Epelboin L.,Center hospitalier Andree Rosemon |
Epelboin L.,Center Hospitalier Pitie Salpetrire |
Chesnais C.,Center hospitalier Andree Rosemon |
Chesnais C.,Montpellier University |
And 5 more authors.
Clinical Infectious Diseases | Year: 2012
Background. Community-acquired pneumonia (CAP) is the major manifestation of Q fever, an emerging disease in French Guiana. Consequently, the empirical antibiotherapy used for the treatment of CAP combines doxycycline and the recommended amoxicillin. Our objectives were to estimate the prevalence of Q fever pneumonia and to build a prediction rule to identify patients with Q fever pneumonia for empirical antibiotic guidance.Methods.A retrospective case-control study was conducted on inpatients admitted with CAP in the Department of Infectious Diseases of Cayenne Hospital from 2004 to 2007. Serodiagnosis for Coxiella burnetii was performed for all patients. Risk factor analysis was performed using multivariate logistic regression, and a prognostic score was computed using bootstrap procedures. The score performance characteristics were used to choose the best prediction rule to identify patients with Q fever pneumonia.Results.One hundred thirty-one patients with CAP were included and the Q fever pneumonia prevalence was 24.4 (95 confidence interval [CI], 17.1-31.9). In multivariate analysis, male sex, middle age (age, 30-60 years), headache, leukocyte count <10 × 109/L and C-reactive protein level >185 mg/L were independently associated with Q fever pneumonia. Patients with a predictive score ≤3 had a low risk of Q fever pneumonia with a negative predictive value of 0.97 (95 CI,. 90-1) and a sensitivity of 0.97 (95 CI,. 89-1).Conclusions.The prediction rule described here accurately identifies patients with low risk of Q fever pneumonia and may help physicians to make more rational decisions about the empirical use of antibiotherapy. Further prospective studies should be performed to validate this score. © 2012 The Author. Source
da Silva J.P.,Para State University |
da Silva J.P.,Federal University of Para |
da Silva M.B.,Para State University |
Campelo S.R.,Para State University |
And 5 more authors.
Cytokine | Year: 2010
Background: Chromoblastomycosis (CBM) is a dermal mycosis. The disease evolves to a chronic state, presenting a suppurative granulomatous dermatitis, combined with variable dermal fibrosis. Pathogenesis of the inflammation and tissue repair in CBM are poorly understood. Aim: To quantify Transforming Growth Factor-β (TGF-β) plasma levels of CBM patients during itraconazole (ITZ) treatment. Methods: Blood plasma of 12 CBM patients was subjected to TGF-β titration with ELISA at 0, 3, 6 and 12. months of 200. mg per day of ITZ therapy, and correlated with the clinical aspects. Plasma of 12 healthy individuals were used for control. Results: CBM patients present high plasma levels of TGF-β (7.016 ± 1988. pg/ml), decreasing after 03. months (4.625 ± 645. pg/ml) of ITZ treatment, which correlates with a rapid clinical improvement. However, after 6 (6.566 ± 777. pg/ml) and 12. months (6.908 ± 776) of treatment, TGF-β levels increase to almost the same levels observed before treatment, which is related to a slow clinical improvement, fungal persistence on the lesion, and fibrotic scars. Conclusion: TGF-β plasma levels are high in CBM patients. Fungal destruction by ITZ correlates with TGF-β downregulation, but tissue remodeling and fungal persistence probably raises its levels again, interfering with cellular immune responses. © 2010 Elsevier Ltd. Source
Caragata E.P.,Monash University |
Caragata E.P.,University of Queensland |
Rances E.,Monash University |
Rances E.,Institute Pasteur Of Guyane |
And 5 more authors.
Microbial Ecology | Year: 2014
The endosymbiont Wolbachia represents a promising method of dengue control, as it reduces the ability of the primary vector, the mosquito Aedes aegypti, to transmit viruses. When mosquitoes infected with the virulent Wolbachia strain wMelPop are fed non-human blood, there is a drastic reduction in mosquito fecundity and egg viability. Wolbachia has a reduced genome and is clearly dependent on its host for a wide range of nutritional needs. The fitness defects seen in wMelPop-infected A. aegypti could be explained by competition between the mosquito and the symbiont for essential blood meal nutrients, the profiles of which are suboptimal in non-human blood. Here, we examine cholesterol and amino acids as candidate molecules for competition, as they have critical roles in egg structural development and are known to vary between blood sources. We found that Wolbachia infection reduces total cholesterol levels in mosquitoes by 15-25 %. We then showed that cholesterol supplementation of a rat blood meal did not improve fecundity or egg viability deficits. Conversely, amino acid supplementation of sucrose before and after a sheep blood meal led to statistically significant increases in fecundity of approximately 15-20 eggs per female and egg viability of 30-40 %. This mosquito system provides the first empirical evidence of competition between Wolbachia and a host over amino acids and may suggest a general feature of Wolbachia-insect associations. These competitive processes could affect many aspects of host physiology and potentially mosquito fitness, a key concern for Wolbachia-based mosquito biocontrol. © 2013 Springer Science+Business Media New York. Source
Jourdain F.,Center National dExpertise sur les Vecteurs |
Girod R.,Center National dExpertise sur les Vecteurs |
Girod R.,Institute Pasteur Of Guyane |
Vassal J.M.,CIRAD - Agricultural Research for Development |
And 9 more authors.
Parasite | Year: 2012
The females of the moths Hylesia metabus have their abdomens covered by urticating hairs looking like micro-arrows and causing a puriginous dermatitis to humans known as "papillonite" in French Guiana and also called yellowtail moth dermatitis or Caripito itch. The densities of the moths show great seasonal and annual variations depending on mechanisms mostly unknown. When H. metabus infestations occur, numerous cases of dermatologic manifestations are reported from people living near the mangrove swamps where the moths are developing. One hundred years after the first " papillonite" epidemic reported from French Guiana in 1912, the data presented herein summarize the actual state of knowledge on H. metabus biology and ecology and on the lepidopterism. Some recommendations are proposed for the surveillance and warning systems of H. metabus infestations and to avoid contact with the moths. Research priorities are suggested to improve the control against this problem emerging between nuisance and public health. Source
Barrau M.,Cellule Of Linstitut Of Veille Sanitaire En Regions Antilles Guyane |
Larrieu S.,Cellule Of Linstitut Of Veille Sanitaire En Regions Antilles Guyane |
Cassadou S.,Cellule Of Linstitut Of Veille Sanitaire En Regions Antilles Guyane |
Chappert J.-L.,Cellule Of Linstitut Of Veille Sanitaire En Regions Antilles Guyane |
And 7 more authors.
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2012
Objective. To describe the methodology used for implementing a surveillance system specifically for influenza A(H1N1)pdm09 in the French West Indies and French Guiana during an outbreak of this new virus in 2009-2010, and to report its main results. Methods. This was an observational descriptive study of confirmed and probable cases of influenza A(H1N1)pdm09 hospitalized for at least 24 hours in 23 July 2009-3 March 2010. Reverse transcription polymerase chain reaction was performed on nasopharyngeal swab samples according to the Centers for Disease Control and Prevention protocol. A probable case was defined as fever ≥ 38°C or aches or asthenia with respiratory symptoms (cough or dyspnea). All confirmed and probable hospitalized cases were reported, along with patient's age, sex, clinical condition at admission, place and length of hospitalization, antiviral treatment, underlying conditions, complications, and clinical evolution. A case was classified as severe if respiratory assistance or intensive care was required or if death resulted. Results. A total of 331 confirmed and 16 probable cases were hospitalized, with a hospitalization rate ranging from 4.3 per 1 000 clinical cases in Saint Martin to 10.3 in French Guiana. Of these, 36 were severe, and subsequently, 10 were fatal. The median length of stay was 4 days for non-severe cases and 9 days for severe (P < 0.05). The mean patient age was 21 years, and severe cases were significantly older than non-severe (mean: 38 years versus 19 years, P < 0.05). Underlying conditions associated with a higher risk of severity were 65 years of age or more (RR = 7.5, 95%CI = 4.2-13.3), diabetes (RR = 3.7, 95%CI = 1.5-9.4), cardiac insufficiency (RR = 8.4, 95%CI = 5.2-13.6), and morbid obesity (RR = 4.4, 95%CI = 1.8- 10.4). Patients who received antiviral treatment within 2 days of symptom onset had shorter hospital stays (mean: 4 days versus 6.5 days, P < 0.05), and the illness tended to become less severe (11.1% versus 19.0%, P = 0.13). Conclusions. Active research of hospitalized cases enabled almost exhaustive surveillance. The pandemic's hospitalization rates and lethality were more moderate than expected. Some previously known underlying conditions of severity were confirmed during this outbreak. Furthermore, these results show the validity of early antiviral treatment. Source