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Guillochon E, Fraering J, Joste V, Kamaliddin C, Vianou B, Houzé L, Baudrin LG, Faucher JF, Aubouy A, Houzé S, Cot M, Argy N, Taboureau O, Bertin GI. OUP accepted manuscript. J Infect Dis 2022; 225:2187-2196. [PMID: 35255125 PMCID: PMC9200161 DOI: 10.1093/infdis/jiac086] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Cerebral malaria (CM) is the severest form of Plasmodium falciparum infection. Children under 5 years old are those most vulnerable to CM, and they consequently have the highest risk of malaria-related death. Parasite-associated factors leading to CM are not yet fully elucidated. We therefore sought to characterize the gene expression profile associated with CM, using RNA sequencing data from 15 CM and 15 uncomplicated malaria isolates from Benin. Cerebral malaria parasites displayed reduced circulation times, possibly related to higher cytoadherence capacity. Consistent with the latter, we detected increased var genes abundance in CM isolates. Differential expression analyses showed that distinct transcriptome profiles are signatures of malaria severity. Genes involved in adhesion, excluding variant surface antigens, were dysregulated, supporting the idea of increased cytoadhesion capacity of CM parasites. Finally, we found dysregulated expression of genes in the entry into host pathway that may reflect greater erythrocyte invasion capacity of CM parasites.
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Affiliation(s)
- E Guillochon
- Université Paris Cité, MERIT, IRD, Paris, France
- Université Paris Cité, INSERM U1133, CNRS UMR 8251, Paris, France
| | - J Fraering
- Université Paris Cité, MERIT, IRD, Paris, France
| | - V Joste
- Université Paris Cité, MERIT, IRD, Paris, France
- Parasitology Laboratory, Hôpital Bichat - Claude-Bernard, APHP, Paris, France
- French Malaria Reference Center, Hôpital Bichat, APHP, Paris, France
| | - C Kamaliddin
- Cumming School of Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - B Vianou
- Université Paris Cité, MERIT, IRD, Paris, France
- Institut de Recherche Clinique du Bénin, Cotonou, Bénin
| | - L Houzé
- Université Paris Cité, MERIT, IRD, Paris, France
| | - L G Baudrin
- Institut Curie Genomics of Excellence Platform, PSL Research University, Research Center, Institut Curie, Paris, France
| | - J F Faucher
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - A Aubouy
- Université de Toulouse, PHARMADEV, IRD, UPS, Toulouse, France
| | - S Houzé
- Université Paris Cité, MERIT, IRD, Paris, France
- Parasitology Laboratory, Hôpital Bichat - Claude-Bernard, APHP, Paris, France
- French Malaria Reference Center, Hôpital Bichat, APHP, Paris, France
| | - M Cot
- Université Paris Cité, MERIT, IRD, Paris, France
| | - N Argy
- Université Paris Cité, MERIT, IRD, Paris, France
- Parasitology Laboratory, Hôpital Bichat - Claude-Bernard, APHP, Paris, France
- French Malaria Reference Center, Hôpital Bichat, APHP, Paris, France
| | - O Taboureau
- Université Paris Cité, INSERM U1133, CNRS UMR 8251, Paris, France
| | - G I Bertin
- Correspondence: Gwladys I. Bertin, PhD, Université Paris Cité, MERIT, IRD, 4 avenue de l’Observatoire, 75006 Paris, France ()
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Bonnet J, Ducroix-Roubertou S, Rogez S, Ajzenberg D, Courtioux B, Faucher JF. [Sleeping Sickness: A Cause of False Positive HIV Rapid Diagnostic Tests]. Med Trop Sante Int 2021; 1:mtsibulletin.2021.115. [PMID: 35586587 PMCID: PMC9022761 DOI: 10.48327/mtsibulletin.2021.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022]
Abstract
Approaching the mechanisms related to false positives HIV rapid diagnostic tests (RDT) in patients with sleeping sickness may help to improve the accuracy of screening for HIV infection in areas endemic for Human African trypanosomiasis (HAT).We report on a patient from Congo who was managed like an AIDS-associated meningoencephalitis, based on a false positive HIV RDT at admission, and eventually received a diagnosis of sleeping sickness. A further retrospective cohort study performed in patients with HAT shows that most of positive HIV RDT obtained prior to treatment for sleeping sickness are false positives. We found that half of them were cleared at the end of treatment course, suggesting an early clearance of some antibodies involved in cross-reactivity.A substantial clearance of HIV RDT false positives occurs during therapy for HAT. In areas where Elisa HIV tests are not readily available, repeating the HIV RDT at the end of therapy may help to identify roughly half of false positives.
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Affiliation(s)
- J. Bonnet
- Université de Limoges, U1094, Neuroépidémiologie tropicale, Institut d'épidémiologie et de neurologie tropicale, GEIST, Limoges, France
| | - S. Ducroix-Roubertou
- Service des maladies infectieuses et tropicales, Centre hospitalier universitaire de Limoges, Limoges, France
| | - S. Rogez
- Service de bacte?riologie, virologie, hygie?ne, Centre hospitalier universitaire de Limoges, Limoges, France
| | - D. Ajzenberg
- Université de Limoges, U1094, Neuroépidémiologie tropicale, Institut d'épidémiologie et de neurologie tropicale, GEIST, Limoges, France.,Service de parasitologie-mycologie, Centre hospitalier universitaire de Limoges, Limoges, France
| | - B. Courtioux
- Université de Limoges, U1094, Neuroépidémiologie tropicale, Institut d'épidémiologie et de neurologie tropicale, GEIST, Limoges, France
| | - J.-F. Faucher
- Université de Limoges, U1094, Neuroépidémiologie tropicale, Institut d'épidémiologie et de neurologie tropicale, GEIST, Limoges, France.,Service des maladies infectieuses et tropicales, Centre hospitalier universitaire de Limoges, Limoges, France,*
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Epelboin L, Rapp C, Faucher JF, Méchaï F, Bottieau E, Matheron S, Malvy D, Caumes E. Management and treatment of uncomplicated imported malaria in adults. Update of the French malaria clinical guidelines. Med Mal Infect 2019; 50:194-212. [PMID: 31493957 DOI: 10.1016/j.medmal.2019.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 07/11/2019] [Indexed: 12/25/2022]
Affiliation(s)
- L Epelboin
- Unité des maladies infectieuses et tropicales, centre hospitalier Andrée Rosemon, avenue des Flamboyants, 97300 Cayenne, French Guiana.
| | - C Rapp
- Hôpital Américain de Paris, 63, boulevard Victor Hugo, 92200 Neuilly, France; Hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94163 Saint-Mandé, France
| | - J F Faucher
- Service des maladies infectieuses et tropicales and UMR 1094, CHU Dupuytren 2, 87042 Limoges, France
| | - F Méchaï
- Service des maladies infectieuses et tropicales, hôpital Avicenne, 93000 Bobigny, France
| | - E Bottieau
- Institute of tropical medicine, Antwerp, Belgium
| | - S Matheron
- Service des maladies infectieuses et tropicales, CHU Bichat - Claude Bernard, 75018 Paris, France
| | - D Malvy
- Service des maladies infectieuses et tropicales, CHU Bordeaux, 33000 Bordeaux France
| | - E Caumes
- Hôpital Pitié-Salpêtrière, 43-87, boulevard de l'Hôpital, 75013 Paris, France
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Foré R, Codde C, Aslanbekova N, Devo N, Genet C, Faucher J, Ly K. Pan-uvéite et vascularite rétinienne chez un patient immunodéprimé atteint de myosite inflammatoire : l’interrogatoire fait le diagnostic ! Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Argy N, Bertin G, Milet J, Hubert V, Clain J, Cojean S, Houzé P, Tuikue-Ndam N, Kendjo E, Deloron P, Houzé S, Matheron S, Casalino E, Wolff M, Delaval A, Agnamey P, Durand R, Pilo J, Rapp C, Faucher J, Cuisenier B, Poilane I, Bemba D, Roide A, Debourgogne A, Thibault M, Toubas D, Patoz P, De Gentile L, Pons D, Hurst J, Lohmann C, Bigel M, Godineau N, Thouvenin M, Dunand J, Ait-Ammar N, Angoulvant A, Dahane N, Lefevre M, Murat J, Garnaud C, Dannaoui E, Botterel F, Dutoit E, Dardé M, Ichou H, Branger C, Penn P, Angebault C, Morio F, Bret L, Thellier M, Mouri O, Cateau E, Siriez J, Fenneteau O, Revest M, Belaz S, Belkadi G, Hamane S, Bretagne S, Aboubacar A, Leloup G, Develoux M, Lapillonne H, Eloy O, Nevez G, Raffenot D, Buret B, Desoubeaux G, Goepp A. Preferential expression of domain cassettes 4, 8 and 13 of Plasmodium falciparum erythrocyte membrane protein 1 in severe malaria imported in France. Clin Microbiol Infect 2017; 23:211.e1-211.e4. [DOI: 10.1016/j.cmi.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 10/06/2016] [Accepted: 10/12/2016] [Indexed: 11/25/2022]
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Faucher JF, Chirouze C, Hoen B, Leroy J, Hustache-Mathieu L, Estavoyer JM. L-14: Traitements courts par ceftriaxone dans la leptospirose : étude rétrospective monocentrique. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70229-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Estavoyer J, Chirouze C, Faucher J, Floret N, Couetdic G, Leroy J, Hoen B. Leptospirosis in Franche-Comté (FRANCE): Clinical, biological, and therapeutic data. Med Mal Infect 2013; 43:379-85. [DOI: 10.1016/j.medmal.2013.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 05/28/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
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Faucher JF, Missinou MA, Brasseur P. [Treatment of pediatric malaria in Africa: act at issue]. Med Trop (Mars) 2006; 66:292-4. [PMID: 16924825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Artemisinin-based combination therapies (ACT) have been proposed as alternatives to currently used antimalarials and are poised large-scale deployment in Africa. These combinations are particularly attractive for managing malaria in children. Expected benefits of ACT include enhanced efficacy, rapid action, stabilized antimalarial resistance growth and lower malaria transmission. This article discusses what can be reasonably expected of ACT in an African setting with emphasis on patient comfort.
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Affiliation(s)
- J F Faucher
- Service des maladies infectieuses et tropicales, CHU de Besançon, France.
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Bard E, Khayatt N, Faucher JF, Dufour V, Slimane M, Estavoyer JM, Meillet D. A-21 La lactoferrine fécale: Indices de performance du leuko-test® pour l'orientation étiologique des gastro-entérites aiguës (GEA) de l'enfant. Med Mal Infect 2004. [DOI: 10.1016/s0399-077x(04)90116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Adjuik M, Agnamey P, Babiker A, Borrmann S, Brasseur P, Cisse M, Cobelens F, Diallo S, Faucher JF, Garner P, Gikunda S, Kremsner PG, Krishna S, Lell B, Loolpapit M, Matsiegui PB, Missinou MA, Mwanza J, Ntoumi F, Olliaro P, Osimbo P, Rezbach P, Some E, Taylor WRJ. Amodiaquine-artesunate versus amodiaquine for uncomplicated Plasmodium falciparum malaria in African children: a randomised, multicentre trial. Lancet 2002; 359:1365-72. [PMID: 11978332 DOI: 10.1016/s0140-6736(02)08348-4] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Increasing drug resistance limits the choice of efficacious chemotherapy against Plasmodium falciparum malaria in Africa. Amodiaquine still retains efficacy against P falciparum in many African countries. We assessed the safety, treatment efficacy, and effect on gametocyte carriage of adding artesunate to amodiaquine in three randomised trials in Kenya, Sénégal, and Gabon. METHODS We enrolled 941 children (400 in Kenya, 321 in Sénégal, and 220 in Gabon) who were 10 years or older and who had uncomplicated P falciparum malaria. Patients were randomly assigned amodiaquine (10 mg/kg per day for 3 days) plus artesunate (4 mg/kg per day for 3 days) or amodiaquine (as above) and placebo (for 3 days). The primary endpoints were parasitological cure rates at days 14 and 28. Analysis was by intention to treat and by an evaluability method. FINDINGS Both regimens were well tolerated. Six patients in the amodiaquine-artesunate group and five in the amodiaquine group developed early, drug-induced vomiting, necessitating alternative treatment. By intention-to-treat analysis, the day-14 cure rates for amodiaquine-artesunate versus amodiaquine were: 175/192 (91%) versus 140/188 (74%) in Kenya (D=16.7% [95% CI 9.3-24.1], p<0.0001), 148/160 (93%) versus 147/157 (94%) in Sénégal (-1.1% [-6.7 to 4.5], p=0.7), and 92/94 (98%) versus 86/96 (90%) in Gabon (8.3% [1.5-15.1], p=0.02). The corresponding rates for day 28 were: 123/180 (68%) versus 75/183 (41%) in Kenya (27.3% [17.5-37.2], p<0.0001), 130/159 (82%) versus 123/156 (79%) in Sénégal (2.9% [-5.9 to 11.7], p=0.5), and 80/94 (85%) versus 70/98 (71%) in Gabon (13.7% [2.2-25.2], p=0.02). Similar rates were obtained by evaluability analysis. INTERPRETATION The combination of artesunate and amodiaquine improved treatment efficacy in Gabon and Kenya, and was equivalent in Sénégal. Amodiaquine-artesunate is a potential combination for use in Africa. Further investigations to assess the potential effect on the evolution of drug resistance, disease transmission, and safety of amodiaquine-artesunate are warranted.
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Affiliation(s)
- M Adjuik
- Navrongo Health Research Centre, Navrongo, Ghana
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Borrmann S, Szlezák N, Faucher JF, Matsiegui PB, Neubauer R, Binder RK, Lell B, Kremsner PG. Artesunate and praziquantel for the treatment of Schistosoma haematobium infections: a double-blind, randomized, placebo-controlled study. J Infect Dis 2001; 184:1363-6. [PMID: 11679932 DOI: 10.1086/324004] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2001] [Revised: 07/20/2001] [Indexed: 11/03/2022] Open
Abstract
Recently, artemisinin derivatives have been shown to be efficacious in chemoprophylaxis of and chemotherapy for Schistosoma japonicum and S. mansoni infections. Therefore, a double-blind, randomized, placebo-controlled study was carried out to investigate the efficacy and tolerability of artesunate plus placebo and the combination of artesunate and praziquantel in the treatment of S. haematobium infections in Gabon. The 300 infected schoolchildren included in the study were randomized to receive artesunate plus placebo (n=90), praziquantel plus placebo (n=90), artesunate and praziquantel (n=90), or only placebo (n=30). End points were efficacy, assessed as cure on day 56, and tolerability. All treatment regimens were well tolerated. The praziquantel plus placebo-treated group attained a cure rate of 73%, artesunate plus placebo a rate of 27%, the combination of artesunate and praziquantel a rate of 81%, and placebo alone a rate of 20%. In summary, earlier findings of efficacy of artemisinin derivitives against S. mansoni and S. japonicum could not be confirmed in S. haematobium infections.
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Affiliation(s)
- S Borrmann
- Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.
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Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG. Comparison of methods for the rapid laboratory assessment of children with malaria. Am J Trop Med Hyg 2001; 65:599-602. [PMID: 11716121 DOI: 10.4269/ajtmh.2001.65.599] [Citation(s) in RCA: 169] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rapid diagnosis and accurate quantification of Plasmodium falciparum parasitemia are important for the management of malaria. The assessment of disease severity also depends on evaluation of metabolic indexes such as blood glucose and lactate concentrations. Here we describe an accurate and rapid alternative to conventional thick film examination (Lambaréné method). We also assess near-patient methods for measuring blood glucose (OneTouch) and lactate (Accusport). The accuracy of the Lambaréné method is similar to that of thin films. Results from the OneTouch glucose meter also are in good agreement with a YSI 2300 reference meter. Overall, the Accusport lactate meter agrees poorly with the YSI 2300 reference meter. However, the sensitivity and specificity to detect hyperlactatemia (blood lactate > or = 5 mmol/L) are 0.94 and 0.98, respectively.
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Affiliation(s)
- T Planche
- Department of Infectious Diseases, St. George's Hospital Medical School, London, United Kingdom
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Luty AJ, Bongartz M, Rezbach P, Faucher JF, Hollingdale MR, Kremsner PG. Plasmodium falciparum liver-stage antigen-1 peptide-specific interferon-gamma responses are not suppressed during uncomplicated malaria in African children. Eur Cytokine Netw 2001; 12:647-53. [PMID: 11781192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Liver-stage antigen (LSA)-1 is a candidate vaccine molecule for Plasmodium falciparum malaria, but knowledge of the evolution of naturally acquired immune responses to LSA-1 in African children is lacking. We therefore assessed cellular immune responses to two defined T cell epitopes of LSA-1, during and after uncomplicated P. falciparum malaria in a group of Gabonese children. In terms of their prevalence, interferon (IFN)-gamma responses of peripheral blood mononuclear cells (PBMC) to an LSA-1 N-terminal peptide, T1, were significantly higher when measured during the acute phase compared with convalescence. IFN-gamma responses to the LSA-J (hinge region) peptide showed a similar profile, but at a lower prevalence. Depletion experiments confirmed that CD8+ T cells are a major source of peptide-driven IFN-gamma, but both lymphoproliferation and the production of IL-10 in response to either of the peptides was low in all children at all times. PBMC from 25% of the children failed to produce IFN-gamma in response to either peptide at any time-point. The results suggest that lymphocytes producing IFN-gamma in response to at least one T cell epitope of LSA-1 are most frequent in the peripheral circulation during the acute phase of P. falciparum malaria. Thus, in this case, the generalised suppression of cell-mediated responses which characterises acute malaria does not affect liver-stage antigen-specific IFN-gamma production. These findings imply that measurements of the frequency of parasite antigen-specific cellular immune responses in clinically healthy individuals may represent significant underestimations, which has important implications for the design of field-based vaccine antigen-related studies.
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Affiliation(s)
- A J Luty
- Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Wilhelmstrasse 27, 72074 Tübingen, Germany.
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Abstract
BACKGROUND Tafenoquine is an analogue of primaquine with an improved therapeutic and safety profile. It has a long half-life and activity against liver-stage malaria parasites, so may be useful for chemoprophylaxis. In this randomised, double-blind study we assessed the efficacy and safety of tafenoquine in different doses. METHODS 2144 individuals aged 12-20 years living in Lambaréné, Gabon, an endemic area for Plasmodium falciparum malaria, were invited to take part. 535 attended, and 426 eligible participants were randomly assigned tafenoquine (250 mg, 125 mg, 62.5 mg, or 31.25 mg) or placebo daily for 3 days. 417 received initial curative treatment with halofantrine, and 410 completed the assigned prophylaxis regimen. During follow-up of 70 days, adverse events were recorded and thick blood smears were examined weekly. The primary and secondary endpoints were the number of individuals with positive blood smears by day 56 and day 77, respectively. Analyses were per-protocol. FINDINGS Eight positive blood smears were recorded by day 56 (four/82 participants in the placebo group; four/79 tafenoquine 31.25 mg group). By day 77, 34 positive blood smears had been recorded (14/82 placebo; 16/79 tafenoquine 31.25 mg; three/86 tafenoquine 62.5 mg; one/79 tafenoquine 125 mg; none/84 tafenoquine 250 mg). Numbers of adverse events did not differ significantly between the treatment groups. INTERPRETATION Tafenoquine is effective and well tolerated. It has the potential to replace currently used drugs for malaria chemoprophylaxis.
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Affiliation(s)
- B Lell
- Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon
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Faucher JF, Abraham B, Segondy M, Jonquet O, Reynes J, Janbon F. [Acquired cytomegalovirus infections in immunocompetent adults: 116 cases]. Presse Med 1998; 27:1774-9. [PMID: 9850689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
OBJECTIVE To analyse retrospectively the clinical, biological and epidemiological features of cytomegalovirus (CMV) infection in the immunocompetent host. PATIENTS AND METHODS A retrospective study was conducted in 116 cases of CMV infection (74 inpatients, 42 out-patients) collected from 1981 to 1997 in a university hospital. Diagnostic was established on serological criteria in all cases. RESULTS Fever was observed in all cases but one (mean duration: 21 days). The most frequent symptoms were headache (51%) and myalgia (46%). Splenomegaly was the most frequent sign (36%). Pulmonary interstitial opacities on chest x-ray were found in 8.5% of patients. Pulmonary (1 case) and neurological (2 cases) complications occurred. Concomitant HIV primary infection was observed in 2 patients. Mononucleosis and ALAT and LDH elevations were observed in 95%, 85% and 95% of cases respectively. Viremia was positive in 79% (30/38). pp65 antigenemia was useful to establish the diagnosis in 9 patients. Antibiotics were prescribed in 46% before diagnosis was established. CONCLUSION CMV infection in the immunocompetent host is a frequent and rarely complicated disease. pp65 antigenemia should be evaluated more in this setting. Most hospitalizations due to this affection could be avoided.
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Affiliation(s)
- J F Faucher
- Service des Maladies infectieuses et tropicales, Hôpital Gui de Chauliac, Montpellier
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Faucher JF, Thiébaut MM, Reynes J, Janbon F. Unusual outcome of disseminated candidiasis treated with fluconazole: a matter of pharmacokinetics? Clin Infect Dis 1998; 26:197-8. [PMID: 9455541 DOI: 10.1086/517064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- J F Faucher
- Service des Maladies Infectieuses et Tropicales, Hôpital Gui de Chauliac, Montpellier, France
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Faucher J, Thiébaut M, Leclercq C, Reynes J, Janbon F. Quel traitement pour les infections rachidiennes à Candida albicans ? A propos de deux observations. Med Mal Infect 1997. [DOI: 10.1016/s0399-077x(97)80226-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Faucher J, Thiébaut M, Rivière S, Janbon F. Candidose profonde multifocale chez une immunocompétente: une observation. Rev Med Interne 1996. [DOI: 10.1016/s0248-8663(97)80995-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Faucher J, Leclercq C, Durant R, Simorre B, Reynes J, Janbon F. Abcès sous-cutanés révélant une aspergillose au cours du sida. Rev Med Interne 1996. [DOI: 10.1016/s0248-8663(97)81040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Monoclonal antibody (mAb) DION 5.1b, derived from mice immunized with Trypanosoma dionisii, recognizes a 72/76-kD surface glycoprotein specific to the epimastigote stage of T. dionisii and T. cruzi. None of the three other stages of the T. cruzi life cycle expresses any DION 5.1b-specific epitope. However, mAb DION 5.1b labels an intracellular form with "epimastigote-like" morphology that appears to be late and transient in the intracellular cycle. This result suggests that the morphological similarity between the observed "epimastigote-like" intracellular form in mammals and the epimastigote form in insects may extent to the antigenic pattern.
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Faucher JF, Pommereau A, Rigalleau V, Martin L, de Precigout V, Combe C, Aparicio M. Deux observations de purpura thrombotique thrombocytopénique induit par la ticlopidine. Rev Med Interne 1994. [DOI: 10.1016/s0248-8663(05)82812-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rigalleau V, Pommereau A, Faucher JF, de Précigout V, Martin L, Cittone S, Lasseur C, Rispal P, Martigne C, Aparicio M. Association thymome-syndrome néphrotique à lésions glomérulaires minimes. Rev Med Interne 1994. [DOI: 10.1016/s0248-8663(05)82647-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chanteau S, Glaziou P, Plichart C, Luquiaud P, Plichart R, Faucher JF, Cartel JL. Low predictive value of PGL-I serology for the early diagnosis of leprosy in family contacts: results of a 10-year prospective field study in French Polynesia. Int J Lepr Other Mycobact Dis 1993; 61:533-41. [PMID: 8151183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
In 1983, a cohort study to follow up the family contacts of leprosy cases was implemented in French Polynesia to assess the usefulness and applicability of phenolic glycolipid-I (PGL-I) serology in a leprosy control program. A total of 1201 contacts (666 females, 535 males) have been included in the study. The IgM anti-PGL-I seroprevalence determined on the initial sera was 17%. It was significantly higher among females than males (20% vs 15%, p = 0.02). From 1983 to 1992, 4 out of 204 (2%) anti-PGL-I seropositive contacts developed the disease (1 indeterminate, 1 BT, 1 BL, 1 LL) compared with 10 out of 997 (1%) seronegative contacts (4 indeterminate, 3 BT, 1 BB, 2 TT). Of these 10 patients, only 3 (2 indeterminate, 1 BT) converted to seropositivity when leprosy was diagnosed. The risk of developing leprosy was not significantly higher among seropositive than among seronegative groups (2% vs 1%, p = 0.2). A PGL-I circulating antigen test performed on 216 selected sera at entry into the trial showed a higher antigen prevalence when the antibody level was higher. PGL-I antigen was detectable in 5 of 12 patients tested prior to diagnosis (1 LL, 1 BL, 3 indeterminate). The median time to externalize the disease was not significantly different among antibody-positive and -negative contacts (17 vs 25 months, p = 0.3). The relative risk of developing leprosy for contact individuals was 30.8 times that of noncontacts, and 15% of the total new cases detected between 1983 and 1992 emerged from the study population.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S Chanteau
- Institut de Recherches Médicales Louis Malardé, Papéete, Tahiti, French Polynésia
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