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1.
Emerg Infect Dis ; 24(3): 558-561, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29460745

RESUMO

We investigated dengue and chikungunya virus antibody seroprevalence in French Polynesia during 2014-2015. Dengue virus seroprevalence was ≈60% among schoolchildren and >83% among the general population; chikungunya virus seroprevalence was <3% before and 76% after Zika virus emergence (2013). Dengue virus herd immunity may affect Zika virus infection and pathogenesis.

2.
Integr Cancer Ther ; 17(1): 52-64, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28088871

RESUMO

RATIONALE: The highest burden of liver cancer occurs in developing countries, where the use of herbal medicine (HM) is still widespread. Despite this trend, few studies have been conducted to report HM practices of patients with a hepatic tumor in the developing world. Hence, this study aimed to document the use of HM among patients with liver cancer in Peru. STUDY DESIGN AND METHODS: A comparative behavioral epidemiological survey was conducted among liver cancer patients attending the National Cancer Institute of Peru. Information was obtained by direct interviews based on a semistructured questionnaire. The use of HM in Peruvian liver cancer patients was reported, first, regarding general consumption prior to the onset of disease, and second, after the appearance of symptoms that patients would relate to their tumor. In parallel, general consumption of HM in noncancerous people was assessed as a comparative figure. A correspondence analysis was performed to reveal potential associations between the symptoms of cancer and the specific use of HM. RESULTS: Eighty-eight patients and 117 noncancerous individuals participated in the survey. Overall, 68.3% of the people interviewed claimed to use HM on a regular basis for general health preservation. Furthermore, 56.8% of the patients turned to plants first to treat the disorders for which they later came to the cancer care center. When compared with the number of plant species used routinely (n = 78), a selection of plants was made by patients in response to the symptoms of cancer (n = 46). At least 2 plant species, Aloe vera and Morinda citrifolia, were significantly associated with the treatment of liver cancer-related symptoms in the patient group. CONCLUSIONS: The present study is the first survey on the HM practices of patients with liver cancer in Latin America and, more broadly, in the developing world. Our findings confirm that HM remains one of the principal primary health care resources in Peru, even for a severe disease like liver cancer. These traditional, complementary and alternative medicine practices should be taken into consideration in Peruvian health programs aiming to educate the population in cancer prevention and treatment, as well as integrative cancer management.


Assuntos
Terapias Complementares/métodos , Neoplasias Hepáticas/tratamento farmacológico , Fitoterapia , Adulto , Feminino , Pesquisas sobre Serviços de Saúde , Medicina Herbária/métodos , Humanos , Medicina Integrativa/métodos , Oncologia Integrativa/métodos , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Peru , Prática Profissional , Adulto Jovem
3.
PLoS One ; 12(9): e0183992, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28863159

RESUMO

Benchmarking surveillance systems requires realistic simulations of disease outbreaks. However, obtaining these data in sufficient quantity, with a realistic shape and covering a sufficient range of agents, size and duration, is known to be very difficult. The dataset of outbreak signals generated should reflect the likely distribution of authentic situations faced by the surveillance system, including very unlikely outbreak signals. We propose and evaluate a new approach based on the use of historical outbreak data to simulate tailored outbreak signals. The method relies on a homothetic transformation of the historical distribution followed by resampling processes (Binomial, Inverse Transform Sampling Method-ITSM, Metropolis-Hasting Random Walk, Metropolis-Hasting Independent, Gibbs Sampler, Hybrid Gibbs Sampler). We carried out an analysis to identify the most important input parameters for simulation quality and to evaluate performance for each of the resampling algorithms. Our analysis confirms the influence of the type of algorithm used and simulation parameters (i.e. days, number of cases, outbreak shape, overall scale factor) on the results. We show that, regardless of the outbreaks, algorithms and metrics chosen for the evaluation, simulation quality decreased with the increase in the number of days simulated and increased with the number of cases simulated. Simulating outbreaks with fewer cases than days of duration (i.e. overall scale factor less than 1) resulted in an important loss of information during the simulation. We found that Gibbs sampling with a shrinkage procedure provides a good balance between accuracy and data dependency. If dependency is of little importance, binomial and ITSM methods are accurate. Given the constraint of keeping the simulation within a range of plausible epidemiological curves faced by the surveillance system, our study confirms that our approach can be used to generate a large spectrum of outbreak signals.


Assuntos
Surtos de Doenças , Vigilância da População/métodos , Algoritmos , Simulação por Computador , Humanos , Modelos Estatísticos , Probabilidade , Reprodutibilidade dos Testes , Estatística como Assunto , Resultado do Tratamento
5.
Int J Med Inform ; 104: 65-73, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28599818

RESUMO

INTRODUCTION: Epidemiologists manage outbreak identification and confirmation by means of a "situation diagnosis", which involves validating (or invalidating) an alarm (signal identified as abnormal) as an alert (a real, characterized outbreak) and proposing the first countermeasures. This work investigates how uncertainty is materialized during this stage, and how experts develop strategies to address this uncertainty with the help of an early warning system. METHODS: We built an experiment using a simulation platform with a scenario involving both a natural and an intentional outbreak. Observations of expert activities were recorded and formalised using a specific task analysis method. These formatted data were then categorized by applying RAWFS (Reduction- Assumption - Weighing - Forestalling- Suppression) heuristics. RESULTS: We quantified uncertainty and the mechanisms involved. During the situation diagnosis, two sorts of uncertainty were characterized: practice-imposed uncertainty and situation-imposed uncertainty. We did not find either weighing pros and cons or suppression strategies in this area of expertise, but highlight the predominance of coping strategies that relied on reduction (66,4%) and assumption-based reasoning. We observed a predominance of the phone (89%) to cope with uncertainty and among electronic tools, the surveillance system plays a major role (69% of cases) and is mainly used in reduction strategies. We detail tools and systems used to support experts in their coping strategy. CONCLUSION: We confirmed that a surveillance system must include different features that provide relevant information to help users reduce uncertainty and thus support their decision making. In that perspective, the flow diagram and proposal presented in this study can help prioritize the necessary changes to surveillance system design.


Assuntos
Tomada de Decisões , Notificação de Doenças/métodos , Surtos de Doenças/prevenção & controle , Vigilância da População/métodos , Informática em Saúde Pública , Coleta de Dados , Indicadores Básicos de Saúde , Humanos , Incerteza
6.
Emerg Infect Dis ; 23(4): 582-589, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28322712

RESUMO

We describe the implementation of an automated infectious disease surveillance system that uses data collected from 210 microbiologic laboratories throughout the Provence-Alpes-Côte d'Azur region in France. Each week, these facilities report bacterial species that have been isolated from patients in their area. An alarm is triggered whenever the case count for a bacterial species infection exceeds 2 SDs of the historical mean for that species at the participating laboratory. At its inception in July 2013, the system monitored 611 bacterial species. During July 1, 2013-March 20, 2016, weekly analyses of incoming surveillance data generated 34 alarms signaling possible infectious disease outbreaks; after investigation, 14 (41%) of these alarms resulted in health alerts declared by the regional health authority. We are currently improving the system by developing an Internet-based surveillance platform and extending our surveillance to include more laboratories in the region.


Assuntos
Infecções Bacterianas/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Laboratórios , Vigilância da População/métodos , França/epidemiologia , Humanos
7.
Emerg Infect Dis ; 23(4): 669-672, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28084987

RESUMO

During 2013-2014, French Polynesia experienced an outbreak of Zika virus infection. Serosurveys conducted at the end of the outbreak and 18 months later showed lower than expected disease prevalence rates (49%) and asymptomatic:symptomatic case ratios (1:1) in the general population but significantly different prevalence rates (66%) and asymptomatic:symptomatic ratios (1:2) in schoolchildren.


Assuntos
Surtos de Doenças , Estudos Soroepidemiológicos , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polinésia/epidemiologia , Adulto Jovem , Infecção por Zika virus/sangue
8.
J Public Health (Oxf) ; 39(3): 523-529, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-27222240

RESUMO

Background: Despite prevention programs, a rising incidence of sexually transmitted infections is currently reported in France. Aims: Research factors associated with risky sexual behaviors (RSBs) among the French population. Methods: Subjects aged 15-54 years from the French national survey 'Baromètre santé 2010' were included (n = 16 598). RSB was defined as having multiple partners or failure to use condom at first intercourse with a new partner over past 12 months. Factors associated were identified using one logistic regression by gender. Results: The overall RSB prevalence was 9.5%, being higher among men (P < 0.001). Factors associated with RSB for both genders were young age (OR = 1.5), single status (men: OR = 7.1; women: OR = 6.4), homosexual relations (men: OR = 2.0; women: OR = 3.2), low incomes (men: OR = 1.5; women: OR = 1.4), use of cannabis (men: OR = 1.4; women: OR = 3.0). Men-specific factors were history of STI (OR = 2.5) and alcohol drunkenness (OR = 2.2), and women-specific factors history of suicide attempt (OR = 1.6) and history of sexual assault (OR = 1.6). Conclusions: Confirming most of known determinants of RSB, this study also identified some specific risky patterns for whom preventive actions can be developed: multiusers of psychoactive substances, people living with low incomes, women having sex with women or presenting history of psychological vulnerability (suicide attempts, sexually harassed).


Assuntos
Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Sexo sem Proteção/psicologia , Adulto Jovem
9.
Noise Health ; 18(85): 297-302, 2016 Nov-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27991460

RESUMO

CONTEXT: Despite existing preventive measures, the number of acute acoustic trauma (AAT) cases reported to the French Military Epidemiological Surveillance System (MESS) remains high. AIMS: The objective of this study was to describe AAT and the preventive measures already implemented. SUBJECTS AND METHODS: We conducted a descriptive cross-sectional analysis of AAT using data from the MESS for the period 2007-2014. In addition, we reviewed the current prevention measures that exist in the French armed forces. STATISTICAL ANALYSIS USED: Comparisons between different incidence rates were made by Poisson and quasi-Poisson regression. RESULTS: Between 2007 and 2014, 10,487 AAT cases were reported to the MESS, with a significant decrease in 2013 (P < 0.001). AAT incidence rates were the highest among those aged <25 years - 14.3 per 1000 person-years (PYs) (P < 0.001), and those in the army; with 8.1 per 1000 PYs (P < 0.001), and men had almost twice the risk of women (P < 0.001). AAT mainly occurred in training schools or at camps during exercises. The main prevention actions identified were the following: official regulations, education, making hearing protection devices (HPDs) available for all service members, and regular hearing monitoring. A working group has been set up and has proposed an informative chapter in the weapon handling instruction book, an AAT simulator, and a new HPD, the 3M® earplug, with an information brochure. CONCLUSIONS: AAT rates decreased from 2007 to 2014 in the French armed forces. Further analysis is needed to identify the underlying factors involved to improve the prevention actions proposed. The MESS and targeted surveys will assess the impact of the different prevention measures implemented.


Assuntos
Perda Auditiva Provocada por Ruído/epidemiologia , Militares , Doenças Profissionais/epidemiologia , Adolescente , Adulto , Estudos Transversais , Dispositivos de Proteção das Orelhas , Feminino , França , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/prevenção & controle , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/prevenção & controle , Adulto Jovem
10.
Pan Afr Med J ; 24: 236, 2016.
Artigo em Francês | MEDLINE | ID: mdl-27800091

RESUMO

INTRODUCTION: Educational assessment focuses on training institutions, programs, teachers or students. It may be predictive, summative or formative. Assessment of teaching by students (ATS) is one of the assessment tools included in the last category. OBJECTIVE: Assessing teaching of the first part of the "Help thesis writing" training course. MATERIAL AND METHODS: This is a cross-sectional study classified under the "ATS" agreement and focused on the "Help thesis writing" module provided to 27 participants preparing their end-of-study at CESPA. RESULTS: Participant representativeness was 100%. F/M sex ratio was 2, the average age was 25.5 years +/- 2.7 years, the respondents were mainly students serving as interns in general medicine. Over 85% of students said he had received no prior training in the treated areas. The participants had expectations that roughly met the objectives of the training. Apart from teaching rhythm which was deemed unsuitable by more than half of participants, 80% of participants were satisfied with the other aspects evaluated and 95.8% of them were planning to attend the second part of training. All the participants judged the training as helpful to significantly improve their knowledge and were certain it might have a positive impact on their research projects. CONCLUSION: Our study aimed to develop teacher-student complicity in order to achieve a common goal: "IMPROVING THE FORMATION".


Assuntos
Internato e Residência/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Ensino , Redação , Adulto , Estudos Transversais , Avaliação Educacional , Feminino , França , Hospitais Militares , Humanos , Masculino , Adulto Jovem
12.
Malar J ; 15: 174, 2016 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-26987358

RESUMO

BACKGROUND: Malaria is a public health concern in the French armed forces, with 400-800 cases reported every year and three deaths in the past 2 years. However, lack of chemoprophylaxis (CP) compliance is often reported among service members. The aim of this study was to explore factors associated with CP compliance. METHODS: A retrospective study (1296 service members) was carried out among troops deployed in Central African Republic. Determinants of CP were collected by self-questionnaire. Socio-demographic variables, behavioural characteristics, belief variables, operational determinants such as troops in contact (TIC) and number of nights worked per week and peer-to-peer reinforcement were studied. Relationships between covariates and compliance were explored using logistic regressions (outcome: compliance as a dummy variable). RESULTS: Chemoprophylaxis compliance was associated with other individual preventive measures against mosquito bites (bed net use, OR (odds ratio) = 1.41 (95% CI [1.08-1.84]), and insecticide on clothing, OR = 1.90 ([1.43-2.51]) and malaria-related behaviours (taking chemoprophylaxis at the same time every day, OR = 2.37 ([1.17-4.78]) and taking chemoprophylaxis with food, OR = 1.45 ([1.11-1.89])). High perceived risk of contracting malaria, OR = 1.59 ([1.02-2.50]), positive perception of CP effectiveness, OR = 1.62 ([1.09-2.40]) and the practice of peer-to-peer reinforcement, OR = 1.38 ([1.05-1.82]) were also associated with better compliance. No association was found with TIC and number of nights worked. CONCLUSIONS: This study, which shows a positive relationship between peer-to-peer reinforcement and CP compliance, also suggests the existence of two main personality profiles among service members: those who seek risks and those who are health-conscious. Health education should be expanded beyond knowledge, know-how and motivational factors by using a comprehensive approach based on identification of health determinants, development of psychosocial skills and peer-to-peer reinforcement.


Assuntos
Antimaláricos/administração & dosagem , Quimioprevenção/métodos , Malária/prevenção & controle , Adesão à Medicação , Adulto , República Centro-Africana , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Militares , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
13.
BMC Med Inform Decis Mak ; 16: 33, 2016 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-26968948

RESUMO

BACKGROUND: Most studies of epidemic detection focus on their start and rarely on the whole signal or the end of the epidemic. In some cases, it may be necessary to retrospectively identify outbreak signals from surveillance data. Our study aims at evaluating the ability of change point analysis (CPA) methods to locate the whole disease outbreak signal. We will compare our approach with the results coming from experts' signal inspections, considered as the gold standard method. METHODS: We simulated 840 time series, each of which includes an epidemic-free baseline (7 options) and a type of epidemic (4 options). We tested the ability of 4 CPA methods (Max-likelihood, Kruskall-Wallis, Kernel, Bayesian) methods and expert inspection to identify the simulated outbreaks. We evaluated the performances using metrics including delay, accuracy, bias, sensitivity, specificity and Bayesian probability of correct classification (PCC). RESULTS: A minimum of 15 h was required for experts for analyzing the 840 curves and a maximum of 25 min for a CPA algorithm. The Kernel algorithm was the most effective overall in terms of accuracy, bias and global decision (PCC = 0.904), compared to PCC of 0.848 for human expert review. CONCLUSIONS: For the aim of retrospectively identifying the start and end of a disease outbreak, in the absence of human resources available to do this work, we recommend using the Kernel change point model. And in case of experts' availability, we also suggest to supplement the Human expertise with a CPA, especially when the signal noise difference is below 0.


Assuntos
Simulação por Computador , Técnicas de Apoio para a Decisão , Surtos de Doenças/estatística & dados numéricos , Monitoramento Epidemiológico , Modelos Estatísticos , Humanos , Saúde Pública
14.
Malar J ; 15: 35, 2016 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-26801629

RESUMO

BACKGROUND: In December 2010, a Plasmodium vivax malaria outbreak occurred among French forces involved in a mission to control illegal gold mining in French Guiana. The findings of epidemiological and entomological investigations conducted after this outbreak are presented here. METHODS: Data related to malaria cases reported to the French armed forces epidemiological surveillance system were collected during the epidemic period from December 2010 to April 2011. A retrospective cohort study was conducted to identify presumed contamination sites. Anopheles mosquitoes were sampled at the identified sites using Mosquito Magnet and CDC light traps. Specimens were identified morphologically and confirmed using molecular methods (sequencing of ITS2 gene and/or barcoding). Anopheles infections with Plasmodium falciparum and P. vivax were tested by both enzyme-linked immunosorbent assay and real-time PCR. RESULTS: Seventy-two P. vivax malaria cases were reported (three were mixed P. falciparum/P. vivax infections), leading to a global attack rate of 26.5% (72/272). Lack of compliance with vector control measures and doxycycline chemoprophylaxis was reported by patients. Two illegal gold mining sites located in remote areas in the primary forest were identified as places of contamination. In all, 595 Anopheles females were caught and 528 specimens were formally identified: 305 Anopheles darlingi, 145 Anopheles nuneztovari s.l., 63 Anopheles marajoara and 15 Anopheles triannulatus s.l. Three An. darlingi were infected by P. falciparum (infection rate: 1.1%) and four An. marajoara by P. vivax (infection rate: 6.4%). DISCUSSION: The main drivers of the outbreak were the lack of adherence by military personnel to malaria prevention measures and the high level of malaria transmission at illegal gold mining sites. Anopheles marajoara was clearly implicated in malaria transmission for the first time in French Guiana. The high infection rates observed confirm that illegal gold mining sites must be considered as high level malaria transmission areas in the territory. CONCLUSIONS: Illegal gold mining activities are challenging the control of malaria in French Guiana. Collaboration with neighbouring countries is necessary to take into account mobile populations such as gold miners. Malaria control strategies in the French armed forces must be adapted to P. vivax malaria and sylvatic Anopheles species.


Assuntos
Anopheles/parasitologia , Malária/epidemiologia , Malária/transmissão , Mineração , Animais , Feminino , Guiana Francesa/epidemiologia , Ouro , Humanos , Insetos Vetores/parasitologia , Masculino , Estudos Retrospectivos
15.
BMC Musculoskelet Disord ; 15: 249, 2014 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-25059583

RESUMO

BACKGROUND: The objective was to identify severity characteristics of initial chikungunya infection (CHIKV) stages associated with post-CHIKV arthritis and arthralgia. METHODS: French gendarmes exposed to the 2005-2006 CHIKV epidemic in Reunion Island who completed the 2006 (self-reporting acute and early chronic [median: 6 months] symptoms) and 2008 (Endpoint [median: 30 months]: self-perceived recovery and rheumatic disorders (RDs)) surveys were included. Multinomial logistic regression and multiple correspondence analysis (MCA) were used. Arthralgia was defined by joint pain and/or stiffness and arthritis by joint swelling in addition to pain and/or stiffness. RESULTS: In 2008, 124 (31.3%)/403 participants (101 CHIKV+/302 CHIKV-) reported arthralgia and 57 (14.1%) arthritis. The multivariate model kept CHIKV infection, comorbidity and acute stage depressed mood as independent prognostic factors for both arthralgia and arthritis, but found early chronic stage RD as the main determinant of the same RD two years later.The MCA performed with the 85 CHIKV + patients who answered the question on self-perceived recovery enabled the calculation of severity scores based on initial symptoms that were strongly associated with persistent arthritis and, to a lesser extent, to arthralgia in bivariate analyses. The MCA graph clearly distinguished arthritis as the only RD associated with early severity indicators represented by sick leave, joint swelling and depressed mood during the acute stage, and early chronification of arthritis and depressed mood. CONCLUSION: Initial CHIKV severity predicted recovery, with higher severity associated with arthritis and lower severity with arthralgia. More interestingly, specific markers of post-CHIKV arthritis, which can easily be used by clinicians for case management, were identified.


Assuntos
Artralgia/virologia , Artrite/virologia , Febre de Chikungunya/virologia , Militares , Doenças Profissionais/virologia , Polícia , Afeto , Artralgia/diagnóstico , Artrite/diagnóstico , Distribuição de Qui-Quadrado , Febre de Chikungunya/complicações , Febre de Chikungunya/diagnóstico , Depressão/diagnóstico , Depressão/virologia , França , Humanos , Modelos Logísticos , Análise Multivariada , Doenças Profissionais/complicações , Doenças Profissionais/diagnóstico , Saúde do Trabalhador , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Licença Médica , Inquéritos e Questionários , Fatores de Tempo
16.
Mil Med ; 179(2): 183-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24491615

RESUMO

OBJECTIVE: The main objective of this study was to evaluate the contribution of a newly implemented daily surveillance system to the management of the 2009 A(H1N1) influenza pandemic by the military decision-makers at different levels in the French Department of Defence. METHODS: The study sample included all medical advisors in the Ministry of Defence and the French Armed Forces Staff and also the members of the specific committee dedicated to flu pandemic control. The variables studied were mental representation of epidemiology, relevance, usefulness, and real-time use of surveillance data using quantitative questionnaires and qualitative face-to-face semistructured interviews. RESULTS: Among the risk managers of the flu pandemic in the Armed Forces, 84% responded. The data generated by epidemiological surveillance were considered relevant and useful, and were reported as effectively used. On the basis of the information produced, concrete actions were planned and implemented in the French Armed Forces. CONCLUSION: In a pandemic situation involving low mortality, the daily monitoring of the disease did not target public health issues, but it was mainly used to assess the availability of the Armed Forces in real time. For the military staff, epidemiological surveillance represents an essential information tool for the conduct of operations.


Assuntos
Tomada de Decisões , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Militares , Pandemias/prevenção & controle , Vigilância da População , França/epidemiologia , Humanos , Influenza Humana/virologia , Gestão de Riscos , Fatores de Tempo
17.
Am J Trop Med Hyg ; 90(3): 438-43, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24470561

RESUMO

Large-scale epidemiological surveillance of dengue in the field and dengue patient management require simple methods for sample collection, storage, and transportation as well as effective diagnostic tools. We evaluated the kinetics of three biological markers of dengue infection-non-structural protein 1 (NS1) antigen, immunoglobulin M (IgM), and IgA-in sequential capillary blood samples collected from fingertips of confirmed dengue patients. The overall sensitivities and specificities of the tests were 96% and 100%, respectively, for NS1, 58.1% and 100%, respectively, for IgM, and 33% and 100%, respectively, for IgA. During the acute phase of the disease, NS1 was the best marker of dengue infection, with a sensitivity of 98.7%, whereas from day 5, all three markers exhibited relevant levels of sensitivity. This first descriptive study of the kinetics of biological markers of dengue in capillary blood samples confirms the usefulness of this biological compartment for dengue diagnosis and argues for its exploitation in community-level and remote settings.


Assuntos
Anticorpos Antivirais/imunologia , Antígenos Virais/imunologia , Vírus da Dengue/imunologia , Dengue/sangue , Imunoglobulina A/imunologia , Imunoglobulina M/imunologia , Proteínas não Estruturais Virais/imunologia , Adolescente , Adulto , Biomarcadores/sangue , Coleta de Amostras Sanguíneas/métodos , Capilares , Dengue/imunologia , Progressão da Doença , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Testes Sorológicos , Fatores de Tempo , Vietnã , Adulto Jovem
19.
Swiss Med Wkly ; 143: w13848, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24089257

RESUMO

QUESTION UNDER STUDY: Influenza is a viral infection caused by a pathogen with considerable ability for genetic mutation, which is responsible for seasonal outbreaks as well as pandemics. This article presents the results of epidemiological and virological monitoring of four successive influenza outbreaks in the French armed forces, for the period 2008 to 2012. METHODS: The main events monitored were acute respiratory infection (ARI). Weekly incidence rates were calculated by relating cases to the number of servicepersons monitored. RESULTS: In continental France, the incidence rates for ARI and for medical consultation attributable to influenza were highest during the pandemic and decreased to reach their lowest values in 2010­2011 and 2011­2012. In terms of virological results, the 2008­2009 outbreak was mainly due to the A(H3N2) virus, while the 2009­2010 pandemic and the following season saw the emergence of the A(H1N1) pdm09 strain. The last season 2011­2012 was characterised by a predominant circulation of A(H3N2) viruses. CONCLUSIONS: Despite some limitations, the MISS represents a good source of information about influenza in young people. Virological results are compatible with those reported by most other influenza surveillance networks, but could be improved by a better knowledge of the other respiratory viruses in circulation in the military community.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A Subtipo H3N2 , Influenza Humana/epidemiologia , Militares/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Adulto , Monitoramento Epidemiológico , Feminino , França/epidemiologia , Humanos , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Masculino , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/fisiopatologia , Infecções Respiratórias/virologia , Adulto Jovem
20.
J Travel Med ; 20(4): 259-61, 2013 Jul-Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23809078

RESUMO

Surveillance of travel-acquired dengue could improve dengue risk estimation in countries without ability. Surveillance in the French army in 2010 to 2011 highlighted 330 dengue cases, mainly in French West Indies and Guiana: DENV-1 circulated in Guadeloupe, Martinique, French Guiana, New Caledonia, Djibouti; DENV-3 in Mayotte and Djibouti; and DENV-4 in French Guiana.


Assuntos
Dengue/etnologia , Surtos de Doenças/estatística & dados numéricos , Militares , Viagem , Adulto , Feminino , França/epidemiologia , Guiana Francesa/etnologia , Guadalupe/etnologia , Humanos , Incidência , Masculino , Martinica/etnologia , Pessoa de Meia-Idade , Nova Caledônia/etnologia , Estudos Retrospectivos , Índias Ocidentais/etnologia , Adulto Jovem
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