Center Hospitalier Of Cayenne

Cayenne, Guyana

Center Hospitalier Of Cayenne

Cayenne, Guyana
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Ginouves M.,University of the French West Indies and Guiana | Carme B.,University of the French West Indies and Guiana | Carme B.,Laboratoire Hospitalo University Of Parasitologie Et Mycologie | Couppie P.,University of the French West Indies and Guiana | And 2 more authors.
Journal of Clinical Microbiology | Year: 2014

In French Guiana, leishmaniasis is an essentially cutaneous infection. It constitutes a major public health problem, with a real incidence of 0.2 to 0.3%. Leishmania guyanensis is the causal species most frequently encountered in French Guiana. The treatment of leishmaniasis is essentially drug based, but the therapeutic compounds available have major side effects (e.g., liver damage and diabetes) and must be administered parenterally or are costly. The efficacy of some of these agents has declined due to the emergence of resistance in certain strains of Leishmania. There is currently no vaccine against leishmaniasis, and it is therefore both necessary and urgent to identify new compounds effective against Leishmania. The search for new drugs requires effective tests for evaluations of the leishmanicidal activity of a particular molecule or extract. Microculture tetrazolium assays (MTAs) are colorimetric tests based on the use of tetrazolium salts. We compared the efficacies of three tetrazolium salts-3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT), and 2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulfophenyl)-2H- tetrazolium (WST-8)-for quantification of the promastigotes of various species of Leishmania. We found that the capacity of Leishmania to metabolize a tetrazolium salt depended on the salt used and the species of Leishmania. WST-8 was the tetrazolium salt best metabolized by L. guyanensis and gave the best sensitivity. © 2014 American Society for Microbiology. All Rights Reserved.

Baba-Moussa L.,University Abomey Calavi | Sina H.,University Abomey Calavi | Scheftel J.-M.,Institute Of Bacteriologie | Moreau B.,Center Hospitalier Of Cayenne | And 4 more authors.
PLoS ONE | Year: 2011

Panton-Valentine Leucocidin (PVL), one of the β-barrel pore-forming staphylococcal leucotoxins, is known to be associated to furuncles and some severe community pneumonia. However, it is still uncertain how many other virulence factors are also associated to furuncles and what the risk factors of furuncles are in immuno-compromised status of patients, especially the HIV (+) patients. In this paper, we use antigen immunoprecipitation and multiplex PCR approach to determine the presence of 19 toxins, 8 adhesion factors and the PFGE profiles associated to furuncles in three independent patient study groups of S. aureus (SA) isolates collected from the Cayenne General Hospital (French Guiana). The patient groups were made of: 16 isolates from HIV (-) patients, 9 from HIV (+) patients suffering from furuncles, and 30 control isolates from patients with diverse secondary infected dermatitis. Our data reveals that the majority (96%) of SA strains isolated from HIV patient-derived furuncles significantly produced PVL (p&10 -7), whereas only 10% of SA strains produced this toxin in secondary infected dermatosis. A high prevalence of LukE-LukD-producing isolates (56 to 78%) was recorded in patient groups. Genes encoding clumping factor B, collagen- and laminin-binding proteins (clfB, cna, lbp, respectively) were markedly frequent (30 to 55%), without being associated to a specific group. Pulse field gel electrophoresis evidenced 24 overall pulsotypes, whereas the 25 PVL-producing isolates were distributed into 15 non clonal fingerprints. These pulsotypes were not specific PVL-producing isolates. PVL appears to be the major virulence factor associated to furuncles in Europe and in South America regardless of the immune status of the HIV patients. © 2011 Baba-Moussa et al.

Berger F.,Institute Pasteur Of La Guyane | Berger F.,Center Depidemiologie Et Of Sante Publique | Desplanches N.,Institute Pasteur Of La Guyane | Baillargeaux S.,Institute Pasteur Of La Guyane | And 5 more authors.
PLoS Neglected Tropical Diseases | Year: 2013

In French Guiana, from 1984 to 2011, 14 animal rabies cases and 1 human rabies case (2008) were diagnosed. In January 2011, vampire-bat attacks occurred in 2 isolated villages. In mid-January, a medical team from the Cayenne Centre for Anti-Rabies Treatment visited the sites to manage individuals potentially exposed to rabies and, in April, an anti-rabies vaccination campaign for dogs was conducted. Twenty individuals were bitten by bats in 1 month, most frequently on the feet. The median time to start management was 15 days. The complete Zagreb vaccination protocol (2 doses on day 0 and 1 dose on days 7 and 21) was administered to 16 patients, 12 also received specific immunoglobulins. The antibody titration was obtained for 12 patients (different from those who received immunoglobulins). The antibody titers were ≥0.5 EU/mL for all of them. The serology has not been implemented for the 12 patients who received immunoglobulins. Accidental destruction of a vampire-bat colony could be responsible for the attacks. The isolation and absence of sensitization of the populations were the main explanations for the management difficulties encountered. Sensitization programs should be conducted regularly. © 2013 Berger et al.

Magand F.,Center Hospitalier Of Cayenne | Nacher M.,Center Hospitalier Of Cayenne | Cazorla C.,Jean Monnet University | Cambazard F.,Jean Monnet University | And 2 more authors.
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2011

Prurigo nodularis and herpes zoster frequently lead to the diagnosis of HIV in tropical areas. The WHO has established a clinical definition of AIDS for undeveloped countries. Prurigo and herpes zoster are both classified as stage 2. The main objective of this study was to compare the level of immunosuppression of patients diagnosed as HIV-positive after consulting for prurigo nodularis or herpes zoster in French Guiana. A retrospective study was conducted including patients consulting at the Department of Dermatology, Cayenne Hospital (French Guiana) for prurigo nodularis or herpes zoster between 1989 and 2007 for which the systematic HIV test was positive. Demographic data and CD4 counts of both groups were compared. Analysis of 346 patients consulting for herpes zoster (n=192) or prurigo nodularis (n=154) led to the discovery of 129 HIV infections. The positive predictive value (PPV) for HIV positivity was 38.5% for herpes zoster and 36% for prurigo nodularis. The median lymphocyte count was 302/mm 3 in herpes zoster and 87/mm 3 in prurigo nodularis (P<0.001). The PPV for having a CD4 lymphocyte count<200/mm 3 was 26.5% for herpes zoster and 72% for prurigo nodularis. Prurigo nodularis was predictive of advanced immunosuppression. This questions the pertinence of the WHO clinical classification of AIDS. In the absence of CD4 count, the present results suggest that for patients with prurigo nodularis, antiretrovirals should be initiated without delay. © 2011 Royal Society of Tropical Medicine and Hygiene.

PubMed | University Of Guyane, Institute Pasteur Of La Guyane, University of Bordeaux 1, French Institute of Health and Medical Research and Center Hospitalier Of Cayenne
Type: Journal Article | Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2016

The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors.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).There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of transaminase 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.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..

PubMed | Institute Pasteur Of La Guyane, University Of Guyane, University of Bordeaux 1 and Center Hospitalier Of Cayenne
Type: Journal Article | Journal: PloS one | Year: 2016

The frequency, the clinical characteristics, and the prognosis of dengue is highly variable. Dengue fever is associated with a range of neurological manifestations. The objective of the present study was to determine the incidence of neurological signs and their predictive factors using data from cases of dengue seen and followed in Cayenne Hospital during the Dengue 2 epidemic in 2013.In 2013, a longitudinal study using data from all cases of dengue seen in Cayenne hospital was collected. Medical records used a standardized form to collect demographic information, clinical signs and biological results and the date at which they were present. The analysis used Cox proportional modeling to obtain adjusted Hazard ratios.A total of 1574 patients were included 221 of whom developed central nervous system signs. These signs were spontaneously resolutive. There were 9298person days of follow-up and the overall incidence rate for central nervous system signs was 2.37 per 100 person-days. The variables independently associated with central nervous system anomalies were headache, Adjusted Hazard ratio (AHR) = 1.9(95%CI = 1.4-2.6), bleeding AHR = 2 ((95%CI = 1.3-3.1), P = 0.001, abdominal pain AHR = 1.9 ((95%CI = 1.4-2.6), P<0.001, aches AHR = 2.1 ((95%CI = 1.5-2.9), P<0.001, and fatigue AHR = 1.5 ((95%CI = 1.3-1.7), P<0.001.Overall, the present study suggests that neurological signs of dengue are not exceptional even in patients without the most severe features of dengue. These manifestations were spontaneously resolutive. Here it was not possible to distinguish between encephalitis or encephalopathy. Further studies would require more in depth exploration of the patients.

Nacher M.,Cayenne General Hospital | Nacher M.,University Antilles Guyane | Guerin P.J.,University of Oxford | Demar-Pierre M.,University Antilles Guyane | And 7 more authors.
Malaria Journal | Year: 2013

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. © 2013 Nacher et al.; licensee BioMed Central Ltd.

Rougeron V.,Montpellier University | Banuls A.-L.,Montpellier University | Carme B.,Center Hospitalier Of Cayenne | Carme B.,Site Guyane Of Luniversite Des Antilles Et Of La Guyane | And 7 more authors.
Molecular Ecology | Year: 2011

Leishmania species of the subgenus Viannia and especially Leishmania Viannia guyanensis are responsible for a large proportion of New World leishmaniasis cases. Since a recent publication on Leishmania Viannia braziliensis, the debate on the mode of reproduction of Leishmania parasites has been reopened. A predominant endogamic reproductive mode (mating with relatives), together with strong Wahlund effects (sampling of strains from heterogeneous subpopulations), was indeed evidenced. To determine whether this hypothesis can be generalized to other Leishmania Viannia species, we performed a population genetic study on 153 human strains of L. (V.) guyanensis from French Guiana based on 12 microsatellite loci. The results revealed important homozygosity and very modest linkage disequilibrium, which is in agreement with a high level of sexual recombination and substantial endogamy. These results also revealed a significant isolation by distance with relatively small neighbourhoods and hence substantial viscosity of Leishmania populations in French Guiana. These results are of epidemiological relevance and suggest a major role for natural hosts and/or vectors in parasite strain diffusion across the country as compared to human hosts. © 2011 Blackwell Publishing Ltd.

PubMed | Aix - Marseille University, University of Queensland and Center Hospitalier Of Cayenne
Type: | Journal: Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases | Year: 2016

The coevolution between a host and its obligate parasite is exemplified in the sucking lice that infest primates. In the context of close lice-host partnerships and cospeciation, Pediculus mjobergi, the louse of New World primates, has long been puzzling because its morphology resembles that of human lice. To investigate the possibility that P. mjobergi was transmitted to monkeys from the first humans who set foot on the American continent thousands of years ago, we obtained and compared P. mjobergi lice collected from howler monkeys from Argentina to human lice gathered from a remote and isolated village in Amazonia that has escaped globalization. Morphological examinations were first conducted and verified the similarity between the monkey and human lice. The molecular characterization of several nuclear and mitochondrial genetic markers in the two types of lice revealed that one of the P. mjobergi specimens had a unique haplotype that clustered with the haplotypes of Amazonian head lice that are prevalent in tropical regions in the Americas, a natural habitat of New World monkeys. Because this phylogenetic group forms a separate branch within the clade of lice from humans that were of American origin, this finding indicates that human lice have transferred to New World monkeys.

PubMed | Center Hospitalier Of Cayenne < >, Coordination Regionale VIH COREVIH Guadeloupe CHU de Pointe a Pitre Abymes Batiment B Ancien Hopital Ricou 2eme etage, Service des maladies infectieuses and Coordination Regionale Vih Corevih Center Hospitalier Of Cayenne < >
Type: Journal Article | Journal: International journal of STD & AIDS | Year: 2016

A retrospective cohort study was conducted to determine the incidence and the predictive factors of depression in a cohort of 2737 HIV/AIDS-infected patients in Guadeloupe followed for a total of 8402 patient-years. The incidence rate of first observed depression was 2.2 per 100 person-years (95% confidence interval [CI], 1.9-2.6). A single failure Cox proportional hazards model showed that the 1997-2000 inclusion period (hazard ratio [HR]=1.60; 95% CI=1.10-2.40;p=0.01), the 2001-2009 inclusion period (HR=1.50; 95% CI=1.02-2.40;p=0.04), the more advanced CDC stage (HR=2.30; 95% CI=1.30-3.10;p=0.000) and the annual frequency of visits>10 (HR=2.30; 95% CI=1.70-3.30;p=0.000) were associated with an increased risk of depression. Incidence of depression in this HIV cohort was high and the hazard function showed three peaks of depression (2, 7 and 12 years). Physicians should be vigilant to psychological distress throughout life with HIV.

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