Dépistage des hépatites au sein d'une association culturelle et cultuelle pakistanaise : retour d'expérience.

INTRODUCTION: Pakistan has the second highest prevalence of hepatitis C globally. The Musafir study, set up in 2018 in a Parisian suburb to understand the representations of hepatitis and HIV within the Urdu-speaking, male, migrant community living there, provided an opportunity to think about culturally acceptable health promotion interventions. These included awareness campaigns on hepatitis—which did not cover the question of HIV, considered taboo—, held in a mosque. PURPOSE OF THE RESEARCH: The aim of this article is to describe the implementation of awareness and testing campaigns within a Pakistani religious and cultural association. METHOD: A partnership with a Pakistani association that runs a place of worship enabled awareness and testing campaigns for hepatitis and HIV to be carried out, thanks to the involvement of the association’s managers and the imam. RESULTS: Between February and June 2023, 113 people were tested during the five campaigns that were carried out. The population screened consisted almost exclusively of Urdu-speaking men. Anti-HCV antibodies were found in six people, three of whom had already recovered, and two people tested positive for HBV. No cases of HIV were detected. CONCLUSIONS: The prevalence of hepatitis C found was 5.3 percent, in line with the prevalence in Pakistan. This experiment highlighted the feasibility conditions of a partnership with a faith-based organization and offers ideas for developing this type of initiative in France.

Estimation of influenza-attributable burden in primary care from season 2014/2015 to 2018/2019, France.

Influenza viruses cause seasonal epidemics whose intensity varies according to the circulating virus type and subtype. We aim to estimate influenza-like illness (ILI) incidence attributable to influenza viruses in France from October 2014 to May 2019. Physicians participating in the French Sentinelles network reported the number of patients with ILI seen in consultation and performed nasopharyngeal swabs in a sample of these patients. The swabs were tested by RT-PCR for the presence of influenza viruses. These clinical and virological data were combined to estimate ILI incidence attributable to influenza viruses by subtypes and age groups. Influenza incidence rates over seasons ranged from 1.9 (95% CI, 1.9; 2.0) to 3.4% (95% CI, 3.2; 3.6) of the population. Each season, more than half of ILI cases were attributable to influenza. Children under 15 years were the most affected, with influenza incidence rates ranging from 3.0 (95% CI, 2.8;3.3) to 5.7% (95% CI, 5.3;6.1). Co-circulation of several (sub)types of influenza viruses was observed each year, except in 2016/2017 where A(H3N2) viruses accounted for 98.0% of the influenza cases. Weekly ILI incidences attributable to each influenza virus (sub)type were mostly synchronized with ILI incidence, except in 2014/2015 and 2017/2018, where incidence attributable to type B viruses peaked few weeks later. The burden of medically attended influenza among patients with ILI is significant in France, varying considerably across years and age groups. These results show the importance of influenza surveillance in primary care combining clinical and virological data.

Risk of Bleeding Associated With Nonsteroidal Anti-inflammatory Drug Use in Patients Exposed to Antithrombotic Therapy: A Case-Crossover Study.

Concomitant nonsteroidal anti-inflammatory drug (NSAIDs) and antithrombotic drug use is associated with an increased risk of bleeding, mainly gastrointestinal. The goal of this study was to quantify the transient increase in the risk of hospitalization for bleeding associated with NSAID use in patients treated with antiplatelet agents or anticoagulants. We performed a unidirectional case-crossover study using the EGB (Échantillon généraliste de bénéficiaires), a permanent random sample of the French nationwide health database. Patients receiving antithrombotic therapy and hospitalized for bleeding between 2009 and 2017 were included. We compared their NSAID exposure during a 15-day hazard window immediately before hospital admission to 3 earlier 15-day control windows. The risk of hospitalization for bleeding associated with the recent use of NSAIDs was estimated using conditional logistic regression to estimate odds ratios (ORs). During the study period, 33 patients treated with anticoagulants and 253 treated with antiplatelet agents received NSAIDs and were included in the case-crossover analysis. We found an increased risk of hospitalization for gastrointestinal bleeding after exposure to NSAIDs, with an adjusted OR of 3.59 (95%CI, 1.58-8.17) in patients receiving anticoagulant therapy and 1.44 (95%CI, 1.07-1.94) in patients receiving antiplatelet therapy. The risk of nongastrointestinal bleeding was also increased after exposure to NSAIDs with an adjusted OR of 2.72 (95%CI, 1.23-6.04) in patients exposed to anticoagulant therapy. The risk of gastrointestinal and nongastrointestinal bleeding increases after NSAID use in patients treated with anticoagulants, while the risk of gastrointestinal bleeding increases, but to a lesser extent in those treated with antiplatelets.

Retinal and choroidal blood flow variations after an endurance exercise: A real-life pilot study at the Paris Marathon.

OBJECTIVES: To collect information about the retinal blood flow variations and other choroidal and retinal parameters during a prolonged effort such as marathon running. DESIGN: Non-randomized prospective cohort study. METHODS: Patients were recruited through an information campaign at the Rothschild Foundation Hospital (Paris, France). A first visit (V1) was planned in the month before the marathon. All participants underwent blood pressure measurement, fundus photography, spectral domain-optical coherence tomography (SD-OCT) and OCT-angiography (OCT-A). A second visit (V2) was scheduled within one hour of crossing the finish line. The same tests were repeated, using the same equipment. RESULTS: Of the 31 runners who were included, 29 finished the marathon and attended V2. At baseline, various ophthalmological abnormalities were found in 45.2% of the 58 eyes, among which almost a third concerned the optic nerve and a quarter the pachychoroid spectrum. A significant decrease in retinal vascular plexus density was found between V1 and V2 (p<0.01). While median macular and retinal nerve fiber layer (RNFL) thicknesses significantly increased after the marathon (p<0.01), median choroidal thickness significantly decreased (p<0.01). Both systolic and diastolic blood pressures significantly decreased (p<0.01 and p=0.021 respectively). CONCLUSIONS: Prolonged physical effort impacts the structure and vascularization of the retina and the choroid. Hypoxia and dehydration due to such an effort may induce a low ocular blood flow rate resulting in a choroidal thinning, contrasting with a transient subclinical ischemic edema of the inner retina and optic nerve head. CLINICAL TRIAL REGISTRATION NUMBER: NCT03864380.