Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
The aim of this study was to investigate the role of socioeconomic and healthcare use characteristics in the participation in breast, cervical and colorectal cancer screening in the French West Indies. We used data from a national health survey conducted in 2014 in Martinique (n=2026) and Guadeloupe (n=2028). Logistic regressions adjusted for various sociodemographic and morbidity variables were performed. The following determinants were investigated: having hot water at home, having received income support for low-income individuals during the last year, educational level, occupational class, complementary health insurance, healthcare renouncement and visit to the general practitioner (GP) during the last year. Multiple imputations were performed to account for missing values. We observed the following cancer screening rates: 78.1% for cervical cancer, 81.5% for breast cancer and 59.5% (women) and 50.8% (men) for colorectal cancer. Higher cervical cancer screening participation was reported among women with qualified occupation and having visited the GP during the last year and lower participation among women who never worked. Higher screening participation was reported among participants having hot water at home and having visited the GP during the last year for breast and colorectal (men and women) cancer. Unexpectedly, a lower colorectal cancer screening participation was found among women with qualified occupation. We observed social inequalities in participation in cancer screening in the French West Indies, which stresses the need to continue efforts to increase screening rates in this population.
ISSN: 0959-8278

hal-01525894
http://hal.upmc.fr/hal-01525894
http://hal.upmc.fr/hal-01525894/document
http://hal.upmc.fr/hal-01525894/file/Menvielle_2016_Socioeconomic_and.pdf
DOI : 10.1097/CEJ.0000000000000329

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Over the last decades, the prevalence of childhood respiratory conditions has dramatically increased worldwide. Considering the time spent in enclosed spaces, indoor air pollutants are of major interest to explain part of this increase. This study aimed to measure the concentrations of pollutants known or suspected to affect respiratory health that are present in dwellings in order to assess children's exposure. Measurements were taken in 150 homes with at least one child, in Brittany (western France), to assess the concentrations of 18 volatile organic compounds (among which four aldehydes and four trihalomethanes) and nine semi-volatile organic compounds (seven phthalates and two synthetic musks). In addition to descriptive statistics, a principal component analysis (PCA) was used to investigate grouping of contaminants. Formaldehyde was highly present and above 30 μg/m(3) in 40% of the homes. Diethyl phthalate, diisobutyl phthalate, and dimethylphthalate were quantified in all dwellings, as well as Galaxolide and Tonalide. For each chemical family, the groups appearing in the PCA could be interpreted in term of sources. The high prevalence and the levels of these compounds, with known or suspected respiratory toxicity, should question regulatory agencies to trigger prevention and mitigation actions.
ISSN: 0905-6947

hal-01162378
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01162378
DOI : 10.1111/ina.12225
PUBMED : 26010323

Éditeur(s) : HAL CCSD Public Library of Science
Résumé : International audience
Objective: To describe characteristics and outcomes of HIV-infected patients with Pneumocystis jirovecii pneumonia (PCP) over 2004–2011 in France, in particular in those previously enrolled (PE) in the French Hospital Database on HIV (FHDH). Methods: PE patients with an incident PCP were compared with patients with an inaugural PCP revealing HIV infection (reference). Adequate adherence to care was defined as a CD4 measurement at least every 6 months. Immune reconstitution (CD4$200/mm 3) and risk of death were studied using Kaplan-Meier estimates and multivariable Cox proportional hazards models. Results: In a context of a decreasing incidence of PCP, 1259 HIV-infected patients had a PCP diagnosis, and 593 (47%) were PE patients of whom 161 (27%) have had a prior history of AIDS-defining clinical illness (prior ADI). Median time since enrolment was 8 years for PE patients; 74% had received cART. Median proportion of time with adequate adherence to care was 85% (IQR, 66–96) for all FHDH enrollees, but only 45% (IQR, 1–81) for PE patients during the 2 years before PCP. Median CD4 cell count (38/mm 3) and HIV viral load (5.2 log10 copies/ml) at PCP diagnosis did not differ between PE patients and the reference group. Three year mortality rate of 25% was observed for PE prior ADI group, higher than in PE non-prior ADI group (8%) and the reference group (9%) (p,0.0001). In the PE prior ADI group, poor prognosis remained even after adjustment for virological control and immune reconstitution (HR, 2.4 [95%CI, 1.5–3.7]). Conclusion: Almost 50% of PCP diagnoses in HIV-infected patients occurred presently in patients already in care, mainly with a previous cART prescription but with waning adherence to care. Having repeated ADI is contributing to the risk of death beyond its impact on immune reconstitution and viral suppression: special efforts must be undertaken to maintain those patients in care.
ISSN: 1932-6203

Droits : http://creativecommons.org/licenses/by/
hal-01345090
http://hal.upmc.fr/hal-01345090
http://hal.upmc.fr/hal-01345090/document
http://hal.upmc.fr/hal-01345090/file/journal.pone.0094183.PDF
DOI : 10.1371/journal.pone.0094183

Éditeur(s) : HAL CCSD Taylor & Francis (Routledge)
Résumé : International audience
Border areas are particular “hot spots” generating high levels of HIV vulnerability and facing great challenges to control epidemics. The objective of this study is to describe the sociodemographic, clinical and biological profiles of newly HIV diagnosed people at the French Guiana - Suriname border, to construct an HIV care cascade and compare it with the Surinamese one. HIV-patients aged over 15 years newly diagnosed in western French Guiana in 2011 and 2012 were included in a retrospective cohort study. Patients were identified using different sources (n=121). The male-to-female ratio was 0.8, 85% of the patients were of foreign origin, 72% were undocumented migrants, 21% were living in Suriname and 48% had baseline CD4 cell counts <200 cells/mm3. After one year, 34% were lost to follow-up, 54% received treatment, 34% had controlled viremia and 6% died. We observed a disappointing HIV cascade, like that of Suriname, requiring to develop a coordinated healthcare offer on both sides of the border. Targeted efforts through a bi-national collaboration are needed to address the specific issues of cross-border patients to reach the 90*3 UNAIDS’s diagnosis, link to care and treatment targets and better control the local epidemic
ISSN: 0954-0121

inserm-01476267
http://www.hal.inserm.fr/inserm-01476267
http://www.hal.inserm.fr/inserm-01476267/document
http://www.hal.inserm.fr/inserm-01476267/file/2017%20Jaries%20-%20Population%20movements%20and%20the%20HIV%20cascade-1.pdf
DOI : 10.1080/09540121.2017.1291899