Migration in French Guiana: Implications in health and infectious diseases.

In French Guiana, more than a third of the population, and nearly half of the adults, are of foreign origin. This immigration is explained by the French standard of living, which is attractive to nationals of surrounding countries. Infectious diseases remain in the top 10 causes of premature death, often in the most precarious populations. In this context we aimed to synthesize the state of the knowledge regarding immigration and infectious diseases in French Guiana and the general implications that follow this diagnosis. For HIV, although the majority of patients are of foreign origin, estimates of the presumed date of infection based on CD4 erosion modelling and from molecular analyses suggest that the majority of transmissions in foreign-born individuals occur in French Guiana and that the Guiana shield has been a crossroad between Latin America and the Caribbean. Among key populations bridging these regions illegal gold miners are very mobile and have the greatest proportion B Caribbean HIV viruses. Gold miners have been a key vulnerable population for falciparum malaria and other tropical diseases such as leishmaniasis, leprosy, or leptospirosis. The complex history of migrations in French Guiana and on the Guiana Shield is also reflected in the fingerprinting of mycobacterium tuberculosis and the high incidence of tuberculosis in French Guiana, notably in immigrants, reflects the incidences in the countries of origin of patients. The high burden of infectious diseases in immigrants in French Guiana is first and foremost a reflection of the precarious living conditions within French Guiana and suggests that community-based proactive interventions are crucial to reduce transmission, morbidity, and mortality from infectious diseases.

Leprosy in French Guiana, 2015 to 2021: Dynamics of a Persistent Public Health Problem.

A resurgence of leprosy as a public health problem in French Guiana was reported over the period 2007 to 2014, particularly among Brazilians gold miners. Prolonged multidrug therapy and reversal reactions represent a therapeutic challenge. The objective of this study was to assess the evolution of leprosy in this European overseas territory. All patients with leprosy confirmed in histopathology between 1 January 2015 and 31 December 2021 were included. A total of 86 patients were included, including 64 new cases and 22 previously diagnosed cases. Sixty patients (70%) were male, 6 cases were paediatric. Brazilian gold miners represented 44.1% of reported occupations (15/34). Maroons represented the second community (13 patients, 15%). Multibacillary and paucibacillary forms were found in 53 (71%) and 22 (29%) patients, respectively. The annual prevalence never exceeded the threshold of 1/10,000. The mean incidence and prevalence were significantly lower than during the period 2007 to 2014 (p < 0.0001). Reversal reactions were found in 29 patients and almost always required a long course of steroids. Infliximab allowed a reduction in the length of treatment with steroids in 2/2 cases. In conclusion, the prevalence of leprosy has decreased significantly in French Guiana, but remains driven by the population of illegal gold miners. Anti-tumour necrosis factor (anti-TNF) drugs represent a promising option in the management of reversal reactions.

Structure, stability and chaperone function of Mycobacterium leprae Heat Shock Protein 18 are differentially affected upon interaction with gold and silver nanoparticles.

Gold nanoparticles (AuNPs) and silver nanoparticles (AgNPs) have several biomedical applications. However, the effective usage of these two nanoparticles is impeded due to limited understanding of their interaction with proteins including small heat shock proteins (sHSPs). Specifically, no evidences of interaction of these two nanoparticles with HSP18 (an antigenic protein) which is an important factor for the growth and survival of M. leprae (the causative organism of leprosy) are available in the literature. Here, we report for the first time evidences of "HSP18-AuNPs/AgNPs interaction" and its impact on the structure and chaperone function of HSP18. Interaction of citrate-capped AuNPs/AgNPs (~20 nm diameter) to HSP18 alters the secondary and tertiary structure of HSP18 in a distinctly opposite manner; while "HSP18-AuNPs interaction" leads to oligomeric association, "HSP18-AgNPs interaction" results in oligomeric dissociation of the protein. Surface hydrophobicity, thermal stability, chaperone function of HSP18 and survival of thermally stressed E. coli harbouring HSP18 are enhanced upon AuNPs interaction, while all of them are reduced upon interaction with AgNPs. Altogether, our study reveals that HSP18 is an important drug target in leprosy and its chaperone function may possibly plays a vital role in the growth and survival of M. leprae pathogen in infected hosts.

Epitope imprinting of Mycobacterium leprae bacteria via molecularly imprinted nanoparticles using multiple monomers approach.

Mycobacterium leprae causes endemic disease leprosy which becomes chronic if not treated timely. To expedite this 'timely diagnosis', and that also at an early stage, here an attempt is made to fabricate an epitope-imprinted sensor. A molecularly imprinted polymer nanoparticles modified electrochemical quartz crystal microbalance sensor was developed for sensing of Mycobacterium leprae bacteria through its epitope sequence. Multiple monomers, 3-sulphopropyl methacrylate potassium salt, benzyl methacrylate and 4-aminothiophenol were utilized to imprint this bacterial epitope. Imprinted nanoparticles were electropolymerized on gold coated quartz electrode. The sensor was able to show specific binding towards the blood samples of infected patients, even in the presence of 'matrix' and other plasma proteins such as albumin and globulin. Even other peptide sequences, similar to epitope sequences only with two amino acid mismatches were also unable to show any binding. Sensor withstood analytical tests viz. selectivity, specificity, matrix effect, detection limit (0.161 nM), quantification limit (and 0.536 nM), reproducibility (RSD 2.01%). Hence a diagnostic tool for bacterium causing leprosy is successfully fabricated in a facile manner which will broaden the clinical access and efficient population screening can be made feasible.

Persistent nodular contact dermatitis to gold: case report of two cases.

Metallic gold has long been regarded as a relatively safe and inert material when in contact with the skin and mucosal membranes, with only sporadic reports of allergic contact dermatitis. We report two cases, where persistent nodules developed at sites of gold piercing with gold jewelry with positive patch test reactions to gold.

Gold weight implants in the management of lagophthalmos in leprosy patients.

OBJECTIVES: To evaluate the use of gold weights as upper lid implants in the management of lagophthalmos due to facial nerve affection in leprosy patients. DESIGN: Gold implants of various weights were inserted in the upper eyelids of 12 patients with leprosy. Pre- and post-operative lid closures were recorded and patients were followed up for 1 year. RESULTS: Despite early satisfactory results with good closure, six out of 12 implants were extruded within the first year. Two more implants had to be removed due to chronic inflammatory reaction. CONCLUSION: Long term result of gold weight implants in leprosy patient is unsatisfactory and needs further evaluation.

[Bilateral lagophthalmos in lepromatous leprosy. Case report]. / Lagoftalmos bilateral en paciente con lepra lepromatosa. Caso clínico.

CASE REPORT: A case of bilateral facial palsy with paralytic ectropion, lagophthalmos and corneal damage secondary to corneal exposure in a long-standing patient with lepromatous leprosy is presented. Correction of paralytic ectropion was performed by medial cantoplasty, tarsal strip and Medpor lower eyelid spacer implantation. Lagophthalmos was corrected by gold weight implant in the upper tarsus. DISCUSSION: Ocular findings in leprosy appear in 72% of patients. Facial nerve palsy occurs in 3-19.8%, being bilateral in 5%. In long standing cases with corneal complications secondary to exposure, surgical treatment is required.

Lagoftalmos bilateral en paciente con lepra lepromatosa. Caso clínico / Bilateral lagophthalmos in lepromatous leprosy. Case report

Caso clínico: Paciente con lepra lepromatosa de larga evolución, con parálisis facial bilateral que provoca ectropión paralítico, lagoftalmos e importante afectación corneal por exposición. Procedemos a corrección quirúrgica del ectropión con cantoplastia interna, tira tarsal y colocación de espaciador de medpor® suturado a borde tarsal inferior. El lagoftalmos es corregido mediante implantación de pesa de oro palpebral suturada a tarso superior.Discusión: La afectación ocular por lepra aparece en un 72 por ciento de los casos. La parálisis facial afecta a un 3-19,8 por ciento de los pacientes, siendo bilateral en un 5 por ciento. En casos avanzados, con complicaciones derivadas de la exposición corneal, es preciso tratamiento quirúrgico (AU)

No disponible

Lagoftalmos bilateral en paciente con lepra lepromatosa. Caso clínico / Bilateral lagophthalmos inlepromatous leprosy. Case report

CASE REPORT: A case of bilateral facial palsy with paralytic ectropion, lagophthalmos and corneal damage secondary to corneal exposure in a long-standing patient with lepromatous leprosy is presented. Correction of paralytic ectropion was performed by medial cantoplasty, tarsal strip and Medpor lower eyelid spacer implantation. Lagophthalmos was corrected by gold weight implant in the upper tarsus. DISCUSSION: Ocular findings in leprosy appear in 72 per cent of patients. Facial nerve palsy occurs in 3-19.8 per cent, being bilateral in 5 per cent. In long standing cases with corneal complications secondary to exposure, surgical treatment is required.