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1.
QJM ; 98(10): 737-43, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16126742

RESUMO

BACKGROUND: Data about anti-malarial drugs prescription practices in Europe and the safety of imported malaria treatments are scanty. In 1999, a French consensus development conference published guidelines for the prevention and treatment of imported P. falciparum malaria. The impact of these guidelines has not been evaluated. AIM: To investigate the impact of these guidelines on the prescription of anti-malarials, and to evaluate the incidence of acute drug events (ADEs) leading to discontinuation of treatment. DESIGN: Cross-sectional survey. METHODS: Members of the medical staff in 14 French infectious and tropical disease wards completed a standardized form for each patient treated for imported malaria in 2001. A propensity score matching technique was used to estimate the risk of ADEs leading to discontinuation of the regimen. RESULTS: In the 474 patients studied, quinine was the first-line anti-malarial most often prescribed. Only 3% of patients received halofantrine. Mefloquine was associated with a RR of 4.9 (95%CI 3.2-7.4, p < 0.00001) risk of discontinuation of treatment due to ADEs. DISCUSSION: The very limited use of halofantrine indicates that the main practice recommendations of the guidelines have been taken into account. Mefloquine was associated with a substantial risk of discontinuing the treatment because of ADEs. This is a serious limitation for the use of mefloquine in the treatment of out-patients with imported malaria.


Assuntos
Antimaláricos/uso terapêutico , Emigração e Imigração , Malária Falciparum/tratamento farmacológico , Adulto , Antimaláricos/efeitos adversos , Estudos Transversais , França/epidemiologia , Fidelidade a Diretrizes , Humanos , Malária Falciparum/epidemiologia , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Resultado do Tratamento
2.
Mar Pollut Bull ; 61(7-12): 269-96, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20637477

RESUMO

The south-west lagoon of New Caledonia is a wide semi-open coral reef lagoon bounded by an intertidal barrier reef and bisected by numerous deep inlets. This paper synthesizes findings from the 2000-2008 French National Program EC2CO-PNEC relative to the circulation and the transport of suspended particles in this lagoon. Numerical model development (hydrodynamic, fine suspended sediment transport, wind-wave, small-scale atmospheric circulation) allowed the determination of circulation patterns in the lagoon and the charting of residence time, the later of which has been recently used in a series of ecological studies. Topical studies based on field measurements permitted the parameterisation of wave set-up induced by the swell breaking on the reef barrier and the validation of a wind-wave model in a fetch-limited environment. The analysis of spatial and temporal variability of suspended matter concentration over short and long time-scales, the measurement of grain size distribution and the density of suspended matter (1.27 kg l(-1)), and the estimation of erodibility of heterogeneous (sand/mud, terrigenous/biogenic) soft bottoms was also conducted. Aggregates were shown to be more abundant near or around reefs and a possible biological influence on this aggregation is discussed. Optical measurements enabled the quantification of suspended matter either in situ (monochromatic measurements) or remotely (surface spectral measurements and satellite observations) and provided indirect calibration and validation of a suspended sediment transport model. The processes that warrant further investigation in order to improve our knowledge of circulation and suspended sediment transport in the New Caledonia lagoon as well as in other coral reef areas are discussed, as are the relevance and reliability of the numerical models for this endeavour.


Assuntos
Antozoários , Ecossistema , Sedimentos Geológicos/análise , Água do Mar/química , Movimentos da Água , Animais , Clima , Modelos Teóricos , Nova Caledônia , Tamanho da Partícula , Salinidade , Estações do Ano , Água do Mar/análise , Temperatura , Fatores de Tempo , Vento
3.
Arch Inst Pasteur Madagascar ; 66(1-2): 68-71, 2000.
Artigo em Francês | MEDLINE | ID: mdl-12463041

RESUMO

In Madagascar, as in several african countries, haematological normal values has not been established. To assess the haematological normal values in the laboratory of the Institut Pasteur de Madagascar, blood cell counts among 67 adults healthy malagasy volunteers, living in highlands of Madagascar, was performed. Blood was analysed with a Coulter STKS haematological autoanalyzer. A significant difference was noted between both sexes for the count of red blood cells, leukocytes, platelets, neutrophile polynuclears, eosinophile polynuclears, lymphocytes and for haemoglobin and haematocrit values. Our data were compared to those of different african and caucasian populations.


Assuntos
Contagem de Células Sanguíneas/estatística & dados numéricos , Hematócrito/estatística & dados numéricos , Hemoglobinas/análise , Adolescente , Adulto , Fatores Etários , População Negra , Contagem de Células Sanguíneas/métodos , Coleta de Amostras Sanguíneas/métodos , Feminino , Hematócrito/métodos , Humanos , Madagáscar , Masculino , Pessoa de Meia-Idade , Valores de Referência , Caracteres Sexuais , População Branca
4.
Arch Inst Pasteur Madagascar ; 69(1-2): 57-62, 2003.
Artigo em Francês | MEDLINE | ID: mdl-15678818

RESUMO

Anopheles mascarensis has been demonstrated to be a vector of human malaria in the East coast of Madagascar. Here, we present original data obtained from 1996 to 2003 on the distribution, biology and vectorial capacity of An. mascarensis in the Middle-West of Madagascar. This species is consistently exophilic both for its trophic and resting behaviour. This accounts for the absence of clear impact of any indoor insecticide spraying. This species is mainly zoophilic, but can occasionally bite humans, which explains a low sporozoitic index (1/2218 = 0.045%). The densities of human landing mosquitoes are most of the time very low, with the exception of a peak between May and August at the beginning of the dry season. It implies that the vector's efficiency is very low but not insignificant in the Middle-West of Madagascar, a situation opposite to what is observed on the East coast. The vectorial efficiency of An. mascarensis and An. arabiensis would enable to maintain a low malarial endemicity in the Middle-West, even in the complete absence of An. funestus.


Assuntos
Anopheles/parasitologia , Doenças Endêmicas/estatística & dados numéricos , Insetos Vetores/parasitologia , Malária/epidemiologia , Altitude , Animais , Anopheles/classificação , Anopheles/patogenicidade , Anopheles/fisiologia , Clima , Ensaio de Imunoadsorção Enzimática , Comportamento Alimentar/fisiologia , Humanos , Insetos Vetores/classificação , Insetos Vetores/patogenicidade , Insetos Vetores/fisiologia , Longevidade , Estudos Longitudinais , Madagáscar/epidemiologia , Malária/parasitologia , Malária/prevenção & controle , Malária/transmissão , Controle de Mosquitos , Densidade Demográfica , Vigilância da População , Características de Residência , Estações do Ano
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