Éditeur(s) : Université de Guyane Fondation de l'Université de Guyane
Extrait de : Conférences de la Fondation de l'Université de Guyane
Description : La consommation de viandes d'élevage ou de gibiers crues, peu cuites ou avariées constitue une voie de transmission des parasites.
Siècle(s) traité(s) : 21
Droits : CC-BY-NC-ND - Attribution - Pas d'utilisation commerciale - Pas de modification
Permalien : http://www.manioc.org/fichiers/V22030
V22030

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
This study investigated the clinical epidemiology and resistance mechanisms of Acinetobacter baumannii and characterised the clonal diversity of carbapenem-resistant A. baumannii (CRAB) during an ICU-associated outbreak at Cayenne Hospital, French Guiana. All non-duplicate A. baumannii isolates from 2008 to 2014 were tested for antibiotic susceptibility by disk diffusion. Multilocus sequence typing, pulsed-field gel electrophoresis (PFGE) and characterisation of carbapenemase-encoding genes were performed on CRAB. Of the 441 A. baumannii isolates, most were from males (54.0%) and were detected mainly from the ICU (30.8%) and medicine wards (21.8%). In the ICU, strains were mainly isolated from the respiratory tract (44.1%) and bloodstream (14.0%), whereas in medicine wards they mainly were from wound/drainage (36.5%) and bloodstream (25.0%). A. baumannii showed the greatest susceptibility to piperacillin/tazobactam (92.7%), imipenem (92.5%), colistin (95.6%) and amikacin (97.2%), being lower in the ICU and medicine wards compared with other wards. An outbreak of OXA-23-producing CRAB occurred in the 13-bed ICU in 2010. CRAB strains were more co-resistant to other antimicrobials compared with non-CRAB. Molecular genetics analysis revealed five sequence types [ST78, ST107 and ST642 and two new STs (ST830 and ST831)]. Analysis of PFGE profiles indicated cross-transmissions of CRAB within the ICU, between the ICU and one medicine ward during transfer of patients, and within that medicine ward. This study provides the first clinical and molecular data of A. baumannii from French Guiana and the Amazon basin. The ICU was the highest risk unit of this nosocomial outbreak of OXA-23-producing CRAB, which could subsequently disseminate within the hospital.
ISSN: 0924-8579

hal-01506828
https://hal.archives-ouvertes.fr/hal-01506828
PUBMED : 27236843

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Diagnosis of toxoplasmic encephalitis (TE) in patients with AIDS is not straightforward because clinicians rely initially on an empiric diagnosis based on clinical and radiographic improvement to specific anti-Toxoplasma gondii therapy. There is therefore a need for biological tools to improve the diagnosis of TE, especially in tropical areas where this diagnosis is likely to be underestimated. The use of PCR testing in blood samples for the diagnosis of TE has been limited by its poor sensitivity in the studies conducted in Europe. In tropical South America, the results of PCR sensitivity in blood samples were controversial. Considering that T. gondii strains from tropical South America have substantial genetic and pathogenic differences with those from USA and Europe, it is therefore important to re-evaluate the performance of the PCR assay in blood samples for the diagnosis of TE in AIDS patients from this region. Our results showed that the only interest of PCR would be in the most severe forms of TE with altered consciousness because PCR is more likely to be positive. We also provided important genotyping data on T. gondii strains isolated in human cases of toxoplasmosis in the Caribbean and in South America.
ISSN: 1935-2727

hal-01503761
https://hal-unilim.archives-ouvertes.fr/hal-01503761
https://hal-unilim.archives-ouvertes.fr/hal-01503761/document
https://hal-unilim.archives-ouvertes.fr/hal-01503761/file/journal.pntd.0004790.pdf
DOI : 10.1371/journal.pntd.0004790

Éditeur(s) : HAL CCSD
Résumé : National audience
La Guyane française, de par sa situation géographique et climatique équatoriale – entraînant uneimmense biodiversité – et le caractère multiculturel et multiethnique de sa population, est le siège d’unlarge panel de pathologies infectieuses et tropicales, dont certaines sont assez mal connues.La fièvre Q, la toxoplasmose, la cryptococcose ou l’infection à VIH sont communes aux pays tempérés,mais présentent ici de grandes spécificités, entraînant une prise en charge et un raisonnement médicalparfois différents. De nombreuses pathologies tropicales sont par ailleurs présentes sur un mode endémiqueet/ou épidémique : paludisme, leishmaniose, maladie de Chagas, histoplasmose, dengue, chikungunya, etc.Des personnes ayant séjourné en Guyane peuvent présenter des problèmes infectieux spécifiques deretour sur le continent européen, et ces pathologies doivent pouvoir être évoquées par l’infectiologue.
La Lettre de l'Infectiologue

inserm-01407150
http://www.hal.inserm.fr/inserm-01407150
http://www.hal.inserm.fr/inserm-01407150/document
http://www.hal.inserm.fr/inserm-01407150/file/2016%2C%20Epelboin%20-%20L%27infectiologie%20en%20Guyane%20synth%C3%A8se%20med%20trop.pdf

Éditeur(s) : HAL CCSD American Society for Microbiology
Résumé : International audience
ISSN: 0066-4804

pasteur-00590987
https://hal-riip.archives-ouvertes.fr/pasteur-00590987
DOI : 10.1128/AAC.01532-06
PUBMED : 17438062

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
Background: The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors. Methods: In 2013, a longitudinal study was performed using data from all cases of dengue seen in Cayenne Hospital. Cox proportional modeling was used. Signs of major transaminase elevation were defined as an increase in aspartate amino transferase (AST) or alanine amino transferase (ALT) concentration over 10 times the normal value (10N). Results: There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of trans-aminase elevation (10N) was 0.55 per 100 person-days. Six patients had major transaminase elevation with AST.1000 units (0.43 per 1000 patient-days), and 73 patients (4.6%) developed transaminase elevation with AST .10N. The variables independently associated with major transaminase elevation were hyponatremia, low platelets, dehydration, hematocrit increase, food intolerance, positive nonstructural protein 1 (NS1), age over 15 years and the notion of paracetamol intake. Conclusions: Although very frequent, the incidence of major transaminase elevation was lower than reported elsewhere perhaps because of good access to care, or of the particular serotype causing this epidemic. The patients with transaminase elevation tended to be older, more severe and taking paracetamol.
ISSN: 0035-9203

inserm-01475594
http://www.hal.inserm.fr/inserm-01475594
http://www.hal.inserm.fr/inserm-01475594/document
http://www.hal.inserm.fr/inserm-01475594/file/2016%2C%20Djossou%20-%20Incidence%20and%20predictive%20factors%20of%20transaminase.pdf
DOI : 10.1093/trstmh/trv117

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BACKGROUND:In French Guiana, a French overseas territory in South America, 6 to 10 thousands undocumented persons work illegally in gold mining sites in the Amazonian forest. Precarious life conditions lead to poor health but few data exist on the health status of illegal gold miners in French Guiana. The objective of this article was to describe the sociodemographic and health status of this vulnerable population.METHOD:A prospective cross-sectional survey was conducted in 2015 on gold mine supply sites at the border between French Guiana and Suriname. Health status was assessed through medical examination, past medical history, haemoglobin concentration, and HIV and malaria testing. A questionnaire was used to collect data about the migration itinerary and life conditions on mining sites.RESULTS:Among the 421 adults included in the study, 93.8% (395/421) were Brazilian, mainly from Maranhão (55.7%, 220/395), the poorest Brazilian state. The sex ratio was 2.4. Overall, 48% of persons never went to school or beyond the primary level. The median time spent in gold mining was quite long (10 years), with a high turn-over. One third of the surveyed population (37.1%, 156/421) had high blood pressure, and only two had a medical follow-up. Most persons had experienced malaria (89.3%, 376/421). They declared frequent arboviroses and digestive disorders. Active leishmaniasis was observed in 8.3% of gold miners. Among women, 28.5% were anemic. Concerning HIV, 36.6% (154/421) of persons, mainly men, never got tested before and 6 were tested positive, which represented an HIV prevalence of 1.43% (95%CI =0.29-2.5).CONCLUSION:These findings support the hypothesis that mining in remote areas is linked to several specific illnesses. Theoretically, gold miners would be presumed to start their economical migration to French Guiana as a healthy group. However, their strenuous working and living conditions there lead to poor health caused by infectious and non infectious diseases. This description of their health status is precious for health policy planners in French Guiana given the importance of controlling communicable disease, and the severity and range of specific illnesses acquired by this neglected population.TRIAL REGISTRATION:Clinical trial registration PRS N° NCT02903706 . Retrospectively registered 09/13/2016.
ISSN: 1471-2458

inserm-01566314
http://www.hal.inserm.fr/inserm-01566314
http://www.hal.inserm.fr/inserm-01566314/document
http://www.hal.inserm.fr/inserm-01566314/file/2017%2C%20Douine%20-%20Illegal%20gold%20miners%20in%20French%20Guiana.pdf
DOI : 10.1016/S0140-6736(10)62169-1

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
In French Guiana, severe cases of toxoplasmosis in immunocompetent patients are associated with atypical strains of Toxoplasma gondii linked to a wild neotropical rainforest cycle and a higher genetic diversity than usually observed for T. gondii isolates from anthropized environment. This raises the question of the impact of anthropization of the natural environment, on genetic diversity and on the population structure of T. gondii. However, few data are available on strains circulating in the anthropized areas from French Guiana. Seropositive animals originating mainly from anthropized sub-urban areas and punctually from wild environment in French Guiana were analyzed for T. gondii isolation and genotyping. Thirty-three strains were obtained by bioassay in mice and compared with 18 previously reported isolates chiefly originating from the Amazon rainforest. The genotyping analysis performed with 15 microsatellite markers located on 12 different chromosomes revealed a lower genetic diversity in the anthropized environment. Results were analyzed in terms of population structure by clustering methods, Neighbor-joining trees reconstruction based on genetic distances, F(ST,) Mantel's tests and linkage disequilibrium. They clearly showed a genetic differentiation between strains associated to the anthropized environment and those associated to the wild, but with some inbreeding between them. The majority of strains from the anthropized environment were clustered into additional lineages of T. gondii that are common in the Caribbean. In conclusion the two environmental populations "wild" and "anthropized" were genetically well differentiated. The anthropization of the environment seems to be accompanied with a decreased diversity of T. gondii associated with a greater structure of the populations. We detected potential interpenetration and genetic exchanges between these two environmental populations. As a higher pathogenicity in human of "wild" genotypes has been described, the interpenetration of both environments leads to hybridization between strains that may be at risk for human health.
ISSN: 1567-1348

pasteur-00654105
https://hal-riip.archives-ouvertes.fr/pasteur-00654105
https://hal-riip.archives-ouvertes.fr/pasteur-00654105/document
https://hal-riip.archives-ouvertes.fr/pasteur-00654105/file/Mercier_et_al_IGE2011.pdf
DOI : 10.1016/j.meegid.2011.05.003

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Toxoplasma gondii is highly virulent in New World monkeys, but despite numerous outbreaks observed in captive populations there are few reports of molecular characterization of strains. In this article, we describe two outbreaks of toxoplasmosis that occurred in 2001 and 2006 in an outdoor captive breeding colony of squirrel monkeys (Saimiri sciureus) kept by the Institut Pasteur in French Guiana. A microsatellite DNA analysis of the biological samples collected in the 2001 and 2006 outbreaks showed that two different Toxoplasma strains were involved. The 2001 strain exhibited a type II genotype whereas the 2006 strain showed a combination of type I, type III and atypical alleles. Infection could be related to oocysts contaminating water or food, or to ingestion of rats by monkeys. In 2006, a second episode was observed 3 weeks after the first, and was believed to be related to direct contamination by tachyzoites of bronchopulmonary origin from dying monkeys of the first event. During both outbreaks, a total of 50 monkeys died and none recovered spontaneously, confirming the virulence of both type II and non-type II Toxoplasma strains in New World monkeys.
ISSN: 0304-4017

hal-00408048
https://hal.archives-ouvertes.fr/hal-00408048
DOI : 10.1016/j.vetpar.2009.04.004
PUBMED : 19423226

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Resistance to artemisinin casts a shadow on the fight against malaria. The importance of illegal gold miners and of malaria in isolated regions of French Guiana constitutes a threat that endangers the fight against malaria in the Amazon. The hurdles of French laws and the remoteness of the territory from France make it impossible for the system to adapt to the problem of total inaccessibility of an important part of the malaria problem. Transmission is high in these areas and gold miners self-medicate with erratic regimens of artemisinin combinations, thus creating perfect conditions for the emergence of resistance. What needs to be done is being done, but within the limits of national law, with some results. However, facing the same difficult problem, Suriname shows more flexibility and is doing much better than French Guiana despite having lower resources. Local authorities in French Guiana cannot overrule the laws that block appropriate malaria care from reaching a third of malaria-exposed persons. Thus the health authorities in France should take immediate calibrated legislative and financial measures to avoid a predictable disaster.
ISSN: 1475-2875

inserm-00838961
http://www.hal.inserm.fr/inserm-00838961
http://www.hal.inserm.fr/inserm-00838961/document
http://www.hal.inserm.fr/inserm-00838961/file/Nacher_et_al._Malaria_J.pdf
PUBMED : 23641802

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
In South America, the presence of the Leishmania RNA virus type 1 (LRV1) was described in Leishmania guyanensis and Leishmania braziliensis strains. The aim of this study was to determine the prevalence distribution of LRV1 in Leishmania isolates in French Guiana given that, in this French overseas department, most Leishmania infections are due to these parasite species. The presence of the virus was observed in 74% of Leishmania spp. isolates, with a highest presence in the internal areas of the country.
ISSN: 0002-9637

pasteur-01583614
https://hal-riip.archives-ouvertes.fr/pasteur-01583614
https://hal-riip.archives-ouvertes.fr/pasteur-01583614/document
https://hal-riip.archives-ouvertes.fr/pasteur-01583614/file/2016%20Ginouves%20et%20al.%20ajtmh.pdf
PUBMED : 26598572

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
BACKGROUND: Dengue fever is the most important arboviral infection that affects humans, particularly in tropical and subtropical regions. Here, we provide the first comprehensive overview of the severity of dengue epidemics in French Guiana. METHODOLOGY/PRINCIPAL FINDINGS: We monitored hospitalized cases between 2008 and 2013. Detailed clinical features and biological parameters were collected on a daily basis from all cases. Among the 1,356 cases, 216 (16%) were classified according to the WHO 2009 classification as dengue without warning signs (WS), 926 (68%) were classified as dengue with WS and 214 (16%) were classified as severe dengue. The severity rates were similar between the three major epidemics that occurred during the study period, whereas the hospitalization rate was highest in 2013. Fluid accumulation, aspartate aminotransferase (ASAT) counts>193 IU/L and platelet counts<75,000 cells/mm3 were associated with dengue severity. CONCLUSIONS/SIGNIFICANCE: Our findings provide a recent epidemiological description of the severity of dengue epidemics in French Guiana. These results highlight the potential impacts and consequences of implementing the WHO 2009 classification on hospital activity. Future studies should include virological and immunological investigations of well-documented serum samples.
ISSN: 1932-6203

hal-01477201
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01477201
DOI : 10.1371/journal.pone.0172267
PUBMED : 28196111

Éditeur(s) : HAL CCSD American Society of Tropical Medicine and Hygiene
Résumé : International audience
Anti-leishmaniasis drug resistance is a common problem worldwide. The aim of this study was to inventory the general in vitro level of sensitivity of Leishmania isolates circulating in French Guiana and to highlight potential in vitro pentamidine-resistant isolates. This sensitivity study was conducted on 36 patient-promastigote isolates for seven drugs (amphotericin B, azithromycin, fluconazole, meglumine antimoniate, miltefosine, paromomycin, and pentamidine) using the Cell Counting Kit-8 viability test. The IC50 values obtained were heterogeneous. One isolate exhibited high IC50 values for almost all drugs tested. Pentamidine, which is the first-line treatment in French Guiana, showed efficacy at very low doses (mean of 0.0038 μg/mL). The concordance of the in vitro pentamidine results with the patients' clinical outcomes was 94% (K = 0.82).
ISSN: 0002-9637

inserm-01481512
http://www.hal.inserm.fr/inserm-01481512
http://www.hal.inserm.fr/inserm-01481512/document
http://www.hal.inserm.fr/inserm-01481512/file/2017%2C%20Ginouves%20-%20In%20vitro%20sensitivity%20of%20cutaneous%20leishmania.pdf
DOI : 10.4269/ajtmh.16-0373

Éditeur(s) : HAL CCSD Saint-Maurice (Val de Marne) : Institut de veille sanitaire
Résumé : National audience
Introduction – Le nombre d’accès palustres diminue globalement en Guyane, alors que les orpailleurs travaillantsur les sites illégaux semblent particulièrement touchés par cette pathologie. Les objectifs de cette étudeétaient de déterminer la prévalence du paludisme dans cette population, les comportements associés ainsi quele niveau de résistance des parasites vis-à-vis des dérivés de l’artémisinine.Matériel et méthodes – Les inclusions ont eu lieu sur les sites de repli fréquentés par les orpailleurs le long dufleuve Maroni. Ont été effectués : un test de diagnostic rapide du paludisme, un questionnaire, un prélèvementsanguin pour PCR et un génotypage du gène pfK13 pour les PCR positives à Plasmodium falciparum.Résultats – De janvier à juin 2015, 421 orpailleurs ont été inclus, majoritairement des hommes (70,6%) brésiliens(93,8%). La prévalence du portage de plasmodies déterminée par PCR était en moyenne de 22,3%(IC95%: [18,3-26,3]), à 84% asymptomatiques. Les espèces identifiées étaient principalement P. falciparum(47,9%) puis P. vivax (37,2%), plus 10,6% de co-infections. Lors du dernier accès palustre, 52,4% des orpailleursavaient eu recours à l’automédication, majoritairement avec des dérivés de l’artémisinine (93,8%) avecune mauvaise observance (37,8%). L’analyse du gène pfK13 n’a pas mis en évidence de mutations associéesà la résistance à P. falciparumDiscussion – La prévalence élevée de porteurs asymptomatiques de plasmodies constitue un réservoir importantde transmission dans la région. L’utilisation massive de dérivés de l’artémisinine associée à une mauvaise observancedes traitements sont des facteurs de risque d’émergence de résistance imposant des mesures rapides
ISSN: 0245-7466

inserm-01491193
http://www.hal.inserm.fr/inserm-01491193
http://www.hal.inserm.fr/inserm-01491193/document
http://www.hal.inserm.fr/inserm-01491193/file/2017%2C%20Douine%20-%20Paludisme%20et%20orpaillage%20ill%C3%A9gal%20en%20Guyane.pdf

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
Résumé : International audience
Reports on dengue morbidity in patients with sickle cell disease (SCD) are scarce. Dengue is arthropod-borne viroses due to dengue virus (DENV) and affects populations with a high prevalence of SCD; therefore, the risk of morbidity may be increased.To determine the impact of dengue infection in SCD patients, we reviewed medical records during a vast outbreak of dengue virus serotype-2 (DENV-2) in French Guiana in 2012-2013. We identified 10 cases of laboratory-confirmed dengue infection;these were classified into A, B and C categories based on levels of severity of dengue according to World Health Organisation (WHO). The average age of SCD patients was 18.2 years. 1, 6 and 3 cases were classified as A, B and C WHO severity criteria, respectively. All patients had an important decrease in haematocrit (while one of the WHO severity criteria is the increase of haematocrit). Only one patient had decreased platelet count. Seven cases had vaso-occlusive crisis (VOC), six patients developed acute hepatitis and eight had a simultaneous bacterial infection. Six of them needed a blood transfusion. The results suggested that the WHO severity laboratory criteria of hemoconcentration and platelet counts were not helpful in themanagement of SCD patients. The morbidity was mainly caused by specific complications of SCD, especially VOC, likely facilitated by vascular endothelial damages consecutive to dengue fever, severe haemolysis, hepatitis and bacterial co-infections.
Journal of Virology and Retrovirology

Droits : info:eu-repo/semantics/OpenAccess
inserm-01419456
http://www.hal.inserm.fr/inserm-01419456
http://www.hal.inserm.fr/inserm-01419456/document
http://www.hal.inserm.fr/inserm-01419456/file/2015%2C%20Mosnier%20-%20Dengue%20infection%20in%20sickle%20cell%20patients%20in%20French%20Guiana.pdf

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 Public Library of Science
Résumé : International audience
ISSN: 1935-2727

hal-00921369
https://hal-unilim.archives-ouvertes.fr/hal-00921369
DOI : 10.1371/journal.pntd.0001802
PUBMED : 23145185

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
BackgroundMalaria is endemic in French Guiana, an overseas territory of France on the Guiana Shield. Since 2005, notified malaria cases are decreasing. However, new data show that malaria affects many Brazilian gold miners working illegally in French Guiana, the majority of whom are not counted in official data. In addition, one major concern is the usual practice of improper self-treatment in this mining population, raising fear of the development of antimalarial resistance. This prospective study, conducted in 2015, aimed to estimate the prevalence of Plasmodium spp. in illegal gold miners working in French Guiana. MethodsThe recruitment of gold miners was carried out in resting sites along the French Guiana-Suriname border, where they go for supplies, medical care or leisure. After recording agreement, three malaria diagnostic methods were performed: rapid diagnostic test, microscopy and PCR,ResultsAmong 421 persons recruited in the study, malaria prevalence, detected by nested-PCR, was 22.3% (CI=[18.3-26.3], n=94/421) of which 84% were asymptomatic. ConclusionThis significant malaria reservoir in a mobile and illegal population with difficult access to a health care system raises the threat of artemisinin resistance and puts the population of the Guiana Shield at risk of new transmission foci while countries of the region aim at malaria elimination. Even though French legislation may hamper dealing with this population, France must face the reality of malaria in illegal gold miners in order to meet its commitment to malaria elimination.
ISSN: 1475-2875

hal-01346800
https://hal.archives-ouvertes.fr/hal-01346800
https://hal.archives-ouvertes.fr/hal-01346800/document
https://hal.archives-ouvertes.fr/hal-01346800/file/2016%2C%20Douine%20-%20Prevalence%20of%20Plasmodium%20spp.%20in%20illegal%20gold%20miners%20in%20French%20Guiana%20in%202015.pdf
DOI : 10.1186/s12936-016-1367-6

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