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Brottet E.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Jaffar-Bandjee M.C.,Laboratoire Of Virologie | Rachou E.,Observatoire regional de la sante de la Reunion ORS | Polycarpe D.,Agence de sante de locean Indien | And 3 more authors.
Medecine et Maladies Infectieuses | Year: 2015

The surveillance of infectious diseases in Reunion Island is based on a sentinel network of family physicians (FPs) coordinated by the Indian Ocean regional institute for public health surveillance (French acronym OI Cire). The objectives are to identify and monitor outbreaks of influenza, gastroenteritis, and chicken pox, and to characterize circulating influenza viruses. The network can monitor other potentially epidemic diseases. Method: The Réunion sentinel network ensures a continuous and permanent surveillance. Physicians send their weekly activity data to the Cire that collects, processes, and interprets it; they also collect samples for biological surveillance of influenza. Statistical thresholds, based on historical data and the estimated numbers of incident cases, are calculated to follow the trend, detect outbreaks, and quantify their impact. Results: The network currently includes 56 FPs and pediatricians, accounting for 6.5% of FPs on the island. The network has clarified the seasonality of influenza during the austral winter and identified the seasonality of acute diarrhea with an epidemic peak when school starts in August. The sentinel FPs's reports allowed monitoring the epidemic trend and estimating the number of cases during the 2005 and 2006 chikungunya outbreaks and 2009 influenza A (H1N1) outbreaks. Conclusion: The network has proven its contribution, responsiveness, and reliability for epidemiological surveillance during outbreak. It is an essential tool for infectious diseases surveillance in Reunion Island. © 2014 Elsevier Masson SAS.


Solet J.-L.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Baroux N.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Pochet M.,Center Hospitalier Of Mayotte | Benoit-Cattin T.,Center Hospitalier Of Mayotte | And 4 more authors.
Diabetes and Metabolism | Year: 2011

Aim: Mayotte, a French overseas territory located in the Indian Ocean, has never had a previous estimate of diabetes prevalence, but has recently undergone socioeconomic changes leading to lifestyle modifications. For this reason, a survey was carried out in 2008 to estimate the prevalence of diabetes and cardiovascular risk factors in the island's population. Methods: A three-step, randomized sample of 1268 individuals, aged 30-69 years, was home-screened, using capillary blood glucose and capillary HbA1c, weight, height, waist circumference and two blood-pressure measurements. Those with a history of diabetes, glucose ≥1g/L (fasting) or ≥1.40g/L (non-fasting), or HbA1c≥6%, and a subgroup of those with normal results were examined at a healthcare centre to measure venous HbA1c and glucose, and to diagnose diabetes, using an oral glucose tolerance test. Results: The weighted prevalence of diabetes (venous plasma glucose ≥1.26g/L at fasting and/or ≥2g/L at 2h, or treatment with oral hypoglycaemic agents or insulin) was 10.5% (95% CI: 8.2-13.4%). This increased with age from 3% at age 30-39 years to 26% at age 60-69 years, with no gender differences. Also, more than 50% of those with diabetes were unaware of it, while half of those treated for diabetes still had HbA1c levels >7%. The prevalence of overweight (BMI: 25-29kg/m2) was estimated to be 35% in men and 32% in women, while obesity (≥30kg/m2) was estimated to be 17% in men and 47% in women. Conclusion: The high prevalence of obesity combined with a high prevalence of diabetes indicates a potential for further increases in the prevalence of diabetes and cardiovascular disease in Mayotte. Preventative action against obesity, diabetes and hypertension is required now, as well as plans for appropriate healthcare delivery in the island. © 2010 Elsevier Masson SAS.


Renault P.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Boidin E.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | D'Ortenzio E.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Balleydier E.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | And 2 more authors.
Bulletin de la Societe de Pathologie Exotique | Year: 2011

In 2006, increased mortality due to leptospirosis in Reunion Island had alerted the authorities and justified the conduct of this study in order to update knowledge on the epidemiology of leptospirosis, whereas the latest epidemiological data published on the disease dated back to 2003. This study followed the scheme of a descriptive retrospective survey based on data from reporting and investigation of hospitalized cases of leptospirosis that occurred in Reunion between the 1st January 2004 and 31st December 2008. Data from the National Reference Center (NRC) have also been used. The annual number of reported cases (40 to 50) was stable over the period, which contrasted with the historical decreasing trend of incidence reported by the NRC. The circumstances of exposure were those usually associated with the disease on the island: about 80% of cases were infected between January and June, during the wet season; the main exposure factor identified was the practice of agriculture, declared or not; Leptospira icterohaemorrhagiae remained the most frequently isolated serovar, although regressing. Finally, our study has shown that excess mortality observed in 2006 did not result from an increased incidence but from a rise in the case fatality rate. This could be linked to the outbreak of chikungunya, which peaked in February 2006. In endemic areas of leptospirosis, health professionals should remain aware of the risk of occurrence of fatal cases during arbovirosis outbreaks. © Société de pathologie exotique et Springer-Verlag France 2010.


Renault P.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Thouillot F.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Do C.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Baroux N.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | And 6 more authors.
Bulletin de la Societe de Pathologie Exotique | Year: 2011

In Reunion Island, a French subtropical island located in the southern hemisphere, the monitoring of the epidemiological dynamics of the epidemic linked to the emergence of pandemic virus A(H1N1) 2009 was achieved through the regular influenza surveillance system which has been reinforced on that occasion. It was mainly based on a network of sentinel physicians, combined with virologic monitoring, and on surveillance of severe cases and deaths. The data were analyzed and retroinformation was distributed according to a weekly frequency. The first imported case was confirmed on July 5, 2009 in a traveler arriving from Australia, whereas the first autochthonous cases were reported on July 23. The epidemic peak was reached in five weeks and the duration of the whole epidemic episode was 9 weeks. Pandemic virus has quickly supplanted seasonal viruses that had begun to circulate. The estimated attack rate for symptomatic cases of infection with virus influenza A(H1N1) 2009 was 12.85%. The hospitalization rate was 32 per 10,000 estimated cases, and 24 people had a serious form requiring care in ICU. Among death certificates received at the regional office for health and social affairs, 14 mentioned the influenza, including 7 in whom the pandemic virus has been laboratory confirmed. These deaths occurred in patients significantly younger than usually observed in Reunion Island during the seasonal influenza epidemics. Overall, the epidemic intensity and severity have been similar to those of seasonal influenza in Reunion Island. © Société de pathologie exotique et Springer-Verlag France 2010.


Sissoko D.,University of Bordeaux Segalen | Ezzedine K.,Center Hospitalier University | Giry C.,Center Hospitalier Of Mayotte | Moendandze A.,Conseil General de Mayotte | And 5 more authors.
PLoS ONE | Year: 2010

Background: Although Dengue virus (DENV) circulation had been documented in neighbouring South-western Indian Ocean Islands, its presence in Mayotte is poorly characterised. To address this issue, we aimed to assess the seroprevalence of dengue IgG antibodies (DENV-IgG Ab) among the population and to investigate potential associations with individual and household characteristics. Methods/Principal Findings: In November-December 2006 we conducted a cross-sectional serologic survey in Mayotte among 1,154 inhabitants aged ≥2 years by using a multistage cluster random sampling method. The overall prevalence of DENV-specific IgG antibodies (ELISA) was 22.73% (95% CI, 18.16-27.31). The age-specific seroprevalence increased with age (x2 for trend = 11.86, P,0.0006), and was linked with previous known outbreaks in this region. In multivariate analysis, older age, being born in the Comoros and living in a household with a low socioeconomic index were positively associated with DENV IgG antibody positivity. Conclusions: These findings document substantial prior exposure of the population of Mayotte to DENV and highlight the risk of severe illness due to the possibility of sequential DENV infections. Further investigations characterizing current DENV circulation patterns and associated serotypes are needed. © 2010 Sissoko et al.


Filleul L.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Durquety E.,Center Hospitalier Of Mayotte | Baroux N.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien | Chollet P.,Center Hospitalier Of Mayotte | And 2 more authors.
Bulletin Epidemiologique Hebdomadaire | Year: 2010

The first epidemic wave of influenza A(H1N1)2009 virus on Reunion Island and in Mayotte occurred during the austral winter. Because of the limited knowledge available on the virulence of the virus and co-circulation of seasonal flu, non-specific surveillance systems were set up. Influenza-like illness activity reported by the sentinel practitioners peaked in week 35 on Reunion Island and in week 37 in Mayotte. Daily data on overall activity at hospital emergency departments (surveillance system Oscour®) on Reunion Island showed an identical temporal trend (peak in week 35). In Mayotte, the peak of activity at the emergency ward was observed in week 39, two weeks after the peak reported by the network of sentinel practitioners. Different data sources have shown great consistency and complementarity, allowing for the appropriate monitoring of the first epidemic wave due to influenza A(H1N1)2009.


Dehecq J.-S.,Agence de Sante Ocean Indien | Baville M.,Agence de Sante Ocean Indien | Margueron T.,Agence de Sante Ocean Indien | Mussard R.,Agence de Sante Ocean Indien | Filleul L.,Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien
Bulletin de la Societe de Pathologie Exotique | Year: 2011

The re-emergence of local transmission of chikungunya virus caused by Aedes albopictus since March 2010 in the Réunion Island, French territory in the southwest Indian Ocean, calls for better epidemiological surveys, vector control, and community-based chikungunya control. This paper describes the strategy and the new ways of vector control applied since the last major chikungunya virus outbreak in 2005-2007, and the high levels of collaboration with mayors and local associations for community involvement. Between March 17, 2010 (first chikungunya case) and July 1, 2010, 313 cases were investigated, 13,036 premises inspected, and 34,393 premises concerned by spatial treatment. The traditional entomologic indices don't explain the distribution map of chikungunya cases, and many other factors have to be measured for evaluating the risk of transmission, such as lifestyle, habitat, and the kind of environment the people live in. A big information campaign was conducted beside the implementation of traditional mosquito control techniques. The two themes of this campaign are environmental management and individual protection, considered as important components of chikungunya prevention. The outcome of the mosquito control strategy demonstrates that community participation is not enough, and more studies are required to define new ways of communication for promoting community-oriented activities to prevent chikungunya epidemics. © Société de pathologie exotique et Springer-Verlag France 2010.


PubMed | Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien
Type: Journal Article | Journal: Bulletin de la Societe de pathologie exotique (1990) | Year: 2011

In 2006, increased mortality due to leptospirosis in Reunion Island had alerted the authorities and justified the conduct of this study in order to update knowledge on the epidemiology of leptospirosis, whereas the latest epidemiological data published on the disease dated back to 2003. This study followed the scheme of a descriptive retrospective survey based on data from reporting and investigation of hospitalized cases of leptospirosis that occurred in Reunion between the 1st January 2004 and 31st December 2008. Data from the National Reference Center (NRC) have also been used. The annual number of reported cases (40 to 50) was stable over the period, which contrasted with the historical decreasing trend of incidence reported by the NRC. The circumstances of exposure were those usually associated with the disease on the island: about 80% of cases were infected between January and June, during the wet season; the main exposure factor identified was the practice of agriculture, declared or not; Leptospira icterohaemorrhagiae remained the most frequently isolated serovar, although regressing. Finally, our study has shown that excess mortality observed in 2006 did not result from an increased incidence but from a rise in the case fatality rate. This could be linked to the outbreak of chikungunya, which peaked in February 2006. In endemic areas of leptospirosis, health professionals should remain aware of the risk of occurrence of fatal cases during arbovirosis outbreaks.


PubMed | Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien
Type: Journal Article | Journal: Bulletin de la Societe de pathologie exotique (1990) | Year: 2011

In Reunion Island, a French subtropical island located in the southern hemisphere, the monitoring of the epidemiological dynamics of the epidemic linked to the emergence of pandemic virus A(H1N1) 2009 was achieved through the regular influenza surveillance system which has been reinforced on that occasion. It was mainly based on a network of sentinel physicians, combined with virologic monitoring, and on surveillance of severe cases and deaths. The data were analyzed and retroinformation was distributed according to a weekly frequency. The first imported case was confirmed on July 5, 2009 in a traveler arriving from Australia, whereas the first autochthonous cases were reported on July 23. The epidemic peak was reached in five weeks and the duration of the whole epidemic episode was 9 weeks. Pandemic virus has quickly supplanted seasonal viruses that had begun to circulate. The estimated attack rate for symptomatic cases of infection with virus influenza A(H1N1) 2009 was 12.85%. The hospitalization rate was 32 per 10,000 estimated cases, and 24 people had a serious form requiring care in ICU. Among death certificates received at the regional office for health and social affairs, 14 mentioned the influenza, including 7 in whom the pandemic virus has been laboratory confirmed. These deaths occurred in patients significantly younger than usually observed in Reunion Island during the seasonal influenza epidemics. Overall, the epidemic intensity and severity have been similar to those of seasonal influenza in Reunion Island.


PubMed | Cellule Of Linstitut Of Veille Sanitaire En Region Ocean Indien
Type: Journal Article | Journal: Diabetes & metabolism | Year: 2011

Mayotte, a French overseas territory located in the Indian Ocean, has never had a previous estimate of diabetes prevalence, but has recently undergone socioeconomic changes leading to lifestyle modifications. For this reason, a survey was carried out in 2008 to estimate the prevalence of diabetes and cardiovascular risk factors in the islands population.A three-step, randomized sample of 1268 individuals, aged 30-69 years, was home-screened, using capillary blood glucose and capillary HbA(1c), weight, height, waist circumference and two blood-pressure measurements. Those with a history of diabetes, glucose 1 g/L (fasting) or 1.40 g/L (non-fasting), or HbA(1c)6%, and a subgroup of those with normal results were examined at a healthcare centre to measure venous HbA(1c) and glucose, and to diagnose diabetes, using an oral glucose tolerance test.The weighted prevalence of diabetes (venous plasma glucose 1.26 g/L at fasting and/or 2 g/L at 2 h, or treatment with oral hypoglycaemic agents or insulin) was 10.5% (95% CI: 8.2-13.4%). This increased with age from 3% at age 30-39 years to 26% at age 60-69 years, with no gender differences. Also, more than 50% of those with diabetes were unaware of it, while half of those treated for diabetes still had HbA(1c) levels >7%. The prevalence of overweight (BMI: 25-29 kg/m(2)) was estimated to be 35% in men and 32% in women, while obesity (30 kg/m(2)) was estimated to be 17% in men and 47% in women.The high prevalence of obesity combined with a high prevalence of diabetes indicates a potential for further increases in the prevalence of diabetes and cardiovascular disease in Mayotte. Preventative action against obesity, diabetes and hypertension is required now, as well as plans for appropriate healthcare delivery in the island.

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