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Pouquet M, Decarreaux D, Di Domenico L, Sabbatini CE, Prévot-Monsacre P, Fourié T, Villarroel PMS, Priet S, Blanché H, Sebaoun JM, Deleuze JF, Turbelin C, Rossignol L, Werner A, Kochert F, Grosgogeat B, Rabiega P, Laupie J, Abraham N, Noël H, van der Werf S, Colizza V, Carrat F, Charrel R, de Lamballerie X, Blanchon T, Falchi A. SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave. Sci Rep 2024; 14:5418. [PMID: 38443618 PMCID: PMC10914718 DOI: 10.1038/s41598-024-55477-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Data on the SARS-CoV-2 infection among primary health care workers (PHCWs) are scarce but essential to reflect on policy regarding prevention and control measures. We assessed the prevalence of PHCWs who have been infected by SARS-CoV-2 in comparison with modeling from the general population in metropolitan France, and associated factors. A cross-sectional study was conducted among general practitioners (GPs), pediatricians, dental and pharmacy workers in primary care between May and August 2021. Participants volunteered to provide a dried-blood spot for SARS-CoV-2 antibody assessment and completed a questionnaire. The primary outcome was defined as the detection of infection-induced antibodies (anti-nucleocapsid IgG, and for non-vaccinees: anti-Spike IgG and neutralizing antibodies) or previous self-reported infection (positive RT-qPCR or antigenic test, or positive ELISA test before vaccination). Estimates were adjusted using weights for representativeness and compared with prediction from the general population. Poisson regressions were used to quantify associated factors. The analysis included 1612 PHCWs. Weighted prevalences were: 31.7% (95% CI 27.5-36.0) for GPs, 28.7% (95% CI 24.4-33.0) for pediatricians, 25.2% (95% CI 20.6-31.0) for dentists, and 25.5% (95% CI 18.2-34.0) for pharmacists. Estimates were compatible with model predictions for the general population. PHCWs more likely to be infected were: GPs compared to pharmacist assistants (adjusted prevalence ratio [aPR] = 2.26; CI 95% 1.01-5.07), those living in Île-de-France (aPR = 1.53; CI 95% 1.14-2.05), South-East (aPR = 1.57; CI 95% 1.19-2.08), North-East (aPR = 1.81; CI 95% 1.38-2.37), and those having an unprotected contact with a COVID-19 case within the household (aPR = 1.48; CI 95% 1.22-1.80). Occupational factors were not associated with infection. In conclusion, the risk of SARS-CoV-2 exposure for PHCWs was more likely to have occurred in the community rather than at their workplace.
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Affiliation(s)
- Marie Pouquet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France.
| | - Dorine Decarreaux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Laura Di Domenico
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Pol Prévot-Monsacre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Toscane Fourié
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | - Stephane Priet
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | | | | | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Andréas Werner
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Fabienne Kochert
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Brigitte Grosgogeat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
- Service d'Odontologie, Hospices Civils de Lyon, 69007, Lyon, France
| | | | - Julien Laupie
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
| | | | - Harold Noël
- Infectious Diseases Division, Santé Publique France, 94410, Saint Maurice, France
| | - Sylvie van der Werf
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Molecular Genetics of RNA Viruses Unit, 75015, Paris, France
- Institut Pasteur, Université Paris Cité, National Reference Center for Respiratory Viruses, 75015, Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Département de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Sorbonne Université, 75012, Paris, France
| | - Remi Charrel
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
- LE Service de Prévention du Risque Infectieux (LESPRI), CLIN AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Xavier de Lamballerie
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Alessandra Falchi
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
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Prévot-Monsacré P, Hamaide-Defrocourt F, Guyonvarch O, Masse S, Souty C, Mamou T, Hamel J, Antona D, Mathieu P, Vasseur P, Lévy-Bruhl D, Baroux N, Rossignol L, Vaillant L, Guerrisi C, Hanslik T, Dina J, Blanchon T. What is the relevancy of a surveillance of mumps without a systematic laboratory confirmation in highly immunized populations? Epidemiology of suspected and biologically confirmed mumps cases seen in general practice in France between 2014 and 2020. Vaccine 2024; 42:1065-1070. [PMID: 38092609 DOI: 10.1016/j.vaccine.2023.12.017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 11/17/2023] [Accepted: 12/03/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND In France, mumps surveillance is conducted in primary care by the Sentinelles network, the National Reference Centre for Measles, Mumps and Rubella and Santé publique France. AIM The objective of this study was to estimate the incidence of suspected mumps in general practice, the proportion of laboratory confirmed cases and the factors associated with a virological confirmation. METHODS General practitioners (GPs) participating in the Sentinelles network should report all patients with suspected mumps according to a clinical definition in case of parotitis and a serological definition in case of clinical expression without parotitis. All suspected mumps cases reported between January 2014 and December 2020 were included. A sample of these cases were tested by real time reverse transcriptase polymerase chain reaction (RT-PCR) for mumps biological confirmation. RESULTS A total of 252 individuals with suspected mumps were included in the study. The average annual incidence rate of suspected mumps in general practice in France between 2014 and 2020 was estimated at 11 cases per 100,000 population [CI95%: 6-17]. A mumps confirmation RT-PCR test was performed on 146 cases amongst which 17 (11.5 %) were positive. Age (between 20 and 29 years old), the presence of a clinical complication and an exposure to a suspected mumps case within the 21 days prior the current episode were associated with a mumps biological confirmation. CONCLUSION If these results confirm the circulation of mumps virus in France, they highlight the limits of a surveillance without a systematic laboratory confirmation in highly immunized populations.
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Affiliation(s)
- Pol Prévot-Monsacré
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Florent Hamaide-Defrocourt
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Ophélie Guyonvarch
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Shirley Masse
- Laboratoire de Virologie, UR7310, Université de Corse Pascal Paoli, 20250 Corte, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Thomas Mamou
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Justine Hamel
- Normandie Université, UNICAEN, INSERM UMR1311, National Reference Center for Measles, Mumps and Rubella, CHU Caen, Virology Department, Caen, France
| | - Denise Antona
- Direction des maladies infectieuses, Santé publique France, Saint-Maurice, France
| | - Pauline Mathieu
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Pauline Vasseur
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Daniel Lévy-Bruhl
- Direction des maladies infectieuses, Santé publique France, Saint-Maurice, France
| | - Noémie Baroux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France; Département de Médecine Générale, Université Paris Cité, F75018 Paris, France
| | - Laetitia Vaillant
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France; Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, APHP, Boulogne Billancourt, France; Université Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine Simone Veil, Versailles, France
| | - Julia Dina
- Normandie Université, UNICAEN, INSERM UMR1311, National Reference Center for Measles, Mumps and Rubella, CHU Caen, Virology Department, Caen, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, F75012 Paris, France.
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Tron A, Schlegel V, Pinot J, Bruel S, Ecollan M, Bel JL, Rossignol L, Gauchet A, Gagneux-Brunon A, Mueller J, Banaszuk AS, Thilly N, Gilberg S, Partouche H. Barriers and facilitators to the HPV vaccine: a multicenter qualitative study of French general practitioners. Arch Public Health 2024; 82:2. [PMID: 38178269 PMCID: PMC10768163 DOI: 10.1186/s13690-023-01227-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In France, human papillomavirus (HPV) vaccination coverage is low, with 30.7% of 17-year-old girls having received a complete HPV vaccination schedule in 2020. AIM To determine the perspective and behaviors of general practitioners (GPs) regarding HPV vaccination with their patients and if a reluctance is observed. DESIGN AND SETTING A qualitative study based on semi-directed individual interviews was conducted between December 2019 and December 2020. A representative sample of GPs with various profiles were included in 4 French regions. METHOD A purposive sampling was used and interviews were continued until data saturation was reached. The analysis was based on the grounded theory. RESULTS Twenty-six GPs aged 29-66 years were interviewed. The measures taken by the French health authorities (lowering the target age, reimbursing the vaccine, extending the target population to boys) were perceived as facilitators. The reported barriers were organizational, due to low attendance of adolescents, and relational, mainly due to parental vaccine hesitancy. Physicians had to deal with fears about the perceived risks and concerns about sexuality conveyed by HPV vaccination and linked to the socio-cultural characteristics of the families. Physicians developed strategies, including scientific knowledge mobilization, empowerment of families by promoting health through prevention, repetition of the vaccination proposals, personal experience and relationship. Different practices were identified according to three GP typologies: effective, convinced but unpersuasive, and reluctant physicians. CONCLUSION Based on these results, specific interventions, including communication techniques, especially for hesitant or unpersuasive physicians, are needed to enable GPs to become more effective.
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Affiliation(s)
- Arthur Tron
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France.
| | - Vincent Schlegel
- Institut de recherche et de documentation en économie de la santé (IRDES), 117 bis rue Manin, Paris, 75019, France
| | - Juliette Pinot
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Sébastien Bruel
- Department of General Practice, Jacques Lisfranc Faculty of Medicine, Saint-Etienne-Lyon University, Saint-Etienne, France
- Univ Lyon, Université Claude Bernard Lyon 1, Lyon, P2S UR4129, F-69008, France
- CIC-INSERM 1408, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Marie Ecollan
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Josselin Le Bel
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Louise Rossignol
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Aurélie Gauchet
- Laboratory of Psychology, University Grenoble Alps, Grenoble, France
| | - Amandine Gagneux-Brunon
- CIC-INSERM 1408, Saint-Etienne University Hospital, Saint-Etienne, France
- Centre International de Recherche en Infectiologie, Team GIMAP, Univ Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR530, Lyon, France
| | - Judith Mueller
- EHESP French School of Public Health, Institut Pasteur, Paris cedex 15, Paris, France
| | - Anne-Sophie Banaszuk
- Centre régional de Coordination des Dépistages des Cancers-Pays de la Loire, 5 rue des Basses Fouassières, Angers, 49000, France
| | - Nathalie Thilly
- Université de Lorraine, APEMAC, Nancy, F-54000, France
- Département Méthodologie, Promotion, Investigation, Université de Lorraine, CHRU-Nancy, Nancy, F-54000, France
| | - Serge Gilberg
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
| | - Henri Partouche
- Faculté de Santé, Département de médecine générale, Université de Paris, UFR de Médecine - Site Cochin, 24, rue du Faubourg Saint-Jacques, Paris, F-75014, France
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Souty C, Vilcu AM, Conte C, Saint-Salvi B, Sarazin M, Rossignol L, Blanchon T, Hanslik T, Lapeyre-Mestre M, Steichen O. Risk of hospitalisation for serious colchicine intoxication after concomitant exposure to pristinamycin: A nationwide healthcare database study. Therapie 2023; 78:769-772. [PMID: 36639292 DOI: 10.1016/j.therap.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Cécile Souty
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France
| | - Ana-Maria Vilcu
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France
| | - Cécile Conte
- Université de Toulouse 3, service de pharmacologie médicale et clinique, CIC 1436, 31000 Toulouse, France
| | - Béatrice Saint-Salvi
- Agence nationale de sécurité du médicament et des produits de santé, 93210 Saint-Denis, France
| | - Marianne Sarazin
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France
| | - Louise Rossignol
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France; Université de Paris, département de médecine générale, 75000 Paris, France
| | - Thierry Blanchon
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France
| | - Thomas Hanslik
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France; Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de médecine, 78000 Versailles, France; Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Ambroise Paré, service de médecine interne, 92100 Boulogne Billancourt, France
| | - Maryse Lapeyre-Mestre
- Université de Toulouse 3, service de pharmacologie médicale et clinique, CIC 1436, 31000 Toulouse, France
| | - Olivier Steichen
- Sorbonne université, Inserm, Institut Pierre-Louis d'épidémiologie et de santé publique, 75000 Paris, France; Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Tenon, service de médecine interne, 4, rue de la Chine, 75020 Paris, France.
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5
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Gosselin L, Vilcu AM, Souty C, Steichen O, Launay T, Conte C, Saint-Salvi B, Turbelin C, Sarazin M, Blanchon T, Hanslik T, Lapeyre-Mestre M, Rossignol L. Prevalence and bleeding risk associated with the concomitant use of direct oral anticoagulants and antiarrhythmic drugs in patients with atrial fibrillation, based on the French healthcare insurance database. Eur J Clin Pharmacol 2023:10.1007/s00228-023-03501-8. [PMID: 37184597 DOI: 10.1007/s00228-023-03501-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE Pharmacokinetic interactions exist between apixaban or rivaroxaban, and CYP3A4 and P-glycoprotein inhibitors such as amiodarone, verapamil and diltiazem. We aimed to estimate the prevalence of exposure to this drug-drug association (DDA) and to assess the bleeding risk associated in patients with atrial fibrillation (AF). METHODS We conducted a cohort study using a representative 1/97th sample of the French healthcare insurance database between 2014 and 2019. Patients with AF receiving apixaban or rivaroxaban were included and followed-up until hospitalization for bleeding, death, discontinuation of apixaban or rivaroxaban, exposure to strong CYP3A4 inhibitor, or until December 31st 2019, whichever came first. Primary outcome was hospitalization for bleeding registered as primary diagnosis. The association between the exposure to the DDA and hospitalization for bleeding was evaluated as a time-dependent variable in Cox model. RESULTS Between 2014 and 2019, the AF population under apixaban or rivaroxaban represented 10,392 patients. During the study period, the annual average prevalence of DDA exposure in this population was 38.9%. Among the 10,392 patients, 223 (2.1%) were hospitalized for bleeding, of which 75 (33.6%) received the association and 148 (66.4%) received apixaban or rivaroxaban alone. There was no association between DDA exposure and risk of hospitalization for bleeding (aHR = 1.19, [95% CI: 0.90, 1.58]). Age (HR 1.03 [1.02, 1.05]) and male gender (HR 1.72 [1.28, 2.30]) were associated with an increased risk of hospitalization for bleeding. CONCLUSION Exposure to antiarrhythmic drugs was not associated with an increased risk of hospitalization for bleeding in patients with AF under rivaroxaban or apixaban.
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Affiliation(s)
- Laëtitia Gosselin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France.
- Département de Médecine Générale, Université Paris Cité, Paris, France.
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Olivier Steichen
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
- Assistance Publique - Hôpitaux de Paris (APHP), hôpital Tenon, Service de Médecine Interne, Paris, France
| | - Titouan Launay
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Cécile Conte
- INSERM, Université de Toulouse, Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Béatrice Saint-Salvi
- Agence National de Sécurité du Médicaments et des produits de santé, Saint-Denis, 93200, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Marianne Sarazin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
- Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, Versailles, France
- Assistance Publique - Hôpitaux de Paris (APHP), hôpital Ambroise Paré, Service de Médecine Interne, Boulogne Billancourt, France
| | - Maryse Lapeyre-Mestre
- INSERM, Université de Toulouse, Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique (IPLESP), Paris, France
- Département de Médecine Générale, Université Paris Cité, Paris, France
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6
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Villette C, Vasseur P, Lapidus N, Debin M, Hanslik T, Blanchon T, Steichen O, Rossignol L. Vegetarian and Vegan Diets: Beliefs and Attitudes of General Practitioners and Pediatricians in France. Nutrients 2022; 14:nu14153101. [PMID: 35956277 PMCID: PMC9370229 DOI: 10.3390/nu14153101] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023] Open
Abstract
Studies suggest a decreasing trend in the consumption of meat products and a growing interest in vegetarian diets. Medical support may be relevant, especially when switching to a vegan diet. Our objective was to describe the beliefs and attitudes of primary care physicians toward vegetarian diets. A cross-sectional survey was conducted among general practitioners and pediatricians thorough a questionnaire including socio-demographic characteristics, specific care to vegetarians, and the risks and benefits of vegetarian diets according to physicians. Out of the 177 participating physicians, 104 (59%) have seen at least one vegetarian patient in consultation in the last three months. Half of the physicians declared that they would dissuade their patients from switching to a vegan diet (n = 88, 51%) and 14% (n = 24) from switching to an ovo-lacto-vegetarian (OLV) diet. Most physicians (n = 141, 88%) did not feel informed enough about these diets. Physicians thought that the most frequent deficiencies for OLV and vegan diets were iron (76% and 84%, respectively) and protein (45% and 79%, respectively). These results highlight the fact that French primary care physicians feel concerned by this subject and need more information on these diets. Specific recommendations would be useful to support their practice and relationship with vegetarians.
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Affiliation(s)
- Cécile Villette
- Département de Médecine Générale, Université de Paris Cité, 16 rue Henri Huchard, F75018 Paris, France
| | - Pauline Vasseur
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
| | - Nathanael Lapidus
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
- Public Health Department, Saint-Antoine Hospital, AP-HP, Sorbonne Université, F75012 Paris, France
| | - Marion Debin
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
| | - Thomas Hanslik
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
- UFR Simone Veil-Santé, Université Versailles Saint Quentin en Yvelines, 55 Avenue de Paris, F78000 Versailles, France
- AP-HP, Hôpital Ambroise Paré, Service de Médecine Interne, 9 Avenue Charles de Gaulle, F92100 Boulogne Billancourt, France
| | - Thierry Blanchon
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
| | - Olivier Steichen
- AP-HP, Hôpital Tenon, Service de Médecine Interne, Sorbonne Université, 4 rue de la Chine, F75020 Paris, France
| | - Louise Rossignol
- Département de Médecine Générale, Université de Paris Cité, 16 rue Henri Huchard, F75018 Paris, France
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, IPLESP, 27 rue de Chaligny, F75012 Paris, France
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7
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Meci A, Du Breuil F, Vilcu A, Pitel T, Guerrisi C, Robard Q, Turbelin C, Hanslik T, Rossignol L, Souty C, Blanchon T. The Sentiworld project: global mapping of sentinel surveillance networks in general practice. BMC Prim Care 2022; 23:173. [PMID: 35836123 PMCID: PMC9281158 DOI: 10.1186/s12875-022-01776-x] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 06/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sentinel networks composed of general practitioners (GPs) represent a powerful tool for epidemiologic surveillance and ad-hoc studies. Globalization necesitates greater international cooperation among sentinel networks. The aim of this study was to inventory GP sentinel networks involved in epidemiological surveillance on a global scale. METHODS GP sentinel surveillance networks were inventoried globally between July 2016 and December 2019. Each identified network was required to fill out an electronic descriptive survey for inclusion. RESULTS A total of 148 networks were identified as potential surveillance networks in general practice and were contacted. Among them, 48 were included in the study. Geographically, 33 networks (68.8%) were located in Europe and 38 (79.2%) had national coverage. The number of GPs registered in these networks represented between 0.1 and 100% of the total number of GPs in the network's country or region, with a median of 2.5%. All networks were involved in continuous epidemiologic surveillance and 47 (97.9%) monitored influenza-like illness. Data collection methods were paper-based forms (n = 26, 55.3%), electronic forms on a dedicated website (n = 18, 38.3%), electronic forms on a dedicated software program (n = 14, 29.8%), and direct extraction from electronic medical records (n = 14, 29.8%). Along with this study, a website has been created to share all data collected. CONCLUSIONS This study represents the first global geographic mapping of GP sentinel surveillance networks. By sharing this information, collaboration between networks will be easier, which can strengthen the quality of international epidemiologic surveillance. In the face of crises like that of COVID-19, this is more imperative than ever before.
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Affiliation(s)
- Andrew Meci
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France.
| | - Florence Du Breuil
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Ana Vilcu
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Thibaud Pitel
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Caroline Guerrisi
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Quentin Robard
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Clément Turbelin
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Thomas Hanslik
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
- Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR Simone Veil - Santé, F78180, Montigny-le-Bretonneux, France
- Assistance Publique - Hôpitaux de Paris, APHP, Hôpital Ambroise Paré, Service de Médecine Interne, F92100, Boulogne-Billancourt, France
| | - Louise Rossignol
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
- Université de Paris, Faculté de Médecine, Département de médecine générale, Université Paris Diderot, F75018, Paris, France
| | - Cécile Souty
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
| | - Thierry Blanchon
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, IPLESP, UMRS 1136, Sorbonne Université, F75012, Paris, France
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8
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Debin M, Launay T, Rossignol L, Ait El Belghiti F, Brisse S, Guillot S, Guiso N, Levy-Bruhl D, Merdrignac L, Toubiana J, Blanchon T, Hanslik T. Pertussis surveillance results from a French general practitioner network, France, 2017 to 2020. Euro Surveill 2022; 27. [PMID: 35485270 PMCID: PMC9052767 DOI: 10.2807/1560-7917.es.2022.27.17.2100515] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Introduction In France, three complementary surveillance networks involving hospitals and paediatrician practices currently allow pertussis surveillance among infants (<1 year old) and children (1–12 years old). Data on incidences among adolescents (13–17 years old) and adults (≥ 18 years) are scarce. In 2017, a sentinel surveillance system called Sentinelles network, was implemented among general practitioners (GPs). Aim The purpose of Sentinelles network is to assess pertussis incidence, monitor the cases’ age distribution and evaluate the impact of the country’s vaccination policy. We present the results from the first 4 years of this surveillance. Methods GPs of the French Sentinelles network reported weekly numbers of epidemiologically or laboratory-confirmed cases and their characteristics. Results A total of 132 cases were reported over 2017–2020. Estimated national incidence rates per 100,000 inhabitants were 17 (95% confidence interval (CI): 12–22) in 2017, 10 (95% CI: 6–14) in 2018, 15 (95% CI: 10–20) in 2019 and three (95% CI: 1–5) in 2020. The incidence rate was significantly lower in 2020 than in 2017–2019. Women were significantly more affected than men (83/132; 63% of women, p = 0.004); 66% (87/132) of cases were aged 15 years or over (median age: 31.5 years; range: 2 months–87 years). Among 37 vaccinated cases with data, 33 had received the recommended number of doses for their age. Conclusions These results concur with incidences reported in other European countries, and with studies showing that the incidences of several respiratory diseases decreased in 2020 during the COVID-19 pandemic. The results also suggest a shift of morbidity towards older age groups, and a rapid waning of immunity after vaccination, justifying to continue this surveillance.
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Affiliation(s)
- Marion Debin
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France
| | - Titouan Launay
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France
| | - Louise Rossignol
- Université Paris Cité, Département de médecine générale, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France
| | | | - Sylvain Brisse
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens Unit, Paris, France.,Institut Pasteur, National Reference Center for Whooping Cough and other Bordetella Infections, Paris, France
| | - Sophie Guillot
- Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens Unit, Paris, France.,Institut Pasteur, National Reference Center for Whooping Cough and other Bordetella Infections, Paris, France
| | | | - Daniel Levy-Bruhl
- Santé publique France, Département des maladies infectieuses, Saint-Maurice, France
| | - Lore Merdrignac
- Epiconcept, Paris, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France
| | - Julie Toubiana
- Université Paris Cité, Service de Pédiatrie Générale et Maladies Infectieuses, Hôpital Necker -Enfants malades, Assistance Publique-Hôpitaux de Paris, AP-HP, Paris, France.,Institut Pasteur, Université Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens Unit, Paris, France.,Institut Pasteur, National Reference Center for Whooping Cough and other Bordetella Infections, Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France
| | - Thomas Hanslik
- Assistance Publique-Hôpitaux de Paris, AP-HP, Hôpital Ambroise Paré, Service de Médecine Interne, Boulogne Billancourt, Paris, France.,Université Versailles-Saint-Quentin-en-Yvelines, UVSQ, UFR des sciences de la santé Simone-Veil, Versailles, France.,Sorbonne Université, INSERM, Institut Pierre-Louis d'Épidémiologie et de santé publique, Paris, France
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9
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Paternoster M, Steichen O, Lapeyre-Mestre M, Blanchon T, Rossignol L, Vilcu AM, Launay T, Sarazin M, Bagheri H, Conte C, Turbelin C, Hanslik T, Souty C. Risk of bleeding associated with nonsteroidal anti-inflammatory drug use in patients exposed to antithrombotic therapy: a case-crossover study. J Clin Pharmacol 2021; 62:636-645. [PMID: 34787325 DOI: 10.1002/jcph.2003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/12/2021] [Indexed: 11/08/2022]
Abstract
Concomitant nonsteroidal anti-inflammatory drug (NSAIDs) and antithrombotic drug use is associated with an increased risk of bleeding, mainly gastrointestinal. The goal of this study was to quantify the transient increase in the risk of hospitalization for bleeding associated with NSAID use in patients treated with antiplatelet agents or anticoagulants. We performed an unidirectional case-crossover study using the EGB (Échantillon généraliste de bénéficiaires), a permanent random sample of the French nationwide health database. Patients receiving antithrombotic therapy and hospitalized for bleeding between 2009 and 2017 were included. We compared their NSAID exposure during a 15-day hazard window immediately prior to hospital admission to three earlier 15-day control windows. The risk of hospitalization for bleeding associated with the recent use of NSAIDs was estimated using conditional logistic regression to estimate odds ratios. During the study period, 33 patients treated with anticoagulants and 253 treated with antiplatelet agents received NSAIDs and were included in the case-crossover analysis. We found an increased risk of hospitalization for gastrointestinal bleeding after exposure to NSAIDs with an adjusted OR of 3.59 (95%CI, 1.58;8.17) in patients receiving anticoagulant therapy and 1.44 (95%CI, 1.07;1.94) in patients receiving antiplatelet therapy. The risk of non-gastrointestinal bleeding was also increased after exposure to NSAIDs with an adjusted OR of 2.72 (95%CI, 1.23;6.04) in patients exposed to anticoagulant therapy. The risk of gastrointestinal and non-gastrointestinal bleeding increases after NSAID use in patients treated with anticoagulants, while the risk of gastrointestinal bleeding increases, but to a lesser extent in those treated with antiplatelets. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Morgane Paternoster
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Olivier Steichen
- Sorbonne Université, INSERM, Université Paris 13, Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-santé, LIMICS, Paris, France.,Assistance Publique - Hôpitaux de Paris (APHP), hôpital Tenon, Service de Médecine Interne, Paris, France
| | - Maryse Lapeyre-Mestre
- INSERM, Université de Toulouse (LEASP UMR 1027), Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France.,Université de Paris, Département de Médecine Générale, Paris, France
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Titouan Launay
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Marianne Sarazin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Haleh Bagheri
- INSERM, Université de Toulouse (LEASP UMR 1027), Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Cécile Conte
- INSERM, Université de Toulouse (LEASP UMR 1027), Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France.,Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, Versailles, France.,Assistance Publique - Hôpitaux de Paris (APHP), hôpital Ambroise Paré, Service de Médecine Interne, Boulogne Billancourt, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
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10
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Hazard A, Fournier L, Rossignol L, Pelletier Fleury N, Hervé C, Pitel T, Pino C, Saint-Lary O, Hanslik T, Blanchon T, François M. A top 5 list for French general practice. BMC Fam Pract 2020; 21:161. [PMID: 32772925 PMCID: PMC7416409 DOI: 10.1186/s12875-020-01235-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/29/2020] [Indexed: 11/23/2022]
Abstract
Background Medical overuse is an issue that has recently gained attention. The “Choosing Wisely” campaign invited each specialty in each country to create its own top five lists of care procedures with a negative benefit-risk balance to promote dialogue between patients and physicians. This study aims to create such a list for French general practice. Methods A panel of general practitioners (GPs) suggested care procedures that they felt ought to be prescribed less. Using the Delphi method, a short list of those suggestions was selected. Systematic literature reviews were performed for each item on the short list. The results were presented to the panel to assist with the final selection of the top five list. Results The panel included 40 GPs. The list includes: i/ antibiotics prescription for acute bronchitis, nasopharyngitis, otitis media with effusion, or uncomplicated influenza, ii/ systematic prostate specific antigen testing in men older than 50, iii/ prescription of cholinesterase inhibitors for mild cognitive impairment and for Alzheimer’s disease and memantine for Alzheimer’s disease, iv/ statins prescription in primary prevention of cardio-vascular risk in older patients, and v/ benzodiazepine or benzodiazepine-like agents prescription for generalised anxiety, insomnia, and for all indications in older patients. Conclusions This study resulted in a French top five list in general practice using a panel of GPs. All the items selected have a negative risk-benefit balance and are frequently prescribed by French general practitioners. This list differs from other top five lists for general practice, reflecting the local medical culture.
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Affiliation(s)
- Agnès Hazard
- Department of Family Medicine, Faculty of Health Sciences Simone Veil, University Versailles-Saint-Quentin-en-Yvelines, Villejuif, Paris, France.
| | - Lucie Fournier
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Nathalie Pelletier Fleury
- Centre for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research (INSERM U 1018), University Versailles Saint-Quentin en Yvelines, University Paris-Sud, Villejuif, France
| | - Corentin Hervé
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Thibaud Pitel
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Cécile Pino
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Olivier Saint-Lary
- Department of Family Medicine, Faculty of Health Sciences Simone Veil, University Versailles-Saint-Quentin-en-Yvelines, Villejuif, Paris, France.,Centre for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research (INSERM U 1018), University Versailles Saint-Quentin en Yvelines, University Paris-Sud, Villejuif, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France.,AP-HP, Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Mathilde François
- Department of Family Medicine, Faculty of Health Sciences Simone Veil, University Versailles-Saint-Quentin-en-Yvelines, Villejuif, Paris, France.,Centre for Research in Epidemiology and Population Health, French National Institute of Health and Medical Research (INSERM U 1018), University Versailles Saint-Quentin en Yvelines, University Paris-Sud, Villejuif, France
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11
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Ecollan M, Guerrisi C, Souty C, Rossignol L, Turbelin C, Hanslik T, Colizza V, Blanchon T. Determinants and risk factors of gastroenteritis in the general population, a web-based cohort between 2014 and 2017 in France. BMC Public Health 2020; 20:1146. [PMID: 32693787 PMCID: PMC7372820 DOI: 10.1186/s12889-020-09212-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 07/05/2020] [Indexed: 12/19/2022] Open
Abstract
Background Although it is rarely fatal in developed countries, acute gastroenteritis (AGE) still induces significant morbidity and economic costs. The objective of this study was to identify factors associated with AGE in winter in the general population. Methods A prospective study was performed during winter seasons from 2014 to 2015 to 2016–2017. Participants filled an inclusion survey and reported weekly data on acute symptoms. Factors associated with having at least one AGE episode per winter season were analyzed using the generalized estimating equations (GEE) approach. Results They were 13,974 participants included in the study over the three seasons. On average, 8.1% of participants declared at least one AGE episode during a winter season. People over 60 declared fewer AGE episodes (adjusted OR (aOR) = 0.76, 95% CI [0.64; 0.89]) compared to individuals between 15 and 60 years old, as well as children between 10 and 15 (aOR = 0.60 [0.37; 0.98]). Overweight (aOR = 1.25 [1.07; 1.45]) and obese (aOR = 1.47 [1.19; 1.81]) individuals, those having frequent cold (aOR = 1.63 [1.37; 1.94]) and those with at least one chronic condition (aOR = 1.35 [1.16; 1.58]) had more AGE episodes. Living alone was associated with a higher AGE episode rate (aOR = 1.31 [1.09; 1.59]), as well as having pets at home (aOR = 1.23 [1.08; 1.41]). Conclusions Having a better knowledge of AGE determinants will be useful to adapt public health prevention messages.
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Affiliation(s)
- Marie Ecollan
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France.,Department of Family Medicine, Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France.,Département de Médecine Générale, Université Paris Diderot, Paris, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France.,Service de Médecine Interne, Hôpital Ambroise-Paré, Assistance Publique - Hôpitaux de Paris, APHP, 92100, Boulogne-Billancourt, France.,UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, 78280, Versailles, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, F75012, Paris, France.
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12
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Ung A, Baidjoe AY, Van Cauteren D, Fawal N, Fabre L, Guerrisi C, Danis K, Morand A, Donguy MP, Lucas E, Rossignol L, Lefèvre S, Vignaud ML, Cadel-Six S, Lailler R, Jourdan-Da Silva N, Le Hello S. Disentangling a complex nationwide Salmonella Dublin outbreak associated with raw-milk cheese consumption, France, 2015 to 2016. ACTA ACUST UNITED AC 2020; 24. [PMID: 30670140 PMCID: PMC6344836 DOI: 10.2807/1560-7917.es.2019.24.3.1700703] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
On 18 January 2016, the French National Reference Centre for Salmonella reported to Santé publique France an excess of Salmonella enterica serotype Dublin (S. Dublin) infections. We investigated to identify the source of infection and implement control measures. Whole genome sequencing (WGS) and multilocus variable-number tandem repeat analysis (MLVA) were performed to identify microbiological clusters and links among cases, animal and food sources. Clusters were defined as isolates with less than 15 single nucleotide polymorphisms determined by WGS and/or with identical MLVA pattern. We compared different clusters of cases with other cases (case–case study) and controls recruited from a web-based cohort (case–control study) in terms of food consumption. We interviewed 63/83 (76%) cases; 2,914 controls completed a questionnaire. Both studies’ findings indicated that successive S. Dublin outbreaks from different sources had occurred between November 2015 and March 2016. In the case–control study, cases of distinct WGS clusters were more likely to have consumed Morbier (adjusted odds ratio (aOR): 14; 95% confidence interval (CI): 4.8–42) or Vacherin Mont d’Or (aOR: 27; 95% CI: 6.8–105), two bovine raw-milk cheeses. Based on these results, the Ministry of Agriculture launched a reinforced control plan for processing plants of raw-milk cheeses in the production region, to prevent future outbreaks.
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Affiliation(s)
- Aymeric Ung
- These authors contributed equally to this article and share first authorship.,European Programme for Intervention Epidemiology Training (EPIET), European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden.,Santé publique France (SpFrance), the French national public health agency, Saint-Maurice, France
| | - Amrish Y Baidjoe
- Institut Pasteur, Enteric Bacterial Pathogens Unit, National Reference Center (NRC) for E. coli, Shigella and Salmonella, Paris, France.,European Programme for Public Health Microbiology Training (EUPHEM), European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden.,These authors contributed equally to this article and share first authorship
| | - Dieter Van Cauteren
- Santé publique France (SpFrance), the French national public health agency, Saint-Maurice, France
| | - Nizar Fawal
- Institut Pasteur, Enteric Bacterial Pathogens Unit, National Reference Center (NRC) for E. coli, Shigella and Salmonella, Paris, France
| | - Laetitia Fabre
- Institut Pasteur, Enteric Bacterial Pathogens Unit, National Reference Center (NRC) for E. coli, Shigella and Salmonella, Paris, France
| | - Caroline Guerrisi
- Sorbonne Université, UPMC, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, Paris, France
| | - Kostas Danis
- European Programme for Intervention Epidemiology Training (EPIET), European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden.,Santé publique France (SpFrance), the French national public health agency, Saint-Maurice, France
| | - Anne Morand
- French Directorate General for Food (DGAL), Ministry of Agriculture and Food, Paris, France
| | - Marie-Pierre Donguy
- French Directorate General for Food (DGAL), Ministry of Agriculture and Food, Paris, France
| | - Etienne Lucas
- Santé publique France (SpFrance), the French national public health agency, Saint-Maurice, France
| | - Louise Rossignol
- Sorbonne Université, UPMC, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP, Paris, France
| | - Sophie Lefèvre
- Institut Pasteur, Enteric Bacterial Pathogens Unit, National Reference Center (NRC) for E. coli, Shigella and Salmonella, Paris, France
| | - Marie-Léone Vignaud
- Université Paris-Est, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Laboratory for Food Safety, Maisons-Alfort, France
| | - Sabrina Cadel-Six
- Université Paris-Est, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Laboratory for Food Safety, Maisons-Alfort, France
| | - Renaud Lailler
- Université Paris-Est, French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Laboratory for Food Safety, Maisons-Alfort, France
| | - Nathalie Jourdan-Da Silva
- These authors contributed equally to this article and share last authorship.,Santé publique France (SpFrance), the French national public health agency, Saint-Maurice, France
| | - Simon Le Hello
- These authors contributed equally to this article and share last authorship.,Institut Pasteur, Enteric Bacterial Pathogens Unit, National Reference Center (NRC) for E. coli, Shigella and Salmonella, Paris, France
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13
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Souty C, Launay T, Steichen O, Conte C, Turbelin C, Sarazin M, Vilcu AM, Rossignol L, Blanchon T, Lapeyre-Mestre M, Hanslik T. Use of the French healthcare insurance database to estimate the prevalence of exposure to potential drug-drug interactions. Eur J Clin Pharmacol 2020; 76:1675-1682. [PMID: 32632714 DOI: 10.1007/s00228-020-02952-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/30/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Drug-drug interactions (DDIs) require monitoring in an aging population with increasing polypharmacy exposure. We aimed to estimate the prevalence of exposure to potential DDIs using the French healthcare insurance system database, for six DDIs with various clinical relevance: angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs (ARBs-ACEIs + NSAIDs), antiplatelet agents and NSAIDs (AAP + NSAIDs), serotonergic drugs and tramadol (SD + T), statins and macrolides (S + M), oral anticoagulant and NSAIDs (OAC + NSAIDs), and colchicine and macrolides (C + M). METHODS We used exhaustive healthcare data from a 1/97th random sample of the population covered by the French health insurance system (EGB) between 2006 and 2016. Exposure to a DDI was defined as overlapping exposure to two interacting drugs. The prevalence of exposure was estimated by year. RESULTS Prevalence of exposure in 2016 was estimated at 3.7% for ARBs-ACEIs + NSAIDs, 1.5% for AAP + NSAIDs, 0.76% for SD + T, 0.36% for S + M, 0.24% for AOC + NSAIDs, and 0.02% for C + M. In 26% to 58% of episodes of exposure, the two interacting drugs were prescribed by the same physician and dispensed by the same pharmacy the same day. Between 2006 and 2016, the yearly prevalence was increasing for SD + T and for DDIs involving NSAIDs, and it was decreasing for those involving macrolides. CONCLUSION Exposures to potential DDIs in France are not uncommon with a high proportion resulting from a co-prescription by the same physician. Monitoring the prevalence of exposure to DDIs is needed to implement prevention measures. Administrative data enable this surveillance in large and representative cohorts.
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Affiliation(s)
- Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France.
| | - Titouan Launay
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Olivier Steichen
- Sorbonne Université, INSERM, Université Paris 13, Laboratoire d'informatique médicale et d'ingénierie des connaissances en e-santé, LIMICS, Paris, France.,Assistance Publique - Hôpitaux de Paris (APHP), hôpital Tenon, Service de Médecine Interne, Paris, France
| | - Cécile Conte
- INSERM, Université de Toulouse (LEASP UMR 1027), Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Marianne Sarazin
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France.,Département de Médecine Générale, Université Paris Diderot, Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France
| | - Maryse Lapeyre-Mestre
- INSERM, Université de Toulouse (LEASP UMR 1027), Service de Pharmacologie médicale et clinique, CIC 1436, Centre Hospitalo-Universitaire de Toulouse (CHU Toulouse), Toulouse, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé publique, Paris, France.,Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, Versailles, France.,Assistance Publique - Hôpitaux de Paris (APHP), hôpital Ambroise Paré, Service de Médecine Interne, Boulogne Billancourt, France
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14
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Lefèvre B, Blanchon T, Saint-Martin P, Tattevin P, Che D, Caumes E, Pitel T, Rossignol L, Dournon N, Duval X, Hoen B. Evaluation of a web-based self-reporting method for monitoring international passengers returning from an area of emerging infection. Infect Dis Now 2020; 51:140-145. [PMID: 32565274 PMCID: PMC7301833 DOI: 10.1016/j.medmal.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/12/2019] [Accepted: 06/09/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Emerging infectious diseases are a public health issue of international concern. Identifying methods to limit their expansion is essential. We assessed the feasibility of a screening strategy in which each traveler would actively participate in the screening process after an intercontinental flight by reporting their own health status via a web-based self-administered questionnaire. PATIENTS AND METHODS In 2015 and 2017, we invited passengers arriving at or departing from Pointe-à-Pitre international airport to answer an online health questionnaire during the four days following their arrival from or at Paris-Orly international airport. SPIRE 1 was intended for passengers arriving at Pointe-à-Pitre and was conceived as a pilot study. SPIRE 2 was an improved version of SPIRE 1 and consisted in three parts, which permitted to further assess the benefits of pre-flight request and email follow-up. Endpoints were the connection rates and response rates to online health questionnaire. RESULTS For SPIRE 1, 4/1038 travelers (0.4%) completed the two steps of the online health questionnaire. In SPIRE 2, response rates ranged from 3/1059 (0.3%) to 19/819 (2.3%). Response rates were significantly better when passengers were approached before their flight. CONCLUSIONS The yield of an online health questionnaire was unexpectedly low.
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Affiliation(s)
- B Lefèvre
- Service de maladies infectieuses et tropicales, hôpitaux de Brabois, centre régional hospitalier universitaire de Nancy, 54511 Vandœuvre-lès-Nancy cedex, France; Service de maladies infectieuses et tropicales, dermatologie, médecine interne, centre hospitalier universitaire de Pointe-à-Pitre, BP 465, 97159 Pointe-à-Pitre, France; EA 4360 APEMAC, faculté de médecine, université de Lorraine, avenue de la Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France.
| | - T Blanchon
- Inserm, institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP UMRS 1136), Sorbonne universités, UPMC université Paris 06, 75012 Paris, France.
| | - P Saint-Martin
- Pôle de veille et sécurité sanitaires, Agence régionale de santé de Guadeloupe, Saint-Martin, Saint-Barthélemy, 97113 Goubeyre, France.
| | - P Tattevin
- Service maladies infectieuses et réanimation médicale, centre hospitalo-universitaire de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex, France.
| | - D Che
- Département des maladies infectieuses, santé publique France, 94415 Saint-Maurice cedex, France.
| | - E Caumes
- Département des maladies infectieuses et de médecine tropicale, hôpital La Pitié-Salpêtrière, Paris, France; Inserm, services des maladies infectieuses et tropicales, hôpital la Pitié-Salpêtrière, institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Sorbonne université, AP-HP, 75571 Paris cedex 12, France.
| | - T Pitel
- Inserm, institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP UMRS 1136), Sorbonne universités, UPMC université Paris 06, 75012 Paris, France.
| | - L Rossignol
- Inserm, institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP UMRS 1136), Sorbonne universités, UPMC université Paris 06, 75012 Paris, France.
| | - N Dournon
- Service de maladies infectieuses et tropicales, dermatologie, médecine interne, centre hospitalier universitaire de Pointe-à-Pitre, BP 465, 97159 Pointe-à-Pitre, France.
| | - X Duval
- Hôpital Bichat-Claude-Bernard, AP-HP, Paris, France; Inserm CIC1425, Paris, France; IAME UMR 1138, 75877 Paris cedex 18, France.
| | - B Hoen
- Service de maladies infectieuses et tropicales, hôpitaux de Brabois, centre régional hospitalier universitaire de Nancy, 54511 Vandœuvre-lès-Nancy cedex, France; Service de maladies infectieuses et tropicales, dermatologie, médecine interne, centre hospitalier universitaire de Pointe-à-Pitre, BP 465, 97159 Pointe-à-Pitre, France; EA 4360 APEMAC, faculté de médecine, université de Lorraine, avenue de la Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France; Inserm, centre d'investigation clinique 1424, centre hospitalier universitaire de Pointe-à-Pitre, BP 465, 97159 Pointe-à-Pitre, France.
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15
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Guerrisi C, Ecollan M, Souty C, Rossignol L, Turbelin C, Debin M, Goronflot T, Boëlle PY, Hanslik T, Colizza V, Blanchon T. Factors associated with influenza-like-illness: a crowdsourced cohort study from 2012/13 to 2017/18. BMC Public Health 2019; 19:879. [PMID: 31272411 PMCID: PMC6610908 DOI: 10.1186/s12889-019-7174-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 06/17/2019] [Indexed: 11/22/2022] Open
Abstract
Background Influenza generates a significant societal impact on morbidity, mortality, and associated costs. The study objective was to identify factors associated with influenza-like-illness (ILI) episodes during seasonal influenza epidemics among the general population. Methods A prospective study was conducted with the GrippeNet.fr crowdsourced cohort between 2012/13 and 2017/18. After having completed a yearly profile survey detailing socio-demographic, lifestyle and health characteristics, participants reported weekly data on symptoms. Factors associated with at least one ILI episode per influenza epidemic, using the European Centre for Disease Prevention and Control case definition, were analyzed through a conditional logistic regression model. Results From 2012/13 to 2017/18, 6992 individuals participated at least once, and 61% of them were women (n = 4258). From 11% (n = 469/4140 in 2013/14) to 29% (n = 866/2943 in 2012/13) of individuals experienced at least one ILI during an influenza epidemic. Factors associated with higher risk for ILI were: gender female (OR = 1.29, 95%CI [1.20; 1.40]), young age (< 5 years old: 3.12 [2.05; 4.68]); from 5 to 14 years old: 1.53 [1.17; 2.00]), respiratory allergies (1.27 [1.18; 1.37]), receiving a treatment for chronic disease (1.20 [1.09; 1.32]), being overweight (1.18 [1.08; 1.29]) or obese (1.28 [1.14; 1.44]), using public transport (1.17 [1.07; 1.29]) and having contact with pets (1.18 [1.09; 1.27]). Older age (≥ 75 years old: 0.70 [0.56; 0.87]) and being vaccinated against influenza (0.91 [0.84; 0.99]) were found to be protective factors for ILI. Conclusions This ILI risk factors analysis confirms and further completes the list of factors observed through traditional surveillance systems. It indicates that crowdsourced cohorts are effective to study ILI determinants at the population level. These findings could be used to adapt influenza prevention messages at the population level to reduce the spread of the disease. Electronic supplementary material The online version of this article (10.1186/s12889-019-7174-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France.
| | - Marie Ecollan
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France.,Department of family Medicine, Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Marion Debin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thomas Goronflot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France.,APHP, Service de Médecine Interne, Hôpital Ambroise-Paré, 92100, Boulogne-Billancourt, France.,UFR des sciences de la santé Simone-Veil, Université de Versailles - Saint-Quentin-en-Yvelines, 78280, Versailles, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
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16
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Rossignol L, Feuillepain L, Ndeikoundam Ngangro N, Souty C, Fournet N, Le Strat Y, Baroux N, Hanslik T, Lot F, Blanchon T. Estimate of male urethritis incidences in France between 2007 and 2017 with a specific focus on Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis infections. BMC Infect Dis 2019; 19:561. [PMID: 31248368 PMCID: PMC6598258 DOI: 10.1186/s12879-019-4202-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 06/18/2019] [Indexed: 12/13/2022] Open
Abstract
Background In a context of increasing use of Nucleic Acid Amplification Test, diagnoses of Neisseria gonorrhoeae and Chlamydia trachomatis infections among men increased in Europe and USA since 2007. We aimed to describe trends in the incidence of male urethritis in France between 2007 and 2017. Methods We analysed male urethritis clinical cases reported by the French GPs’ Sentinelles network. Results GPs reported 1944 cases of male urethritis during the study period. The estimated annual incidence rates in men aged 15 years and older remained stable between 226 cases per 100,000 seen in 2007 and 196 in 2017 (P value = 0.9). A third-generation cephalosporin with macrolide or tetracycline was prescribed in 17.5% of cases in 2009 (27/154) and 32.4% in 2017 (47/145) (P value = 0.0327). Conclusions The incidence rates for adult male urethritis diagnosed in primary care have remained stable since 2007 in France in contrast with the increasing trend of Neisseria gonorrhoeae and Chlamydia trachomatis infections based on microbiological surveillance. Using stable clinical definition for male urethritis seems essential to follow correctly epidemiological dynamic.
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Affiliation(s)
- Louise Rossignol
- Réseau Sentinelles, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136 Inserm Sorbonne Université, Faculté de médecine Sorbonne Université - site Saint Antoine, 27 rue Chaligny, 75571, cedex 12, Paris, France.
| | - Laurianne Feuillepain
- Réseau Sentinelles, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136 Inserm Sorbonne Université, Faculté de médecine Sorbonne Université - site Saint Antoine, 27 rue Chaligny, 75571, cedex 12, Paris, France
| | | | - Cécile Souty
- Réseau Sentinelles, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136 Inserm Sorbonne Université, Faculté de médecine Sorbonne Université - site Saint Antoine, 27 rue Chaligny, 75571, cedex 12, Paris, France
| | - Nelly Fournet
- Infectious Diseases Division, Santé publique France, F-954415, Saint-Maurice, France
| | - Yann Le Strat
- Data Science Division, Santé publique France, F-954415, Saint-Maurice, France
| | - Noémie Baroux
- Réseau Sentinelles, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136 Inserm Sorbonne Université, Faculté de médecine Sorbonne Université - site Saint Antoine, 27 rue Chaligny, 75571, cedex 12, Paris, France
| | - Thomas Hanslik
- Réseau Sentinelles, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136 Inserm Sorbonne Université, Faculté de médecine Sorbonne Université - site Saint Antoine, 27 rue Chaligny, 75571, cedex 12, Paris, France.,Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, FR-78000, Versailles, France.,Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, APHP, FR-92100, Boulogne Billancourt, France
| | - Florence Lot
- Infectious Diseases Division, Santé publique France, F-954415, Saint-Maurice, France
| | - Thierry Blanchon
- Réseau Sentinelles, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), UMR S 1136 Inserm Sorbonne Université, Faculté de médecine Sorbonne Université - site Saint Antoine, 27 rue Chaligny, 75571, cedex 12, Paris, France
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17
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Mathieu P, Gautier A, Raude J, Goronflot T, Launay T, Debin M, Guerrisi C, Turbelin C, Hanslik T, Jestin C, Colizza V, Blanchon T, Rossignol L. Population perception of mandatory childhood vaccination programme before its implementation, France, 2017. Euro Surveill 2019; 24:1900053. [PMID: 31241041 PMCID: PMC6593904 DOI: 10.2807/1560-7917.es.2019.24.25.1900053] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BackgroundVaccination policy in France was previously characterised by the coexistence of eight recommended and three mandatory vaccinations for children younger than 2 years old. These 11 vaccines are now mandatory for all children born after 1 January 2018.AimTo study the French population's opinion about this new policy and to assess factors associated with a positive opinion during this changing phase.MethodsA cross-sectional survey about vaccination was conducted from 16 November-19 December 2017 among the GrippeNet.fr cohort. Data were weighted for age, sex and education according to the French population. Univariate and multivariate analyses were performed to identify factors associated with a favourable opinion on mandatory vaccines' extension and defined in the '3Cs' model by the World Health Organization Strategic Advisory Group of Experts working group on vaccine hesitancy.ResultsOf the 3,222 participants (response rate 50.5%) and after adjustment, 64.5% agreed with the extension of mandatory vaccines. It was considered a necessary step by 68.7% of the study population, while 33.8% considered it unsafe for children and 56.9% saw it as authoritarian. Factors associated with a positive opinion about the extension of mandatory vaccines were components of the confidence, complacency and convenience dimensions of the '3Cs' model.ConclusionsIn our sample, two thirds of the French population was in favour of the extension of mandatory vaccines for children. Perception of vaccine safety and benefits were major predictors for positive and negative opinions about this new policy.
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Affiliation(s)
- Pauline Mathieu
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | | | - Jocelyn Raude
- EHESP Rennes, Université Sorbonne Paris Cité, France
| | - Thomas Goronflot
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Titouan Launay
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Marion Debin
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Caroline Guerrisi
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Clément Turbelin
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thomas Hanslik
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France,Université de Versailles Saint-Quentin-en-Yvelines, UVSQ, UFR de Médecine, FR-78000, Versailles, France,Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris, APHP, FR-92100, Boulogne Billancourt, France
| | | | - Vittoria Colizza
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Thierry Blanchon
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
| | - Louise Rossignol
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP), F-75012, Paris, France
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Souty C, Amoros P, Falchi A, Capai L, Bonmarin I, van der Werf S, Masse S, Turbelin C, Rossignol L, Vilcu A, Lévy‐Bruhl D, Lina B, Minodier L, Dorléans Y, Guerrisi C, Hanslik T, Blanchon T. Influenza epidemics observed in primary care from 1984 to 2017 in France: A decrease in epidemic size over time. Influenza Other Respir Viruses 2019; 13:148-157. [PMID: 30428158 PMCID: PMC6379635 DOI: 10.1111/irv.12620] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 09/07/2018] [Accepted: 11/06/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Epidemiological analysis of past influenza epidemics remains essential to understand the evolution of the disease and optimize control and prevention strategies. Here, we aimed to use data collected by a primary care surveillance system over the last three decades to study trends in influenza epidemics and describe epidemic profiles according to circulating influenza viruses. METHODS Influenza-like illness (ILI) weekly incidences were estimated using cases reported by general practitioners participating in the French Sentinelles network, between 1984 and 2017. Influenza epidemics were detected by applying a periodic regression to this time series. Epidemic (co-)dominant influenza virus (sub)types were determined using French virology data. RESULTS During the study period, 297 607 ILI cases were reported allowing the detection of 33 influenza epidemics. On average, seasonal epidemics lasted 9 weeks and affected 4.1% of the population (95% CI 3.5; 4.7). Mean age of cases was 29 years. Epidemic size decreased over time by -66 cases per 100 000 population per season on average (95% CI -132; -0.2, P value = 0.049) and epidemic height decreased by -15 cases per 100 000 (95% CI -28; -2, P value = 0.022). Epidemic duration appeared stable over time. Epidemics were mostly dominated by A(H3N2) (n = 17, 52%), associated with larger epidemic size, higher epidemic peak and older age of cases. CONCLUSIONS The declining trend in influenza epidemic size and height over the last 33 years might be related to several factors like increased vaccine coverage, hygiene improvements or changing in influenza viruses. However, further researches are needed to assess the impact of potential contributing factors to adapt influenza plans.
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Affiliation(s)
- Cécile Souty
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Philippe Amoros
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Alessandra Falchi
- EA7310, Laboratoire de VirologieUniversité de Corse‐InsermCorteFrance
| | - Lisandru Capai
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
- EA7310, Laboratoire de VirologieUniversité de Corse‐InsermCorteFrance
| | - Isabelle Bonmarin
- Department of Infectious DiseasesSanté publique FranceSaint‐MauriceFrance
| | - Sylvie van der Werf
- Institut PasteurUnité de Génétique Moléculaire des Virus à ARNParisFrance
- Institut PasteurCentre Coordonnateur du Centre National de Référence des virus des infections respiratoires (dont la grippe)ParisFrance
- UMR CNRS 3569ParisFrance
- Université Paris DiderotSorbonne Paris CitéUnité de Génétique Moléculaire des Virus à ARNParisFrance
| | - Shirley Masse
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
- EA7310, Laboratoire de VirologieUniversité de Corse‐InsermCorteFrance
| | - Clément Turbelin
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Louise Rossignol
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Ana‐Maria Vilcu
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Daniel Lévy‐Bruhl
- Department of Infectious DiseasesSanté publique FranceSaint‐MauriceFrance
| | - Bruno Lina
- Laboratoire de VirologieHospices Civils de LyonInstitut des Agents Infectieux (IAI)Centre National de Référence des virus respiratoires (dont la grippe)Centre de Biologie et de Pathologie NordGroupement Hospitalier NordLyonFrance
- Université de LyonVirpath, CIRI, INSERM U1111CNRS UMR5308ENS Lyon, Université Claude Bernard Lyon 1LyonFrance
| | - Laëtitia Minodier
- EA7310, Laboratoire de VirologieUniversité de Corse‐InsermCorteFrance
| | - Yves Dorléans
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Caroline Guerrisi
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
| | - Thomas Hanslik
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
- Université de Versailles Saint‐Quentin‐en‐YvelinesUVSQUFR de MédecineVersaillesFrance
- Service de Médecine InterneHôpital Ambroise ParéAssistance Publique – Hôpitaux de ParisAPHPBoulogne BillancourtFrance
| | - Thierry Blanchon
- Sorbonne UniversitéINSERMInstitut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP)ParisFrance
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Skonieczny C, McGee D, Winckler G, Bory A, Bradtmiller LI, Kinsley CW, Polissar PJ, De Pol-Holz R, Rossignol L, Malaizé B. Monsoon-driven Saharan dust variability over the past 240,000 years. Sci Adv 2019; 5:eaav1887. [PMID: 30613782 PMCID: PMC6314818 DOI: 10.1126/sciadv.aav1887] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/21/2018] [Indexed: 06/09/2023]
Abstract
Reconstructions of past Saharan dust deposition in marine sediments provide foundational records of North African climate over time scales of 103 to 106 years. Previous dust records show primarily glacial-interglacial variability in the Pleistocene, in contrast to other monsoon records showing strong precessional variability. Here, we present the first Saharan dust record spanning multiple glacial cycles obtained using 230Th normalization, an improved method of calculating fluxes. Contrary to previous data, our record from the West African margin demonstrates high correlation with summer insolation and limited glacial-interglacial changes, indicating coherent variability in the African monsoon belt throughout the late Pleistocene. Our results demonstrate that low-latitude Saharan dust emissions do not vary synchronously with high- and mid-latitude dust emissions, and they call into question the use of existing Plio-Pleistocene dust records to investigate links between climate and hominid evolution.
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Affiliation(s)
- C. Skonieczny
- Laboratoire Géosciences Paris-Sud, UMR CNRS 8148, Université de Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - D. McGee
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - G. Winckler
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA
| | - A. Bory
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
- Université de Lille, CNRS, Université Littoral Cote d’Opale, UMR 8187, LOG, Laboratoire d’Océanologie et de Géosciences, Lille, France
| | - L. I. Bradtmiller
- Department of Environmental Studies, Macalester College, St. Paul, MN, USA
| | - C. W. Kinsley
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - P. J. Polissar
- Department of Earth and Environmental Sciences, Columbia University, New York, NY, USA
| | - R. De Pol-Holz
- GAIA-Antártica, Universidad de Magallanes, Punta Arenas, Chile
| | - L. Rossignol
- Laboratoire Environnements et Paléoenvironnements Océaniques et Continentaux, UMR CNRS 5805, Université de Bordeaux, Pessac, France
| | - B. Malaizé
- Laboratoire Environnements et Paléoenvironnements Océaniques et Continentaux, UMR CNRS 5805, Université de Bordeaux, Pessac, France
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François M, Clais B, Blanchon T, Souty C, Hanslik T, Rossignol L. Factors associated with the duration of symptoms in adult women with suspected cystitis in primary care. PLoS One 2018; 13:e0201057. [PMID: 30044831 PMCID: PMC6059455 DOI: 10.1371/journal.pone.0201057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 07/06/2018] [Indexed: 01/07/2023] Open
Abstract
Objective The aim of this study was to identify factors associated to the duration of symptoms of cystitis. Patients and methods We conducted a nested survival study using Druti study data. Druti was a cross-sectional survey conducted in adult women visiting a general practitioner in France, for a suspected urinary tract infection between January 2012 and February 2013. For this study, urine cultures were systematically performed for all women. The evolution of symptoms were monitored daily for two weeks. This nested study considered only women with suspected cystitis from Druti; women with pyelonephritis were excluded. To identify independent predictors for duration of symptoms, a Cox proportional hazards regression model was performed. Results In Druti, 449 patients had a suspected cystitis. Among them, 440 had a follow up at two weeks. Out of the 440 patients, 424 had a prescription of antibiotic treatment (96.4%). The urine culture was positive for 326 patients (74.1%). The median duration of symptoms after consultation was two days (interquartile 1–3). The absence of urinary frequency (median two days versus three days, p = 0.008), age over 55 years (median two days versus three days, p<0.001) and patient’s bet about the presence of a urinary tract infection (median two days, p = 0.021) were associated to a longer duration of symptoms. Positive culture (p = 0.99) and presence of a multi-drug resistant organism (p = 0.38) did not influence the duration of symptoms. Conclusion In a real-life study, factors influencing the duration of symptoms are clinical factors. The delay before re-evaluation in case of persistent symptoms after treatment could be adapted according to the initial clinical examination.
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Affiliation(s)
- Mathilde François
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
- Université Paris Saclay, INSERM, Centre de Recherche en Epidémiologie et Santé des Populations, UMR1018, hôpital Paul Brousse, Villejuif, France
- * E-mail:
| | - Barbara Clais
- Département de médecine générale, Université Paris Descartes, Paris, France
| | - Thierry Blanchon
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Cécile Souty
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Thomas Hanslik
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
- Hopital Universitaire Ambroise Paré AP-HP, Boulogne-Billancourt, France
| | - Louise Rossignol
- Sorbonne Universités, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
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21
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Thierry P, Lasserre A, Rossignol L, Kernéis S, Blaizeau F, Stheneur C, Blanchon T, Levy-Bruhl D, Hanslik T. Human Papillomavirus vaccination in general practice in France, three years after the implementation of a targeted vaccine recommendation based on age and sexual history. Hum Vaccin Immunother 2016; 12:528-33. [PMID: 26309144 DOI: 10.1080/21645515.2015.1078042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
In France, vaccination against human papilloma virus (HPV) was recommended in 2007 for all 14-year-old girls as well as "catch-up" vaccination for girls between 15-23 y of age either before or within one year of becoming sexually active. We evaluated the vaccine coverage according to the eligibility for vaccination in a sample of young girls aged 14 to 23 years, who were seen in general practices. A survey was proposed to 706 general practitioners (GPs) and carried out from July to September 2010. GPs, also called "family doctor," are physicians whose practice is not restricted to a specific field of medicine but instead covers a variety of medical problems in patients of all ages. Each participating GP included, retrospectively, the last female patient aged 14-17 y and the last female patient aged 18-23 y whom he had seen. A questionnaire collected information regarding the GP and the patients' characteristics. The vaccine coverage was determined according to the eligibility for vaccination, i.e. the coverage among younger women (14-17) and among those sexually active in the second age range (18-23). Sexual activity status was assessed by GP, according to information stated in the medical record. The 363 participating physicians (response rate 51.4%) included 712 patients (357 in the 14- to 17-year-old group and 355 in the 15- to 23-year-old group) in their responses. The rate of the vaccination coverage in the 14- to 17-year-old group was 55%. Among the girls in the 18- to 23-year-old group, 126 were eligible, and their vaccination coverage rate was 82%. The evaluation of the eligibility by the GPs was incorrect in 36% of the cases. Of the 712 patients, 6% of the girls had been vaccinated without a need for the vaccination, and 26% of the girls had not been vaccinated, although they needed to be vaccinated. Regarding the vaccine uptake, vaccination at the age of 14 was not as effective as vaccinating the older population for which vaccination was indicated as a catch-up program, based on sexual history. However, in more than one-third of the older population, difficulties remained regarding the determination of eligibility, according to the sexual history of the patient.
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Affiliation(s)
- Pascale Thierry
- a INSERM ; Paris , France.,b Sorbonne Universités; UPMC Univ Paris 06 ; Paris , France
| | - Andrea Lasserre
- a INSERM ; Paris , France.,b Sorbonne Universités; UPMC Univ Paris 06 ; Paris , France
| | - Louise Rossignol
- a INSERM ; Paris , France.,b Sorbonne Universités; UPMC Univ Paris 06 ; Paris , France
| | - Solen Kernéis
- a INSERM ; Paris , France.,b Sorbonne Universités; UPMC Univ Paris 06 ; Paris , France
| | - Fanette Blaizeau
- a INSERM ; Paris , France.,b Sorbonne Universités; UPMC Univ Paris 06 ; Paris , France
| | - Chantal Stheneur
- c Institut de Veille Sanitaire ; Département des Maladies Infectieuses ; Saint-Maurice , France
| | - Thierry Blanchon
- a INSERM ; Paris , France.,b Sorbonne Universités; UPMC Univ Paris 06 ; Paris , France
| | - Daniel Levy-Bruhl
- d Assistance Publique Hôpitaux de Paris; Service de Médecine Interne; Hôpital Ambroise Paré ; Boulogne Billancourt , France
| | - Thomas Hanslik
- e Assistance Publique Hôpitaux de Paris; Service de Pédiatrie; Hôpital Ambroise Paré ; Boulogne Billancourt , France.,f Université Versailles Saint Quentin en Yvelines ; Versailles , France
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22
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François M, Hanslik T, Dervaux B, Le Strat Y, Souty C, Vaux S, Maugat S, Rondet C, Sarazin M, Heym B, Coignard B, Rossignol L. The economic burden of urinary tract infections in women visiting general practices in France: a cross-sectional survey. BMC Health Serv Res 2016; 16:365. [PMID: 27507292 PMCID: PMC4977873 DOI: 10.1186/s12913-016-1620-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 08/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background Urinary tract infections (UTIs) are among the most common bacterial infections. Despite this burden, there are few studies of the costs of UTIs. The objective of this study was to determine the costs of UTIs in women over 18 years of age who visit general practitioners in France. Methods The direct and indirect costs of clinical UTIs were estimated from societal, French National Health Insurance and patient perspectives. The study population was derived from a national cross-sectional survey entitled the Drug-Resistant Urinary Tract Infection (Druti). The Druti included every woman over 18 years of age who presented with symptoms of UTI and was conducted in France in 2012 and 2013 to estimate the annual incidence of UTIs due to antibiotic-resistant Enterobacteriaceae in women visiting general practitioners (GPs) for suspected UTIs. Results Of the 538 women included in Druti, 460 were followed over 8 weeks and included in the cost analysis. The mean age of the women was 46 years old. The median cost of care for one episode of a suspected UTI was €38, and the mean cost was €70. The annual societal cost was €58 million, and €29 million of this was reimbursed by the French National Health Insurance system. In 25 % of the cases, the suspected UTIs were associated with negative urine cultures. The societal cost of these suspected UTIs with negative urine cultures was €13.5 million. No significant difference was found between the costs of the UTIs due to antibiotic-resistant E. coli and those due to wild E. coli (p = 0.63). Conclusion In the current context in which the care costs are continually increasing, the results of this study suggests that it is possible to decrease the cost of UTIs by reducing the costs of suspected UTIs and unnecessary treatments, as well as limiting the use of non-recommended tests. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1620-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M François
- Département de médecine générale, Faculté des sciences de la santé Simone Veille, Université Versailles-Saint-Quentin-en-Yvelines, 78180, Montigny le Bretonneux, France. .,Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.
| | - T Hanslik
- Hopital universitaire Ambroise Paré AP-HP, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France.,Université Versailles-Saint-Quentin-en-Yvelines, 55 Avenue de Paris, 78000, Versailles, France
| | - B Dervaux
- Faculté de médecine, CHRU, Lille, France
| | - Y Le Strat
- Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415, Saint-Maurice cedex, France
| | - C Souty
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - S Vaux
- Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415, Saint-Maurice cedex, France
| | - S Maugat
- Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415, Saint-Maurice cedex, France
| | - C Rondet
- Département de médecine générale, Faculté de médecine Pierre et Marie Curie, Sorbonne Université, UPMC Univ Paris 06, Paris, France
| | - M Sarazin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - B Heym
- Hopital universitaire Ambroise Paré AP-HP, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France
| | - B Coignard
- Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415, Saint-Maurice cedex, France
| | - L Rossignol
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
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23
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Rossignol L, Vaux S, Maugat S, Blake A, Barlier R, Heym B, Le Strat Y, Blanchon T, Hanslik T, Coignard B. Incidence of urinary tract infections and antibiotic resistance in the outpatient setting: a cross-sectional study. Infection 2016; 45:33-40. [DOI: 10.1007/s15010-016-0910-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 05/17/2016] [Indexed: 01/03/2023]
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24
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Rossignol L, Maugat S, Blake A, Vaux S, Heym B, Le Strat Y, Kernéis S, Blanchon T, Coignard B, Hanslik T. Risk factors for resistance in urinary tract infections in women in general practice: A cross-sectional survey. J Infect 2015; 71:302-11. [DOI: 10.1016/j.jinf.2015.05.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/06/2015] [Accepted: 05/19/2015] [Indexed: 12/30/2022]
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25
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Boiron K, Sarazin M, Debin M, Raude J, Rossignol L, Guerrisi C, Odinkemelu D, Hanslik T, Colizza V, Blanchon T. Opinion about seasonal influenza vaccination among the general population 3 years after the A(H1N1)pdm2009 influenza pandemic. Vaccine 2015; 33:6849-54. [PMID: 26322844 DOI: 10.1016/j.vaccine.2015.08.067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 07/09/2015] [Accepted: 08/20/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To assess the opinions of the French general population about seasonal influenza vaccination three years after the A(H1N1)pdm 09 pandemic and identify factors associated with a neutral or negative opinion about this vaccination. STUDY DESIGN The study was conducted using data collected from 5374 participants during the 2012/2013 season of the GrippeNet.fr study. The opinion about seasonal influenza vaccination was studied on three levels ("positive", "negative" or "neutral"). The link between the participant's characteristics and their opinion regarding the seasonal influenza vaccination were studied using a multinomial logistic regression with categorical variables. The "positive" opinion was used as the reference for identifying individuals being at risk of having a "neutral" or a "negative" opinion. RESULTS Among the participants, 39% reported having a positive opinion about seasonal influenza vaccine, 39% a neutral opinion, and 22% a negative opinion. Factors associated with a neutral or negative opinion were young age, low educational level, lack of contact with sick or elderly individuals, lack of treatment for a chronic disease and taking a homeopathic preventive treatment. CONCLUSIONS These results show that an important part of the French population does not have a positive opinion about influenza vaccination in France. Furthermore, it allows outlining the profiles of particularly reluctant individuals who could be targeted by informative campaigns.
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Affiliation(s)
- Karine Boiron
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Marianne Sarazin
- INSERM, UMR_S 1136, F-75012 Paris, France; Département d'information médicale, Centre Hospitalier, Firminy, France
| | - Marion Debin
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Jocelyn Raude
- Department of Social and Behavioral Sciences, EHESP Rennes, Sorbonne Paris Cité, Rennes, France
| | - Louise Rossignol
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Caroline Guerrisi
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Didi Odinkemelu
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Thomas Hanslik
- INSERM, UMR_S 1136, F-75012 Paris, France; APHP, Service de médecine interne, Hôpital Ambroise-Paré, 92100 Boulogne-Billancourt, France; UFR des sciences de la santé Simone-Veil, Université de Versailles-Saint-Quentin-en-Yvelines, 78280 Versailles, France
| | - Vittoria Colizza
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France
| | - Thierry Blanchon
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, F-75012 Paris, France; INSERM, UMR_S 1136, F-75012 Paris, France.
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26
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Rossignol L, Pelat C, Lambert B, Flahault A, Chartier-Kastler E, Hanslik T. A method to assess seasonality of urinary tract infections based on medication sales and google trends. PLoS One 2013; 8:e76020. [PMID: 24204587 PMCID: PMC3808386 DOI: 10.1371/journal.pone.0076020] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 08/16/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite the fact that urinary tract infection (UTI) is a very frequent disease, little is known about its seasonality in the community. METHODS AND FINDINGS To estimate seasonality of UTI using multiple time series constructed with available proxies of UTI. Eight time series based on two databases were used: sales of urinary antibacterial medications reported by a panel of pharmacy stores in France between 2000 and 2012, and search trends on the Google search engine for UTI-related terms between 2004 and 2012 in France, Germany, Italy, the USA, China, Australia and Brazil. Differences between summers and winters were statistically assessed with the Mann-Whitney test. We evaluated seasonality by applying the Harmonics Product Spectrum on Fast Fourier Transform. Seven time series out of eight displayed a significant increase in medication sales or web searches in the summer compared to the winter, ranging from 8% to 20%. The eight time series displayed a periodicity of one year. Annual increases were seen in the summer for UTI drug sales in France and Google searches in France, the USA, Germany, Italy, and China. Increases occurred in the austral summer for Google searches in Brazil and Australia. CONCLUSIONS An annual seasonality of UTIs was evidenced in seven different countries, with peaks during the summer.
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Affiliation(s)
- Louise Rossignol
- Département de médecine générale, UPMC Univ Paris 06, Paris, France
- UMRS 707, UPMC Univ Paris 06, Paris, France
- U707, INSERM, Paris, France
| | - Camille Pelat
- U738, INSERM, Paris, France
- UMRS 738, Université Paris Diderot, Paris, France
| | | | - Antoine Flahault
- U707, INSERM, Paris, France
- Descartes School of Medicine, Sorbonne Paris Cité, Paris, France
| | - Emmanuel Chartier-Kastler
- Urologist hopital universitaire Pitié-Salpêtrière AP-HP, faculté de médecine Pierre et Marie Curie Paris VI, Paris, France
| | - Thomas Hanslik
- U707, INSERM, Paris, France
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Lungarde K, Blaizeau F, Auger-Aubin I, Floret D, Gilberg S, Jestin C, Hanslik T, Le Goaster C, Lévy-Bruhl D, Blanchon T, Rossignol L. How French physicians manage with a future change in the primary vaccination of infants against diphtheria, tetanus, pertussis and poliomyelitis? A qualitative study with focus groups. BMC Fam Pract 2013; 14:85. [PMID: 23782853 PMCID: PMC3691920 DOI: 10.1186/1471-2296-14-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 06/14/2013] [Indexed: 11/18/2022]
Abstract
Background As in other European countries, the French vaccination schedule changes according to epidemiological and socio-economic situations. Further changes are planned for 2013, including the withdrawal of one dose for primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. A partnership between the French Technical Vaccination Committee and the French Institute for Health and Medical Research designed a study to assess primary care physicians’ agreement about this modification. Methods Qualitative study with focus groups and semi-structured interviews in France. Four focus groups were conducted with physicians, supplemented by four individual interviews. Results The physicians of the survey had accepted the suggested vaccination schedule well. A few concerns had been underlined: fear of less follow-up care for infants resulting from the removal of one visit driven by the primary vaccination; fear of loss of vaccine efficacy; suspicion of the existence of financial arguments at the origin of this change; and adjustment to current vaccination schedule. Several suggestions were made: providing strong support from health authorities; developing stable and simple recommendations; providing effective tools for monitoring patient’s vaccination status. Conclusions Physicians’ opinions suggested a good acceptance of a possible change about primary vaccination against diphtheria, tetanus, polio, pertussis and Haemophilus influenzae. Physicians’ suggestions resulted from this qualitative study on a new vaccination schedule. It showed how that their involvement was feasible for preparing the implementation of a new vaccination schedule.
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Blaizeau F, Lasserre A, Rossignol L, Blanchon T, Kernéis S, Hanslik T, Levy-Bruhl D. Practices of French family physicians concerning varicella vaccination for teenagers. Med Mal Infect 2012; 42:429-34. [PMID: 22939236 DOI: 10.1016/j.medmal.2012.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 06/18/2012] [Accepted: 07/24/2012] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The authors assessed the knowledge and practices of French family physicians concerning the application of the new 2007 varicella vaccination guidelines for non-immune teenagers, 12 to 18 years of age. They also estimated the vaccination coverage in this population. METHOD A questionnaire link was sent by to 1008 family physicians of the French Inserm Sentinel network. Each family physician had to include the last teenager aged 12 to 18 years seen in consultation, with no or uncertain history of clinical varicella. RESULTS One hundred and forty-one family physicians agreed to participate and included one patient (participation rate=14%) between 4th November 2010 and 4th January 2011. One hundred and thirty-three questionnaires out of 141 (94%) were analyzed. Three patients were vaccinated and 127 were not, giving a weak vaccination coverage in the investigated population at 2%. Eighty-nine family physicians (70%) did not know about the recommendation, and 90 (71%) declared that they had no intention to vaccinate their patient against varicella. CONCLUSION Guidelines on varicella vaccination of non-immune teenagers are poorly followed and accepted by family physicians. Vaccination coverage is very low, and efforts should be made to improve application of recommendations.
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Affiliation(s)
- F Blaizeau
- Inserm U707, 27, rue de Chaligny, 75571 Paris cedex 12, France.
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29
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Rossignol L, Guthmann JP, Kernéis S, Aubin-Auger I, Lasserre A, Chauvin P, Pelat C, Hanslik T, Lévy-Bruhl D, Blanchon T. Barriers to implementation of the new targeted BCG vaccination in France: A cross sectional study. Vaccine 2011; 29:5232-7. [PMID: 21609744 DOI: 10.1016/j.vaccine.2011.05.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 04/28/2011] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
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30
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Sihachakr D, Daunay MC, Serraf I, Chaput MH, Mussio I, Haicour R, Rossignol L, Ducreux G. Somatic Hybridization of Eggplant (Solanum melongena L.) with Its Close and Wild Relatives. Somatic Hybridization in Crop Improvement I 1994. [DOI: 10.1007/978-3-642-57945-5_17] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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31
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Megia R, Haïcour R, Tizroutine S, Trang VB, Rossignol L, Sihachakr D, Schwendiman J. Plant regeneration from cultured protoplasts of the cooking banana cv. Bluggoe (Musa spp., ABB group). Plant Cell Rep 1993; 13:41-44. [PMID: 24196181 DOI: 10.1007/bf00232313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/1993] [Revised: 06/09/1993] [Indexed: 06/02/2023]
Abstract
Suspensions of embryogenic cells of a triploid banana (Musa spp., cv. Bluggoe) were initiated from the uppermost part of meristematic buds, and used as protoplast source. After 20 weeks in culture, the suspension contained a mixture of globular structures or globules and embryogenic cell clusters, as well as single cells. Two types of protoplasts were obtained from embryogenic suspension culture: small (20-30 μm) and larger (30-50 μm) protoplasts with a dense cytoplasm and large starch grains respectively. The small protoplasts probably originated from embryogenic cell clusters, and also from pseudocambial cells of globules, while larger protoplasts were probably released from oval starchy cells and those of the globule peripheral area. In co-culture with a suitable feeder, consisting of suspensions of diploid banana cells, the protoplasts of triploid banana reformed the cell wall within 24 h and underwent sustained divisions leading to the formation of small clusters of 2-3 cells within 7 days. The latter developed directly into embryos without passing through an apparent callus phase. 10% of such embryos gave rise to plantlets when subcultured in 2.2 μM 6-benzylaminopurine and 2 μM 4 amino-3,5,6-trichloropicolinic acid for 1 week, before transfer to MS medium containing 10 μM 6-benzylaminopurine. The rest of the embryos underwent intensive direct secondary embryogenesis which could lead to the formation of plantlets with a frequency of up to 50% upon further transfer to hormone-free medium.
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Affiliation(s)
- R Megia
- Morphogénèse Végétale Expérimentale, Bât. 360, Université Paris Sud, F-91405, Orsay Cedex, France
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Breuil C, Luck BT, Rossignol L, Little J, Echeverri CJ, Banerjee S, Brown DL. Monoclonal antibodies to Gliocladium roseum, a potential biological control fungus of sap-staining fungi in wood. J Gen Microbiol 1992; 138:2311-9. [PMID: 1479354 DOI: 10.1099/00221287-138-11-2311] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Immunological probes were developed to discriminate between a potential biological control fungus and sap-staining fungi present in wood. This paper describes the production of monoclonal antibodies to isolated cell wall fragments of the biological control fungus Gliocladium roseum. Two monoclonals, designated 6A5 and 3F12, were characterized. Their specificity was assessed by ELISA, by immunogold silver staining light microscopy, by immunogold electron microscopy, and by immunoblotting. Monoclonal 6A5 specifically recognized G. roseum and closely related species and did not react with any of 21 sap-staining fungi tested. Monoclonal 3F12 recognized most of the biological control fungi tested and also showed reactivity with two of the 21 sap-staining fungi. Both monoclonals appeared to recognize carbohydrate epitopes of the cell wall in G. roseum. Although the antibodies were produced against the cell wall of fungus grown in liquid culture, they also detected specific fungi in wood and, therefore, can be used for studies of wood colonization by fungi and for investigations of the interactions between different fungi growing on wood.
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Affiliation(s)
- C Breuil
- Faculty of Forestry, University of British Columbia, Vancouver, Canada
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Sihachakr D, Haicour R, Chaput MH, Barrientos E, Ducreux G, Rossignol L. Somatic hybrid plants produced by electrofusion between Solanum melongena L. and Solanum torvum Sw. Theor Appl Genet 1989; 77:1-6. [PMID: 24232465 DOI: 10.1007/bf00292307] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/1988] [Accepted: 07/18/1988] [Indexed: 06/02/2023]
Abstract
Somatic hybrid plants between eggplant (Solanum melongena) and Solanum torvum have been produced by the electrofusion of mesophyll protoplasts in a movable multi-electrode fusion chamber. Using hair structure as a selection criteria, we identified a total of 19 somatic hybrids, which represented an overall average of 15.3% of the 124 regenerated plants obtained in the two fusion experiments. Several morphological traits were intermediate to those of the parents, including trichome density and structure, height, leaf form and inflorescence. Cytological analyses revealed that the chromosome numbers of the somatic hybrids approximated the expected tetraploid level (2n=4x=48). Fifteen hybrid plants were homogeneous and had relatively stable chromosome numbers (46-48), while four other hybrids had variable chromosome numbers (35-48) and exhibited greater morphological variation. The hybridity of these 19 somatic hybrid plants was confirmed by analyses of phosphoglucomutase (Pgm) and esterase zymograms.
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Affiliation(s)
- D Sihachakr
- Laboratoire de Morphogénèse Végétale Expérimentale, CNRS UA 115, Bât 360, Université Paris Sud, F-91405, Orsay Cedex, France
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Rossignol L, Plantavid M, Chap H, Douste-Blazy L. [Effects of pentoxifylline and propentofylline on the turnover of polyphosphoinositides of the erythrocyte membrane and on the metabolism of arachidonic acid in platelets]. Pathol Biol (Paris) 1988; 36:1073-5. [PMID: 2851765] [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: 01/02/2023]
Abstract
[gamma-32p] ATP incorporation into polyphosphoinositides of the erythrocyte membrane has been studied in the presence of increasing concentrations of pentoxifylline and propentofylline. Our results show an inhibitory effect on the labelling of phosphatidylinositol 4,5-bisphosphate and phosphatidylinositol 4-phosphate, higher with propentofylline. We have then demonstrated that these two drugs block the metabolism of arachidonic acid in platelets stimulated by thrombin. The inhibition is located at the first biochemical steps of platelet activation, probably on phospholipase C. These results are discussed in relation with the modifications of platelet cyclic AMP content.
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Affiliation(s)
- L Rossignol
- INSERM Unité 101, Hôpital Purpan, Toulouse, France
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Rossignol L, Plantavid M, Chap H, Douste-Blazy L. Effects of two methylxanthines, pentoxifylline and propentofylline, on arachidonic acid metabolism in platelets stimulated by thrombin. Biochem Pharmacol 1988; 37:3229-36. [PMID: 2840908 DOI: 10.1016/0006-2952(88)90632-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [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: 01/02/2023]
Abstract
[3H]Pentoxifylline and [3H]propentofylline were taken up by human platelets in a dose-dependent manner probably involving a passive diffusion through the plasma membrane. In vitro, the two drugs were able to inhibit platelet activation induced by thrombin. serotonin secretion was reduced from 57% to 38% and 28% in the presence of 1 mM pentoxifylline and 1 mM propentofylline, respectively. Platelet aggregation was inhibited in the same way. Modifications of [14C]arachidonic acid metabolism in human platelets stimulated by thrombin were then measured in the presence of drugs. Preincubation of platelets with 1 mM pentoxifylline or propentofylline inhibited the production of [14C]arachidonic acid metabolites, without any accumulation of free arachidonic acid, suggesting an action at a step preceding its conversion. Phosphatidylinositol and phosphatidylcholine hydrolysis measured upon thrombin treatment as well as phosphatidic acid production were reduced or suppressed in the presence of the drugs. A dose-dependence study showed that phosphatidylcholine hydrolysis was totally inhibited at 5.10(-4) M propentofylline, while phosphatidic acid formation was reduced by only 40%. Propentofylline was in general more efficient than pentoxifylline in inhibiting events occurring upon thrombin stimulation. Our results suggest that the two methylxanthines inhibit both phospholipase A2 and phospholipase C, the former displaying a greater sensitivity to the two drugs.
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Affiliation(s)
- L Rossignol
- INSERM Unité 101, Hôpital Purpan, Toulouse, France
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36
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Plantavid M, Rossignol L, Chap H, Douste-Blazy L. Studies of endogenous polyphosphoinositide hydrolysis in human platelet membranes. Evidence that polyphosphoinositides remain inaccessible to phosphodiesterase in the native membrane. Biochim Biophys Acta 1986; 875:147-56. [PMID: 3002480 DOI: 10.1016/0005-2760(86)90163-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Human platelet plasma membranes incubated in the presence of [gamma-32P]ATP and 15 mM MgCl2 incorporated radioactivity mostly into phosphatidylinositol 4,5-bisphosphate (PIP2) and phosphatidylinositol 4-phosphate (PIP), which represented together over 90% of the total lipid radioactivity. After washing, reincubation of prelabelled membranes revealed some hydrolysis of the two compounds by phosphomonoesterase(s), as detected by the release of radioactive inorganic phosphate (Pi) from the two phospholipids. This degradation attained 40%/30 min for PIP in the presence of 2 mM calcium and cytosol. The effect of calcium was observed at concentrations equal to or greater than 10(-4) M. In no case did calcium alone facilitate the formation of inositol 1,4,5-trisphosphate (IP3) and inositol 1,4-bisphosphate (IP2). In contrast, simultaneous addition of 2 mM calcium and 2 mg/ml sodium deoxycholate promoted the formation of IP3 and IP2, indicating phosphodiesteratic cleavage of PIP2 and PIP. Phospholipase C activity was detected at calcium concentrations as low as 10(-7) M, in which case PIP2 hydrolysis was slightly more pronounced compared to PIP. Addition of cytosol increased to some extent the phospholipase C activity, suggesting that the low amount of enzyme remaining in the membrane is sufficient to promote submaximal degradation of PIP2 and PIP. We conclude that platelet polyphosphoinositides are present in the plasma membrane in a state where they remain inaccessible to phospholipase C, which is still fully active even at basal calcium concentrations, i.e., 10(-7) M. These results support the view that phosphodiesteratic cleavage of PIP2 promotes and thus precedes calcium mobilization brought about by IP3. The in vitro model presented here may prove very useful in future studies dealing with the mechanism rendering polyphosphoinositides accessible to phospholipase C attack upon agonist-receptor binding.
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