevalence of PTSD is very high in this study, about 24 times higher than in a general population survey using the same screening tool.A large number of comorbidities have been identified, which corresponds to those described in the literature. The specific issues of psychiatry in prison lead us to examine more specifically the significance of the results about suicide risk. A comprehensive suicide risk (sum of medium and high risk screened by the M.I.N.I.) was found in significantly more PTSD+ inmates (17% versus 7%, p = 0.005). This study supports the need for routine screening of PTSD among incomers in detention. This disease is both worrying and common in this population but the real issues are the comorbidities. Suicidal potential is among the most important issues in detention. Its evaluation should be completed by an early recognition of a PTSD.
Soumis à des mouvements de population importants, la Guyane Française et son centre pénitentiaire abritentune population métissée chez qui l’histoire récente a laissé une empreinte forte (tremblement de terre en Haïti,guerre civile au Suriname, violence liée à l’orpaillage et au trafic de stupéfiants). Ces événements de vienégatifs apparaissent comme autant de vecteurs potentiels de psychotraumatismes. Dans ces conditions, il nous a paru essentiel de mettre l’accent sur le repérage du TSPT (Trouble de Stress Post-traumatique) dans cette population sensible. A l'aide d’entretiens d’accueil dédiés nous nous sommes proposé de repérer les TSPT, de décrire sur un plan sociodémographique la population étudiée et de rechercher les comorbidités psychiatriques. Le résultat principal de cette étude était une prévalence du TSPT de 17% chez les arrivants en détention. Le MINI 5.0 a montré une prévalence plus élevée des pathologies psychiatriques dans le groupe présentant un TSPT avec un lien très fort (p<0.005) pour l’épisode dépressif majeur actuel, l’épisode (hypo)maniaque actuel et le risque suicidaire. Cette étude appuie la nécessité d’avoir un dépistage systématique du TSPT chez les arrivants en détention. Cette pathologie est à la fois fréquente dans cette population et invalidante mais ce sont ses comorbidités, dont le potentiel suicidaire, qui font tout l’enjeu d’un repérage précoce.
ISSN: 0383-6320

inserm-01421075
http://www.hal.inserm.fr/inserm-01421075
http://www.hal.inserm.fr/inserm-01421075/document
http://www.hal.inserm.fr/inserm-01421075/file/2016%2C%20Arnal%20-%20Post-Traumatic%20Stress%20Disorder%20among%20Incomers%20in%20Remire-Montjoly%20Prison%2C%20French%20Guiana.pdf
PUBMED : 27570960

Éditeur(s) : Université de La Rochelle
Résumé : Shrimp aquaculture in New Caledonia is a developing industry, exclusively based on the species Litopenaeus stylirostris. However, it is subject to mortalities during grow out as observed all over the world. Since 1993, shrimp reared during the cold period are affected by a disease named "syndrome 93". As a consequence, the whole industry has become seasonal and produces essentially during the warm season. The climatic conditions during the periods of transition between the two main seasons could be responsible for an environmental stress and the origin reason for mortality outbreaks. Stocking density is the main risk factor. It increases the probability of the appearance and development of the epizooty in the pond. The "Summer Syndrome", a septicemic vibriosis caused by Vibrio nigripulchritudo, was identified for the first time in December 1997 in an intensive shrimp farm (DF). It has become enzootic ever since and is expressed after 50d of rearing. Since 2003, two others farms located near DF have developed the disease. As a consequence, the summer syndrome is considered to be a potential threat for all the industry. Between 1991 and 2005, the increase of feed input and nitrogen levels in feed has led to a significant increase in the growth rate over the years in the farms affected by the disease. In consequence, an early eutrophication of the water is observed, which is concomitant with the beginning of the mortality outbreaks. An early eutrophication and the virulence level of the pathogen are considered as the main risk factors of the disease. Factors may act synergistically to explain the summer syndrome. As part of a multidisciplinary approach (pathology – physiology – environment), two high-frequency surveys were carried out to analyse the pond ecosystem. Since the feed quantity increases with the biomass of shrimp, the eutrophication level of the pond ecosystem will also tend to increase with the duration of rearing. During the first part of the rearing, the abundance of each picoplankton type is exceptionally high and picophytoplankton dominated the autotrophic compartment. The nanophytoplankton dominated the second part of the rearing and was more unstable. The shift from pico to nanophytoplankton could be considered as an environmental stress and was observed in relation to the beginning of the mortalities, whatever the disease. Shift intensity could play a role by inducing directly or indirectly a stress for shrimp and/or a growth and/or virulence factors of the pathogen. Results from sediment studies show that mortality was best characterized by TAN concentration in pore water and even more when the TAN concentration was high. TAN and pH are potential stress factors for shrimp reared in ponds affected by these diseases.
L'aquaculture mondiale de crevettes est un secteur à très forte croissance. Toutefois, les problèmes liés aux maladies dans les élevages ne cessent d'augmenter depuis 1980. Au cours du développement de la filière de Nouvelle-Calédonie, deux épisodes saisonniers de mortalités associées à la présence de Vibrio pathogènes sont apparus et ont fortement perturbé les techniques et les schémas de production. Les premières mortalités hivernales, décrites sous le nom de « syndrome 93 » ont été observées en mai 1993. Elles ont affecté depuis tous les élevages de saison froide de toutes les fermes de production. Les conditions climatiques pendant les périodes de transitions entre les deux principales saisons caractérisant le climat de la Nouvelle-Calédonie, seraient responsables d'un stress environnemental à l'origine du déclenchement du syndrome 93. La densité initiale d'ensemencement, apparaît comme le principal facteur de risque, augmentant la probabilité d'apparition de la maladie et l'ampleur de ses effets. Le « syndrome d'été » a été identifié pour la première fois en 1997 dans une ferme pratiquant une production intensive. Il s'est déclaré depuis 2003 dans deux autres fermes géographiquement proches. Les mortalités apparaissent 58 jours en moyenne après l'ensemencement des post-larves dans les bassins. La recherche d'une croissance maximale des animaux a induit, avec les années, une intensification progressive du système caractérisée par une augmentation de la quantité d'aliment distribuée. L'examen des données historiques fait apparaître une eutrophisation du milieu de plus en plus précoce concomitante au déclenchement des mortalités. En l'état actuel de nos connaissances, cette évolution précoce de l'écosystème en présence de façon récurrente de la souche hautement pathogène du Vibrio incriminé et à une période où la fréquence des mues des crevettes est élevée, constitue le principal facteur de risque de la maladie. Avec l'apport croissant en aliment, la colonne d'eau évolue vers une autotrophie croissante alors que le sédiment devient de plus en plus hétérotrophe au fur et à mesure que l'élevage progresse. Au cours du processus d'eutrophisation, le compartiment autotrophe montre une succession de deux assemblages. Le picophytoplancton domine sur la première partie de l'élevage et laisse place à du nanophytoplancton en seconde partie. Cette phase de transition, concomitante à l'apparition des mortalités quel que soit le syndrome, caractérise un stress environnemental dont l'intensité pourrait favoriser ou non le déclenchement des mortalités. Les suivis de différents indicateurs dans les sédiments - pH, potentiel d'oxydoréduction et concentration en ammoniaque dans l'eau interstitielle – indiquent dans les bassins déclarant les épizooties des conditions qui ont été définies expérimentalement comme potentiellement plus stressantes pour les animaux.

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/2007/these-2643.pdf
http://archimer.ifremer.fr/doc/00000/2643/

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Sampling design is a key issue when establishing species inventories and characterizing habitats within highly heterogeneous landscapes. Sampling efforts in such environments may be constrained and many field studies only rely on subjective and/or qualitative approaches to design collection strategy. The region of Cacao, in French Guiana, provides an excellent study site to understand the presence and abundance of Anopheles mosquitoes, their species dynamics and the transmission risk of malaria across various environments. We propose an objective methodology to define a stratified sampling design. Following thorough environmental characterization, a factorial analysis of mixed groups allows the data to be reduced and non-collinear principal components to be identified while balancing the influences of the different environmental factors. Such components defined new variables which could then be used in a robust k-means clustering procedure. Then, we identified five clusters that corresponded to our sampling strata and selected sampling sites in each stratum. RESULTS: We validated our method by comparing the species overlap of entomological collections from selected sites and the environmental similarities of the same sites. The Morisita index was significantly correlated (Pearson linear correlation) with environmental similarity based on i) the balanced environmental variable groups considered jointly (p = 0.001) and ii) land cover/use (p-value<0.001). The Jaccard index was significantly correlated with land cover/use-based environmental similarity (p-value = 0.001). CONCLUSIONS: The results validate our sampling approach. Land cover/use maps (based on high spatial resolution satellite images) were shown to be particularly useful when studying the presence, density and diversity of Anopheles mosquitoes at local scales and in very heterogeneous landscapes.
BMC Ecology

pasteur-00914104
https://hal-riip.archives-ouvertes.fr/pasteur-00914104
https://hal-riip.archives-ouvertes.fr/pasteur-00914104/document
DOI : 10.1186/1472-6785-13-45
PUBMED : 24289184

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
ABSTRACT: BACKGROUND: Climate change poses unprecedented challenges, ranging from global and local policy challenges to personal and social action. Heat-related deaths are largely preventable, but interventions for the most vulnerable populations need improvement. Therefore, the prior identification of high risk areas at the community level is required to better inform planning and prevention. We aimed to demonstrate a simple and flexible conceptual framework relying upon satellite thermal data and other digital data with the goal of easily reproducing this framework in a variety of urban configurations. RESULTS: The study area encompasses Rennes, a medium-sized French city. A Landsat ETM + image (60 m resolution) acquired during a localized heatwave (June 2001) was used to estimate land surface temperature (LST) and derive a hazard index. A land-use regression model was performed to predict the LST. Vulnerability was assessed through census data describing four dimensions (socio-economic status, extreme age, population density and building obsolescence). Then, hazard and vulnerability indices were combined to deliver a heatwave health risk index. The LST patterns were quite heterogeneous, reflecting the land cover mosaic inside the city boundary, with hotspots of elevated temperature mainly observed in the city center. A spatial error regression model was highly predictive of the spatial variation in the LST (R2 = 0.87) and was parsimonious. Three land cover descriptors (NDVI, vegetation and water fractions) were negatively linked with the LST. A sensitivity analysis (based on an image acquired on July 2000) yielded similar results. Southern areas exhibited the most vulnerability, although some pockets of higher vulnerability were observed northeast and west of the city. The heatwave health risk map showed evidence of infra-city spatial clustering, with the highest risks observed in a north--south central band. Another sensitivity analysis gave a very high correlation between 2000 and 2001 risk indices (r = 0.98, p < 10-12). CONCLUSIONS: Building on previous work, we developed a reproducible method that can provide guidance for local planners in developing more efficient climate impact adaptations. We recommend, however, using the health risk index together with hazard and vulnerability indices to implement tailored programs because exposure to heat and vulnerability do not require the same prevention strategies.
ISSN: 1476-072X

inserm-00762303
http://www.hal.inserm.fr/inserm-00762303
http://www.hal.inserm.fr/inserm-00762303/document
http://www.hal.inserm.fr/inserm-00762303/file/1476-072X-11-38.pdf
DOI : 10.1186/1476-072X-11-38

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Purpose: Active surveillance is a treatment option for favorable risk prostate cancer. However, data are missing on populations of African descent. We evaluated the safety and benefit of active surveillance in an African Caribbean cohort with favorable risk prostate cancer. Materials and Methods: Between 2005 and 2016, a single center, prospective cohort study was performed in Guadeloupe, French West Indies, including patients on active surveillance who had low risk prostate cancer (prostate specific antigen 10 ng/ml or less and Gleason score 6 or less) or favorable intermediate risk prostate cancer (prostate specific antigen 10 to 20 ng/ml, Gleason score 3 + 4 or less and life expectancy less than 10 years). Treatment was recommended in case of grade progression, increased tumor volume, prostate cancer doubling time less than 36 months or patient wish. Overall survival, disease specific survival and duration of active surveillance were calculated with the KaplanMeier method. Multivariate analysis was performed using the Cox proportional hazards model to identify predictors of active surveillance termination. Results: A total of 234 patients with a median age of 64 years were enrolled in study. Median followup was 4 years (IQR 2.3-5.5). Overall survival at 30 months, 5 years and 10 years was 99.5%, 98.5% and 90.7%, respectively. Disease specific survival at 30 months, and 5 and 10 years was 100%. At 30 months, 5 years and 10 years 72.7%, 52.6% and 40.4% of patients, respectively, remained untreated and on active surveillance. Age (HR 0.96 per additional year, 95% CI 0.93-0.99) and prostate specific antigen density (HR 1.52 per additional 0.1 ng/ml, 95% CI 1.20-1.89) were found to be independent predictors of active surveillance termination. Conclusions: Active surveillance is safe and beneficial for highly selected African Caribbean patients. It seems to be feasible for patients at low risk and intermediate favorable risk. Prostate specific antigen density could help better select these patients.
ISSN: 0022-5347

hal-01519251
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01519251
DOI : 10.1016/j.juro.2016.12.047
PUBMED : 27993665

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: HCV treatment uptake has drastically increased in HIV-HCV coinfected patients in France since direct-acting antiviral (DAA) treatment approval, resulting in HCV cure in 63% of all HIV-HCV patients by the end of 2015. We investigated the impact of scaling-up DAA on HCV prevalence in the whole HIV population and in various risk groups over the next 10 years in France using a transmission dynamic compartmental model.Methods: The model was based on epidemiological data from the French Dat’AIDS cohort. Eight risk groups wereconsidered, including high-risk (HR) and low-risk (LR) men who have sex with men (MSM) and male/female heterosexuals,intra-venous drug users, or patients from other risk groups. The model was calibrated on prevalence and incidence dataobserved in the cohort between 2012 and 2015.Results: On January 1, 2016, 156,811 patients were registered as infected with HIV in France (24,900 undiagnosedpatients) of whom 7938 (5.1%) had detectable HCV-RNA (722 undiagnosed patients). Assuming a treatmentcoverage (TC) rate of 30%/year (i.e., the observed rate in 2015), model projections showed that HCV prevalenceamong HIV patients is expected to drop to 0.81% in 2026. Sub-analyses showed a similar decrease of HIV-HCVprevalence in most risk groups, including LR MSM. Due to higher infection and reinfection rates, predicted prevalencein HR MSM remained stable from 6.96% in 2016 to 6.34% in 2026. Increasing annual TC rate in HR MSM to 50/70%would decrease HCV prevalence in this group to 2.35/1.25% in 2026. With a 30% TC rate, undiagnosed patients wouldaccount for 34% of HCV infections in 2026.Conclusions: Our model suggests that DAA could nearly eliminate coinfection in France within 10 years for most riskgroups, including LR MSM. Elimination in HR MSM will require increased TC.
ISSN: 1741-7015

Droits : info:eu-repo/semantics/OpenAccess
inserm-01685739
http://www.hal.inserm.fr/inserm-01685739
http://www.hal.inserm.fr/inserm-01685739/document
http://www.hal.inserm.fr/inserm-01685739/file/2017%2C%20Virlogeux%20-%20Modeling%20HIV-HCV%20coinfection.pdf
DOI : 10.1186/s12916-017-0979-1

Éditeur(s) : Elsevier
Résumé : Beach sediment cementation (beachrock formation) is a sedimentary process that can transform significant sections of beaches into rock outcrops. This contribution reports the results of two questionnaire surveys (one focusing on foreign tourists and the other on local people) carried out in coastal resorts of the island of Lesbos (Greece), on the perceptions of beach users regarding the impacts of beachrocks on their recreational activities. The survey focusing on foreign tourists showed that the majority of the interviewees took notice of the formations and commented negatively on them. Although most of the interviewees did not consider beachrocks a significant safety risk, a considerable proportion of the sample stated that beachrocks influenced their beach ratings that they would prefer beachrock-free beaches and would be willing to contribute financially to preventative and protective measures. In contrast, the results of the survey focusing on local people, who are more familiar with the phenomenon, showed a high perception of beachrock-related risks and limited beachrock tolerance. In addition to the safety risks that the irregular, slippery, beachrock surfaces may pose to beach users, beachrocks may also degrade beach aesthetics. promote beach sediment erosion and decrease the beach carrying capacity. As beachrocks are a common attribute of tropical, subtropical and low-temperate beaches that are typically associated with major tourist destinations, and are likely to spread under global warming conditions, they may be considered as a significant threat to the coastal tourist industry. (c) 2008 Elsevier Ltd. All rights reserved.
Tourism Management (0261-5177) (Elsevier), 2009-08 , Vol. 30 , N. 4 , P. 544-552

Droits : 2009 Elsevier Ltd All rights reserved.
http://archimer.ifremer.fr/doc/2009/publication-6625.pdf
DOI:10.1016/j.tourman.2008.09.007
http://archimer.ifremer.fr/doc/00000/6625/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
BACKGROUND: Thrombophilias are common disorders that increase the risk of pregnancy-associated venous thromboembolism and pregnancy loss and can also increase the risk of placenta-mediated pregnancy complications (severe pre-eclampsia, small-for-gestational-age infants, and placental abruption). We postulated that antepartum dalteparin would reduce these complications in pregnant women with thrombophilia. METHODS: In this open-label randomised trial undertaken in 36 tertiary care centres in five countries, we enrolled consenting pregnant women with thrombophilia at increased risk of venous thromboembolism or with previous placenta-mediated pregnancy complications. Eligible participants were randomly allocated in a 1:1 ratio to either antepartum prophylactic dose dalteparin (5000 international units once daily up to 20 weeks' gestation, and twice daily thereafter until at least 37 weeks' gestation) or to no antepartum dalteparin (control group). Randomisation was done by a web-based randomisation system, and was stratified by country and gestational age at randomisation day with a permuted block design (block sizes 4 and 8). At randomisation, site pharmacists (or delegates) received a randomisation number and treatment allocation (by fax and/or e-mail) from the central web randomisation system and then dispensed study drug to the local coordinator. Patients and study personnel were not masked to treatment assignment, but the outcome adjudicators were masked. The primary composite outcome was independently adjudicated severe or early-onset pre-eclampsia, small-for-gestational-age infant (birthweight <10th percentile), pregnancy loss, or venous thromboembolism. We did intention-to-treat and on-treatment analyses. This trial is registered with ClinicalTrials.gov, number NCT00967382, and with Current Controlled Trials, number ISRCTN87441504. FINDINGS: Between Feb 28, 2000, and Sept 14, 2012, 292 women consented to participate and were randomly assigned to the two groups. Three women were excluded after randomisation because of ineligibility (two in the antepartum dalteparin group and one in the control group), leaving 146 women assigned to antepartum dalteparin and 143 assigned to no antepartum dalteparin. Some patients crossed over to the other group during treatment, and therefore for on-treatment and safety analysis there were 143 patients in the dalteparin group and 141 in the no dalteparin group. Dalteparin did not reduce the incidence of the primary composite outcome in both intention-to-treat analysis (dalteparin 25/146 [17.1%; 95% CI 11.4-24.2%] vs no dalteparin 27/143 [18.9%; 95% CI 12.8-26.3%]; risk difference -1.8% [95% CI -10.6% to 7.1%)) and on-treatment analysis (dalteparin 28/143 [19.6%] vs no dalteparin 24/141 [17.0%]; risk difference +2.6% [95% CI -6.4 to 11.6%]). In safety analysis, the occurrence of major bleeding did not differ between the two groups. However, minor bleeding was more common in the dalteparin group (28/143 [19.6%]) than in the no dalteparin group (13/141 [9.2%]; risk difference 10.4%, 95% CI 2.3-18.4; p=0.01). INTERPRETATION: Antepartum prophylactic dalteparin does not reduce the occurrence of venous thromboembolism, pregnancy loss, or placenta-mediated pregnancy complications in pregnant women with thrombophilia at high risk of these complications and is associated with an increased risk of minor bleeding. FUNDING: Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, and Pharmacia and UpJohn.
ISSN: 0923-7577

hal-01258557
http://hal.univ-brest.fr/hal-01258557
DOI : 10.1016/S0140-6736(14)60793-5
PUBMED : 25066248

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
The effects of biodiversity on the transmission of infectious diseases now stand as a cornerstone of many public health policies. The upper Amazonia and Guyana shield are hot-spots of biodiversity that offer genuine opportunities to explore the relationship between the risk of transmission of Chagas disease and the diversity of its triatomine vectors. Over 730 triato-mines were light-trapped in four geomorphological landscapes shaping French-Guiana, and we determined their taxonomic status and infection by Trypanosoma cruzi. We used a model selection approach to unravel the spatial and temporal variations in species abundance , diversity and infection. The vector community in French-Guiana is typically made of one key species (Panstrongylus geniculatus) that is more abundant than three secondary species combined (Rhodnius pictipes, Panstrongylus lignarius and Eratyrus mucronatus), and four other species that complete the assemblage. Although the overall abundance of adult triatomines does not vary across French-Guiana, their diversity increases along a coastal-inland gradient. These variations unravelled a non-monotonic relationship between vector biodiversity and the risk of transmission of Chagas disease, so that intermediate biodiversity levels are associated with the lowest risks. We also observed biannual variations in triatomine abundance, representing the first report of a biannual pattern in the risk of Cha-gas disease transmission. Those variations were highly and negatively correlated with the average monthly rainfall. We discuss the implications of these patterns for the transmission of T. cruzi by assemblages of triatomine species, and for the dual challenge of controlling Amazonian vector communities that are made of both highly diverse and mostly intrusive species.
ISSN: 1935-2727

Droits : http://creativecommons.org/licenses/by/
hal-01298091
https://hal-univ-perp.archives-ouvertes.fr/hal-01298091
https://hal-univ-perp.archives-ouvertes.fr/hal-01298091/document
https://hal-univ-perp.archives-ouvertes.fr/hal-01298091/file/journal.pntd.0004427.PDF
DOI : 10.1371/journal.pntd.0004427

Éditeur(s) : Montpellier 1
Résumé : Understanding bioaccumulation mechanisms of persistent organic pollutants (POPs) is a major issue for environmental risk assessment. In this work, polychlorinated biphenyls (PCBs), a model contaminant family, has been studied in the European hake (Merluccius merluccius), a high trophic level species from the Gulf of Lions. High concentrations of PCBs were measured in hake from this area compared to those encountered in the population of the Bay of Biscay. PCB biomagnification was highlighted along its food web from marine phytoplankton, suggesting a strong influence of diet on contamination levels. The role of other biological processes was also apprehended in order to understand the high variability of observed levels. Thus, growth, sex, and also the degree of sexual maturity appear as major factors explaining the measured concentrations in fish. A PCB bioaccumulation model in the hake, based on the Dynamic Energy Budget theory (DEB), was developed. This approach is based on a bioenergetic model, reproducing the main physiological functions of an organism (feeding, growth and reproduction), coupled with a kinetic model of contaminants. The growth and evolution of contamination levels of several PCB congeners during the life of male and female hakes is satisfactorily simulated, both in the Gulf of Lions and in the Bay of Biscay, validating the processes taken into account. This combined modelling approach appears well adapted to study the fate of contaminants in fish, and paves the way for a realistic understanding of their effects on major biological functions of fish.
La compréhension des mécanismes de bioaccumulation des contaminants organiques persistants (POP) est un enjeu majeur pour l'évaluation des risques environnementaux. Lors de ce travail, le devenir d'une famille de contaminants modèles, les polychlorobiphényles (PCB), a été étudié chez une espèce de rang trophique élevé du golfe du Lion, le merlu Européen (Merluccius merluccius). Des concentrations élevées en PCB ont été mesurées dans les merlus de ce secteur en comparaison à celles rencontrées dans la population du golfe de Gascogne. La mise en évidence d'une bioamplification des PCB le long de son réseau trophique, depuis le phytoplancton marin, suggère une influence importante de l'alimentation sur les niveaux de contamination. Le rôle d'autres processus biologiques a également été appréhendé afin de comprendre la forte variabilité des niveaux observés. Ainsi, la croissance, le sexe, mais également le degré de maturité sexuel apparaissent comme des facteurs explicatifs majeurs des concentrations en PCB mesurées dans les poissons. Un modèle de bioaccumulation des PCB chez le merlu, basé sur la théorie de Budget d'Energie Dynamique (DEB), a été développé. Il s'agit d'une approche basée sur le couplage d'un modèle bioénergétique, reproduisant les principales fonctions physiologiques de l'organisme (nutrition, croissance et reproduction), avec un modèle de cinétique des contaminants. La croissance et l'évolution des niveaux de contamination de plusieurs congénères de PCB au cours de la vie des merlus mâles et femelles est simulée de manière satisfaisante, tant dans le golfe de Gascogne que dans le golfe du Lion, validant ainsi les processus pris en compte. Cette approche combinée de modélisation apparaît tout à fait adaptée à l'étude du devenir des contaminants chez les poissons, et ouvre la voie à une compréhension réaliste de leurs effets sur les grandes fonctions biologiques de ces organismes.

Droits : info:eu-repo/semantics/openAccess
http://archimer.ifremer.fr/doc/2008/these-6490.pdf
http://archimer.ifremer.fr/doc/00000/6490/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Background: Influenza is an important cause of serious illness and death, particularly in elderly and high-risk groups. Objectives Aim of this study was to identify factors associated with poor outcomes among adults hospitalized in France for laboratory-confirmed seasonal influenza. Study design Patients hospitalized for influenza were identified in a prospective, multicenter study carried out in French hospitals during three consecutive influenza seasons (2012–2015). Influenza virus infection was confirmed by reverse transcription polymerase chain reaction. Sociodemographic and clinical variables were compared according to the virus type and subtype. Risk factors for complications, intensive care unit (ICU) admission and death were analyzed by backward stepwise logistic regression. Results The study population consisted of 566 patients, of whom 56% were older than 65 years and 82% had underlying chronic illnesses. Type A influenza viruses infected 422 patients (75%), including subtype H3N2 in 239 patients (57%). The prior vaccine coverage rate was 38%. Complications occurred in 255 patients (45%), consisting mainly of pneumonia (n = 143, 30%) and respiratory failure (n = 116, 20%). Eighty-three patients (15%) were admitted to an ICU, and the in-hospital mortality rate was 4% (n = 21). Sixty-six patients (12%) received oseltamivir. Age over 65 years was the only identified risk factor for complications. Risk factors for ICU admission were an absence of vaccination, no oseltamivir administration before admission, pre-existing chronic respiratory disease, and current smoking. Age over 65 years and ICU admission were risk factors for death. Conclusions Older individuals and patients with underlying conditions are most at risk of influenza complications. Vaccination and early oseltamivir administration, both of which are recommended for these patients, appear to reduce ICU admissions
ISSN: 1386-6532

hal-01302409
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01302409/file/Factors%20associated%20with%20poor%20outcomes.pdf
DOI : 10.1016/j.jcv.2016.04.005

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Dietary exposure to pesticide residues may present a risk to public health, especially for sensitive populations such as pregnant women. To characterize this risk, this study assessed chronic dietary exposure to pesticide residues based on the French ELFE cohort. A self-administered food frequency questionnaire (FFQ) about the last three months of pregnancy filled in by pregnant women in 2011 was used in combination with occurrence data from French Total Diet Studies completed by the results of national monitoring programs on pesticide residues in food. The dietary intake of pesticides (μg/kg of body weight/day) was estimated for 14,099 pregnant women with a complete FFQ, for 317 substances under two occurrence scenarios to handle left-censored data: a lower-bound scenario (LB), where undetected results were set to zero, and an upper-bound scenario (UB), where undetected results were set to the detection limit if the substance was expected to be found in food and zero if it was not. The risk was assessed for 284 substances with a toxicological reference value (TRV) and a good coverage level of the diet potentially contributing to pesticide intake. The cumulative risk was also assessed for seven effects on nervous and thyroid systems using the hazard index and the Cumulative Assessment Groups defined by EFSA. Substances with the highest exposure levels under the LB scenario were, in decreasing order, imazalil, piperonyl butoxide, chlorpropham, thiabendazole, iprodione and propargite. Under the LB scenario, only for lindane did women have a statistically significant probability of exceeding the TRV (2.4%). Under the UB scenario, risk could not be excluded for nine other substances. A better management of left-censored data and more sensitive analyses of the main food contributors might help to refine the UB exposure and risk assessments. A statistically significant cumulative risk was found for neurochemical effects related to high intake levels of three organophosphate insecticides (chlorpyrifos, pirimiphos-methyl and dimethoate) mainly detected in fruits and cereals
ISSN: 0160-4120

hal-01319892
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01319892
DOI : 10.1016/j.envint.2016.04.007
PUBMED : 27187793

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Heterogeneous patterns of malaria transmission are thought to be driven by factors including host genetics, distance to mosquito breeding sites, housing construction, and socio-behavioural characteristics. Evaluation of local transmission epidemiology to characterize malaria risk is essential for planning malaria control and elimination programmes. The use of geographical information systems (GIS) techniques has been a major asset to this approach. To assess time and space distribution of malaria disease in Bandiagara, Mali, within a transmission season, data were used from an ongoing malaria incidence study that enrolled 300 participants aged under six years old ". Methods: Children's households were georeferenced using a handheld global position system. Clinical malaria was defined as a positive blood slide for Plasmodium falciparum asexual stages associated with at least one of the following signs: headache, body aches, fever, chills and weakness. Daily rainfall was measured at the local weather station. Landscape features of Bandiagara were obtained from satellite images and field survey. QGIS™ software was used to map malaria cases, affected and non-affected children, and the number of malaria episodes per child in each block of Bandiagara. Clusters of high or low risk were identified under SaTScan W software according to a Bernoulli model. Results: From June 2009 to May 2010, 296 clinical malaria cases were recorded. Though clearly temporally related to the rains, Plasmodium falciparum occurrence persisted late in the dry season. Two " hot spots " of malaria transmission also found, notably along the Yamé River, characterized by higher than expected numbers of malaria cases, and high numbers of clinical episodes per child. Conversely, the northeastern sector of the town had fewer cases despite its proximity to a large body of standing water which was mosquito habitat. Conclusion: These results confirm the existence of a marked spatial heterogeneity of malaria transmission in Bandiagara, providing support for implementation of targeted interventions. Background Malaria is one of the leading causes of morbidity and mortality in the world, with an estimated 3.3 billion people at risk of malaria [1]. The incidence of malaria worldwide is estimated to be 216 million cases per year, with 81% of these cases occurring in sub-Saharan Africa. Malaria kills approximately 655,000 people per year; 91% of deaths occur in sub-Saharan Africa [1], mostly in children under five years of age. In Mali, West Africa, malaria represents 36.5% of consultation motives in health center, it is a leading cause of morbidity and mortality children of less than five years of age and the first reason of anaemia in pregnant women [2]. Malaria transmission is seasonal. Malaria parasite transmission and clinical disease are characterized by important microgeographic variation, often between adjacent villages, households or families [3-8]. This local heterogeneity is driven by a variety of factors including human genetics [9,10], distance to potential breeding sites [11,12], housing construction
ISSN: 1475-2875

hal-01307672
https://hal-amu.archives-ouvertes.fr/hal-01307672
https://hal-amu.archives-ouvertes.fr/hal-01307672/document
https://hal-amu.archives-ouvertes.fr/hal-01307672/file/1475-2875-12-82.pdf
DOI : 10.1186/1476-072X-2-5

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
AbstractBackgroundFew epidemiological studies have investigated the link between occupational exposure to solvents and head and neck cancer risk, and available findings are sparse and inconsistent. The objective of this study was to examine the association between occupational exposure to chlorinated solvents and head and neck cancer risk.MethodsWe analyzed data from 4637 men (1857 cases and 2780 controls) included in a population-based case-control study, ICARE (France). Occupational exposure to five chlorinated solvents (perchloroethylene [PCE], trichloroethylene [TCE], methylene chloride [MC], chloroform [CF], and carbon tetrachloride [CT]) was assessed through job-exposure matrices. Odds ratios (ORs) and confidence intervals (95% CI) were estimated by unconditional logistic regression, adjusted for age, tobacco smoking, alcohol consumption, asbestos exposure, and other potential confounders.ResultsWe observed no association between chlorinated solvent exposure and head and neck cancer risk, despite a non-significant increase in risk among subjects who had the highest cumulative level of exposure to PCE, (OR = 1.81; 95% CI = 0.68 to 4.82). In subsite analysis, the risk of laryngeal cancer increased with cumulative exposure to PCE (p for trend = 0.04). The OR was 3.86 (95% CI = 1.30 to 11.48) for those exposed to the highest levels of PCE. A non-significant elevated risk of hypopharyngeal cancer was also observed in subjects exposed to the highest levels of MC (OR = 2.36; 95% CI = 0.98 to 5.85).ConclusionOur findings provide evidence that high exposure to PCE increases the risk of laryngeal cancer, and suggest an association between exposure to MC and hypopharyngeal cancer. Exposure to other chlorinated solvents was not associated with the risk of head and neck cancer.
ISSN: 1476-069X

inserm-01570445
http://www.hal.inserm.fr/inserm-01570445
http://www.hal.inserm.fr/inserm-01570445/document
http://www.hal.inserm.fr/inserm-01570445/file/12940_2017_Article_286.pdf
http://www.hal.inserm.fr/inserm-01570445/file/12940_2017_286_MOESM1_ESM.pdf

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Estrogens are thought to play a critical role in prostate carcinogenesis. It has been suggested that polymorphisms of genes encoding enzymes involved in estrogen metabolism are risk factors for prostate cancer. However, few studies have been performed on populations of African ancestry, which are known to have a high risk of prostate cancer. OBJECTIVE: We investigated whether functional polymorphisms of CYP17, CYP19, CYP1B1, COMT and UGT1A1 affected the risk of prostate cancer in two different populations of African ancestry. METHODS: In Guadeloupe (French West Indies), we compared 498 prostate cancer patients and 565 control subjects. In Kinshasa (Democratic Republic of Congo), 162 prostate cancer patients were compared with 144 controls. Gene polymorphisms were determined by the SNaPshot technique or short tandem repeat PCR analysis. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The AA genotype and the A allele of rs4680 (COMT) appeared to be inversely associated with the risk of prostate cancer in adjusted models for both Afro-Caribbean and native African men. For the A allele, a significant inverse association was observed among cases with low-grade Gleason scores and localized clinical stage, in both populations. CONCLUSIONS: These preliminary results support the hypothesis that polymorphisms of genes encoding enzymes involved in estrogen metabolism may modulate the risk of prostate cancer in populations of African ancestry
ISSN: 1932-6203

hal-01305477
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01305477
DOI : 10.1371/journal.pone.0153609
PUBMED : 27074016

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Exposure to disturbance is rarely considered in marine protected area planning. Typically, representing and replicating the habitat types present within protected areas is used to spread the risk of protecting frequently disturbed sites. This was the approach used during the 2004 re-zoning of the Great Barrier Reef Marine Park (GBRMP) via the Representative Areas Program. Over 10 years later, we examine whether the risk was spread by mapping exposure of coral reefs in the GBRMP to four disturbances that cause coral mortality: bleaching, tropical cyclones, crown-of-thorns starfish outbreaks, and freshwater inundation. Our objectives were to: (1) assess whether no-take areas include a range of disturbance regimes, and (2) identify coral reef areas with lower relative exposure. At least 13% and an average of 31% of reef locations in each of 11 exposure classes are included within no-take areas. A greater proportion of low-exposure areas are within no-take areas than high-exposure areas (34.2% vs. 28.3%). The results demonstrate the value of risk spreading when exposure data are not available while also showing that regularly assessing exposure increases capacity for adaptive, resilience-based reef management.
ISSN: 1755-263X

Droits : http://creativecommons.org/licenses/by/
hal-01225201
https://hal-univ-perp.archives-ouvertes.fr/hal-01225201
https://hal-univ-perp.archives-ouvertes.fr/hal-01225201/document
https://hal-univ-perp.archives-ouvertes.fr/hal-01225201/file/Maynard_et_al-2015-Conservation_Letters.pdf
DOI : 10.1111/conl.12198

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
AbstractBackgroundSuicide rates in prison are high and their risk factors are incompletely understood. The objective of the present study is to measure the risk of suicide and its predictors in the only prison of multicultural French Guiana.MethodsAll new prisoners arriving between September 2013 and December 2014 were included. The Mini International Neuropsychiatric Interview (MINI) was used and socio-demographic data was collected. In order to identify the predictors of suicide risk multivariate logistic regression was used.ResultsOf the 707 prisoners included 13.2% had a suicidal risk, 14.0% of whom had a high risk, 15.1% a moderate risk and 41.9% a low risk. Predictive factors were depression (OR 7.44, 95% CI: 3.50–15.87), dysthymia (OR 4.22, 95% CI: 1.34–13.36), panic disorder (OR 3.47, 95% CI: 1.33–8.99), general anxiety disorder (GAD) (OR 2.19, 95% CI: 1.13–4.22), men having been abused during childhood (OR 21.01, 95%, CI: 3.26–135.48), having been sentenced for sexual assault (OR 7.12, 95% CI: 1.98–25.99) and smoking (OR 2.93, 95%, CI 1.30–6.63).ConclusionThe suicide risk was lower than in mainland France, possibly reflecting the differences in the social stigma attached to incarceration because of migrant populations and the importance and trivialization of drug trafficking among detainees. However, there were no differences between nationalities. The results reemphasize the importance of promptly identifying and treating psychiatric disorders, which were the main suicide risk factors.
ISSN: 1471-244X

inserm-01517176
http://www.hal.inserm.fr/inserm-01517176
http://www.hal.inserm.fr/inserm-01517176/document
http://www.hal.inserm.fr/inserm-01517176/file/12888_2017_Article_1320.pdf
DOI : 10.1186/s12888-017-1320-4

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Hemorheological abnormalities have been well characterized in sickle cell disease (SCD) and seem to modulate the clinical severity [1]. For instance, increased blood viscosity raises the risk for frequent vaso-occlusive crisis (VOC) and increased red blood cell (RBC) aggregates robustness (i.e., RBC disaggregation threshold) enhances the risks for acute chest syndrome (ACS) [2]. Moreover, patients with the most rigid RBCs are characterized by high hemolytic rate, which increases the risks to develop leg ulcers or glomerulopathy [3]. However, except few studies supporting an effect of alpha-thalassemia and oxidative stress [1] on RBC rheological properties of SCD patients, very few experiments focused on the genetic and cellular factors modulating blood rheology in this disease.
ISSN: 1079-9796

hal-01263890
https://hal.archives-ouvertes.fr/hal-01263890
https://hal.archives-ouvertes.fr/hal-01263890/document
https://hal.archives-ouvertes.fr/hal-01263890/file/Ferdinand%20et%20al.%20eNOS%20and%20RBC%20rheology%20in%20SCD_BCMD.pdf
PUBMED : 26142331

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND: Few studies have considered using environmental amenities to explain social health inequalities.Nevertheless, Green spaces that promote good health may have an effect on socioeconomic health inequalities. In developed countries, there is considerable evidence that green spaces have a beneficial effect on the health of urban populations and recent studies suggest they can have a positive effect on pregnancy outcomes. To investigate the relationship between green spaces and the spatial distribution of infant mortality taking account neighborhood deprivation levels. METHODS: The study took place in Lyon metropolitan area, France. All infant deaths that occurred between 2000 and 2009 were geocoded at census block level. Each census block was assigned greenness and socioeconomic deprivation levels. The spatial--scan statistic was used to identify high risk cluster of infant mortality according to these neighborhood characteristics. RESULTS: The spatial distribution of infant mortality was not random with a high risk cluster in the south east of the Lyon metropolitan area (p<0.003). This cluster disappeared (p=0.12) after adjustment for greenness level and socioeconomic deprivation, suggesting that these factors explain part of the spatial distribution of infant mortality. These results are discussed using a conceptual framework with 3 hypothetical pathways by which green spaces may have a beneficial effect on adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an environmental pathway. CONCLUSIONS: These results add some evidence to the hypothesis that there is a relationship between access to green spaces and pregnancy outcomes but further research is required to confirm this.
BMC Pregnancy and Childbirth

hal-00876083
https://hal.archives-ouvertes.fr/hal-00876083
https://hal.archives-ouvertes.fr/hal-00876083/document
DOI : 10.1186/1471-2393-13-191