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1.
Article in English | PAHO-IRIS | ID: phr-53771

ABSTRACT

[ABSTRACT]. Hospitals in the French Territories in the Americas (FTA) work according to international and French standards. This paper aims to describe different aspects of critical care in the FTA. For this, we reviewed official information about population size and intensive care unit (ICU) bed capacity in the FTA and literature on FTA ICU specificities. Persons living in or visiting the FTA are exposed to specific risks, mainly severe road traffic injuries, envenoming, stab or ballistic wounds, and emergent tropical infectious diseases. These diseases may require specific knowledge and critical care management. However, there are not enough ICU beds in the FTA. Indeed, there are 7.2 ICU beds/100 000 population in Guadeloupe, 7.2 in Martinique, and 4.5 in French Guiana. In addition, seriously ill patients in remote areas regularly have to be transferred, most often by helicopter, resulting in a delay in admission to intensive care. The COVID-19 crisis has shown that the health care system in the FTA is unready to face such an epidemic and that intensive care bed capacity must be increased. In conclusion, the critical care sector in the FTA requires upgrading of infrastructure, human resources, and equipment as well as enhancement of multidisciplinary care. Also needed are promotion of training, research, and regional and international medical and scientific cooperation.


[RESUMEN]. Los hospitales en los territorios franceses de la Región de las Américas funcionan según las normas francesas e internacionales. El objetivo de este artículo es describir distintos aspectos de los cuidados intensivos en los territorios franceses. Para ello, hemos revisado los datos oficiales sobre el tamaño de la población y el número de camas de las unidades de cuidados intensivos (UCI), así como la bibliografía sobre algunos aspectos específicos de las UCI, en los territorios franceses. Las personas que viven en los territorios franceses, o que están de visita en ellos, están expuestas a riesgos específicos: principalmente traumatismos graves causados por el tránsito, envenenamiento por mordeduras, heridas de bala o por apuñalamiento, y enfermedades infecciosas tropicales emergentes. La atención de estos traumatismos y enfermedades puede requerir conocimientos específicos y cuidados intensivos. Sin embargo, no hay suficientes camas de UCI en los territorios franceses. De hecho, hay 7,2 camas de UCI por 100 000 habitantes en Guadalupe, 7,2 en Martinica y 4,5 en Guayana Francesa. Además, los pacientes gravemente enfermos que viven en zonas remotas a menudo tienen que ser trasladados, normalmente por helicóptero, lo que retrasa su ingreso en la unidad de cuidados intensivos. La crisis de la COVID-19 ha puesto de manifiesto que el sistema de atención de salud en los territorios franceses no está preparado para enfrentarse a una epidemia de estas dimensiones y que debe aumentarse la capacidad hospitalaria de las unidades de cuidados intensivos. En conclusión, el sector de los cuidados intensivos en los territorios franceses tiene que mejorar su infraestructura, recursos humanos y equipamiento, así como perfeccionar la atención multidisciplinaria. También es necesario promover la capacitación, la investigación y la cooperación médica y científica, tanto regional como internacional.


[RESUMO]. Os hospitais nos territórios ultramarinos franceses nas Américas funcionam segundo os padrões franceses e internacionais. O objetivo deste artigo é descrever os diversos aspectos da atenção intensiva nesta região. Analisamos os dados oficiais relativos ao tamanho da população e ao número de leitos de unidade de terapia intensiva (UTI) nestes territórios junto com uma revisão da literatura científica sobre as características particulares destes centros de terapia intensiva. Os residentes locais ou visitantes dos territórios ultramarinos franceses nas Américas são expostos a riscos específicos, sobretudo acidentes de trânsito graves, envenenamentos por animais peçonhentos, ferimentos por armas brancas ou armas de fogo e doenças infecciosas tropicais emergentes que requerem conhecimento especializado e atenção intensiva. Porém, não há leitos suficientes de UTI nos territórios ultramarinos franceses nas Américas: são 7,2 leitos de UTI por 100.000 habitantes em Guadalupe, 7,2 na Martinica e 4,5 na Guiana Francesa. Ademais, em áreas remotas, os pacientes em estado crítico frequentemente precisam ser transferidos por helicóptero, o que causa demora na internação em UTI. A crise da COVID-19 demonstra o despreparo do sistema de saúde para enfrentar a pandemia e a necessidade de aumentar o número de leitos de UTI nestes territórios. Em conclusão, é imprescindível modernizar a infraestrutura e os equipamentos, capacitar melhor os recursos humanos e melhorar a atenção multidisciplinar. Incentivar a formação profissional, pesquisa e cooperação médico-científica regional e mundial é também fundamental.


Subject(s)
Critical Care , Tropical Medicine , Coronavirus Infections , Coronavirus Infections , Betacoronavirus , French Guiana , Guadeloupe , Martinique , Critical Care , Coronavirus Infections , Tropical Medicine , French Guiana , Guadeloupe , Martinique , Coronavirus Infections , French Guiana
2.
Zootaxa ; 4926(3): zootaxa.4926.3.1, 2021 Feb 09.
Article in English | MEDLINE | ID: mdl-33756737

ABSTRACT

Among the thecate hydroids brought back by the Proteus-Guyane 2017 expedition of the Muséum national d'histoire naturelle of Paris, France, from French Guiana, two interesting species are reported upon. The plumulariid Callicarpa gracilis Fewkes, 1881, known so far from the type specimen only, is comprehensively redescribed 140 years after its original description. It adopts two different morphotypes with respect to both its tropho- and gonosome, forming either simple or ramified colonies, with either structurally-complex or rudimentary phylactocarps, respectively. Taxonomic notes on the genera Callicarpa Fewkes, 1881 and Hippurella Allman, 1877 are provided in light of their intricate history of origin and fate, together with the provisional resurrection of Antomma Stechow, 1919, as an allied genus of the former. The aglaopheniid Aglaophenia trifida L. Agassiz, 1862, whose gonosome was only partly documented to date, is redescribed thoroughly based on specimens bearing male and female corbulae. Scanning electron microscopy and molecular data were also used to document both species. A checklist of the thecate hydroids from French Guiana gathered during Proteus-Guyane 2017 and Guyane 2014 expeditions is provided as an appendix, together with brief notes on some species. Not dealing with the present study, but taking advantage of it, a new name, Antennella billardi Galea, nom. nov., is proposed as a replacement name for Plumularia balei Billard, 1911, which is a permanently invalid junior primary homonym of P. balei Bartlett, 1907.


Subject(s)
Callicarpa , Expeditions , Hydrozoa , Animals , Female , French Guiana , Male
3.
Front Public Health ; 9: 586299, 2021.
Article in English | MEDLINE | ID: mdl-33777876

ABSTRACT

Background: The COVID 19 epidemic submerged many health systems in the Amazon. The objective of the present study was to focus on the epidemic curves of the COVID 19 epidemic in different centers, and to look at testing and mortality data. Methods: Publicly available datasets were used. The log10 of the daily cumulated number of cases starting from the day the territory reached 100 cumulated cases was plotted to compare the magnitude, shape and slope of the different curves. The maximum daily testing efforts were plotted for each territory in relation to the maximum daily number of diagnoses. The case fatality rate was computed by dividing the number of COVID 19 deaths by the number of confirmed cases. Results: In the Amazonian regions in general the speed of growth was generally lower than in Europe or the USA, or Southern Brazil. Whereas, countries like South Korea or New Zealand "broke" the curve relatively rapidly the log linear trajectory seemed much longer with signs of a decline in growth rate as of early July 2020. After a very slow start, French Guiana had the lowest slope when compared to other Amazonian territories with significant epidemics. The Amazonian states of Roraima, Amazonas, Parà, and Amapà had among the highest number of cases and deaths per million inhabitants in the world. French Guiana had significantly fewer deaths relative to its number of confirmed cases than other Amazonian territories. French Guiana had a late epidemic surge with intense testing scale-up often exceeding 4,000 persons tested daily per million inhabitants. Brazil was an outlier with low daily testing levels in relation to the number of daily diagnoses. Conclusions: There were marked heterogeneities mortality rates suggesting that socioeconomic, political factors, and perhaps ethnic vulnerability led to striking outcome differences in this Amazonian context.


Subject(s)
/epidemiology , Cause of Death , Disease Outbreaks/statistics & numerical data , Epidemics/statistics & numerical data , Internationality , Brazil/epidemiology , Europe/epidemiology , French Guiana/epidemiology , Humans , North America/epidemiology
4.
Nat Commun ; 12(1): 1634, 2021 03 12.
Article in English | MEDLINE | ID: mdl-33712596

ABSTRACT

While general lockdowns have proven effective to control SARS-CoV-2 epidemics, they come with enormous costs for society. It is therefore essential to identify control strategies with lower social and economic impact. Here, we report and evaluate the control strategy implemented during a large SARS-CoV-2 epidemic in June-July 2020 in French Guiana that relied on curfews, targeted lockdowns, and other measures. We find that the combination of these interventions coincided with a reduction in the basic reproduction number of SARS-CoV-2 from 1.7 to 1.1, which was sufficient to avoid hospital saturation. We estimate that thanks to the young demographics, the risk of hospitalisation following infection was 0.3 times that of metropolitan France and that about 20% of the population was infected by July. Our model projections are consistent with a recent seroprevalence study. The study showcases how mathematical modelling can be used to support healthcare planning in a context of high uncertainty.


Subject(s)
/prevention & control , Pandemics , Quarantine/methods , Adolescent , Adult , Aged , Aged, 80 and over , Basic Reproduction Number/prevention & control , Basic Reproduction Number/statistics & numerical data , Child , Child, Preschool , Female , French Guiana/epidemiology , Hospitalization/statistics & numerical data , Hospitalization/trends , Humans , Infant , Infant, Newborn , Male , Middle Aged , Models, Statistical , Pandemics/prevention & control , Pandemics/statistics & numerical data , Quarantine/statistics & numerical data , Quarantine/trends , Young Adult
5.
Medicine (Baltimore) ; 100(4): e22670, 2021 Jan 29.
Article in English | MEDLINE | ID: mdl-33530154

ABSTRACT

ABSTRACT: This study aimed to evaluate the relationships between different types of antiretroviral therapy (ART) and preterm birth.Preterm birth was studied among all singleton pregnancies and compared between human immunodeficiency virus (HIV)-infected and uninfected women.We performed a matched case-control study from the pregnancy outcome registry of Cayenne Hospital. HIV-infected and uninfected women who delivered in the maternity ward of Cayenne Hospital from January 1, 2013 to December 31, 2015 were studied. We conducted an initial analysis to determine the risk factors for preterm birth among HIV-infected pregnant women. We also evaluated associations between exposure to antiretroviral therapy (ART) and preterm birth.There were 8682 deliveries; of these, 117 involved HIV-infected women, representing a prevalence of 1.34%. There were 470 controls. The sociodemographic characteristics were comparable. HIV-infected women were more likely to experience preterm birth (adjusted odds ratio [AOR] = 3.9, 95% confidence interval [CI] 1.5-9.9). Overall, 95.73% of the women received antiretroviral therapy before becoming pregnant, and they were in good clinical condition. The median CD4 count at the beginning of pregnancy was 500 cells/mm3 (357-722). Additionally, 53% of HIV-infected women had an undetectable viral load count (<20 copies/mL). Their median haemoglobin level was 120 g/L (100-120). There were 2 human immunodeficiency virus-infected babies. A higher rate of preterm birth was associated with protease inhibitor-based ART than a reverse transcriptase inhibitor-based ART regimen. The sample size being small this result would be considered with caution.The preterm birth rate among HIV-infected pregnant women was twice that of the general population; this trend was not explained by sociodemographic characteristics. Preterm birth was independently associated with combination ART, especially with ritonavir-boosted protease inhibitor therapy during pregnancy.


Subject(s)
Anti-HIV Agents/adverse effects , HIV Infections/drug therapy , HIV Protease Inhibitors/adverse effects , Pregnancy Complications, Infectious/drug therapy , Premature Birth/chemically induced , Adult , CD4 Lymphocyte Count , Case-Control Studies , Female , French Guiana/epidemiology , HIV , Humans , Infectious Disease Transmission, Vertical/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Odds Ratio , Pregnancy , Pregnancy Complications, Infectious/virology , Premature Birth/epidemiology , Premature Birth/virology , Registries , Risk Factors , Ritonavir/adverse effects
6.
Mem Inst Oswaldo Cruz ; 115: e200313, 2021.
Article in English | MEDLINE | ID: mdl-33533870

ABSTRACT

BACKGROUND: Aedes aegypti is the sole vector of urban arboviruses in French Guiana. Overtime, the species has been responsible for the transmission of viruses during yellow fever, dengue, chikungunya and Zika outbreaks. Decades of vector control have produced resistant populations to deltamethrin, the sole molecule available to control adult mosquitoes in this French Territory. OBJECTIVES: Our surveillance aimed to provide public health authorities with data on insecticide resistance in Ae. aegypti populations and other species of interest in French Guiana. Monitoring resistance to the insecticide used for vector control and to other molecule is a key component to develop an insecticide resistance management plan. METHODS: In 2009, we started to monitor resistance phenotypes to deltamethrin and target-site mechanisms in Ae. aegypti populations across the territory using the WHO impregnated paper test and allelic discrimination assay. FINDINGS: Eight years surveillance revealed well-installed resistance and the dramatic increase of alleles on the sodium voltage-gated gene, known to confer resistance to pyrethroids (PY). In addition, we observed that populations were resistant to malathion (organophosphorous, OP) and alpha-cypermethrin (PY). Some resistance was also detected to molecules from the carbamate family. Finally, those populations somehow recovered susceptibility against fenitrothion (OP). In addition, other species distributed in urban areas revealed to be also resistant to pyrethroids. CONCLUSION: The resistance level can jeopardize the efficiency of chemical adult control in absence of other alternatives and conducts to strongly rely on larval control measures to reduce mosquito burden. Vector control strategies need to evolve to maintain or regain efficacy during epidemics.


Subject(s)
Aedes/drug effects , Insect Vectors/genetics , Insecticide Resistance/genetics , Insecticides/pharmacology , Mosquito Vectors/drug effects , Pyrethrins/pharmacology , Aedes/genetics , Aedes/virology , Animals , French Guiana , Insect Vectors/drug effects , Mosquito Control/methods , Mosquito Vectors/virology , Spatio-Temporal Analysis
7.
Article in English | MEDLINE | ID: mdl-33530386

ABSTRACT

Aims: This study examines the dynamics of malaria as influenced by meteorological factors in French Guiana from 2005 to 2019. It explores spatial hotspots of malaria transmission and aims to determine the factors associated with variation of hotspots with time. Methods: Data for individual malaria cases came from the surveillance system of the Delocalized Centers for Prevention and Care (CDPS) (n = 17) from 2005-2019. Meteorological data was acquired from the NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) database. The Box-Jenkins autoregressive integrated moving average (ARIMA) model tested stationarity of the time series, and the impact of meteorological indices (issued from principal component analysis-PCA) on malaria incidence was determined with a general additive model. Hotspot characterization was performed using spatial scan statistics. Results: The current sample includes 7050 eligible Plasmodium vivax (n = 4111) and Plasmodium falciparum (n = 2939) cases from health centers across French Guiana. The first and second PCA-derived meteorological components (maximum/minimum temperature/minimum humidity and maximum humidity, respectively) were significantly negatively correlated with total malaria incidence with a lag of one week and 10 days, respectively. Overall malaria incidence decreased across the time series until 2017 when incidence began to trend upwards. Hotspot characterization revealed a few health centers that exhibited spatial stability across the entire time series: Saint Georges de l'Oyapock and Antecume Pata for P. falciparum, and Saint Georges de l'Oyapock, Antecume Pata, Régina and Camopi for P. vivax. Conclusions: This study highlighted changing malaria incidence in French Guiana and the influences of meteorological factors on transmission. Many health centers showed spatial stability in transmission, albeit not temporal. Knowledge of the areas of high transmission as well as how and why transmission has changed over time can inform strategies to reduce the transmission of malaria in French Guiana. Hotspots should be further investigated to understand other influences on local transmission, which will help to facilitate elimination.


Subject(s)
Malaria, Falciparum , Malaria, Vivax , French Guiana/epidemiology , Humans , Malaria, Falciparum/epidemiology , Malaria, Vivax/epidemiology , Plasmodium falciparum , Plasmodium vivax
8.
Prog Urol ; 2021 Jan 30.
Article in French | MEDLINE | ID: mdl-33531219

ABSTRACT

INTRODUCTION: French Guyana is 83,500 km2 wide (equivalent to 1/6 of France). Communes are distant. Public urology is set in Kourou only. These particularities led to develop ambulatory urological surgery including for patients living far away from the reference centre. We report our experience with patient ureteroscopy (URS). MATERIAL: The study is retrospective (2018-2019), and includes 125 patients. Among these patients, 19.2% live in Kourou, 71.1% live 40 to 100km from the hospital and 9.7% beyond 100km. Every patient had an outpatient procedure for rigid and/or flexible URS to treat stone disease, including in lower calyx [LC] (38.4%). Ambulatory surgery was also proposed to the patients living away with the usual restrictions. Complications, results and switch to conventional hospitalisation (CH) were studied. RESULTS: Mean stone size was 10,5mm (4-30), stone density was 1030 UH (470-1700). The postoperative complication rate was 4%. There were 90.4% 'stone free' patients (85.4% for LC). One patient was rehospitalised within 48hours for acute flank pain and 9 patients had a switch of ambulatory to CH: 6 for discharge too late and 3 for complication (fever and/or pain). Distance between home and hospital was linked neither to complication rate, nor to switch to CH. CONCLUSION: Ambulatory URS is possible without further complications in selected patients living beyond 100km from the hospital, because of a specific organisation and an appropriate training of the caregivers involved in postoperative patient care. LEVEL OF PROOF: 3.

9.
AIDS ; 35(6): 979-984, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33470610

ABSTRACT

OBJECTIVE: The aim of this study was to understand the transmission dynamics of the HIV-1 subtype B epidemic in French Guiana and the factors that shaped the expansion of major phylogenetic transmission clusters. DESIGN: HIV-1 subtype B pol sequences with associated epidemiological data obtained from 703 treatment-naive patients living in French Guiana between 2006 and 2012, which correspond to 91% of all HIV cases diagnosed in that period, were employed in this study. METHODS: Maximum likelihood and Bayesian methods were used to construct phylogenetic trees, identify transmission clusters and estimate intervals between successive infections. Statistical analysis was performed to evaluate epidemiological characteristics associated with cluster membership. RESULTS: HIV-1 subtype B pol sequences from French Guiana were distributed in 10 large/medium transmission clades (LMTC, n > 10, 55%), 19 small transmission clades (STC, n = 3-8, 10%), 36 dyads (10%) or were nonclustered (25%). The rate of clustering did not differ by sex or clinical stage, but sex workers, crack-cocaine users, young individuals (15-20 years) and nationals or migrants from neighbouring South American countries were more likely to cluster within LMTC than individuals from other groups. We estimated that 53-63% of immigrants were infected after the arrival in French Guiana and that 50% of HIV transmissions within LMTC occurred during the first 2 years after infection. CONCLUSION: These findings reinforce the notion that high-risk sexual behaviours among young individuals and migrants (postmigration) combined with late HIV diagnosis are key drivers of onward dissemination of major HIV transmission clusters in French Guiana.


Subject(s)
HIV Infections , HIV-1 , Bayes Theorem , French Guiana/epidemiology , HIV Infections/epidemiology , HIV-1/genetics , Humans , Phylogeny , South America
10.
PLoS One ; 16(1): e0243992, 2021.
Article in English | MEDLINE | ID: mdl-33428654

ABSTRACT

Insecticide resistance is a worldwide threat for vector control around the world, and Aedes aegypti, the main vector of several arboviruses, is a particular concern. To better understand the mechanisms of resistance, four isofemale strains originally from French Guiana were isolated and analysed using combined approaches. The activity of detoxification enzymes involved in insecticide resistance was assayed, and mutations located at positions 1016 and 1534 of the sodium voltage-gated channel gene, which have been associated with pyrethroid resistance in Aedes aegypti populations in Latin America, were monitored. Resistance to other insecticide families (organophosphates and carbamates) was evaluated. A large-scale proteomic analysis was performed to identify proteins involved in insecticide resistance. Our results revealed a metabolic resistance and resistance associated with a mutation of the sodium voltage-gated channel gene at position 1016. Metabolic resistance was mediated through an increase of esterase activity in most strains but also through the shifts in the abundance of several cytochrome P450 (CYP450s). Overall, resistance to deltamethrin was linked in the isofemale strains to resistance to other class of insecticides, suggesting that cross- and multiple resistance occur through selection of mechanisms of metabolic resistance. These results give some insights into resistance to deltamethrin and into multiple resistance phenomena in populations of Ae. aegypti.


Subject(s)
Aedes/metabolism , Cytochrome P-450 Enzyme System/genetics , Insect Proteins/genetics , Insecticide Resistance/genetics , Voltage-Gated Sodium Channels/genetics , Aedes/drug effects , Aedes/genetics , Animals , Esterases/metabolism , Female , French Guiana , Gene Knockdown Techniques , Genotype , Inactivation, Metabolic/genetics , Insect Proteins/antagonists & inhibitors , Insect Proteins/metabolism , Insecticides/pharmacology , Intestinal Mucosa/metabolism , Nitriles/pharmacology , Oligonucleotides/metabolism , Polymorphism, Single Nucleotide , Proteome/analysis , Proteomics , Pyrethrins/pharmacology , Voltage-Gated Sodium Channels/chemistry , Voltage-Gated Sodium Channels/metabolism
11.
Chemosphere ; 262: 127819, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32768753

ABSTRACT

Mercury (Hg) is a contaminant that is impacting ecosystems worldwide. Its toxicity is threatening wildlife and human populations, leading to the necessity of identifying the most affected ecosystems. Therefore, it is essential to identify pertinent bioindicator organisms to monitor Hg contamination. In this study, we determined the stable carbon (δ13C) and nitrogen (δ15N) isotope ratios in the red blood cells (RBCs), and the total Hg concentration in total blood of 72 Melanosuchus niger in French Guiana. The goals of our study were to assess the level of Hg contamination in total blood of Black caimans and to further investigate the influence of individual traits (i.e., sex, size/age, diet) on Hg concentrations. Mercury concentration in total blood of Black caimans ranged from 0.572 to 3.408 µg g-1 dw (mean ± SD is 1.284 ± 0.672 µg g-1 dw) and was positively correlated to individual body size and trophic position (δ15N). We did not find any sexual or seasonal effects on Hg concentrations in the blood. The use of blood of M. niger is relevant to determine Hg concentrations within the population and suggests that this species can be used as a bioindicator for environmental contamination. In addition, our results emphasize trophic position as a major source of Hg variation and further suggest that it is essential to take trophic position (δ15N) into account for future studies.


Subject(s)
Alligators and Crocodiles/blood , Environmental Monitoring , Mercury/blood , Water Pollutants, Chemical/blood , Animals , Ecosystem , Food Chain , French Guiana , Humans , Mercury/analysis , Niger , Water Pollutants, Chemical/analysis
12.
Eur J Obstet Gynecol Reprod Biol ; 257: 11-18, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33310656

ABSTRACT

OBJECTIVE: To describe the proportions of asymptomatic, mild and severe diseases in infected pregnant women admitted for delivery. To compare maternal, fetal and neonatal outcomes of SARS-CoV-2 infected pregnant women with those of non-infected patients. STUDY DESIGN: Through an universal PCR testing for SARS-COV-2 at admission (not symptoms-based), this prospective cohort study enrolled all pregnant women admitted for delivery between 16th of June and the 16th of August 2020 in the West French Guiana Hospital Center. RESULTS: 507 pregnant women were included during the study period, of which 137 (27 %) were infected with SARS-COV-2. On admission, only 34/137 (24.8 %) of these patients presented with clinical symptoms. Among asymptomatic women, 16 /103 (15 %) became symptomatic after diagnosis. Throughout the delivery hospitalization and follow-up, 87/137 (63.5 %) remained always asymptomatic, 45/137 (32.8 %) developed a mild COVID-19 and 5/137 (3.6 %) developed a severe infection. SARS-CoV-2 infected patients were more likely to have post-partum hemorrhage >500 mL (14.2 % vs 7.2 %, RR 2.0 [95 %CI 1.1-3.4]), to be transfused (5.5 % vs 1.1 %, RR 4.9 [1.5-16.6]), and to be hospitalized in ICU (3.6 % vs 0.8 %, RR 4.5 [95 %CI 1.1-18.6] than uninfected ones. Intra-uterine fetal demises were more common in infected mothers compared to controls (5.1 % vs 1.1 %, RR 4.7 [95 % CI 1.4-45.9). Among 108 neonates from infected mothers tested at birth, none tested positive (0/108). When tested between 25 and 42 h after delivery, 4/29 (13.7 %) were positive for SARS-CoV-2 RT-PCR on nasopharyngeal swabs and remained asymptomatic. CONCLUSION: Pregnant women admitted for delivery and diagnosed with a SARS-COV-2 infection through an universal screening were symptomatic in only a quarter of cases. Their risks of post-partum hemorrhage, transfusion and admission to ICU were higher than those of uninfected patients. They also presented a higher risk of intra-uterine fetal demise. There were no other differences in maternal, obstetrical or neonatal outcomes.


Subject(s)
Asymptomatic Infections , Pregnancy Complications, Infectious/diagnosis , Severity of Illness Index , Adult , /therapy , Female , Follow-Up Studies , French Guiana/epidemiology , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/therapy , Prognosis , Prospective Studies , Stillbirth/epidemiology
13.
Zootaxa ; 4869(2): zootaxa.4869.2.2, 2020 Nov 02.
Article in English | MEDLINE | ID: mdl-33311360

ABSTRACT

The genus Valdasus Stål, 1860 is reviewed. Four species are described as new: Valdasus favrei n. sp., V. ferrerai n. sp., V. flavinotum n. sp., and V. henryi n. sp. V. erebeus Distant, 1883 and V. stygius Distant, 1883 are transferred again to Valdasus (original combination reestablished) from Peltidocylapus Poppius and they are redescribed along with the type species V. schoenherri Stål, 1860. Presence of V. bolivianus in Argentina is challenged after new analysis of female specimen mentioned in literature.


Subject(s)
Heteroptera , Animal Distribution , Animals , Brazil , Ecuador , Female , French Guiana
14.
Encephale ; 2020 Nov 11.
Article in French | MEDLINE | ID: mdl-33189352

ABSTRACT

OBJECTIVES: A survey was conducted in the maternity hospitals of French Guiana in 2017-2018 centered on uses of tobacco, alcohol and pemba (clay) during pregnancy, including questions about violence and the perception of adverse situations during pregnancy. The data used here allow an analysis of lifetime violence and the experience of the last pregnancy. METHODS: An ad hoc questionnaire was designed including some questions to identify at risk situations and T-Ace items for measuring problematic alcohol use. It was adapted to specificities of the local population groups, migrants or from borders, and asking for the maternal tongue. It was administered to women following childbirth. The questionnaire was strictly anonymous. The ethics committee had validated the questionnaire and the collection procedures (Decision 2017-25). In addition, to the issue of violence, seven questions were asked about women's experiences with pregnancy. A bivariate analysis identified significantly associated variables that were used for a multicomponent analysis to identify a typology of women based on their pregnancy experience (Modalisa8 and SPSS19). The very small number of women who smoked tobacco or cannabis during pregnancy (16 and 7 women respectively) led us to ignore these variables. RESULTS: The survey interviewed 789 women throughout Guyana. They were on average 28.9 years old at this pregnancy and had an average of 3.24 living children comprised this newborn. The questioned women were younger than in metropolitan France, less often married, with a low level of education, often foreigners, especially Haitian or Surinamese. Overall, 174 women, or 22% of the total reported having experienced violence in their lifetime, with four women refusing to answer the question. The profiles of the concerned women were not very different according to their ages or levels of education, but differed significantly from the average on several characteristics, such as their mother tongue, marital status, nationalities, whether living on state aid not related to employment or family allowances, or having no resources, living around Cayenne or Kourou and having been on the territory for less than two years. Three groups of women were distinguished by the multicomponent analysis. The first group comprised essentially foreign women living around Cayenne, alone with children, having a low educational level, and having experienced difficulties to cope with this pregnancy. They reported no use of psychoactive substances. They experienced violence more often than in the other groups (almost one in two). One in five had migrated during the last pregnancy. The second group was composed more often of French women, born in Guyana or in metropolitan France. They more often lived with a partner, had a good educational level, personal or marital incomes. They expressed more often worry, with sleep problems but with an entourage to rely on. Before pregnancy they drank alcohol at events but one in three had a T-Ace scoring at two or more. They had a good pregnancy follow-up. The last group was composed of women living around Saint-Laurent-du-Maroni or in remote communities, with a low educational level, living alone with numerous children. They didn't feel worry and had good sleep. They didn't experience violence. They differed by their use of pemba and beer and late or inadequate pregnancy follow-up. CONCLUSIONS: Data on violence in French Guyana show that young people and women declare more often having experienced physical violence, in or out of family life. Young women are overrepresented thus a survey in childbearing women must reveal a high frequency of these events. Our data allow us to go further, by associating this experience of violence and the experience of pregnancy with socio-demographic variables. We can thus see that the overall average obtained on a large number of indicators is smoothed by extremely contrasting situations, of women feeling safe or not, well followed or not for this pregnancy, etc. The groups distinguished by the MCA reveal the contrast between women of Haitian nationality in the Cayenne region and Surinamese or Nengee-speaking women, who are grouped around Saint-Laurent-du-Maroni or in the isolated municipalities of western Guyana. One sub-group stands out in particular for the combination of lifetime violence and very unfavorable conditions during the last pregnancy, both of precariousness, isolation and recent migration. The experience of violence and pregnancy in poor conditions require close actions to take charge of these women, especially since they are at risk for sexually transmitted diseases, including HIV.

15.
Rev Infirm ; 69(264): 30-32, 2020 Oct.
Article in French | MEDLINE | ID: mdl-33129474

ABSTRACT

World Breastfeeding Week is held every year from 1-7 August to promote breastfeeding as a way to make infants around the world healthier. In French Guiana, caregivers work within a network to support this approach with young mothers, as evidenced by a midwife who has worked for several years on site, particularly in remote prevention and health centres and at the Kourou Hospital Centre.


Subject(s)
Health Priorities , Mothers , Public Health , Breast Feeding , Female , French Guiana , Hospitals , Humans , Infant
16.
Zootaxa ; 4814(1): zootaxa.4814.1.1, 2020 Jul 14.
Article in English | MEDLINE | ID: mdl-33055727

ABSTRACT

The present paper describes 16 new species and one new genus from French Guiana and numerous taxonomic changes are proposed prior to the publication of a comprehensive guide to the Phasmatodea of French Guiana. The following 16 new species are described and illustrated: Phanocles procerus n. sp., Phanocloidea lobulatipes n. sp., Cladomorphus guianensis n. sp., Hirtuleius gracilis n. sp., Parastratocles rosanti n. sp., Parastratocles fuscomarginatus n. sp., Paraprisopus apterus n. sp., Paraprisopus multicolorus n. sp., Agrostia longicerca n. sp., Isagoras similis n. sp., Paragrostia brulei n. sp., Prexaspes globosicaput n. sp., Prexaspes guianensis n. sp., Dinelytron cahureli n. sp., Prisopus clarus n. sp. and Prisopus conocephalus n. sp.. The new genus Paragrostia n. gen. is established for the newly described Paragrostia brulei n. sp. and Paragrostia flavimaculata (Heleodoro, Mendes Rafael, 2017) n. comb. the latter of which is here transferred from Agrostia Redtenbacher, 1906.                Fifty-six new combinations are proposed with species transferred to other genera: Bacteria pallidenotata Redtenbacher, 1908, is transferred to Phanocloidea Zompro, 2001 (n. comb.); Bacteria maroniensis Chopard, 1911 is transferred to Phanocles Stål, 1875 (n. comb.); Cladomorphus gibbosus (Chopard, 1911) is transferred to Hirtuleius Stål, 1875 (n. comb.); Stratocles soror Redtenbacher, 1906, Parastratocles lugubris (Redtenbacher, 1906) and Parastratocles cryptochloris (Rehn, 1904) are transferred to Brizoides Redtenbacher, 1906 (n. comb.); Stratocles xanthomela (Olivier, 1792), Stratocles forcipatus Bolívar, 1896 and Stratocles tessulatus (Olivier, 1792) are transferred to Parastratocles (n. comb.); Olcyphides cinereus (Olivier, 1792), Perliodes affinis Redtenbacher, 1906, Perliodes nigrogranulosus Redtenbacher, 1906, Perliodes sexmaculatus Redtenbacher, 1906, Isagoras rugicollis (Gray, 1835), Isagoras sauropterus Rehn, 1947, Brizoides viridipes (Rehn, 1905) and Brizoides graminea Redtenbacher, 1906 are transferred to Agrostia Redtenbacher, 1906 (n. comb.); Agrostia flavimaculata Heleodoro, Mendes Rafael, 2017 is transferred to Paragrostia n. gen. (n. comb.); Isagoras affinis Chopard, 1911, Isagoras chocoensis Hebard, 1921, Isagoras metricus Rehn, 1947 and Isagoras schraderi Rehn, 1947 are transferred to Tenerella Redtenbacher, 1906 (n. comb.); Xerosoma glyptomerion Rehn, 1904 is transferred to Isagoras Stål, 1875 (n. comb.); Isagoras venosus (Burmeister, 1838), Paraphasma paulense Rehn, 1918 and Paraphasma quadratum (Bates, 1865) are transferred to Prexaspes Stål, 1875 (n. comb.); Prexaspes (Prexaspes) cneius (Westwood, 1859) is transferred to Tenerella Redtenbacher, 1906 (n. comb.); Prexaspes lateralis (Fabricius, 1775) is transferred to Paraphasma Redtenbacher, 1906 (n. comb.); Isagoras santara (Westwood, 1859) and Prexaspes olivaceus Chopard, 1911 are transferred to Periphloea Redtenbacher, 1906 (n. comb.); Dinelytron agrion Westwood, 1859 is transferred to Paraprisopus Redtenbacher, 1906 (n. comb.); Anarchodes atrophicus (Pallas, 1772) is transferred to Ignacia Rehn, 1904 (n. comb.); Planudes asperus Bellanger Conle, 2013, Planudes brunni Redtenbacher, 1906, Planudes cortex Hebard, 1919, Planudes crenulipes Rehn, 1904, Planudes funestus Redtenbacher, 1906, Planudes melzeri Piza, 1937, Planudes molorchus (Westwood, 1859), Planudes paxillus (Westwood, 1859), Planudes perillus Stål, 1875, Planudes pygmaeus (Redtenbacher, 1906) and Planudes taeniatus Piza, 1944 are transferred to Isagoras Stål, 1875 (n. comb.); Prisopoides atrobrunneus Heleodoro Rafael, 2020, Prisopoides brunnescens Heleodoro Rafael, 2020, Prisopoides caatingaensis Heleodoro Rafael, 2020 and Prisopoides villosipes (Redtenbacher, 1906) are transferred to Prisopus Peletier de Saint Fargeau Serville, 1828 (n. comb.); Melophasma antillarum (Caudell, 1914), Melophasma brachypterum Conle, Hennemann Gutiérrez, 2011, Melophasma colombianum Conle, Hennemann Gutiérrez, 2011 and Melophasma vermiculare Redtenbacher, 1906 are transferred to Paraprisopus Redtenbacher, 1906 (n. comb.); Prexaspes (Elasia) ambiguus (Stoll, 1813), Prexaspes (Elasia) brevipennis (Burmeister, 1838), Prexaspes (Elasia) pholcus (Westwood, 1859), Prexaspes (Elasia) viridipes Redtenbacher, 1906 and Prexaspes (Elasia) vittata (Piza, 1985) are transferred to Prexaspes Stål, 1875 (n. comb.).                Twenty-six new synonymies are established: Perliodes Redtenbacher, 1906 and Chlorophasma Redtenbacher, 1906 are synonymised with Agrostia Redtenbacher, 1906 (n. syn.); Chlorophasma Redtenbacher, 1906 is synonymised with Agrostia Redtenbacher, 1906 (n. syn.); Elasia Redtenbacher, 1906 is synonymised with Prexaspes Stål, 1875 (n. syn.); Prisopoides Heleodoro Rafael, 2020 is synonymised with Prisopus Peletier de Saint Fargeau Serville, 1828 (n. syn.); Melophasma Redtenbacher, 1906 is synonymised with Paraprisopus Redtenbacher, 1906 (n. syn.); Bacteria crassipes Chopard, 1911 is synonymised with Bacteria pallidenotata Redtenbacher, 1908 (n. syn.); Perliodes grisescens Redtenbacher, 1906 and Metriophasma (Metriophasma) pallidum (Chopard, 1911) are synonymised with Agrostia cinerea (Olivier, 1792) (n. syn.); Perliodes nigrogranulosus Redtenbacher, 1906 and Metriophasma (Metriophasma) ocellatum (Piza, 1937) are synonymised with Isagoras rugicollis (Gray, 1835) (n. syn.); Isagoras chopardi Hebard, 1933 is synonymised with Tenerella cneius (Westwood, 1859) (n. syn.); Isagoras proximus Redtenbacher, 1906 is synonymised with Isagoras glyptomerion (Rehn, 1904) (n. syn.); Chlorophasma hyalina Redtenbacher, 1906 is synonymised with Agrostia graminea (Redtenbacher, 1906) (n. syn.); Isagoras nitidus Redtenbacher, 1906 is synonymised with Anisa flavomaculatus (Gray, 1835) (n. syn.); Prexaspes acuticornis (Gray, 1835) is synonymised with Prexaspes servillei (Gray, 1835) (n. syn.); Prexaspes nigromaculatus Chopard, 1911 is synonymised with Periphloea santara (Westwood, 1859) (n. syn.); Prexaspes (Elasia) janus Kirby, 1904 is synonymised with Paraphasma maculatum (Gray, 1835) (n. syn.); Prexaspes dictys (Westwood, 1859) is synonymised with Prexaspes brevipennis (Burmeister, 1838) (n. syn.); Parastratocles aeruginosus Redtenbacher, 1906: 107 is synonymised with Parastratocles forcipatus Bolívar, 1896 (n. syn.); Parastratocles carbonarius (Redtenbacher, 1906: 106) is synonymised with Parastratocles lugubris (Redtenbacher, 1906) (n. syn.); Prisopus spinicollis Burmeister, 1838, Prisopus spiniceps Burmeister, 1838 and Prisopus cornutus Gray, 1835 are synonymised with Prisopus ohrtmanni (Lichtenstein, 1802) (n. syn.); the genus Planudes Stål, 1875 is synonymised with Isagoras Stål, 1875 (n. syn.); Pseudophasma annulipes (Redtenbacher, 1906) is synonymised with Pseudophasma blanchardi (Westwood, 1859) (n. syn.); Ignacia appendiculatum (Kirby, 1904) is synonymised with Anarchodes atrophicus (Pallas, 1772) (n. syn.).                Isagoras obscurum Guérin-Méneville, 1838 is shown to have been erroneously synonymised with Isagoras rugicollis (Gray, 1835) and is here re-established as a valid species (rev. stat.). Pseudophasma castaneum (Bates, 1865) is re-established as a valid species here (rev. stat.).                Paraprisopus Redtenbacher, 1906 and the entire tribe Paraprisopodini are transferred to Pseudophasmatidae: Pseudophasmatinae (n. comb.).                Lectotypes are designated for Perliodes grisescens Redtenbacher, 1906, Isagoras plagiatus Redtenbacher, 1906.Neotypes are designated for Agrostia cinerea (Olivier, 1792), Prexaspes ambiguus (Stoll, 1813), Prisopus horridus (Gray, 1835) and Prisopus sacratus (Olivier, 1792).


Subject(s)
Coleoptera , Heteroptera , Animals , French Guiana , Neoptera
17.
Article in English | MEDLINE | ID: mdl-33067006

ABSTRACT

BACKGROUND: French Guiana is an overseas territory of France with marked specificities in terms of populations, socioeconomic factors, risk factors, and an access to care. In this context, the objective of the present study was to describe the epidemiology of acute coronary syndromes in French Guiana and to make comparisons with mainland France and neighbouring country. METHODS: The data were obtained from a retrospective descriptive hospital-based cohort conceived to describe the incidence of acute coronary syndromes and their epidemiologic and clinical characteristics. It included patients aged 18 or more hospitalised for a first coronary syndrome in the reference centre for coronary syndromes in Cayenne French Guiana between Jan 1st 2012 and Dec 31st 2014. Overall, 266 patients were analysed. RESULTS: The mean age was 64 years (SD=12.54). A majority of patients were men (sex ratio=1.83). The proportion of patients born in an overseas French territory (44.36%) was similar to that of those born in a foreign country (43.98%), and 11.65% were born in mainland France. Only 59% of patients had regular health insurance. Moreover, 33.21% had universal medical insurance (CMU for those below a minimal income), 4.91% had state insurance (for illegal foreign patients) and 2.64% had no insurance at all. The main risk factors were high blood pressure (73.68%), diabetes (39.85%), hypercholesterolemia (40.23%), and smoking (37.97%). Overall, 82/266 patients developed an ST elevation coronary syndrome (STEMI) and 184/266 had a non-ST elevation coronary syndrome NSTEMI or unstable angina pectoris. Thrombolysis was only performed in 20.73% of patients with STEMI. Mortality at 1 month was 8/82 (9.76%) for STEMI and 2/184 (1.09%) for NSTEMI. CONCLUSIONS: The epidemiologic profile of acute coronary syndromes in French Guiana is different from that of mainland France and Europe to the neighbouring country Brazil. Mortality of STEMI also seems higher than in mainland France, but similar to Brazil. In a context of frequent health inequalities, interventions targeting the major risk factors, notably high blood pressure, obesity and diabetes, have the potential to significantly impact cardiovascular morbidity and mortality.

18.
Sante Publique ; 32(2): 199-210, 2020 09 15.
Article in French | MEDLINE | ID: mdl-32989949

ABSTRACT

INTRODUCTION: The western French Guiana hospital (Chog) is atypical. The creation of a public health department (PSP) is the result of a willingness of the institution to respond to public health issues on its territory. The main objective of this article is to identify the levers and impediments for the development of public health activities within this hospital, after five years of implementation. METHOD: This article was based on the analysis of documents produced within the PSP, the institution and at the regional level (2013-2018), and on interviews conducted in 2017 with PSP professionals, and chiefs of other departments of the Chog (N = 16). RESULTS: The added value of the PSP is based on the pooling of human resources and technical skills, the coexistence of clinical activities, prevention, research, teaching and international cooperation with Suriname, and the development of multidisciplinary and evaluative approaches. The lack of a set of public health objectives in the establishment project, the lack of place for these activities in its new hospital, and the difficult mobilization of financial resources, however, limit the prospects. CONCLUSION: This analysis has shown difficulties in developing public health activities within this hospital, in an overseas territory with nonetheless multiple and complex needs. The authors invite politics and health authorities to value, and develop these activities, conditions necessary for the positioning of the hospital as an actor of the “turn in prevention”.


Subject(s)
Hospital Departments/organization & administration , Public Health , French Guiana , Hospitals , Humans
19.
Sante Publique ; 32(2): 199-210, 2020.
Article in French | MEDLINE | ID: mdl-32985836

ABSTRACT

INTRODUCTION: The western French Guiana hospital (Chog) is atypical. The creation of a public health department (PSP) is the result of a willingness of the institution to respond to public health issues on its territory. The main objective of this article is to identify the levers and impediments for the development of public health activities within this hospital, after five years of implementation. METHOD: This article was based on the analysis of documents produced within the PSP, the institution and at the regional level (2013-2018), and on interviews conducted in 2017 with PSP professionals, and chiefs of other departments of the Chog (N = 16). RESULTS: The added value of the PSP is based on the pooling of human resources and technical skills, the coexistence of clinical activities, prevention, research, teaching and international cooperation with Suriname, and the development of multidisciplinary and evaluative approaches. The lack of a set of public health objectives in the establishment project, the lack of place for these activities in its new hospital, and the difficult mobilization of financial resources, however, limit the prospects. CONCLUSION: This analysis has shown difficulties in developing public health activities within this hospital, in an overseas territory with nonetheless multiple and complex needs. The authors invite politics and health authorities to value, and develop these activities, conditions necessary for the positioning of the hospital as an actor of the “turn in prevention”.


Subject(s)
Hospital Departments/organization & administration , Public Health , French Guiana , Hospitals , Humans
20.
PLoS One ; 15(9): e0238691, 2020.
Article in English | MEDLINE | ID: mdl-32881938

ABSTRACT

OBJECTIVES: This cross-sectional study aimed to investigate the influence of haplotypes, alpha-gene status and UGTA1 polymorphism on the severity of sickle cell disease in children. METHODS: This cross-sectional study was conducted between 2012 and 2014 at the Cayenne Hospital, in French Guiana. Acute clinical complications were grouped into (i) severe SCD defined by the presence of stroke and/or abnormal-transcranial Doppler (TCD), (ii) moderate SCD defined by the presence of at least three annual events requiring hospitalization and/or at least one acute chest syndrome, (iii) no severe SCD (in the absence of the precited events). RESULTS: Among the 86 patients, 33.7% were female with a median age of 10 years (range: 6-12 years). The vast majority of patients had SCA (HbSS) phenotype (74.4%; n = 64). The severe haplotype was found in 40% of patients. 30% were BEN/BEN. Analysis of α-globin gene deletions revealed that 32 patients (37.2%) were heterozygous (loss of 2 genes in 2 cases and loss of 1 gene in 30 cases) for α-thalassemia (3.7 kb deletion). Homozygous (TA) n TA7/7 was found in 24 (28%). In the multivariate analysis, the factors associated with the severity of sickle cell disease were the first vaso-occlusive crisis before one year of age (OR 25, [95% CI = 6.0-107.0], p<0.001) and a baseline MCV >80 fL (OR 0.20 [95% CI = 0.04-0.96], p = 0.04). The area of the ROC curve was 0.90. CONCLUSION: Prospective studies with greater statistical power would provide more knowledge on the relationship between UGT1A1 mutations and the clinical and hematological manifestations of SCA.


Subject(s)
Anemia, Sickle Cell/blood , Anemia, Sickle Cell/genetics , Glucuronosyltransferase/genetics , Haplotypes/genetics , Multigene Family , Polymorphism, Genetic , alpha-Globins/genetics , beta-Globins/genetics , Child , Female , French Guiana , Humans , Male , Multivariate Analysis , ROC Curve
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