Phylogenetic Investigations of Dengue 2019-2021 Outbreak in Guadeloupe and Martinique Caribbean Islands.

Dengue fever has been a public health problem in the Caribbean region since 1981, when it first reappeared in Cuba. In 1989, it was reported in Martinique and Guadeloupe (two French islands 200 km apart); since then, DENV has caused several epidemics locally. In 2019-2021, DENV-1, DENV-2, and DENV-3 were detected. Serotype distribution was differentiated, with DENV-2 and DENV-3 predominating in Guadeloupe and Martinique, respectively. Complete genome sequencing was carried out on 32 specimens, and phylogenic analysis identified the circulation of genotype V for DENV-1, cosmopolitan genotype for DENV-2, and genotype III for DENV-3. However, two distinct circulating groups were identified for DENV-1 and DENV-3, suggesting independent introductions. Overall, despite the context of the COVID-19 pandemic and the associated travel restrictions, these results confirm the active circulation of DENV and specific epidemiological features on each of the two islands. Such differences may be linked to the founder effect of the various introduction events, and to local factors such as the population immunity and the transmission capacity of the vectors. Further genomic and epidemiological characterization of DENV strains remains essential to understand how dengue spreads in each specific geographical context and to prevent future epidemics.

Sickle cell disease patients with COVID-19 in Guadeloupe: Surprisingly favorable outcomes.

We investigate risk factors for hospitalization and difference between sickle cell syndromes in a cohort of COVID-19 sickle cell disease (SCD) adult patients managed in the Reference Center of Guadeloupe. We retrospectively collected data of symptomatic SCD adult patients infected with SARS-CoV-2 between March and December 2020. Thirty-eight SCD adult patients with symptomatic COVID-19 infection were included during the first wave, representing 9.6% of the active patient file at our center. The median age (IQR) was 39 years (24-47). Four patients were obese and two had moderate renal failure. The median duration of symptoms (IQR) was 10 days (5-15). Seventeen (44.7%) patients were hospitalized, including two in intensive care unit (ICU) for acute chest syndrome. An 85-year-old SC patient with prostate cancer died. No difference was detected between inpatient and outpatient groups in terms of age, gender, BMI, SCD clinical complications, and in history SCD treatment. There was no difference for severity, hospitalization, length of stay, ICU stay, or death between SS or Sß°-thal patients and SC or Sß+-thal patients. These overall favorable outcomes among symptomatic patients may be related to the low prevalence of comorbidity known to be linked to the more severe forms of COVID-19, but also to the prompt coordinated management of SCD patients in the Reference Center.

Frailty index, mortality, and length of stay in a geriatric short-stay unit in Guadeloupe.

Context: The COVID-19 pandemic has placed a tremendous stress on healthcare systems and caused reorganization. As the pandemic intensifies, identifying the profile of patients with COVID-19 was primordial in order to predict negative outcomes and organize healthcare resources. Age is associated with COVID-19's mortality, but for obvious ethical reasons, chronological age cannot be the sole criterion for predicting negative outcomes. Objective: The objective of this study was to determine the relationship between frailty index (FI) and length of hospital stay, and death in a non-COVID population of patients aged 75 years old and above. Methods and design: A retrospective, analytical, single-centered observational study was performed in the geriatric short-stay accommodation unit at Guadeloupe University Hospital. For this study, 158 patients who were at least 75 years old were recruited from November 2020 to May 2021. FI was calculated as the number of deficits in a participant divided by the total number of deficits considered (the cut-off of FI is.25 in outpatient). Multivariate logistics regression analyses were conducted to assess the association between frailty and death, and length of stay. Results: The average age of the participants was 85.7 ± 6.74 with a range of 75-104. Twenty-four of the patients died during hospitalization. FI was only significantly associated with mortality even after adjustment for age and gender (HR 26.3, 95% CI 1.7-413.4, P = 0.021). The association was stronger in the highest tertile of the FI (age- and gender-adjusted HR 4.6, 95% CI 1.39-15.11, P = 0.01). There was no significant interaction between FI and length of stay. Conclusion: Our study shows an association between FI (in terms of age-related deficit accumulation) and mortality in a non-COVID geriatric short-stay unit in Guadeloupe. The FI seems to have a lower capacity to catch events such as length of stay in this very complex population. Further research studies have to be conducted for better understanding and investigation of our findings.

Estilo de vida relacionado con el COVID-19 en pacientes adultos que acuden al Centro de Salud Guadalupe Ica 2021 / Lifestyle related to covid-19 in patients adults attending The Guadalupe Ica Health Center 2021

Objetivo: Analizar el estilo de vida y su relación con el COVID-19 en pacientes adultos que acuden al Centro de Salud Guadalupe Ica 2021. Material y Métodos: Estudio descriptivo, cuantitativo y transversal con diseño no experimental de alcance correlacional, muestra de 108 pacientes adultos, muestreo probabilístico de poblaciones finitas, con técnica de encuesta e instrumento un cuestionario estructurado. Resultados: El estilo de vida en mayor proporción deficiente con 42,6%. Por dimensiones la conducta alimentaria es en mayor proporción regular 40,8%, actividad física deficiente 45,4%, manejo del estrés deficiente 52,8%, descanso-sueño regular 54,6% y responsabilidad en salud regular con 58,3%. El 46,3% tuvo COVID-19. Se encontró relación entre el estilo de vida y elCOVID-19 (p=0,004), y por dimensiones se encontró relación con la conducta alimentaria (p=0,024) y la actividad física (p=0,006)Conclusiones: El estilo de vida es con mayor predominio deficiente, y se relaciona con el COVID-19 en pacientes adultos del Centro de Salud Guadalupe Ica 2021. (AU)

Objective: To analyze the lifestyle and its relationship with COVID-19 in adult patients who attend the Guadalupe Ica 2021 Health Center. Material and methods: Descriptive, quantitative and cross-sectional study with non-experimental design of correlational scope, sample of 108 patients'adults, probability sampling of finite populations, with a survey technique and a structured questionnaire instrument. Results: The lifestyle in the highest deficient proportion with 42.6%. By dimensions, eating behavior is in a higher proportion regular 40.8%, poor physical activity 45.4%, poor stress management 52.8%, regular rest-sleep 54.6% and responsibility in regular health with 58.3%. 46.3% had COVID-19. A relationship was found between lifestyle and COVID-19 (p = 0.004), and by dimensions a relationship was found with eating behavior (p = 0.024) and physical activity (p = 0.006). Conclusions: The lifestyle is in a greater predominance deficient, and is related to COVID-19 in adult patients of the Guadalupe Ica 2021 Health Center. (AU)

Seroprevalence of SARS-CoV-2 IgG antibodies among workers in the University Hospital of Guadeloupe.

OBJECTIVE: The Covid-19 pandemic is the major global health crisis of our time. The purpose of this study is to estimate the seroprevalence of IgG against SARS-CoV-2 among workers in the University Hospi-tal of Guadeloupe and to assess this seroprevalence in asymptomatic personnel as well as the proportion of asymptomatic agents among seropositive agents. SETTING AND METHODS: We carried out a seroprevalence study in the staff of the University Hospital of Guadeloupe. The presence of IgG anti SARS-CoV-2 was determined by a micro-particulate immunolo-gical assay using the chemiluminescence technique (CMIA, Architect i2000SR, Abbott). Data on the previous presence of symptoms sugge-stive of COVID-19, were identified using a standardized questionnaire. Statistical analyses were performed using Epi Info® software. RESULTS: From 07/05/2020 to 28/10/2020, 892 serologies were performed, 45 of which were positive for SARS-CoV-2 : a prevalence of 5.0% [95% CI: 3.6% - 6.5%]. Seroprevalence was 1.5% [95% CI: 0.6% - 2.3%] among agents who reported being asymptomatic. Among seropositive individuals, 24.4% [95% CI:12% - 36%] was totally asymptomatic. CONCLUSION: Our results highlight the importance of continuing seroprevalence studies for SARS-CoV-2 in hospital staff, which can provide important information on the level of exposure in healthcare workers and asymptomatic transmission of SARS-CoV-2 in clinical set-tings.

A Data-Based Approach Using a Multi-Group SIR Model with Fuzzy Subsets: Application to the COVID-19 Simulation in the Islands of Guadeloupe.

In this paper, we propose a multi-group SIR to simulate the spread of COVID-19 in an island context. The multi-group aspect enables us to modelize transmissions of the virus between non-vaccinated individuals within an age group as well as between different age groups. In addition, fuzzy subsets and aggregation operators are used to account for the increased risks associated with age and obesity within these different groups. From a conceptual point of view, the model emphasizes the notion of Hospitalization which is the major stake of this pandemic by replacing the compartment R (Removed) by compartment H (Hospitalization). The experimental results were carried out using medical and demographic data from the archipelago, Guadeloupe (French West Indies) in the Caribbean. These results show that without the respect of barrier gestures, a first wave would concern the elderly then a second the adults and the young people, which conforms to the real data.

Changes to an urban marina soundscape associated with COVID-19 lockdown in Guadeloupe.

In 2020, the COVID-19 pandemic led to government-enforced limits on activities worldwide, causing a marked reduction of human presence in outdoors environments, including in coastal areas that normally support substantial levels of boat traffic. These restrictions provided a unique opportunity to quantify the degree to which anthropogenic noise contributes to and impacts underwater soundscapes. In Guadeloupe, French West Indies, a significantly lower number of motor boats were recorded in the vicinity of the major urban marina during the peak of the first COVID-19 lockdown (April-May 2020), compared with the number recorded post-lockdown. The resumption of human activities at the end of May was correlated with a maximum increase of 6 decibels in the ambient noise level underwater. The change in noise level did not impact daily sound production patterns of vocal fishes, with increased activity at dusk seen both during and after the lockdown period. However, during the lockdown vocal activity was comprised of a reduced number of sounds, suggesting that anthropogenic noise has the potential to interfere with vocalization behaviours in fishes.

Critical care medicine in the French Territories in the Americas: Current situation and prospects

[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.

Critical care medicine in the French Territories in the Americas: Current situation and prospects / La medicina intensiva en los territorios franceses de la Región de las Américas: situación actual y perspectivas / Medicina intensiva nos territórios ultramarinos franceses nas Américas: situação atual e perspectivas

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.

Early Action, Applied Research & Collaboration to Combat COVID-19: María Guadalupe Guzmán MD PhD DSc.

Virologist Dr María Guadalupe Guzmán is recognized as a global leader in dengue research and heads the Pedro Kourí Tropical Medicine Institute's work as a WHO/PAHO Collaborating Center for the Study of Dengue and Its Vector. The Institute (IPK) was founded in 1937 and is now Cuba's national reference center for the diagnosis, treatment, control and prevention of communicable diseases. Dr Guzmán is also president of the Cuban Society of Microbiology and Parasitology and directs IPK's Scientifi c Council, which is responsible for setting the Institute's research priorities. A recent h-index analysis found that Dr Guzmán is among the most widelypublished and cited Cuban researchers.