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Sissoko D.,Institute of Veille Sanitaire | Sissoko D.,University of Bordeaux Segalen | Ezzedine K.,University of Bordeaux Segalen | Ezzedine K.,Bordeaux University Hospital Center | And 5 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.

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.

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.

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.

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.

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