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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.


Epelboin L.,Center Hospitalier Of Mayotte | Jaureguiberry S.,Tropicales et Parasitaires | Esteve J.-B.,Assistance Publique des Hopitaux de Paris | Danis M.,Tropicales et Parasitaires | And 3 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

We report two cases of myocarditis complicating acute schistosomiasis in returning travelers. Treatment with corticosteroids led to full recovery in both cases. Although the pathophysiology of this complication remains unclear, we recommend treating such patients with corticosteroids rather than praziquantel, which can be associated with clinical deterioration. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene.


PubMed | Aix - Marseille University, Center Hospitalier Of Mayotte and Service dAnatomie Pathologique
Type: | Journal: The American journal of tropical medicine and hygiene | Year: 2017

Arthrocladium fulminans is the only species in the Arthrocladium genus that has been involved in a previous human infection. To date, only one case of A. fulminans infection in a patient with GATA-2 immunodeficiency has been reported. We here report the second human case and the first case of septic arthritis and osteomyelitis due to A. fulminans in an immunocompetent patient, living in Mayotte, a French island in western Indian Ocean. He was successfully treated with surgical debridement and 6 months of antifungal treatment. This second observation of human invasive disease caused by A. fulminans is an additional argument for the pathogenicity of this rare species.


Sissoko D.,Institute of Veille Sanitaire | Sissoko D.,La Reunion Virtuelle | Sissoko D.,University of Bordeaux Segalen | Ezzedine K.,University of Bordeaux Segalen | And 7 more authors.
Tropical Medicine and International Health | Year: 2010

Background To record and assess the clinical features of chikungunya fever (CHIKF), with a view to enable diagnosis based on clinical criteria rather than costly laboratory procedures in field conditions. Methods As part of a cross-sectional serologic survey conducted in Mayotte after a massive chikungunya outbreak in 2006, we collected data on clinical features of chikungunya infection and assessed the performance and accuracy of clinical case definition criteria combining different symptoms. Results Of 1154 participants included, 440 (38.1%) had chikungunya-specific IgM or IgG antibodies by enzyme-linked immunosorbent assay (ELISA). Of symptomatic participants, 318 (72.3%) had confirmed chikungunya, the dominant symptoms reported were incapacitating polyarthralgia (98.7%), myalgia (93.1%), backache (86%), fever of abrupt onset (85%) and headache (81.4%). There was a strong linear association between symptomatic infection and age (κ2 for trend = 9.85, P < 0.001). Only 52% of persons with presumptive chikungunya sought medical advice, principally at public primary health care facilities. The association of fever and polyarthralgia had a sensitivity of 84% (95% CI: 79-87) and a specificity of 89% (95% CI: 86-91). This association allowed to classify correctly 87% (95% CI: 85-89) of individuals with serologically confirmed chikungunya. Conclusions Our results suggest that the pair fever and incapacitating polyarthralgia is an accurate and reliable tool for identifying presumptive CHIKF cases in the field. These criteria provide a useful evidence base to support operational syndromic surveillance in laboratory-confirmed chikungunya epidemic settings. © 2010 Blackwell Publishing Ltd.


Bourhy P.,Institute Pasteur Paris | Collet L.,Center Hospitalier Of Mayotte | Clement S.,Institute Pasteur Paris | Huerre M.,Institute Pasteur Paris | And 4 more authors.
PLoS Neglected Tropical Diseases | Year: 2010

Background: Leptospirosis has been implicated as a severe and fatal form of disease in Mayotte, a French-administrated territory located in the Comoros archipelago (southwestern Indian Ocean). To date, Leptospira isolates have never been isolated in this endemic region. Methods and Findings: Leptospires were isolated from blood samples from 22 patients with febrile illness during a 17- month period after a PCR-based screening test was positive. Strains were typed using hyper-immune antisera raised against the major Leptospira serogroups: 20 of 22 clinical isolates were assigned to serogroup Mini; the other two strains belonged to serogroups Grippotyphosa and Pyrogenes, respectively. These isolates were further characterized using partial sequencing of 16S rRNA and ligB gene, Multi Locus VNTR Analysis (MLVA), and pulsed field gel electrophoresis (PFGE). Of the 22 isolates, 14 were L. borgpetersenii strains, 7 L. kirschneri strains, and 1, belonging to serogoup Pyrogenes, was L. interrogans. Results of the genotyping methods were consistent. MLVA defined five genotypes, whereas PFGE allowed the recognition of additional subgroups within the genotypes. PFGE fingerprint patterns of clinical strains did not match any of the patterns in the reference strains belonging to the same serogroup, suggesting that the strains were novel serovars. Conclusions: Preliminary PCR screening of blood specimen allowed a high isolation frequency of leptospires among patients with febrile illness. Typing of leptospiral isolates showed that causative agents of leptospirosis in Mayotte have unique molecular features. © 2010 Bourhy et al.


Cetre-Sossah C.,CIRAD - Agricultural Research for Development | Zeller H.,Institute Pasteur Paris | Grandadam M.,Institute Pasteur Paris | Caro V.,Institute Pasteur Paris | And 4 more authors.
Emerging Infectious Diseases | Year: 2012

As further confirmation of a first human case of Rift Valley fever in 2007 in Comoros, we isolated Rift Valley fever virus in suspected human cases. These viruses are genetically closely linked to the 2006-2007 isolates from Kenya.


Bourhy P.,Institute Pasteur Paris | Bremont S.,Institute Pasteur Paris | Zinini F.,Institute Pasteur Paris | Giry C.,Center Hospitalier Of Mayotte | Picardeau M.,Institute Pasteur Paris
Journal of Clinical Microbiology | Year: 2011

Leptospirosis is considered an underdiagnosed disease. Although several PCR-based methods are currently in use, there is little information on their comparability. In this study, four quantitative real-time PCR (qPCR) assays (SYBR green and TaqMan chemistries) targeting the secY, lfb1, and lipL32 genes were evaluated as diagnostic assays. In our hands, these assays can detect between 102 and 103 bacteria/ml of pure culture, whole-blood, plasma, and serum samples. In three independent experiments, we found a slightly higher sensitivity of the PCR assays in plasma than in whole blood and serum. We also evaluated the specificity of the PCR assays on reference Leptospira strains, including newly described Leptospira species, and clinical isolates. No amplification was detected for DNA obtained from saprophytic or intermediate Leptospira species. However, among the pathogens, we identified sequence polymorphisms in target genes that result in primer and probe mismatches and affect qPCR assay performance. In conclusion, most of these assays are sensitive and specific tools for routine diagnosis of leptospirosis. However, it is important to continually evaluate and, if necessary, modify the primers and/or probes used to ensure effective detection of the circulating Leptospira isolates. Copyright © 2011, American Society for Microbiology. All Rights Reserved.


PubMed | University of Bordeaux Segalen, Center Hospitalier Of Mayotte, Institute Pasteur Paris and University of Paris Pantheon Sorbonne
Type: Journal Article | Journal: PLoS neglected tropical diseases | Year: 2016

Human angiostrongyliasis (HA) is a neurological helminthic disease caused by the lung worm Angiostrongylus cantonensis. It is suspected in the combination of travel or a residence in an endemic area and eosinophilic meningitis. In Mayotte, an island in the Indian Ocean, cases are rare but regular. The main objective of our study was to describe the epidemiological and diagnosis clues of HA in Mayotte. The secondary objectives were to evaluate the contribution of Real-Time Polymerase Chain Reaction (RT- PCR) for the diagnosis of HA, delineate the characteristics of the local transmission and ascertain the presence of A. cantonensis in Achatina fulica, the potential vector of the disease.Between 2007 and 2012, all cases of eosinophilic meningitis were retrospectively included and investigated by RT- PCR in the CSF. Descriptive analysis was conducted for clinical, biological and radiological features, and were analyzed for all patients together with the search for prognostic factors for mortality. Concurrently, geolocalization and temporal parameters were studied to correlate the occurrence of the cases with rainfall seasons and snails were collected to enhance a parasitic carriage with real time PCR.During the 6-year period of the study, 14 cases were identified (2.3 cases/year) and 9 among 10 remaining CSF were positive in PCR. Among 14 cases of EM, 13 were less than 2 year-old children. The 1 year mortality rate was 5/14 (35.7%). Among survivors, 3/7 (42.8%) presented neurological sequelae. Factors associated with mortality were dysfunction of cranial nerves, abnormal brain imaging, and CSF glucose level inferior to 2 mmol/l. Occurrence of cases was temporarily and spatially correlated to the rainy season. Among the 64 collected giant snails, 6 (9.4%) were positive with A. cantonensis PCR. The likely main route of transmission was the children licking snails, carriers of the parasite.In Mayotte, HA was mainly found in paediatric cases under 2 years old, and evidenced a life-threatening disease. PCR seems to be a promising tool in the definitive diagnosis of HA. Population should be aware of the role of A. fulica, and not let the children have direct contact with the snails.


Chakvetadze C.,University of Paris Descartes | Chakvetadze C.,Groupe Hospitalier Cochin Hotel Dieu | Roussin C.,Center Hospitalier Of Mayotte | Roux J.,Center Hospitalier Of Mayotte | And 7 more authors.
Vaccine | Year: 2011

Background: Maternal-infant transmission of hepatitis B virus (HBV) during birth carries a high risk of chronic HBV infection in infants. Appropriate neonatal prophylaxis is effective in preventing perinatal transmission of HBV. The purpose of this study was to evaluate the protective efficacy of anti-HBV sero-vaccination in newborns of HBsAg positive mothers from Mayotte, French island in the Mozambican canal. Patients and methods: One-hundred newborns of HBsAg positive mothers were identified retrospectively on the basis of hospital medical record and hepatitis B immune globulin (HBIG) prescriptions review from 1994 to 2007. To determine the rate of protective efficacy of neonatal prophylaxis defined by anti HBs antibodies >10. IU/mL with negative HBsAg, anti HBc and HBV DNA testing, HBV serological markers were performed in vaccinated children. Results: Eighty-three of 100 newborns (83%) were given a complete sero-vaccination. Maternal HBe Ag status at delivery (available in 93%) was positive in 56 (60%) of cases and HBV viral load (available in 57%) was <5. log. IU/mL, between 5 and 7. logs. IU/mL and >7. logs. IU/mL in 23 (40.4%), 12 (21%) and 22 (38.6%), respectively. HBV markers in all children at a median age of 5. years [IQR 2-8] showed that 76% were protected with anti HBs >10. IU/mL, despite incomplete sero-vaccination in 12 infants; 6% of infants had anti-HBs and anti-HBc positivity with undetectable HBV DNA, 1% had isolated anti HBc while 14% were seronegative. Only 3% had evidence of immunoprophylaxis failure: 1 infant was HBsAg carrier and 2 had detectable HBV DNA without HBsAg (occult HBV infection). The only factor associated with sustained protective efficacy was on time serological control performed within one year of life, whereas maternal age, HBeAg status and HBV viral load on delivery were not. Conclusion: The anti-HBV sero-vaccination of newborns of HBsAg-positive mothers is fairly done in Mayotte and allows a high protection of mother-to-child transmission in a mean endemic area with fair safety. Screening of sero-vaccination failures has to be reinforced in order either to revaccinate or to treat infected children. © 2011 Elsevier Ltd.


Gillard-Berthod C.,Center Hospitalier Of Mayotte
Revue de l'Infirmiere | Year: 2013

Caregivers and nursing students practising in Mayotte can find themselves in a difficult position when faced with patients believing themselves to be possessed by spirits called Jinn. Through a multidisciplinary roundtable, different perspectives and practices can be shared leading to a more enlightened treatment of patients which respects their beliefs, blending traditional and modern medicine. © 2013 Elsevier Masson SAS.

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