[Using French national health insurance data for non-specific monitoring on Reunion Island]. / Utilisation des données de la Caisse générale de Sécurité sociale de la Réunion dans le cadre de la surveillance non spécifique.

BACKGROUND: In Reunion Island, non-specific surveillance developed mainly in 2009 and was based on the activity of hospital emergency department, emergency calls and mortality. From March 2010, a new surveillance was implemented in collaboration between the Indian Ocean regional epidemiology unit and the regional office of the National Health Insurance. The system is based on the weekly number of general practitioner consultations and home visits by municipality. This article presents methods of using these data for non-specific monitoring in Reunion Island. MATERIALS AND METHODS: Data analyzed cover consultations and visits to general practitioners and pediatricians for each of the 24 municipalities. Data were received in week S+1 and were updated week by week following the flow of repayments. To perform weekly monitoring, determine monitoring impact and detect any unusual health event, a correction factor was thus calculated and applied for the overall data set and for each municipality. Received data covered 72% of the population of the island. RESULTS: Over the study period from 2005 to 2009, the monthly average of consultations was 80,000 (min: 58,000 - max 12,0000). Two main peaks of activity were noticed throughout the island during the study period, the first one from weeks 4 to 9 of 2006 with a peak of 105,000 consultations in week 8 and the second one from weeks 34 to 41 of 2009 with a peak of 120,000 consultations in week 35. CONCLUSION: The two peaks described in 2006 and 2009 respectively correspond to outbreaks of chikungunya and influenza A(H1N1) 2009. This monitoring study has two main advantages: an almost exhaustive data set corresponding to three-quarters of the Reunion Island population and the geographic analysis by municipality. Positioned alongside other monitoring networks, this system expands the indicators monitored reflecting varying uses of care.

[Epidemic of influenza A(H1N1) 2009 in Reunion Island: epidemiological data]. / L'épidémie de grippe à virus A(H1N1) 2009 à la Réunion: données épidémiologiques.

In Reunion Island, a French subtropical island located in the southern hemisphere, the monitoring of the epidemiological dynamics of the epidemic linked to the emergence of pandemic virus A(H1N1) 2009 was achieved through the regular influenza surveillance system which has been reinforced on that occasion. It was mainly based on a network of sentinel physicians, combined with virologic monitoring, and on surveillance of severe cases and deaths. The data were analyzed and retroinformation was distributed according to a weekly frequency. The first imported case was confirmed on July 5, 2009 in a traveler arriving from Australia, whereas the first autochthonous cases were reported on July 23. The epidemic peak was reached in five weeks and the duration of the whole epidemic episode was 9 weeks. Pandemic virus has quickly supplanted seasonal viruses that had begun to circulate. The estimated attack rate for symptomatic cases of infection with virus influenza A(H1N1) 2009 was 12.85%. The hospitalization rate was 32 per 10,000 estimated cases, and 24 people had a serious form requiring care in ICU. Among death certificates received at the regional office for health and social affairs, 14 mentioned the influenza, including 7 in whom the pandemic virus has been laboratory confirmed. These deaths occurred in patients significantly younger than usually observed in Reunion Island during the seasonal influenza epidemics. Overall, the epidemic intensity and severity have been similar to those of seasonal influenza in Reunion Island.

Prevalence of type 2 diabetes and other cardiovascular risk factors in Mayotte in 2008: the MAYDIA study.

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 HbA(1c), weight, height, waist circumference and two blood-pressure measurements. Those with a history of diabetes, glucose ≥1 g/L (fasting) or ≥1.40 g/L (non-fasting), or HbA(1c)≥6%, and a subgroup of those with normal results were examined at a healthcare centre to measure venous HbA(1c) and glucose, and to diagnose diabetes, using an oral glucose tolerance test. RESULTS: The weighted prevalence of diabetes (venous plasma glucose ≥1.26 g/L at fasting and/or ≥2 g/L at 2 h, 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 HbA(1c) levels >7%. The prevalence of overweight (BMI: 25-29 kg/m(2)) was estimated to be 35% in men and 32% in women, while obesity (≥30 kg/m(2)) 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.

[Tuberculosis in Reunion island: epidemiological characteristics of notified cases, 2000-2007]. / La tuberculose à la Réunion : caractéristiques épidémiologiques issues des déclarations obligatoires, 2000-2007.

UNLABELLED: Located in the South West Indian Ocean, Reunion island is close to countries with a strong incidence of tuberculosis disease: Madagascar, 246 per 100,000, Comoros, 44 per 100,000 or Mayotte, 22 per 100,000 in 2006. However, the epidemiology of tuberculosis in Reunion is poorly documented. OBJECTIVE: This article presents epidemiological characteristics of tuberculosis disease notified between 2000 and 2007 and cases of latent tuberculosis infection for children under 15years old between 2003 and 2007 in Reunion. METHOD: The data analysed in this article are collected through the mandatory notification. Multi-drug resistant data come from National Reference Centre for Mycobacteria and Antituberculosis Drug Resistance and mortality data from Centre for the epidemiology of medical causes of death in France. RESULTS: In Reunion, 495 cases-patients with tuberculosis disease were notified, that is an incidence of eight cases per 100,000 habitants and four cases-patients of latent tuberculosis infection were notified. Regarding tuberculosis disease, the incidence was respectively, 2.4, 6 and 15.9 for the cases-patients aged 0-14, 15-39 and more than 40years old. Pulmonary tuberculosis accounted for 82% of tuberculosis disease notified cases-patients, 90% of which were microbiologically confirmed. Between 2000 and 2006, the frequency of multidrug-resistant was of 2% (8/423) and the mortality rate was 1.2 per 100,000. CONCLUSION: These results indicate a low incidence in Reunion which can be explained by a low HIV infection incidence (3.2 per 100,000 in 2003-2005), a good standard of hygiene and a good access to care. However, due to migratory fluxes from nearby high incidence countries, the epidemiological surveillance in Reunion must continue and be enhanced to set up the preventive and control measures around the notified cases.