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Pokeerbux MR, Mavingui P, Gérardin P, Agrinier N, Gokalsing E, Meilhac O, Cournot M. A Holistic Approach to Cardiometabolic and Infectious Health in the General Population of Reunion Island: The REUNION Study. J Epidemiol Glob Health 2024:10.1007/s44197-024-00221-9. [PMID: 38564109 DOI: 10.1007/s44197-024-00221-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Reunion Island is a French overseas department in the South West Indian Ocean with a unique multi-ethnic population. Cardiovascular diseases are the most common chronic conditions with higher prevalences of hypertension and diabetes compared to mainland France. Moreover, Reunion Island is particularly exposed to vector-borne diseases such as chikungunya and dengue. Our objective is to describe the prevalence of cardiometabolic and infectious diseases in Reunion Island and explore causal mechanisms linking these diseases. METHODS The REUNION study is an ongoing French prospective study. From January 2022, 2,000 consenting participants (18-68 years old) are being recruited from the general population according to polling lists and random generation of cellphone number. Baseline examination consists of (i) general health examination, assessment of cardiovascular risk factors, markers of subclinical atherosclerosis, bronchial obstruction, neuropathic and autonomic dysfunction, (ii) questionnaires to determine sociodemographic characteristics, diet, exposure to vector-borne diseases, mental health and cognitive functions, social inequalities in health and ethnic origins, (iii) biological sampling for determination of cardiovascular risk factors, seroprevalence of infectious diseases, innovative lipid biomarkers, advanced omics, composition of intestinal, periodontal and skin microbiota, and biobanking. CONCLUSIONS The REUNION study should provide new insights into the prevalence of cardiometabolic and infectious diseases, as well as their potential associations through the examination of various environmental pathways and a wide range of health aspects.
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Affiliation(s)
- Mohammad Ryadh Pokeerbux
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France.
| | - Patrick Mavingui
- Université de La Réunion, UMR Processus Infectieux en Milieu Insulaire et Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Sainte-Clotilde, La Réunion, 97490, France
| | - Patrick Gérardin
- Plateforme de Recherche Clinique et Translationnelle, INSERM CIC1410, CHU de La Réunion, Saint-Pierre, La Réunion, 97400, France
| | - Nelly Agrinier
- CHRU-Nancy, Université de Lorraine, CIC, Epidémiologie clinique, Inserm, Nancy, F-54000, France
- Université de Lorraine, Inserm, INSPIIRE, Nancy, F-54000, France
| | - Erick Gokalsing
- Etablissement Public de Santé Mentale de La Réunion, 42 chemin du Grand Pourpier, 97866, Saint-Paul Cedex, France
- Laboratoire IRISSE (IngéniéRIe de la Santé, du Sport et de l'Environnement), Université de La Réunion, UFR SHE, Saint Pierre, EA, 4075, France
| | - Olivier Meilhac
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France
- Plateforme de Recherche Clinique et Translationnelle, INSERM CIC1410, CHU de La Réunion, Saint-Pierre, La Réunion, 97400, France
| | - Maxime Cournot
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France
- Groupe de santé Clinifutur, Clinique Les Orchidées, Le Port, La Réunion, 97420, France
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Alvarez A, Maillard O, Diarra YM, Bertolotti A, Gérardin P. Hepatitis and secondary dengue infection in Reunion island. Travel Med Infect Dis 2024; 59:102717. [PMID: 38552728 DOI: 10.1016/j.tmaid.2024.102717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Antoine Alvarez
- Clinical Investigation Center, INSERM CIC 1410, CHU Reunion, Saint-Pierre, 97410, Reunion, France.
| | - Olivier Maillard
- Clinical Investigation Center, INSERM CIC 1410, CHU Reunion, Saint-Pierre, 97410, Reunion, France
| | - Yves-Marie Diarra
- Clinical Investigation Center, INSERM CIC 1410, CHU Reunion, Saint-Pierre, 97410, Reunion, France
| | - Antoine Bertolotti
- Clinical Investigation Center, INSERM CIC 1410, CHU Reunion, Saint-Pierre, 97410, Reunion, France
| | - Patrick Gérardin
- Clinical Investigation Center, INSERM CIC 1410, CHU Reunion, Saint-Pierre, 97410, Reunion, France
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Gérardin P, Issop A, Diarra YM, Cousty J, Jaffar-Bandjee MC, Maillard O, Raffray L, Nobécourt E, Bertolotti A. Harness risk stratification of diabetic patients with dengue in a cohort study. J Infect Public Health 2024; 17:535-541. [PMID: 38310745 DOI: 10.1016/j.jiph.2024.01.012] [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: 08/02/2023] [Revised: 12/13/2023] [Accepted: 01/18/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Identifying predictors of severe dengue (SD) is key for triage and management of patients as well as for advising travellers to countries where dengue is endemic. In this, meta-analyses have raised diabetes mellitus as a risk factor for SD and a prognostic factor for dengue-related mortality. The purpose of this study was to assess whether diabetic patients (DPs) are at increased risk for SD in comparison to non-diabetic patients (NDPs) in a setting of high prevalence of type 2 diabetes mellitus and increasing endemicity for dengue. METHODS In a cohort study conducted during the 2019 dengue epidemic on Reunion Island, we estimated the risk ratios (RR) of DPs for SD (WHO 2009 definition), hospitalisation, intensive care unit (ICU) admission, critical care need or death in the ICU, and scales rating severity or multiple organ dysfunction syndrome (MODS), among confirmed cases of dengue (positive RT-PCR or NS1 antigen). RESULTS In a Poisson regression model adjusted for age, gender and comorbidity, DPs were more likely to develop SD (adjusted RR: 1.46, 95%CI 1.10-1.95), to be hospitalised, admitted to the ICU, and need critical care or die in the ICU. Subgroup analyses identified female DPs, non-elderly DPs (< 65 years) and DPs with low Charlson score (< 3) to be at higher risk for SD, the two first subgroups trough more severe presentation (higher Simplified Acute Physiology Score-2 values; higher MODS scores, respectively). Male gender, age less than 65 years and mixed comorbidity were identified as prognostic factors for critical care need or death in the ICU, male and non-elderly DPs being more likely to develop MODS than their non-diabetic counterparts. CONCLUSIONS Together, these data highlight the role of diabetes mellitus in the progression from dengue to SD through higher severity per se or the event of MODS.
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Affiliation(s)
- Patrick Gérardin
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France.
| | - Azizah Issop
- Service d'Endocrinologie et de Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Yves-Marie Diarra
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; UMR PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion), Sainte Clotilde, La Réunion, France
| | - Julien Cousty
- Service de Réanimation Polyvalente et de Soins Continus, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Marie-Christine Jaffar-Bandjee
- Centre National de Référence associé des arbovirus, Centre Hospitalier Universitaire Réunion, Pôle de Biologie, Saint Denis, La Réunion, France
| | - Olivier Maillard
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
| | - Loïc Raffray
- UMR PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion), Sainte Clotilde, La Réunion, France; Service de Médecine Interne, Centre Hospitalier Universitaire Réunion, Saint Denis, La Réunion, France
| | - Estelle Nobécourt
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Service d'Endocrinologie et de Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France; UMR Diabète Athérothrombose Thérapies Réunion Océan Indien (DéTROI) (INSERM U1188), Plateforme CYROI, University of La Réunion, Sainte Clotilde, La Réunion, France
| | - Antoine Bertolotti
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Service des Maladies Infectieuses, Médecine Interne, Dermatologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
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Klitting R, Piorkowski G, Rousset D, Cabié A, Frumence E, Lagrave A, Lavergne A, Enfissi A, Dos Santos G, Fagour L, Césaire R, Jaffar-Bandjee MC, Traversier N, Gérardin P, Amaral R, Fournier L, Leon L, Dorléans F, Vincent M, Fontaine A, Failloux AB, Ayhan N, Pezzi L, Grard G, Durand GA, de Lamballerie X. Molecular epidemiology identifies the expansion of the DENV2 epidemic lineage from the French Caribbean Islands to French Guiana and mainland France, 2023 to 2024. Euro Surveill 2024; 29:2400123. [PMID: 38551097 PMCID: PMC10979529 DOI: 10.2807/1560-7917.es.2024.29.13.2400123] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 03/27/2024] [Indexed: 04/01/2024] Open
Abstract
In 2023, dengue virus serotype 2 (DENV2) affected most French overseas territories. In the French Caribbean Islands, viral circulation continues with > 30,000 suspected infections by March 2024. Genome sequence analysis reveals that the epidemic lineage in the French Caribbean islands has also become established in French Guiana but not Réunion. It has moreover seeded autochthonous circulation events in mainland France. To guide prevention of further inter-territorial spread and DENV introduction in non-endemic settings, continued molecular surveillance and mosquito control are essential.
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Affiliation(s)
- Raphaëlle Klitting
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Géraldine Piorkowski
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Dominique Rousset
- Associated National Reference Center for Arboviruses, Virology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - André Cabié
- Service de Maladies infectieuses et tropicales, CHU de Martinique, Fort-de-France, France
- PCCEI, Université de Montpellier, INSERM, EFS, Montpellier, France
- CIC Antilles Guyane, INSERM CIC1424, Fort-de-France, France
| | - Etienne Frumence
- Associated National Reference Center for Arboviruses, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Alisé Lagrave
- Associated National Reference Center for Arboviruses, Virology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Anne Lavergne
- Associated National Reference Center for Arboviruses, Virology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - Antoine Enfissi
- Associated National Reference Center for Arboviruses, Virology unit, Institut Pasteur in French Guiana, Cayenne, French Guiana
| | - George Dos Santos
- PCCEI, Université de Montpellier, INSERM, EFS, Montpellier, France
- Laboratoire de virologie, CHU de Martinique, Fort-de-France, France
| | - Laurence Fagour
- PCCEI, Université de Montpellier, INSERM, EFS, Montpellier, France
- Laboratoire de virologie, CHU de Martinique, Fort-de-France, France
| | - Raymond Césaire
- Pôle de biologie territoriale, CHU de Guadeloupe, Pointe-à-Pitre, France
- PCCEI, Université de Montpellier, INSERM, EFS, Montpellier, France
| | - Marie-Christine Jaffar-Bandjee
- Associated National Reference Center for Arboviruses, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | - Nicolas Traversier
- Associated National Reference Center for Arboviruses, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
- Laboratoire de microbiologie, CHU de la Réunion-Site Nord, Saint-Denis, Réunion, France
| | | | - Rayane Amaral
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | | | - Lucie Leon
- Santé publique France, Cellule Antilles, Saint-Maurice, France
| | | | - Muriel Vincent
- Santé publique France - La Réunion, Saint-Denis, La Réunion, France
| | - Albin Fontaine
- Institut de Recherche Biomédicale des Armées (IRBA), Unité de virologie, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Anna-Bella Failloux
- Department of Virology, Arboviruses and Insect Vectors, Institut Pasteur, Paris, France
| | - Nazli Ayhan
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Laura Pezzi
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Gilda Grard
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Guillaume André Durand
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
| | - Xavier de Lamballerie
- National Reference Center for Arboviruses, Inserm-IRBA, Marseille, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ, Università di Corsica, IRD 190, Inserm 1207, IRBA), Marseille, France
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Diarra YM, Maillard O, Vague A, Guihard B, Gérardin P, Bertolotti A. Diagnostic performance of the WHO definition of probable dengue within the first 5 days of symptoms on Reunion Island. PLoS One 2024; 19:e0295260. [PMID: 38358967 PMCID: PMC10868786 DOI: 10.1371/journal.pone.0295260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/16/2023] [Indexed: 02/17/2024] Open
Abstract
The relevance of the World Health Organization (WHO) criteria for defining probable dengue had not yet been evaluated in the context of dengue endemicity on Reunion Island. The objective of this retrospective diagnostic study was to evaluate the diagnostic performance of the 2009 WHO definition of probable dengue and to propose an improvement thereof. From the medical database, we retrieved the data of subjects admitted to the emergency department of the University Hospital of Reunion Island in 2019 with suspected dengue fever (DF) within a maximum of 5 days post symptom onset, and whose diagnosis was confirmed by a Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). The intrinsic characteristics of probable dengue definitions were reported in terms of sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), using RT-PCR as the gold standard. Of the 1,181 subjects who exhibited a positive RT-PCR, 652 (55%) were classified as probable dengue. The WHO definition of probable dengue yielded a sensitivity of 64% (95%CI 60-67%), a specificity of 57% (95%CI 52-61%), a LR+ of 1.49 (95%CI 1.33-1.67), and a LR- of 0.63 (95%CI 0.56-0.72). The sensitivity and LR- for diagnosing and ruling out probable dengue could be improved by the addition of lymphopenia on admission (74% [95%CI: 71-78%] and 0.54 [95%CI: 0.46-0.63] respectively), at the cost of slight reductions of specificity and LR+ (48% [95%CI: 44-53%] and 1.42 [95%CI: 1.29-1.57], respectively). In the absence of, or when rapid diagnostic testing is unreliable, the use of the improved 2009 WHO definition of probable dengue could facilitate the identification of subjects who require further RT-PCR testing, which should encourage the development of patient management, while also optimizing the count and quarantine of cases, and guiding disease control.
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Affiliation(s)
- Yves Marie Diarra
- UMR Processus Infectieux en Milieux Insulaire Tropical (CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion), Sainte Clotilde, La Réunion, France
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
| | - Olivier Maillard
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
| | - Adrien Vague
- Service d’Accueil des Urgences, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
| | - Bertrand Guihard
- Service d’Aide Médicale Urgente, Centre Hospitalier Universitaire Réunion, Saint-Denis, France
| | - Patrick Gérardin
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
| | - Antoine Bertolotti
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
- Service des Maladies Infectieuses - Dermatologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
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Aubin A, Eldin C, Zemali N, Jaubert J, Koumar Y, Moiton MP, Poubeau P, Braunberger E, Gérardin P, Bertolotti A. Clinical and Epidemiological Aspects of Acute Q Fever in Reunion Island over Fourteen Years: A Retrospective Cohort Study. Microorganisms 2023; 11:2485. [PMID: 37894143 PMCID: PMC10609548 DOI: 10.3390/microorganisms11102485] [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: 08/24/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
The clinical characteristics and epidemiology of Q fever in the Tropics are poorly described. We performed a retrospective cohort study of hospitalized cases between 2004 and 2017 in Reunion Island. Acute Q fever was defined in presence of a positive serology (phase II IgG ≥ 200 and phase II IgM ≥ 50), or a seroconversion (4-fold increase in phase II IgG between paired samples), or a positive PCR (blood or serum). Forty-two cases matched the diagnostic criteria. The most common clinical manifestations were fever (85.7%) and pulmonary symptoms (61.9%), including pneumonia (45.2%). Ninety percent of the patients were living in a farming area. Cumulative incidence was estimated at 9.3 per 100,000 inhabitants (95%CI: 6.4-12.1) with cases diagnosed yearly all throughout the study period except in 2006. Together with the seroprevalence figures, these data suggest that Q fever reaches low to moderate endemic levels on Reunion Island. As previously reported, pulmonary symptoms are in the foreground.
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Affiliation(s)
- Alexandra Aubin
- Service des Maladies Infectieuses—Dermatologie, Centre Hospitalier Universitaire (CHU) Réunion, BP 350, 97448 Saint Pierre, La Réunion, France; (A.A.); (Y.K.); (A.B.)
| | - Carole Eldin
- Comité de Lutte Contre les Infections Nosocomiales (CLIN), Hôpital Nord, Chemin des Bourrély, 13015 Marseille, France
- Unité des Virus Emergents (UVE), Aix-Marseille Université, IRD 190 INSERM 1207 EFS-IRBA, 13005 Marseille, France
| | - Naël Zemali
- Laboratoire de Microbiologie, CHU Réunion, BP 350, 97448 Saint Pierre, La Réunion, France (J.J.)
| | - Julien Jaubert
- Laboratoire de Microbiologie, CHU Réunion, BP 350, 97448 Saint Pierre, La Réunion, France (J.J.)
| | - Yatrika Koumar
- Service des Maladies Infectieuses—Dermatologie, Centre Hospitalier Universitaire (CHU) Réunion, BP 350, 97448 Saint Pierre, La Réunion, France; (A.A.); (Y.K.); (A.B.)
| | - Marie-Pierre Moiton
- Service des Maladies Infectieuses-Médecine Interne, CHU Réunion, 97400 Saint Denis, La Réunion, France;
| | - Patrice Poubeau
- Service des Maladies Infectieuses—Dermatologie, Centre Hospitalier Universitaire (CHU) Réunion, BP 350, 97448 Saint Pierre, La Réunion, France; (A.A.); (Y.K.); (A.B.)
| | - Eric Braunberger
- Service de Chirurgie Thoracique, CHU Réunion, 97400 Saint Denis, La Réunion, France
| | - Patrick Gérardin
- Inserm CIC1410, CHU Réunion, BP 350, 97448 Saint Pierre, La Réunion, France;
| | - Antoine Bertolotti
- Service des Maladies Infectieuses—Dermatologie, Centre Hospitalier Universitaire (CHU) Réunion, BP 350, 97448 Saint Pierre, La Réunion, France; (A.A.); (Y.K.); (A.B.)
- Inserm CIC1410, CHU Réunion, BP 350, 97448 Saint Pierre, La Réunion, France;
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Devaraju M, Li A, Ha S, Li M, Shivakumar M, Li H, Nishiguchi EP, Gérardin P, Waldorf KA, Al-Haddad BJS. Beyond TORCH: A narrative review of the impact of antenatal and perinatal infections on the risk of disability. Neurosci Biobehav Rev 2023; 153:105390. [PMID: 37708918 PMCID: PMC10617835 DOI: 10.1016/j.neubiorev.2023.105390] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/07/2023] [Accepted: 09/10/2023] [Indexed: 09/16/2023]
Abstract
Infections and inflammation during pregnancy or early life can alter child neurodevelopment and increase the risk for structural brain abnormalities and mental health disorders. There is strong evidence that TORCH infections (i.e., Treponema pallidum, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes virus) alter fetal neurodevelopment across multiple developmental domains and contribute to motor and cognitive disabilities. However, the impact of a broader range of viral and bacterial infections on fetal development and disability is less well understood. We performed a literature review of human studies to identify gaps in the link between maternal infections, inflammation, and several neurodevelopmental domains. We found strong and moderate evidence respectively for a higher risk of motor and cognitive delays and disabilities in offspring exposed to a range of non-TORCH pathogens during fetal life. In contrast, there is little evidence for an increased risk of language and sensory disabilities. While guidelines for TORCH infection prevention during pregnancy are common, further consideration for prevention of non-TORCH infections during pregnancy for fetal neuroprotection may be warranted.
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Affiliation(s)
- Monica Devaraju
- University of Washington, School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA; University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Amanda Li
- University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA; Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH, USA
| | - Sandy Ha
- University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Miranda Li
- University of Washington, School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA; University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Megana Shivakumar
- University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Hanning Li
- University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Erika Phelps Nishiguchi
- University of Hawaii, Department of Pediatrics, Division of Community Pediatrics, 1319 Punahou St, Honolulu, HI, USA
| | - Patrick Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion, France; Platform for Clinical and Translational Research, Centre Hospitalier Universitaire, Saint Pierre, Réunion, France
| | - Kristina Adams Waldorf
- University of Washington, Department of Obstetrics, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Benjamin J S Al-Haddad
- University of Minnesota, Department of Pediatrics, Division of Neonatology, Academic Office Building, 2450 Riverside Ave S AO-401, Minneapolis, MN 55454, USA; Masonic Institute for the Developing Brain, 2025 E River Pkwy, Minneapolis, MN 55414, USA.
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Issop A, Bertolotti A, Diarra YM, Maïza JC, Jarlet É, Cogne M, Doussiet É, Magny É, Maillard O, Nobécourt E, Gérardin P. Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019. Travel Med Infect Dis 2023; 54:102586. [PMID: 37286121 DOI: 10.1016/j.tmaid.2023.102586] [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: 03/03/2023] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 06/09/2023]
Abstract
AIM Diabetes mellitus is associated with both the risks of severe dengue and dengue-related deaths, however the factors characterizing dengue in the diabetic patient are ill-recognized. The objective of this hospital-based cohort study was to identify the factors characterizing dengue and those able to early identify dengue severity in the diabetic patient. METHODS We retrospectively analysed demographic, clinical and biological parameters at admission in the cohort of patients who consulted at the university hospital between January and June 2019 with confirmed dengue. Bivariate and multivariate analyses were conducted. RESULTS Of 936 patients, 184 patients (20%) were diabetic. One hundred and eighty-eight patients (20%) developed severe dengue according to the WHO 2009 definition. Diabetic patients were older and had more comorbidities than non-diabetics. In an age-adjusted logistic regression model, loss of appetite, altered mental status, high neutrophil to platelet ratios (>14.7), low haematocrit (≤ 38%), upper-range serum creatinine (>100 µmol/l) and high urea to creatinine ratio (>50) were indicative of dengue in the diabetic patient. A modified Poisson regression model identified four key independent harbingers of severe dengue in the diabetic patient: presence of diabetes complications, non-severe bleeding, altered mental status and cough. Among diabetes complications, diabetic retinopathy and neuropathy, but not diabetic nephropathy nor diabetic foot, were associated with severe dengue. CONCLUSION At hospital first presentation, dengue in the diabetic patient is characterized by deteriorations in appetite, mental and renal functioning, while severe dengue can be early identified by presence of diabetes complications, dengue-related non-severe haemorrhages, cough, and dengue-related encephalopathy.
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Affiliation(s)
- Azizah Issop
- Service d'Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Antoine Bertolotti
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Service des Maladies Infectieuses, Médecine Interne, Dermatologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Yves-Marie Diarra
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; UMR PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion), Sainte Clotilde, La Réunion, France
| | - Jean-Christophe Maïza
- Service d'Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Éric Jarlet
- Service d'Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Muriel Cogne
- Service d'Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Éric Doussiet
- Service d'Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France; Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire, Réunion, Saint-Pierre, La Réunion, France
| | - Éric Magny
- Service de Biochimie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France
| | - Olivier Maillard
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France
| | - Estelle Nobécourt
- Service d'Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France; INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; UMR Diabète Athérothrombose Thérapies Réunion Océan Indien (DéTROI) (INSERM U1188), Plateforme CYROI, University of La Réunion, Sainte Clotilde, La Réunion, France
| | - Patrick Gérardin
- INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire, Réunion, Saint-Pierre, La Réunion, France.
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Kiener M, Cudjoe N, Evans R, Mapp-Alexander V, Tariq A, Macpherson C, Noël T, Gérardin P, Waechter R, LaBeaud AD. Factors Associated with Chikungunya Infection among Pregnant Women in Grenada, West Indies. Am J Trop Med Hyg 2023:tpmd230157. [PMID: 37253436 DOI: 10.4269/ajtmh.23-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/21/2023] [Indexed: 06/01/2023] Open
Abstract
Neonates are vulnerable to vector-borne diseases given the potential for mother-to-child congenital transmission. To determine factors associated with chikungunya virus (CHIKV) infection among pregnant women in Grenada, West Indies, a retrospective cohort study enrolled women who were pregnant during the 2014 CHIKV epidemic. In all, 520/688 women (75.5%) were CHIKV IgG positive. Low incomes, use of pit latrines, lack of home window screens, and subjective reporting of frequent mosquito bites were associated with increased risk of CHIKV infection in bivariate analyses. In the multivariate modified Poisson regression model, low income (adjusted relative risk [aRR]: 1.05 [95% CI: 1.01-1.10]) and frequent mosquito bites (aRR: 1.05 [95% CI: 1.01-1.10]) were linked to increased infection risk. In Grenada, markers of low socioeconomic status are associated with CHIKV infection among pregnant women. Given that Grenada will continue to face vector-borne outbreaks, interventions dedicated to improving living conditions of the most disadvantaged will help reduce the incidence of arboviral infections.
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Affiliation(s)
- Melanie Kiener
- Division of Infectious Diseases, Department of Medicine, Stanford University, Stanford, California
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St. George's, Grenada
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St. George's, Grenada
| | | | - Amna Tariq
- Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, California
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St. George's, Grenada
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St. George's, Grenada
| | - Patrick Gérardin
- INSERM CIC1410/Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire Réunion, Saint-Pierre, France
| | - Randall Waechter
- Windward Islands Research and Education Foundation, St. George's, Grenada
| | - A Desiree LaBeaud
- Division of Infectious Diseases, Department of Pediatrics, Stanford University, Stanford, California
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Carras M, Maillard O, Cousty J, Gérardin P, Boukerrou M, Raffray L, Mavingui P, Poubeau P, Cabie A, Bertolotti A. Associated risk factors of severe dengue in Reunion Island: A prospective cohort study. PLoS Negl Trop Dis 2023; 17:e0011260. [PMID: 37068115 PMCID: PMC10138848 DOI: 10.1371/journal.pntd.0011260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/27/2023] [Accepted: 03/21/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Since 2018, a dengue epidemic has been raging annually in Reunion Island, which poses the major problem of its morbidity and mortality. However, there is no consensus in the literature on factors associated with severity of illness. The objective of this study was to identify the factors associated with the occurrence of severe dengue (SD) according to the criteria adopted in 2009 by the World Health Organization (WHO), during the 2019 epidemic. METHODOLOGY/PRINCIPAL FINDINGS A total of 163 patients with RT-PCR-confirmed dengue were included in a multicenter prospective cohort study in Reunion Island between January and June 2019. Of these, 37 (23%) were classified as SD, which involves presentation dominated by at least one organ failure, and 126 (77%) classified as non-SD (of which 90 (71%) had warning signs). Confusion, dehydration, and relative hypovolemia were significantly associated with SD in bivariate analysis (p < 0.05). The factors associated with SD in multivariate analysis were a time from first symptom to hospital consultation over 2 days (OR: 2.46, CI: 1.42-4.27), a history of cardiovascular disease (OR: 2.75, 95%CI: 1.57-4.80) and being of Western European origin (OR: 17.60, CI: 4.15-74). CONCLUSIONS/SIGNIFICANCE This study confirms that SD is a frequent cause of hospitalization during dengue epidemics in Reunion Island. It suggests that cardiovascular disease, Western European origin, and delay in diagnosis and management are risk factors associated with SD fever, and that restoration of blood volume and correction of dehydration must be performed early to be effective. TRIAL REGISTRATION NCT01099852; clinicaltrials.gov.
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Affiliation(s)
- Mathys Carras
- Intensive Care Unit, CHU Réunion, Saint Pierre, Reunion, France
| | - Olivier Maillard
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Julien Cousty
- Intensive Care Unit, CHU Réunion, Saint Pierre, Reunion, France
| | - Patrick Gérardin
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Malik Boukerrou
- Department of Gynecology and Obstetrics, CHU Réunion, Saint Pierre, Reunion, France
| | - Loïc Raffray
- Department of Internal Medicine, CHU Réunion, Saint Denis, Reunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM 1187, IRD 249, Université de La Réunion, Sainte-Clotilde, Reunion, France
| | - Patrick Mavingui
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM 1187, IRD 249, Université de La Réunion, Sainte-Clotilde, Reunion, France
| | - Patrice Poubeau
- Department of Infectious Diseases, CHU Réunion, Saint-Pierre, Reunion, France
| | - André Cabie
- Department of Infectious and Tropical Diseases, CHU Martinique, Fort-de-France, Martinique, France
- Clinical Investigation Center, INSERM CIC1424, CHU Martinique, Fort-de-France, Martinique, France
| | - Antoine Bertolotti
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases, CHU Réunion, Saint-Pierre, Reunion, France
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11
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Maillard O, Belot J, Adenis T, Rollot O, Adenis A, Guihard B, Gérardin P, Bertolotti A. Early diagnosis of dengue: Diagnostic utility of the SD BIOLINE Dengue Duo rapid test in Reunion Island. PLoS Negl Trop Dis 2023; 17:e0011253. [PMID: 36996260 PMCID: PMC10089357 DOI: 10.1371/journal.pntd.0011253] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/11/2023] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND In Reunion Island, dengue outbreaks have been occurring since 2018. The healthcare facilities are facing the problem of managing a massive influx of patients and a growing care burden. The aim of this study was to evaluate the performance of the SD Bioline Dengue Duo rapid diagnostic test in adults consulting at an emergency department during the 2019 epidemic. METHODOLOGY/PRINCIPAL FINDINGS This retrospective study of diagnostic accuracy included patients over 18 years old, suspected of dengue, who were admitted to emergency units of the University Hospital of Reunion between the 1st of January and 30th of June, 2019, and were tested for dengue fever with the SD Bioline Dengue Duo rapid diagnostic test and reverse transcriptase polymerase chain reaction. Over the study period, 2099 patients were screened retrospectively. Of them, 671 patients matched the inclusion criteria. The overall rapid diagnostic test performance was 42% for sensitivity and 15% for specificity. The non-structural 1 antigen component had a good specificity of 82% but a low sensitivity of 12%. The immunoglobulin M component had a sensitivity of 28% and a specificity of 33%. Sensitivities were slightly improved beyond the 5th day of illness compared to the early stage for all components, but only the non-structural 1 antigen component had a better specificity of 91%. Furthermore, predictive values were low and post-test probabilities never improved pre-test probabilities in our setting. CONCLUSIONS/SIGNIFICANCE These results suggest that the SD Bioline Dengue Duo RDT did not achieve sufficient performance levels to rule in, or discard, an early point of care dengue diagnosis in the emergency department during the 2019 epidemic in Reunion.
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Affiliation(s)
- Olivier Maillard
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Jeanne Belot
- Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France
| | - Thibault Adenis
- Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France
| | - Olivier Rollot
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Antoine Adenis
- Department of Public Health and Research, CH Andrée Rosemon, Cayenne, French Guiana, France
- Clinical Investigation Center, INSERM CIC1424, CH Andrée Rosemon, Cayenne, French Guiana, France
| | - Bertrand Guihard
- Department of Emergency Medicine, CHU Réunion, Saint Denis, Reunion, France
| | - Patrick Gérardin
- Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
| | - Antoine Bertolotti
- Clinical Investigation Center, INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Dermatology, CHU Réunion, Saint-Pierre, Reunion, France
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Gérardin P, Fianu A. Commentary: Adverse perinatal outcomes in the SHINE cluster-randomized trial: another dark facade of the House of Hunger? Int J Epidemiol 2022; 51:1800-1802. [PMID: 35381087 DOI: 10.1093/ije/dyac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/23/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
- Patrick Gérardin
- Center for Clinical Investigation-Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France.,Platform for Clinical and Translational Research (PRCT), Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Adrian Fianu
- Center for Clinical Investigation-Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France.,Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, INSERM, Université Paul Sabatier, Toulouse, France
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13
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Fianu A, Aissaoui H, Naty N, Lenclume V, Casimir AF, Chirpaz E, Maillard O, Spodenkiewicz M, Bouscaren N, Kelly-Irving M, Rachou E, Delpierre C, Gérardin P. Health Impacts of the COVID-19 Lockdown Measure in a Low Socio-Economic Setting: A Cross-Sectional Study on Reunion Island. Int J Environ Res Public Health 2022; 19:13932. [PMID: 36360811 PMCID: PMC9657094 DOI: 10.3390/ijerph192113932] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
In March 2020, the French government implemented nation-wide measures to reduce social contact and slow the progression of the emerging coronavirus responsible for COVID-19, the most significant being a complete home lockdown that lasted 8 weeks. Reunion Island is a French overseas department marked by large social inequalities. We draw the hypothesis that distancing and lockdown measures may have contributed to an increase in the social inequalities in health (SIH) on Reunion Island. The aim of our study was to describe the SIH during lockdown in the Reunionese population. We implemented a cross-sectional telephone survey conducted between 13 May and 22 July 2020, using a retrospective data collection on the lockdown period. A total of 892 adult participants (≥18 years) were recruited in the 114 large Reunionese neighborhoods using the quota method within the national "White Pages" telephone directory. Degraded psychological states, an increase in addictive behaviors, difficulties in accessing food, a decrease in physical activity, delayed medical appointments, violence against women, and health problems in children were driven by the socio-economic characteristics of the population, most often to the disadvantage of social groups exposed to poor living conditions. These results suggest that the COVID-19 lockdown contributed to an increase in SIH.
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Affiliation(s)
- Adrian Fianu
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
- Center for Epidemiology and Research in POPulation Health (CERPOP), Université de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paul Sabatier (UPS), 31000 Toulouse, France
| | - Hind Aissaoui
- Unité de Soutien Méthodologique, Centre Hospitalier Universitaire de La Réunion, 97400 Saint-Denis, France
| | - Nadège Naty
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
| | - Victorine Lenclume
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
| | - Anne-Françoise Casimir
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
| | - Emmanuel Chirpaz
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
| | - Olivier Maillard
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
| | - Michel Spodenkiewicz
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
- Moods Team, Centre de Recherche en Épidémiologie et Santé des Populations UMR-1178, 94275 Le Kremlin-Bicetre, France
| | - Nicolas Bouscaren
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
| | - Michelle Kelly-Irving
- Center for Epidemiology and Research in POPulation Health (CERPOP), Université de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paul Sabatier (UPS), 31000 Toulouse, France
| | - Emmanuelle Rachou
- Observatoire Régional de la Santé—La Réunion, 97400 Saint-Denis, France
| | - Cyrille Delpierre
- Center for Epidemiology and Research in POPulation Health (CERPOP), Université de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paul Sabatier (UPS), 31000 Toulouse, France
| | - Patrick Gérardin
- Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Investigation Clinique CIC1410, Centre Hospitalier Universitaire de La Réunion, CEDEX, 97448 Saint-Pierre, France
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Fianu A, Doussiet É, Naty N, Porcherat S, Mussard C, Boussaïd K, Cogne M, Gérardin P, Favier F. Usefulness of Home Screening for Promoting Awareness of Impaired Glycemic Status and Utilization of Primary Care in a Low Socio-Economic Setting: A Follow-Up Study in Reunion Island. Int J Health Policy Manag 2022; 11:2208-2218. [PMID: 34634871 PMCID: PMC9808280 DOI: 10.34172/ijhpm.2021.114] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/21/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Low socio-economic settings are characterized by high prevalence of diabetes and difficulty in accessing healthcare. In these contexts, proximity health services could improve healthcare access for diabetes prevention. Our primary objective was to evaluate the usefulness of home screening for promoting awareness of impaired glycemic status and utilization of primary care among adults aged 18-79 in a low socio-economic setting. METHODS This follow-up study was conducted in 2015-2016 in Reunion Island, a French overseas department in the Indian Ocean. Enrollment and screening occurred on the same day at the home of participants (N=907). Impaired glycemic status was defined as [glycated hemoglobin (HbA1c) ≥5.7%] OR [fasting capillary blood glucose (FCBG) ≥1.10 g/L] OR [HbA1c=5.5-5.6% and FCBG=1.00-1.09 g/L]. Medical, socio-cultural, and socio-economic characteristics were collected via a face-to-face questionnaire. A one-month telephone follow-up survey was conducted to determine whether participants had consulted a general practitioner (GP) for confirmation of screening results. A multinomial polytomous logistic regression model was used to identify factors independently associated with non-use of GP consultation for confirmation of screening results and nonresponse to the telephone follow-up survey. RESULTS Prevalence of glycemic abnormalities was 46.0% (95% CI = 42.7-49.2%). Among participants with impaired glycemic status (N=417), 77.7% (95% CI=73.7-81.7%) consulted a GP for confirmation of screening results, 12.5% (95% CI=9.3-15.6%) did not, and 9.8% failed to respond to the follow-up survey. Factors independently associated with non-use of GP consultation for confirmation of screening results were self-reported unwillingness to consult a GP (adjusted odds ratio [OR]: 4.86, 95% CI=1.70-13.84), usual GP consultation frequency of less than once a year (adjusted OR: 4.13, 95% CI=1.56-10.97), and age 18-39 years (adjusted OR: 3.09, 95% CI=1.46-6.57). CONCLUSION Home screening for glycemic abnormalities is a useful proximity health service for diabetes prevention in low socio-economic settings. Further efforts, including health literacy interventions, are needed to increase utilization of primary care.
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Affiliation(s)
- Adrian Fianu
- INSERM CIC1410, CHU Réunion, Saint-Pierre, France
- CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | | | - Nadège Naty
- INSERM CIC1410, CHU Réunion, Saint-Pierre, France
| | | | | | | | - Muriel Cogne
- Service de Diabétologie - Site Sud, CHU de la Réunion, Saint-Pierre, France
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Gérardin P, Lenclume V, Doussiet E, Sarda J, Boussaid K, Naty N, Bertolotti A, Favier F, Nobécourt E, Fianu A. Impact du chikungunya sur le risque cardiovasculaire d'une population de diabétiques. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Gérardin P, Maillard O, Bruneau L, Accot F, Legrand F, Poubeau P, Manaquin R, Andry F, Bertolotti A, Cecile L. Différencier la COVID-19 et la dengue des autres maladies fébriles dans un contexte de co-épidémie : développement et validation internes des scores COVIDENGUE. MÉDECINE ET MALADIES INFECTIEUSES FORMATION 2022. [PMCID: PMC9152492 DOI: 10.1016/j.mmifmc.2022.03.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Matériels et méthodes Résultats Conclusion
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Affiliation(s)
- P. Gérardin
- CHU Réunion / INSERM CIC1410, Saint Pierre, Réunion
| | - O. Maillard
- CHU Réunion / INSERM CIC1410, Saint Pierre, Réunion
| | - L. Bruneau
- CHU Réunion / INSERM CIC1410, Saint Denis, Réunion
| | - F. Accot
- CHU Réunion, Saint Pierre, Réunion
| | - F. Legrand
- Université de La Réunion, Saint Denis, Réunion
| | | | | | - F. Andry
- CHU Réunion, Saint Pierre, Réunion
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Gérardin P, Maillard O, Bruneau L, Accot F, Legrand F, Poubeau P, Manaquin R, Andry F, Bertolotti A, Levin C. Differentiating COVID-19 and dengue from other febrile illnesses in co-epidemics: Development and internal validation of COVIDENGUE scores. Travel Med Infect Dis 2021; 45:102232. [PMID: 34896649 PMCID: PMC8656151 DOI: 10.1016/j.tmaid.2021.102232] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this cohort study was to develop two scores able to differentiate coronavirus 2019 (COVID-19) from dengue and other febrile illnesses (OFIs). METHODS All subjects suspected of COVID-19 who attended the SARS-CoV-2 testing center of Saint-Pierre hospital, Reunion, between March 23 and May 10, 2020, were assessed for identifying predictors of both infectious diseases from a multinomial logistic regression model. Two scores were developed after weighting the odd ratios then validated by bootstrapping. RESULTS Over 49 days, 80 COVID-19, 60 non-severe dengue and 872 OFIs were diagnosed. The translation of the best fit model yielded two scores composed of 11 criteria: contact with a COVID-19 positive case (+3 points for COVID-19; 0 point for dengue), return from travel abroad within 15 days (+3/-1), previous individual episode of dengue (+1/+3), active smoking (-3/0), body ache (0/+5), cough (0/-2), upper respiratory tract infection symptoms (-1/-1), anosmia (+7/-1), headache (0/+5), retro-orbital pain (-1/+5), and delayed presentation (>3 days) to hospital (+1/0). The area under the receiver operating characteristic curve was 0.79 (95%CI 0.76-0.82) for COVID-19 score and 0.88 (95%CI 0.85-0.90) for dengue score. Calibration was satisfactory for COVID-19 score and excellent for dengue score. For predicting COVID-19, sensitivity was 97% at the 0-point cut-off and specificity 99% at the 10-point cut-off. For predicting dengue, sensitivity was 97% at the 3-point cut-off and specificity 98% at the 11-point cut-off. CONCLUSIONS COVIDENGUE scores proved discriminant to differentiate COVID-19 and dengue from OFIs in the context of SARS-CoV-2 testing center during a co-epidemic.
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Affiliation(s)
- Patrick Gérardin
- Centre for Clinical Investigation - Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion.
| | - Olivier Maillard
- Centre for Clinical Investigation - Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Léa Bruneau
- Department of Public Health and Research Support, Centre Hospitalier Universitaire de La Réunion, Saint Denis, Reunion
| | - Frédéric Accot
- COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Florian Legrand
- COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; City to Hospital Outpatient Clinic for the Care of COVID-19, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Patrice Poubeau
- COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; City to Hospital Outpatient Clinic for the Care of COVID-19, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Rodolphe Manaquin
- COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; City to Hospital Outpatient Clinic for the Care of COVID-19, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Fanny Andry
- COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; City to Hospital Outpatient Clinic for the Care of COVID-19, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Antoine Bertolotti
- Centre for Clinical Investigation - Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
| | - Cécile Levin
- COVID-19 Testing Centre, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion; City to Hospital Outpatient Clinic for the Care of COVID-19, Centre Hospitalier Universitaire de La Réunion, Saint Pierre, Reunion
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18
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Bruneau L, Lenclume V, Maillot A, Rousseau A, Lagrange-Xélot M, Allou N, Gérardin P. Exhaustive assessment of Reunion Island inpatients with COVID-19 during the first wave. Infect Dis Now 2021; 52:112-116. [PMID: 34706299 PMCID: PMC8542257 DOI: 10.1016/j.idnow.2021.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/18/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022]
Affiliation(s)
- L Bruneau
- National institute of Health and Medical Research (INSERM) Center for Clinical Investigation (CIC) 1410 Clinical Epidemiology, Centre Hospitalier Universitaire, Saint Pierre, Reunion Island, France; Department of Public health and Research Support, Methodological Support and Biostatistics Unit, Centre Hospitalier Universitaire, Saint Denis, Reunion Island, France.
| | - V Lenclume
- National institute of Health and Medical Research (INSERM) Center for Clinical Investigation (CIC) 1410 Clinical Epidemiology, Centre Hospitalier Universitaire, Saint Pierre, Reunion Island, France.
| | - A Maillot
- National institute of Health and Medical Research (INSERM) Center for Clinical Investigation (CIC) 1410 Clinical Epidemiology, Centre Hospitalier Universitaire, Saint Pierre, Reunion Island, France.
| | - A Rousseau
- Department of Public health and Research Support, Methodological Support and Biostatistics Unit, Centre Hospitalier Universitaire, Saint Denis, Reunion Island, France.
| | - M Lagrange-Xélot
- Department of Infectious Diseases, Centre Hospitalier Universitaire, Saint Denis, Reunion Island, France.
| | - N Allou
- Intensive Care Unit, Centre Hospitalier Universitaire, Saint Denis, Reunion Island, France.
| | - P Gérardin
- National institute of Health and Medical Research (INSERM) Center for Clinical Investigation (CIC) 1410 Clinical Epidemiology, Centre Hospitalier Universitaire, Saint Pierre, Reunion Island, France.
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19
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Joubert A, Andry F, Bertolotti A, Accot F, Koumar Y, Legrand F, Poubeau P, Manaquin R, Gérardin P, Levin C. Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island. PLoS Negl Trop Dis 2021; 15:e0008879. [PMID: 33901185 PMCID: PMC8102001 DOI: 10.1371/journal.pntd.0008879] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 11/03/2020] [Revised: 05/06/2021] [Accepted: 03/15/2021] [Indexed: 12/21/2022] Open
Abstract
Background As coronavirus 2019 (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. Hence, we performed a retrospective cohort study to identify predictors of both infections. Methodology/Principal findings All the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls. Adjusted Odds ratios (OR) and 95% Confidence Intervals (95%CI) were assessed. Over a two-month study period, we diagnosed 80 COVID-19, 61 non-severe dengue and 872 OFIs cases eligible to multivariate analysis. Among these, we identified delayed presentation (>3 days) since symptom onset (Odds ratio 1.91, 95% confidence interval 1.07–3.39), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.21–6.55) and anosmia (OR 7.80, 95%CI 4.20–14.49) as independent predictors of COVID-19, body ache (OR 6.17, 95%CI 2.69–14.14), headache (OR 5.03, 95%CI 1.88–13.44) and retro-orbital pain (OR 5.55, 95%CI 2.51–12.28) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.09–0.79) and upper respiratory tract infection symptoms were associated with OFIs. Conclusions/Significance Although prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates. At clinical presentation, nine basic clinical and epidemiological indicators may help to distinguish COVID-19 or dengue from each other and other febrile illnesses. As coronavirus 2019 (COVID-19) is spreading globally, several countries are facing dengue epidemics with the fear the two plagues might overburden their healthcare systems. On Reunion island, southwestern Indian ocean: dengue virus is circulating since 2004 under an endemo-epidemic pattern with yearly outbreaks peaking between March and May since 2015, whereas Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the pathogen responsible of COVID-19, emerged in March 2020, imported from the Bahamas. COVID-19 and dengue are deemed two clinically similar entities, especially within the first two days from symptom onset. In this context, we conducted a cohort study between March 23 and May 10, 2020, within a SARS-CoV-2 testing center, aimed at identifying the factors discriminating both infections. Surprisingly, we found that non-severe dengue was more symptomatic than mild to moderate COVID-19. Indeed, we found body ache, headache and retro-orbital pain to be indicative of dengue, whereas contact with a COVID-19 positive case, anosmia, delayed presentation (>3 days post symptom onset) and absence of active smoking were indicative of COVID-19. These findings highlight the need for accurate diagnostic tools and not to jeopardize dengue control in areas wherever COVID-19 dengue co-epidemics have the potential to wrought havoc to the healthcare system.
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Affiliation(s)
- Antoine Joubert
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Fanny Andry
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- City to Hospital Outpatient Clinic for the care of COVID-19, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Antoine Bertolotti
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Center for Clinical Investigation–Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Frédéric Accot
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Yatrika Koumar
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- City to Hospital Outpatient Clinic for the care of COVID-19, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Florian Legrand
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- City to Hospital Outpatient Clinic for the care of COVID-19, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Patrice Poubeau
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- City to Hospital Outpatient Clinic for the care of COVID-19, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Rodolphe Manaquin
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- City to Hospital Outpatient Clinic for the care of COVID-19, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
| | - Patrick Gérardin
- Center for Clinical Investigation–Clinical Epidemiology (CIC 1410), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- * E-mail: (PG); (CL)
| | - Cécile Levin
- COVID-19 testing center, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- Department of Infectious Diseases and Tropical Medicine, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- City to Hospital Outpatient Clinic for the care of COVID-19, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Reunion, France
- * E-mail: (PG); (CL)
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20
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Foeller ME, Nosrat C, Krystosik A, Noel T, Gérardin P, Cudjoe N, Mapp-Alexander V, Mitchell G, Macpherson C, Waechter R, LaBeaud AD. Chikungunya infection in pregnancy - reassuring maternal and perinatal outcomes: a retrospective observational study. BJOG 2020; 128:1077-1086. [PMID: 33040457 DOI: 10.1111/1471-0528.16562] [Citation(s) in RCA: 4] [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] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate pregnancy and neonatal outcomes, disease severity, and mother-to-child transmission of pregnant women with Chikungunya infection (CHIKV). DESIGN Retrospective observational study. SETTING Grenada. POPULATION Women who gave birth during a Chikungunya outbreak between January 2014 and September 2015 were eligible. METHODS This descriptive study investigated 731 mother-infant pairs who gave birth during a CHIKV outbreak. Women and infants underwent serological testing for CHIKV by ELISA. MAIN OUTCOME MEASURES Primary outcomes: composite pregnancy complication (abruption, vaginal bleeding, preterm labour/cervical incompetence, cesarean delivery for fetal distress/abruption/placental abnormality or delivery for fetal distress) and composite neonatal morbidity. RESULTS Of 416 mother-infant pairs, 150 (36%) had CHIKV during pregnancy, 135 (33%) had never had CHIKV, and 131 (31%) had CHIKV outside of pregnancy. Mean duration of joint pain was shorter among women infected during pregnancy (μ = 898 days, σ = 277 days) compared with infections outside of pregnancy (μ = 1064 days, σ = 244 days) (P < 0.0001). Rates of pregnancy complications (RR = 0.76, P = 0.599), intrapartum complications (RR = 1.50, P = 0.633), and neonatal outcomes were otherwise similar. Possible mother-to-child transmission occurred in two (1.3%) mother-infant pairs and two of eight intrapartum infections (25%). CONCLUSION CHIKV infection during pregnancy may be protective against long-term joint pain sequelae that are often associated with acute CHIKV infection. Infection during pregnancy did not appear to pose a risk for pregnancy complications or neonatal health, but maternal infection just prior to delivery might have increased risk of mother-to-child transmission of CHIKV. TWEETABLE ABSTRACT Chikungunya infection did not increase risk of pregnancy complications or adverse neonatal outcomes, unless infection was just prior to delivery.
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Affiliation(s)
- M E Foeller
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - C Nosrat
- Program in Human Biology, Stanford University, Stanford, CA, USA
| | - A Krystosik
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
| | - T Noel
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - P Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion.,Unité Mixte 134 PIMIT (INSERM 1187, CNRS 9192, IRD 249, Université de La Réunion), Sainte Clotilde, Réunion
| | - N Cudjoe
- Windward Islands Research and Education Foundation, True Blue, Grenada
| | - V Mapp-Alexander
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - G Mitchell
- Ministry of Health, St. Georges, Grenada
| | - C Macpherson
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - R Waechter
- Windward Islands Research and Education Foundation, True Blue, Grenada.,St. George's University, St. Georges, Grenada
| | - A D LaBeaud
- Division of Infectious Disease, Department of Pediatrics, Stanford University, School of Medicine, Stanford, CA, USA
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21
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Macaux L, Zemali N, Jaubert J, Koumar Y, Manaquin R, Poubeau P, Camuset G, Gérardin P, Bertolotti A. Single Dose of Azithromycin for Treatment of Patients with Asymptomatic Rectal Chlamydia trachomatis. Acta Derm Venereol 2020; 100:adv00313. [PMID: 33111150 PMCID: PMC9309833 DOI: 10.2340/00015555-3675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lou Macaux
- Infectious Diseases and Dermatology, CHU Réunion, FR-97410 Saint Pierre, France
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22
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Waechter R, Ingraham E, Evans R, Cudjoe N, Krystosik A, Isaac R, Watts A, Noël T, Landon B, Fernandes M, Mapp-Alexander V, Suresh P, Mitchell G, Macpherson C, Gérardin P, LaBeaud AD. Pre and postnatal exposure to Chikungunya virus does not affect child neurodevelopmental outcomes at two years of age. PLoS Negl Trop Dis 2020; 14:e0008546. [PMID: 33017393 PMCID: PMC7535067 DOI: 10.1371/journal.pntd.0008546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/30/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The 2005-06 chikungunya virus (CHIKV) outbreak in La Réunion suggested that mothers could transmit CHIKV to their neonates while viremic during the intrapartum period, and more than half of the infected neonates showed impaired neurodevelopment at two years of age. However, data sparsity precluded an overview of the developmental impact of vertical infection within the whole prenatal period. OBJECTIVE & METHODS The current study assessed two-year old children born to mothers who were infected during the 2014 CHIKV outbreak in Grenada to determine the neurodevelopmental impact of perinatal CHIKV infection throughout gestation. Mother and child infection status were confirmed by serologic testing (IgG and IgM) for CHIKV. Cognitive, fine motor, gross motor, language and behavioral outcomes were assessed at two years of age on the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA). RESULTS No differences in neurodevelopmental outcomes were observed between two-year-old children born to mothers infected with CHIKV during gestation (n = 149) and those born to mothers not infected with CHIKV (n = 161). No differences were found in INTER-NDA scores between children infected with CHIKV (n = 47) and children not infected with CHIKV (n = 592). Likewise, there were no differences between children infected with CHIKV post-partum (n = 19) versus children not infected with CHIKV (n = 592). CONCLUSION Our findings suggest that children exposed and/or infected with CHIKV outside of the intrapartum period experience no significant neurodevelopmental delay at two years of age, as measured by the INTER-NDA, compared to their unexposed and/or uninfected peers. These results complement those of previous studies which showed a neurodevelopmental risk only for children infected during the intrapartum period, while the mother was highly viremic. These results might be reassuring for women of childbearing age and public health officials in CHIKV-endemic regions.
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Affiliation(s)
- Randall Waechter
- Department of Neuroscience and Physiology and Behavioral Sciences, School of Medicine, St. George’s University, St. George’s, Grenada, West Indies
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Erinique Ingraham
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Roberta Evans
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Nikita Cudjoe
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Amy Krystosik
- Stanford University, School of Medicine, Department of Pediatrics, Division of Infectious Disease, California, United States of America
| | - Rashida Isaac
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Ashlee Watts
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
| | - Trevor Noël
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- Office of Research, St. George’s University, St. George’s, Grenada, West Indies
| | - Barbara Landon
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- Psychological Services Center, St. George’s University, St. George’s, Grenada, West Indies
| | - Michelle Fernandes
- Faculty of Medicine, Department of Paediatrics, University Hospitals Southampton, University of Southampton, Southampton, United Kingdom
- Nuffield Department of Women’s & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Veronica Mapp-Alexander
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- School of Veterinary Medicine, St. George’s University, St. George’s, Grenada, West Indies
| | - Priyanka Suresh
- Stanford University, School of Medicine, Department of Pediatrics, Division of Infectious Disease, California, United States of America
| | - George Mitchell
- Office of Chief Medical Officer, Ministry of Health, St, George’s, Grenada, West Indies
| | - Calum Macpherson
- Windward Islands Research and Education Foundation, St. George’s, Grenada, West Indies
- Office of Research, St. George’s University, St. George’s, Grenada, West Indies
| | - Patrick Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion / Unité Mixte 134 PIMIT (Université de La Réunion, CNRS 9192, INSERM U1187, IRD 249), Sainte Clotilde, Réunion
| | - A. Desiree LaBeaud
- Stanford University, School of Medicine, Department of Pediatrics, Division of Infectious Disease, California, United States of America
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23
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Venkatesan S, Myles PR, Bolton KJ, Muthuri SG, Al Khuwaitir T, Anovadiya AP, Azziz-Baumgartner E, Bajjou T, Bassetti M, Beovic B, Bertisch B, Bonmarin I, Booy R, Borja-Aburto VH, Burgmann H, Cao B, Carratala J, Chinbayar T, Cilloniz C, Denholm JT, Dominguez SR, Duarte PAD, Dubnov-Raz G, Fanella S, Gao Z, Gérardin P, Giannella M, Gubbels S, Herberg J, Higuera Iglesias AL, Hoeger PH, Hu XY, Islam QT, Jiménez MF, Keijzers G, Khalili H, Kusznierz G, Kuzman I, Langenegger E, Lankarani KB, Leo YS, Libster RP, Linko R, Madanat F, Maltezos E, Mamun A, Manabe T, Metan G, Mickiene A, Mikić D, Mohn KGI, Oliva ME, Ozkan M, Parekh D, Paul M, Rath BA, Refaey S, Rodríguez AH, Sertogullarindan B, Skręt-Magierło J, Somer A, Talarek E, Tang JW, To K, Tran D, Uyeki TM, Vaudry W, Vidmar T, Zarogoulidis P, Nguyen-Van-Tam JS. Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection. J Infect Dis 2020; 221:356-366. [PMID: 31314899 PMCID: PMC7313925 DOI: 10.1093/infdis/jiz152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/25/2018] [Accepted: 05/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. Methods We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded. Results We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78–.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS. Conclusions When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment.
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Affiliation(s)
- Sudhir Venkatesan
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham
- Correspondence: S. Venkatesan, MPH, PhD, Rm B104, Clinical Sciences Bldg, Nottingham City Hospital, Hucknall Rd, Nottingham NG5 1PB, UK ()
| | - Puja R Myles
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham
| | - Kirsty J Bolton
- School of Mathematical Sciences, University of Nottingham, Nottingham
| | - Stella G Muthuri
- MRC Unit for Lifelong Health and Ageing, University College London
| | - Tarig Al Khuwaitir
- Department of Medicine, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ashish P Anovadiya
- Department of Pharmacology, Government Medical College and Sir Takhtasinhji General Hospital, Bhavnagar, India
| | - Eduardo Azziz-Baumgartner
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tahar Bajjou
- University Mohammed V-Souissi, Faculty of Medicine and Pharmacy, Mohammed V Military Teaching Hospital, Biosafety Level 3 and Research Laboratory, Rabat, Morocco
| | | | - Bojana Beovic
- Department of Infectious Diseases, University Medical Center, Ljubljana
| | | | | | - Robert Booy
- National Centre for Immunisation Research and Surveillance, Children’s Hospital at Westmead, University of Sydney
| | | | | | - Bin Cao
- Beijing Chao-Yang Hospital, Capital Medical University
| | - Jordi Carratala
- Department of Infectious Diseases, Bellvitge University Hospital, Bellvitge Biomedical Research Institute, Spanish Network for Research in Infectious Diseases
| | - Tserendorj Chinbayar
- National Influenza Center, National Center of Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Catia Cilloniz
- Hospital Clinic, August Pi I Sunyer Biomedical Research Institute, University of Barcelona, CIBERES, Barcelona
| | - Justin T Denholm
- Victorian Infectious Diseases Service and Department of Microbiology and Immunology, at the Peter Doherty Institute for Infection and Immunity, Parkville
| | - Samuel R Dominguez
- Department of Pediatric Infectious Diseases, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora
| | | | - Gal Dubnov-Raz
- Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Ramat Gan
| | - Sergio Fanella
- Section of Pediatric Infectious Diseases, University of Manitoba, Winnipeg
| | - Zhancheng Gao
- Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital
| | - Patrick Gérardin
- Pôle Femme Mère Enfant
- Center for Clinical Investigation 1410, Institut National de la Santé et de la Recherche Médical (INSERM), Centre Hospitalier Universitaire de la Réunion, Saint Pierre
- Unité Mixte 134 Processus Infectieux en Milieu Insulaire Tropical, Centre National de la Recherche Scientifique 9192, INSERM U1187, Institut Recherche et Développement 249, Université de la Réunion, Cyclotron Réunion-océan Indien, Sainte Clotilde, Reunion
| | - Maddalena Giannella
- Department of Clinical and Surgical Sciences, Sant’Orsola Malpighi Hospital, University of Bologna, Bologna, Italy
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid
| | - Sophie Gubbels
- Department of Infectious Disease Epidemiology, Sector for National Health Documentation and Research, Statens Serum Institut, Copenhagen, Denmark
| | - Jethro Herberg
- Section of Paediatrics, Division of Infectious Disease, Imperial College, London
| | - Anjarath Lorena Higuera Iglesias
- Department of Research in Clinical Epidemiology, Instituto Nacional de Enfermedades Respiratorias Dr. Ismael Cosío Villegas, Mexico City, Mexico
| | | | - Xiao Yun Hu
- Peking Union Medical College Hospital, Beijing
| | | | - Mirela F Jiménez
- Departamento de Ginecologia e Obstetrícia–UFCSPA, Preceptora da Residência Médica do Hospital Fêmina, Fêmina, Brazil
| | | | - Hossein Khalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Gabriela Kusznierz
- National Institute of Respiratory Diseases “Emilio Coni” ANLIS “C. Malbran,” Santa Fe
| | - Ilija Kuzman
- University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Croatia
| | - Eduard Langenegger
- Department of Obstetrics and Gynaecology, Stellenbosch University–Tygerberg, Cape Town, South Africa
| | - Kamran B Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yee-Sin Leo
- Department of Infectious Diseases, Tan Tock Seng Hospital
| | - Romina P Libster
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
- Fundacion INFANT
- National Scientific and Technical Research Council, Buenos Aires
| | | | - Faris Madanat
- Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan
| | - Efstratios Maltezos
- Unit of Infectious Diseases, University General Hospital of Alexandroupolis, Democritus University Thrace, Dragana
| | | | - Toshie Manabe
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Gokhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Ankara
| | - Auksė Mickiene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dragan Mikić
- Military Medical Academy, Clinic for Infectious and Tropical Diseases, University of Defense, Belgrade, Serbia
| | - Kristin G I Mohn
- Influenza Center, Department of Clinical Science, University of Bergen
- Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway
| | - Maria E Oliva
- Department of Infection Control, Hospital San Martín de Paraná, Entre Ríos, Argentina
| | - Mehpare Ozkan
- Pediatric Neurology Department, Bahçeşehir University
| | - Dhruv Parekh
- Respiratory and Critical Care Medicine, Institute of Inflammation and Ageing, University of Birmingham, Birmingham
| | - Mical Paul
- Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel
| | - Barbara A Rath
- Department of Pediatrics, Charité–University Medical Center Berlin, Berlin, Germany
| | - Samir Refaey
- Epidemiology and Surveillance Department, Ministry of Health and Population, Cairo, Egypt
| | | | | | | | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul University, Istanbul
| | - Ewa Talarek
- Department of Children’s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Julian W Tang
- Department of Respiratory Sciences, University of Leicester
- University Hospitals Leicester, Leicester, United Kingdom
- Molecular Diagnostic Centre, Department of Laboratory Medicine, National University Hospital, Singapore
| | - Kelvin To
- Carol Yu Centre for Infection and Division of Infectious Diseases, Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Dat Tran
- Acute and Communicable Disease Prevention, Public Health Division, Oregon Health Authority, Portland
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wendy Vaudry
- Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Stollery Children’s Hospital, Edmonton, Canada
| | - Tjasa Vidmar
- General Hospital Slovenj Gradec, Slovenj Gradec, Slovenia
| | - Paul Zarogoulidis
- Pulmonary Department, “G. Papanikalaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Dumez J, Lenclume V, Fianu A, Doussiet E, Boussaid K, Naty N, Ballichi J, Bertolotti A, Nobécourt E, Gérardin P. Impact d’une épidémie de chikungunya sur l’équilibre glycémique d’une population à risque de diabète de type 2 : étude de cohorte en population. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jaubert J, Atiana L, Larrieu S, De Vos P, Somon-Payet C, Porcherat S, Mboussou Y, Naze F, Picot S, Boukerrou M, Robillard PY, Gérardin P. Q fever seroprevalence in parturient women: the EQRUN cross-sectional study on Reunion Island. BMC Infect Dis 2020; 20:261. [PMID: 32245372 PMCID: PMC7118902 DOI: 10.1186/s12879-020-04969-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
Background Q fever (Coxiella burnetii infection) has been associated with adverse perinatal outcomes. After investigating the obstetrical importance of Q fever on Reunion island and demonstrating an association between incident Q fever and miscarriage, we conducted a cross-sectional serosurvey to assess the prevalence of Coxiella burnetii infection among parturient women. Methods Between January 9 and July 24, 2014, within the level-4 maternity of Saint Pierre hospital and the level-1 maternity of Le Tampon, we proposed to screen all parturient women for Coxiella burnetii serology. Seropositivity was defined using indirect immunofluorescence for a dilution of phase 2 IgG titre ≥1:64. Further dilutions were chosen to discriminate recent or active infections from past or prevalent infections (< 1:128) and classify these as either possible (1:128), or probable (≥1:256). Recurrent miscarriage, stillbirth, preterm birth, small-for-gestational as well as a composite outcome of these adverse pregnancy outcomes were compared according to seropositivity using bivariate analysis or propensity score matching of seropositive and seronegative women on confounding factors. Results Among 1112 parturient women screened for Q fever over this 7-month period, 203 (18.3%) were seropositive. Overall weighted seroprevalence was of 20.1% (95%CI, 17.7–22.5%). Weighted seroprevalence of probable infections was 4.7% (95%CI 3.4–5.9%), while > 90% of positive serologies corresponded to past infections or false positives. Seropositivity was associated with none of the abovementioned adverse perinatal outcomes, whether in unpaired or matched analyses on propensity score. Conclusion The magnitude and the pattern of seroprevalence suggest that Q fever is endemic on Reunion island. In this context, we found no significant contribution of prevalent Coxiella burnetii infection to adverse pregnancy outcomes. Although reassuring, these data put in our endemic context, with a previously demonstrated increased risk of incident Q fever associated miscarriage, encourage us to protect pregnant women against the risk of new infection, periconceptional or early in pregnancy.
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Affiliation(s)
- Julien Jaubert
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Laura Atiana
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Sophie Larrieu
- CIRE Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | | | - Claudine Somon-Payet
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France
| | - Sylvaine Porcherat
- INSERM CIC 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire, Groupe Hospitalier Sud Réunion, CHU Réunion, BP 350, 97448, Saint Pierre, Cedex-Reunion, France
| | - Yoan Mboussou
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Florence Naze
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Malik Boukerrou
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France.,CEPOI-EA7388, Pôle Femme Mère Enfant, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Pierre-Yves Robillard
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France.,CEPOI-EA7388, Pôle Femme Mère Enfant, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Patrick Gérardin
- INSERM CIC 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire, Groupe Hospitalier Sud Réunion, CHU Réunion, BP 350, 97448, Saint Pierre, Cedex-Reunion, France. .,UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France.
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Stachetti T, Spodenkiewicz M, Winer A, Boukerrou M, Jesson J, Gérardin P. Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework. Journal of Global Health Reports 2019. [DOI: 10.29392/joghr.3.e2019085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Godeluck A, Gérardin P, Lenclume V, Mussard C, Robillard PY, Sampériz S, Benhammou V, Truffert P, Ancel PY, Ramful D. Mortality and severe morbidity of very preterm infants: comparison of two French cohort studies. BMC Pediatr 2019; 19:360. [PMID: 31623604 PMCID: PMC6796444 DOI: 10.1186/s12887-019-1700-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/29/2019] [Indexed: 01/28/2023] Open
Abstract
Background In Reunion Island, a French overseas department, the burden of preterm birth and perinatal mortality exceed those observed in mainland France, despite similar access to standard perinatal care. The purpose of the study was to compare the outcome of two cohorts of NICU-admitted very preterm infants born between 24 and 31 weeks of gestation (WG): the registry-based OGP (Observatoire de la Grande Prématurité, Reunion Island, 2008–2013) cohort, and the nationwide EPIPAGE-2 (mainland France, 2011) observational cohort. Methods The primary outcome was adverse neonatal outcomes defined as a composite indicator of in-hospital mortality or any of three following severe morbidities: bronchopulmonary dysplasia (BPD), necrotising enterocolitis, or severe neurological injury (periventricular leukomalacia or grade III-IV intraventricular haemorrhages). Logistic regression modelling adjusting for confounders was performed. Results A total of 1272 very preterm infants from the Reunionese OGP cohort and 3669 peers from the mainland EPIPAGE-2 cohort were compared. Adverse neonatal outcomes were more likely observed in the OGP cohort (32.6% versus 26.6%, p < 0.001), as result of both increased in-hospital mortality across all gestational age strata and increased BPD among the survivors of the 29–31 WG stratum. After adjusting for gestational age, gender and multiple perinatal factors, the risk of adverse neonatal outcomes was higher in the OGP cohort than in the EPIPAGE-2 cohort across all gestational age strata. Conclusions Despite similar guidelines for standard perinatal care, very preterm infants born in Reunion Island have a higher risk for death or severe morbidity compared with those born in mainland France. Electronic supplementary material The online version of this article (10.1186/s12887-019-1700-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Patrick Gérardin
- INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion
| | - Victorine Lenclume
- INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion
| | - Corinne Mussard
- INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion
| | - Pierre-Yves Robillard
- CHU de la Réunion, Saint Pierre, Réunion.,Centre d'Etudes Périnatales de l'Océan Indien (CEPOI), Université de la Réunion, EA 7388, Saint-Denis, France
| | | | | | - Patrick Truffert
- CHU Lille, EA 2694 Public Health, Epidemiology and Quality of Care unit, F-59000, Lille, France
| | - Pierre-Yves Ancel
- INSERM U 1153, CHU Cochin Hôtel Dieu, Paris, France.,Université Paris Descartes, Paris, France.,URC - CIC1419 Plurithématique, Cochin Hôtel Dieu, Paris, France
| | - Duksha Ramful
- CHU de la Réunion, Saint Denis, Réunion. .,INSERM CIC1410 Epidémiologie Clinique, CHU de la Réunion, Saint Pierre, Réunion. .,Postal address: Neonatal and pediatric intensive care unit, Félix Guyon Hospital, CHU de La Réunion, Allée des Topazes, CS 11021, 97400, Saint-Denis Cedex, La Réunion, France.
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Gérardin P, Freitas ARR, Sissoko D, Teixeira MG. Transmission Dynamics and Disease Severity in Children Infected With East Central South African (ECSA) or ECSA-diverged Clades of Chikungunya Virus. Clin Infect Dis 2019; 68:171-172. [PMID: 29982440 DOI: 10.1093/cid/ciy534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 06/28/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Patrick Gérardin
- Centre Hospitalier Universitaire Réunion, Institut National de la Santé Et de la Recherche Médicale (INSERM) Centre d'Investigation Clinique (CIC) 1410, Saint Pierre/Unité Mixte de Recherche 134 Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, Sainte Clotilde, Réunion, France
| | | | | | - Maria Gloria Teixeira
- Universidade Federal da Bahia/Instituto de Saúde Coletiva, Rua Basílio da Gama, s/n.Canela, Salvador, Bahia, Brazil
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Paixão ES, Rodrigues LC, Costa MDCN, Itaparica M, Barreto F, Gérardin P, Teixeira MG. Chikungunya chronic disease: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2019; 112:301-316. [PMID: 30007303 DOI: 10.1093/trstmh/try063] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/11/2018] [Indexed: 12/13/2022] Open
Abstract
Background Chikungunya is a mosquito-borne disease caused by an arthritogenic alphavirus, with four genotypes: East Central South African (ECSA), West African, ECSA-diverged or Indian Ocean Lineage (IOL) and Asian lineage. Overall, the disease is self-limited; however, in some patients, joint pain and other non-specific symptoms can last for months or years. This systematic review and meta-analysis aims to estimate the proportion of people that self-report chikungunya-related chronic non-specific symptoms. Methods Medline, EMBASE, Global Health Library and Scopus were searched for articles published before March 2017. Case-control, cohort, cross-sectional, clinical trials studies and outcome-independent case series were eligible. It was estimated that the proportion of patients who did not recover, by virus genotype, and by the time between disease onset and assessment of chronic symptoms. Results A total of 38 studies were included in the review and 34 in the meta-analysis. Of 6532 chikungunya patients, 3157 did not recover fully after 3 months. The overall no recovery rate associated with chikungunya was 43% (95% CI, 35-52%); Inter-genotype group heterogeneity was observed, the highest prevalence in the ECSA-diverged genotype: 50% (95% CI; 40-60%), followed by the Asian lineage genotype: 36% (95% CI; 20-52%). After 12 months follow-up, the overall no-recovery rate was 21% (95% CI; 19-22%). Conclusion The evidence suggests that the prevalence of chronic discomfort associated with chikungunya illness varies by virus lineage. The proportion of people that do not fully recovered after chikungunya was high and, therefore, health authorities must prepare to treat patients with symptoms of long-lasting chikungunya adequately addressing the physical, psychological and social needs.
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Affiliation(s)
- Enny S Paixão
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, UK.,Instituto de Saúde Coletiva. Rua Basílio da Gama, s/n. Canela. CEP 40110040. Salvador, Bahia, Brasil
| | - Laura C Rodrigues
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, UK
| | | | - Martha Itaparica
- Instituto de Saúde Coletiva. Rua Basílio da Gama, s/n. Canela. CEP 40110040. Salvador, Bahia, Brasil
| | - Florisneide Barreto
- Instituto de Saúde Coletiva. Rua Basílio da Gama, s/n. Canela. CEP 40110040. Salvador, Bahia, Brasil
| | - Patrick Gérardin
- INSERM CIC1410, CHU Réunion, Saint Pierre, Reunion/UM 134 PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de la Réunion), CYROI, Sainte Clotilde, Reunion
| | - Maria Glória Teixeira
- Instituto de Saúde Coletiva. Rua Basílio da Gama, s/n. Canela. CEP 40110040. Salvador, Bahia, Brasil
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Gérardin P, Zemali N, Bactora M, Camuset G, Balleydier E, Pascalis H, Guernier V, Mussard C, Bertolotti A, Koumar Y, Naze F, Picot S, Filleul L, Pages F, Tortosa P, Jaubert J. Seroprevalence of typhus group and spotted fever group Rickettsia exposures on Reunion island. BMC Res Notes 2019; 12:387. [PMID: 31288833 PMCID: PMC6617902 DOI: 10.1186/s13104-019-4416-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/06/2019] [Accepted: 06/29/2019] [Indexed: 11/19/2022] Open
Abstract
Objective Murine typhus has been increasingly reported on Reunion island, Indian ocean, following documentation of eight autochthonous infections in 2012–2013. We conducted a serosurvey to assess the magnitude of the seroprevalence of rickettsioses in the population. Two hundred and forty-one stored frozen sera taken from the 2009 Copanflu-RUN cohort were analysed using an immunofluorescence assay allowing to distinguish typhus group (TGR) and spotted fever group Rickesttsiae (SFGR). Seropositivity was defined for a dilution titre of Rickettsia IgG antibodies ≥ 1:64. Seroprevalence was weighted to account for the discrepancy between the Copanflu-RUN subset and the general population, as to infer prevalence at community level. Prevalence proportion ratios (PPR) were measured using log-binomial models. Results The weighted seroprevalences of typhus group rickettsioses and spotted fever group rickettsioses were of 12.71% (95% CI 8.84–16.58%) and 17.68% (95% CI 13.25–22.11%), respectively. Pooled together, data suggested that a fifth of the population had been exposed at least to one Rickettsia group. Youths (< 20 years) were less likely seropositive than adults (adjusted PPR 0.13, 95% CI 0.01–0.91). People living in the western dryer part of the island were more exposed (adjusted PPR 2.53, 95% CI 1.07–5.97). Rickettsioses are endemic on Reunion island and circulated before their first identification as murine typhus in year 2011. Surprisingly, since isolation of Rickettsia africae from Amblyomma variegatum in year 2004 or isolation of Rickettsia felis from Amblyomma loculosum, no autochthonous cases of African tick-bite fever or flea-borne spotted fever has yet been diagnosed. Electronic supplementary material The online version of this article (10.1186/s13104-019-4416-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Gérardin
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex, Reunion, France. .,UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, INSERM 1187, CNRS 9192, IRD 249, CYROI, Université de La Réunion, Sainte Clotilde, Reunion, France.
| | - Naël Zemali
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Marie Bactora
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Guillaume Camuset
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Elsa Balleydier
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Hervé Pascalis
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, INSERM 1187, CNRS 9192, IRD 249, CYROI, Université de La Réunion, Sainte Clotilde, Reunion, France
| | - Vanina Guernier
- Geelong Centre for Emerging Infectious Diseases, Deakin University, Geelong, VIC, Australia
| | - Corinne Mussard
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex, Reunion, France
| | - Antoine Bertolotti
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire (CHU), Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex, Reunion, France.,Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Yatrika Koumar
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Florence Naze
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Laurent Filleul
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Frédéric Pages
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Pablo Tortosa
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, INSERM 1187, CNRS 9192, IRD 249, CYROI, Université de La Réunion, Sainte Clotilde, Reunion, France
| | - Julien Jaubert
- Laboratoire de Bactériologie, Virologie et Parasitologie, CHU de la Réunion, Saint Pierre, Reunion, France
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Wilder-Smith A, Wei Y, de Araújo TVB, VanKerkhove M, Turchi Martelli CM, Turchi MD, Teixeira M, Tami A, Souza J, Sousa P, Soriano-Arandes A, Soria-Segarra C, Sanchez Clemente N, Rosenberger KD, Reveiz L, Prata-Barbosa A, Pomar L, Pelá Rosado LE, Perez F, Passos SD, Nogueira M, Noel TP, Moura da Silva A, Moreira ME, Morales I, Miranda Montoya MC, Miranda-Filho DDB, Maxwell L, Macpherson CNL, Low N, Lan Z, LaBeaud AD, Koopmans M, Kim C, João E, Jaenisch T, Hofer CB, Gustafson P, Gérardin P, Ganz JS, Dias ACF, Elias V, Duarte G, Debray TPA, Cafferata ML, Buekens P, Broutet N, Brickley EB, Brasil P, Brant F, Bethencourt S, Benedetti A, Avelino-Silva VL, Ximenes RADA, Alves da Cunha A, Alger J. Understanding the relation between Zika virus infection during pregnancy and adverse fetal, infant and child outcomes: a protocol for a systematic review and individual participant data meta-analysis of longitudinal studies of pregnant women and their infants and children. BMJ Open 2019; 9:e026092. [PMID: 31217315 PMCID: PMC6588966 DOI: 10.1136/bmjopen-2018-026092] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Zika virus (ZIKV) infection during pregnancy is a known cause of microcephaly and other congenital and developmental anomalies. In the absence of a ZIKV vaccine or prophylactics, principal investigators (PIs) and international leaders in ZIKV research have formed the ZIKV Individual Participant Data (IPD) Consortium to identify, collect and synthesise IPD from longitudinal studies of pregnant women that measure ZIKV infection during pregnancy and fetal, infant or child outcomes. METHODS AND ANALYSIS We will identify eligible studies through the ZIKV IPD Consortium membership and a systematic review and invite study PIs to participate in the IPD meta-analysis (IPD-MA). We will use the combined dataset to estimate the relative and absolute risk of congenital Zika syndrome (CZS), including microcephaly and late symptomatic congenital infections; identify and explore sources of heterogeneity in those estimates and develop and validate a risk prediction model to identify the pregnancies at the highest risk of CZS or adverse developmental outcomes. The variable accuracy of diagnostic assays and differences in exposure and outcome definitions means that included studies will have a higher level of systematic variability, a component of measurement error, than an IPD-MA of studies of an established pathogen. We will use expert testimony, existing internal and external diagnostic accuracy validation studies and laboratory external quality assessments to inform the distribution of measurement error in our models. We will apply both Bayesian and frequentist methods to directly account for these and other sources of uncertainty. ETHICS AND DISSEMINATION The IPD-MA was deemed exempt from ethical review. We will convene a group of patient advocates to evaluate the ethical implications and utility of the risk stratification tool. Findings from these analyses will be shared via national and international conferences and through publication in open access, peer-reviewed journals. TRIAL REGISTRATION NUMBER PROSPERO International prospective register of systematic reviews (CRD42017068915).
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Affiliation(s)
- Annelies Wilder-Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yinghui Wei
- Centre for Mathematical Sciences, University of Plymouth, Plymouth, UK
| | | | - Maria VanKerkhove
- Health Emergencies Programme, Organisation mondiale de la Sante, Geneve, Switzerland
| | | | - Marília Dalva Turchi
- Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil
| | - Mauro Teixeira
- Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Adriana Tami
- Department of Medical Microbiology, University Medical Center Groningen, Groningen, The Netherlands
| | - João Souza
- Department of Social Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia Sousa
- Reference Center for Neurodevelopment, Assistance, and Rehabilitation of Children, State Department of Health of Maranhão, Sao Luís, Brazil
| | | | | | | | - Kerstin Daniela Rosenberger
- Department of Infectious Diseases, Section Clinical Tropical Medicine, UniversitatsKlinikum Heidelberg, Heidelberg, Germany
| | - Ludovic Reveiz
- Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Arnaldo Prata-Barbosa
- Department of Pediatrics, D’Or Institute for Research & Education, Rio de Janeiro, Brazil
| | - Léo Pomar
- Department of Obstetrics and Gynecology, Centre Hospitalier de l’Ouest Guyanais, Saint-Laurent du Maroni, French Guiana
| | | | - Freddy Perez
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington, District of Columbia, USA
| | | | - Mauricio Nogueira
- Faculdade de Medicina de Sao Jose do Rio Preto, Department of Dermatologic Diseases, São José do Rio Preto, Brazil
| | - Trevor P. Noel
- Windward Islands Research and Education Foundation, St. George’s University, True Blue Point, Grenada
| | - Antônio Moura da Silva
- Department of Public Health, Universidade Federal do Maranhão – São Luís, São Luís, Brazil
| | | | - Ivonne Morales
- Department of Infectious Diseases, Section Clinical Tropical Medicine, UniversitatsKlinikum Heidelberg, Heidelberg, Germany
| | | | | | - Lauren Maxwell
- Reproductive Health and Research, World Health Organization, Geneva, Switzerland
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA
| | - Calum N. L. Macpherson
- Windward Islands Research and Education Foundation, St. George’s University, True Blue Point, Grenada
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Zhiyi Lan
- McGill University Health Centre, McGill University, Montréal, Canada
| | | | - Marion Koopmans
- Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Caron Kim
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Esaú João
- Department of Infectious Diseases, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil
| | - Thomas Jaenisch
- Department of Infectious Diseases, Section Clinical Tropical Medicine, UniversitatsKlinikum Heidelberg, Heidelberg, Germany
| | - Cristina Barroso Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paul Gustafson
- Statistics, University of British Columbia, British Columbia, Vancouver, Canada
| | - Patrick Gérardin
- INSERM CIC1410 Clinical Epidemiology, CHU La Réunion, Saint Pierre, Réunion
- UM 134 PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de la Réunion), Universite de la Reunion, Sainte Clotilde, Réunion
| | | | - Ana Carolina Fialho Dias
- Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa Elias
- Sustainable Development and Environmental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Geraldo Duarte
- Department of Gynecology and Obstetrics, University of São Paulo, São Paulo, Brazil
| | - Thomas Paul Alfons Debray
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - María Luisa Cafferata
- Mother and Children Health Research Department, Instituto de Efectividad Clinica y Sanitaria, Buenos Aires, Argentina
| | - Pierre Buekens
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - Nathalie Broutet
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Elizabeth B. Brickley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Patrícia Brasil
- Instituto de pesquisa Clínica Evandro Chagas, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Fátima Brant
- Department of Biochemistry and Immunology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sarah Bethencourt
- Facultad de Ciencias de la Salud, Universidad de Carabobo, Valencia, Carabobo, Bolivarian Republic of Venezuela
| | - Andrea Benedetti
- Departments of Medicine and of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Vivian Lida Avelino-Silva
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | | | | | - Jackeline Alger
- Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
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Jaubert J, Naze F, Camuset G, Larrieu S, Pascalis H, Guernier V, Naty N, Bertolotti A, Manaquin R, Mboussou Y, Atiana L, Picot S, Filleul L, Tortosa P, Cardinale E, Gérardin P. Seroprevalence of Coxiella burnetii (Q fever) Exposure in Humans on Reunion Island. Open Forum Infect Dis 2019; 6:ofz227. [PMID: 31281854 PMCID: PMC6602885 DOI: 10.1093/ofid/ofz227] [Citation(s) in RCA: 4] [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: 02/21/2019] [Accepted: 05/14/2019] [Indexed: 12/04/2022] Open
Abstract
After the documentation of sporadic cases of Q fever endocarditis, we conducted a serosurvey to assess Coxiella burnetii exposure on Reunion Island. Two hundred forty-one stored frozen human sera were analyzed using an immunofluorescence assay. The weighted seroprevalence of Q fever was of 6.81% (95% confidence interval, 4.02%–9.59%). Despite the absence of infection in youths <20 years of age, exposure was not driven by age or by gender. There was a spatial disparity in exposure across the island, with higher prevalence being reported in regions where ruminant farms are present. The seroprevalence pattern suggests that Q fever is endemic on Reunion Island.
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Affiliation(s)
- Julien Jaubert
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Florence Naze
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Guillaume Camuset
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Sophie Larrieu
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Hervé Pascalis
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France
| | - Vanina Guernier
- Geelong Centre for Emerging Infectious Diseases, Deakin University, Geelong, Victoria, Australia
| | - Nadège Naty
- INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France
| | - Antoine Bertolotti
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France.,INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France
| | - Rodolphe Manaquin
- Service des Maladies Infectieuses, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Yoan Mboussou
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Laura Atiana
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Laurent Filleul
- Cellule d'Intervention Régionale et d'Epidémiologie, Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | - Pablo Tortosa
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France
| | - Eric Cardinale
- UMR ASTRE, Centre de Coopération Internationale en Recherche Agronomique pour le Développement (CIRAD) CYROI platform, Sainte Clotilde, Reunion, France.,UMR 1309 ASTRE, Institut National de Recherche Agronomique (INRA), Montpellier, France
| | - Patrick Gérardin
- UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France.,INSERM Centre d'Investigation Clinique 1410 Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France
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Mirkovic B, Gérardin P. Asperger's syndrome: What to consider? Encephale 2019; 45:169-174. [PMID: 30736970 DOI: 10.1016/j.encep.2018.11.005] [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: 06/09/2018] [Revised: 10/29/2018] [Accepted: 11/11/2018] [Indexed: 10/27/2022]
Abstract
Asperger's syndrome is a neurodevelopmental disorder which is part of the large family of autism spectrum disorders. People with Asperger's syndrome have difficulties in social interactions, verbal and non-verbal communication, and may display behavioural oddities, with stereotypies and limited interests. They show no language delay and their cognitive development is not marked by an overall delay but by specific impairments in certain areas such as the executive functions. The clinical presentations are very heterogeneous, varying according to age and psychiatric comorbidities. Screening, diagnosis and specialized treatment are not made any easier by the diversity of the clinical manifestations. Asperger's syndrome is often diagnosed belatedly, at 11years of age on average and even in adulthood in some cases. This late diagnosis has a significant impact on the risks of depression and a poor quality of life. However, in adulthood or in adolescence, certain situations, personality traits and cognitive profiles or certain comorbidities should suggest the hypothesis of an Asperger-type autism spectrum disorder. We propose here a review of the clinical situations at different ages of life that could help with the screening and the referral of patients to specialized clinicians for diagnosis and appropriate treatment.
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Affiliation(s)
- B Mirkovic
- Department of Child and Adolescent Psychiatry, University Hospital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - P Gérardin
- Department of Child and Adolescent Psychiatry, University Hospital Charles-Nicolle, University of Normandie, 76000 Rouen, France
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Abstract
Although traditionally chikungunya virus is considered non-fatal, recent studies suggest that there may be in fact underreporting of deaths in some situations. A major chikungunya epidemic hit Jamaica in 2014 but no chikungunya-associated deaths were reported. We assessed the excess of all-cause deaths during this epidemic. Excess deaths were estimated by difference between observed and expected mortality based on the average age-specific mortality rate of 2012-2013, using the 99% confidence interval. There was an excess of 2,499 deaths during the epidemic (91.9/100,000 population), and a strong positive correlation between the monthly incidence of chikungunya and the excess of deaths (Rho = 0.939, p < 0.005). No significant concomitant epidemiological or climatic phenomenon occurred. Chikungunya is a major contributor to morbidity during epidemics and may be an unrecognized cause of death. Thus, it is urgent to review clinical protocols and improve the investigations of specific-cause deaths during chikungunya epidemics. Excess deaths could be a strategic tool for epidemiological surveillance.
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Affiliation(s)
- André Ricardo Ribas Freitas
- a Faculdade de Medicina São Leopoldo Mandic , Instituto de Pesquisa São Leopoldo Mandic , Campinas , Brasil.,b Departamento de Vigilância em Saúde , Secretaria Municipal de Saúde de Campinas , Campinas , Brasil
| | - Patrick Gérardin
- c Inserm Cic 1410 , CHU Réunion , Saint Pierre , France.,d UM 134 PIMIT Processus infectieux en Milieu Insulaire Tropical , Université de La Réunion, CNRS 919, INSERM U 1187, IRD 249), CYROI , Sainte Clotilde , France
| | - Luiza Kassar
- a Faculdade de Medicina São Leopoldo Mandic , Instituto de Pesquisa São Leopoldo Mandic , Campinas , Brasil
| | - Maria Rita Donalisio
- e Faculdade de Ciências Médicas , Universidade Estadual de Campinas , Campinas , Brasil
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Cardona-Ospina JA, Rodríguez-Morales AJ, Teixeira MG, Gérardin P. Need for Accurate and Consistent Definition of Chronic Chikungunya Arthritis: Comment on the Article by Chang et al. Arthritis Rheumatol 2018; 70:1891. [DOI: 10.1002/art.40666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | - Patrick Gérardin
- Centre Hospitalier Universitaire INSERM CIC1410; Saint Pierre, Réunion, France; and UMR 134 PIMIT (CNRS 9192; INSERM 1187 IRD 249; Universite de la Réunion); Sainte Clotilde, Réunion France
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Gérardin P, Cardona-Ospina JA, Rodríguez-Morales AJ. Autoimmunity or Lineage-Specific Virulence as Drivers of Chikungunya Chronic Arthritis: Comment on the Article by Chang et al. Arthritis Rheumatol 2018; 70:1892-1893. [DOI: 10.1002/art.40665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Patrick Gérardin
- Centre Hospitalier Universitaire, INSERM CIC1410; Saint Pierre Réunion France
- UMR 134 PIMIT (CNRS 9192 INSERM 1187 IRD 249 Universite de la Réunion); Sainte Clotilde Réunion France
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Abstract
BACKGROUND Chikungunya fever is a globally spreading mosquito-borne disease that shows an unexpected neurovirulence. Even though the neurological complications have been a major cause of intensive care unit admission and death, to date, there is no systematic analysis of their spectrum available. OBJECTIVE To review evidence of neurological manifestations in Chikungunya fever and map their epidemiology, clinical spectrum, pathomechanisms, diagnostics, therapies and outcomes. METHODS Case report and systematic review of the literature followed established guidelines. All cases found were assessed using a 5-step clinical diagnostic algorithm assigning categories A-C, category A representing the highest level of quality. Only A and B cases were considered for further analysis. After general analysis, cases were clustered according to geospatial criteria for subgroup analysis. RESULTS Thirty-six of 1196 studies were included, yielding 130 cases. Nine were ranked as category A (diagnosis of Neuro-Chikungunya probable), 55 as B (plausible), and 51 as C (disputable). In 15 cases, alternative diagnoses were more likely. Patient age distribution was bimodal with a mean of 49 years and a second peak in infants. Fifty percent of the cases occurred in patients <45 years with no reported comorbidity. Frequent diagnoses were encephalitis, optic neuropathy, neuroretinitis, and Guillain-Barré syndrome. Neurologic conditions showing characteristics of a direct viral pathomechanism showed a peak in infants and a second one in elder patients, and complications and neurologic sequelae were more frequent in these groups. Autoimmune-mediated conditions appeared mainly in patients over 20 years and tended to show longer latencies and better outcomes. Geospatial subgrouping of case reports from either India or Réunion revealed diverging phenotypic trends (Réunion: 88% direct viral vs. India: 81% autoimmune). CONCLUSIONS Direct viral forms of Neuro-Chikungunya seem to occur particularly in infants and elderly patients, while autoimmune forms have to be also considered in middle-aged, previously healthy patients, especially after an asymptomatic interval. This knowledge will help to identify future Neuro-Chikungunya cases and to improve outcome especially in autoimmune-mediated conditions. The genetics of Chikungunya virus might play a key role in determining the course of neuropathogenesis. With further research, this could prove diagnostically significant.
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Affiliation(s)
- T Cerny
- Neurointensive Care Unit, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - M Schwarz
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - U Schwarz
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - J Lemant
- Intensive Care Unit, CHU de la Réunion, Saint Pierre, Réunion, France
| | - P Gérardin
- INSERM CIC 1410, CHU de la Réunion, Saint Pierre, Réunion, France.,CNRS 9192, INSERM U1187, IRD 249, CHU Réunion, Unité Mixte 134 Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CYROI, Université de La Réunion, Sainte-Clotilde, Réunion, France
| | - E Keller
- Neurointensive Care Unit, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
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Gauthier A, Gérardin P, Renou P, Sagnier S, Debruxelles S, Poli M, Rouanet F, Olindo S, Sibon I. Trendelenburg Positioning in Large Vessel Ischaemic Stroke: A Pre-Post Observational Study Using Propensity Score Matching. Cerebrovasc Dis 2018; 46:24-32. [DOI: 10.1159/000490423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022] Open
Abstract
Background: Along with pharmacological and mechanical recanalization, improving cerebral perfusion through the recruitment of collateral vessels during the acute phase of ischaemic stroke (IS) is a clinical challenge. Our objective was to assess the effectiveness and safety of Trendelenburg positioning (TP), a procedure intended to increase cerebral blood flow, on the outcome of IS. Methods: Two cohorts of patients with an acute supratentorial IS related to a large artery occlusion were compared. In the first cohort (n = 119), we used standard positioning (0 to +30°); in the second cohort (n = 90), we used TP (0 to –15°). The primary outcome measure was the improvement of National Institutes of Health Stroke Scale (NIHSS) score between admission and day 2. Factors associated with an improvement ≥4 points of NIHSS score were assessed using multiple logistic regression and propensity score (PS) matching analyses. Results: TP was significantly associated with a greater improvement of NIHSS score within 48 h following stroke onset (4.0 ± 5.7 vs. 1.8 ± 5.9, p = 0.011) but also at discharge (p = 0.005). Multiple logistic regression analysis suggested that TP was an independent predictor of early neurological improvement (adjusted OR 1.81, 95% CI 1.00–3.27) in a model controlling recanalization and haemoglobin level. In addition, PS matching analysis confirmed the possible effectiveness of TP (unadjusted OR 1.99, 95% CI 1.04–3.82), especially in male subjects. The effect of TP was more pronounced in patients with admission mean arterial blood pressure ≥100 mm Hg, those exhibiting a good collateral vessel network on admission CT-angiography or experiencing an effective recanalization. Furthermore, TP was not associated with life-threatening complications. Conclusion: TP could be an effective and safe strategy in patients with large IS resulting from the proximal occlusion of a large vessel.
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Gérardin P, Rollot O, Maillard O, Mussard C, Porcherat S, Lenclume V, Fianu A, Bertolotti A, Huiart L, Marimoutou C. Qualité de vie à 10–11 ans d’une épidémie de Chikungunya : étude en population générale. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Le Moullec N, Fianu A, Maillard O, Chazelle E, Naty N, Schneebeli C, Gérardin P, Huiart L, Charles MA, Favier F. Sexual dimorphism in the association between gestational diabetes mellitus and overweight in offspring at 5-7 years: The OBEGEST cohort study. PLoS One 2018; 13:e0195531. [PMID: 29621322 PMCID: PMC5886576 DOI: 10.1371/journal.pone.0195531] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/23/2018] [Indexed: 01/10/2023] Open
Abstract
Evidence from literature is mixed regarding a possible association of maternal gestational diabetes mellitus (GDM) and overweight in the offspring. Sexual dimorphism, or sex disparities in the pathogenesis linking GDM exposure to overweight, could be at play. The objective of this study was to investigate the association between GDM and child overweight at 5–7 years. Six hundred pairs (1:1) of Reunionese liveborn singletons selected from a hospital-based birth registry, matched for sex, gestational age, and birth period, underwent a prospective in-home follow-up and were analyzed with respect to their exposure to GDM. The primary outcome was child overweight at 5–7 years, as defined by the International Obesity Task Force. The association between GDM exposure and child overweight was estimated by the odds ratio (OR) using conditional logistic regression models. For the subset of children exposed to GDM with available maternal glycemic data, we analyzed the relationship between maternal glycemic levels during pregnancy and child body mass index (BMI) at 5–7 years with a linear regression model. In light of the significant interaction between sex and GDM, all statistical analyses were then stratified by sex. After controlling for pre-pregnancy BMI and maternal sociodemographic characteristics, the risk of overweight increased with exposure to GDM for boys (adjusted OR: 2.34; 95% confidence interval = 1.26–4.34, P = 0.007) but not for girls (adjusted OR: 0.56; 95%CI = 0.28–1.10, P = 0.093). Consistent with this, the linear increase of boys’ BMI at 5–7 years with maternal blood glucose levels during pregnancy, in the exposed group, displayed a dose-response relationship. Our findings indicate that exposure to GDM is a risk factor for childhood overweight in boys but not in girls, which adds to the growing body of evidence suggesting greater sensitivity of male offspring to intrauterine hyperglycemia.
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Affiliation(s)
- Nathalie Le Moullec
- Department of Endocrinology, Diabetology and Nutrition, Centre Hospitalier Universitaire (CHU) Réunion, Saint-Pierre, Reunion, France
| | - Adrian Fianu
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
- UMR1027, Université de Toulouse, UPS, Inserm, Toulouse, France
- * E-mail:
| | - Olivier Maillard
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Emilie Chazelle
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Nadège Naty
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Chantal Schneebeli
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Patrick Gérardin
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Laetitia Huiart
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
| | - Marie-Aline Charles
- Center for Research in Epidemiology and Population Health, Paris, France
- Paris Descartes University, Paris, France
| | - François Favier
- INSERM CIC 1410 Clinical and Epidemiology/ CHU Réunion/Université de la Réunion, Saint-Pierre, Reunion, France
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Zaid A, Gérardin P, Taylor A, Mostafavi H, Malvy D, Mahalingam S. Chikungunya Arthritis: Implications of Acute and Chronic Inflammation Mechanisms on Disease Management. Arthritis Rheumatol 2018; 70:484-495. [PMID: 29287308 DOI: 10.1002/art.40403] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/18/2017] [Indexed: 12/14/2022]
Abstract
In the past decade, arboviruses-arthropod-borne viruses-have been the focus of public health institutions worldwide following a spate of devastating outbreaks. Chikungunya virus, an arbovirus that belongs to the alphavirus genus, is a reemerging arthritogenic virus that has caused explosive outbreaks since 2006, notably on Réunion Island, and more recently in the Caribbean, South America, India, and Southeast Asia. The severity of arthritic disease caused by chikungunya virus has prompted public health authorities in affected countries to develop specific guidelines to tackle this pathogen. Chikungunya virus disease manifests first as an acute stage of severe joint inflammation and febrile illness, which later progresses to a chronic stage, during which patients may experience debilitating and persisting articular pain for extended periods. This review aims to provide a broad perspective on current knowledge of chikungunya virus pathogenesis by identifying key clinical and experimental studies that have contributed to our understanding of chikungunya virus to date. In addition, the review explores the practical aspects of treatment and management of both acute and chronic chikungunya virus based on clinical experience during chikungunya virus outbreaks. Finally, recent findings on potential therapeutic solutions-from antiviral agents to immunomodulators-are reviewed to provide both viral immunologists and clinical rheumatologists with a balanced perspective on the nature of a reemerging arboviral disease of significant public health concern, and insight into future therapeutic approaches to better address the treatment and management of chikungunya virus.
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Affiliation(s)
- Ali Zaid
- Griffith University, Gold Coast, Queensland, Australia
| | - Patrick Gérardin
- INSERM CIC1410, Centre Hospitalier Universitaire de la Réunion, Saint Pierre, Réunion, France, and CNRS 9192, INSERM U1187, Université de la Réunion, Sainte Clotilde, Réunion, France
| | - Adam Taylor
- Griffith University, Gold Coast, Queensland, Australia
| | | | - Denis Malvy
- Department of Tropical Medicine and Clinical International Health, University Hospital Center and INSERM 1219, University of Bordeaux, Bordeaux, France
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Oliveira JRM, Gérardin P, Couderc T, Randrianaivo H, Fritel X, Lecuit M. Chikungunya virus-associated encephalitis: A cohort study on La Réunion Island, 2005-2009. Neurology 2018; 86:2025-6. [PMID: 27217467 DOI: 10.1212/wnl.0000000000002732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Venkatesan S, Myles PR, Leonardi-Bee J, Muthuri SG, Al Masri M, Andrews N, Bantar C, Dubnov-Raz G, Gérardin P, Koay ESC, Loh TP, Memish Z, Miller E, Oliva ME, Rath BA, Schweiger B, Tang JW, Tran D, Vidmar T, Waight PA, Nguyen-Van-Tam JS. Impact of Outpatient Neuraminidase Inhibitor Treatment in Patients Infected With Influenza A(H1N1)pdm09 at High Risk of Hospitalization: An Individual Participant Data Metaanalysis. Clin Infect Dis 2018; 64:1328-1334. [PMID: 28199524 PMCID: PMC5411393 DOI: 10.1093/cid/cix127] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 02/10/2017] [Indexed: 12/05/2022] Open
Abstract
Background. While evidence exists to support the effectiveness of neuraminidase inhibitors (NAIs) in reducing mortality when given to hospitalized patients with A(H1N1)pdm09 virus infection, the impact of outpatient treatment on hospitalization has not been clearly established. We investigated the impact of outpatient NAI treatment on subsequent hospitalization in patients with A(H1N1)pdm09 virus infection. Methods. We assembled general community and outpatient data from 9 clinical centers in different countries collected between January 2009 and December 2010. We standardized data from each study center to create a pooled dataset and then used mixed-effects logistic regression modeling to determine the effect of NAI treatment on hospitalization. We adjusted for NAI treatment propensity and preadmission antibiotic use, including “study center” as a random intercept to account for differences in baseline hospitalization rate between centers. Results. We included 3376 patients with influenza A(H1N1)pdm09, of whom 3085 (91.4%) had laboratory-confirmed infection. Eight hundred seventy-three patients (25.8%) received outpatient or community-based NAI treatment, 928 of 2395 (38.8%) with available data had dyspnea or respiratory distress, and hospitalizations occurred in 1705 (50.5%). After adjustment for preadmission antibiotics and NAI treatment propensity, preadmission NAI treatment was associated with decreased odds of hospital admission compared to no NAI treatment (adjusted odds ratio, 0.24; 95% confidence interval, 0.20–0.30). Conclusions. In a population with confirmed or suspected A(H1N1)pdm09 and at high risk of hospitalization, outpatient or community-based NAI treatment significantly reduced the likelihood of requiring hospital admission. These data suggest that community patients with severe influenza should receive NAI treatment.
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Affiliation(s)
- Sudhir Venkatesan
- Division of Epidemiology and Public Health, University of Nottingham, and
| | - Puja R Myles
- Division of Epidemiology and Public Health, University of Nottingham, and
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, University of Nottingham, and
| | - Stella G Muthuri
- MRC Unit for Lifelong Health and Ageing, University College London, United Kingdom
| | | | | | - Carlos Bantar
- Department of Infection Control, Hospital San Martín de Paraná, Entre Ríos, Argentina
| | - Gal Dubnov-Raz
- Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel
| | - Patrick Gérardin
- Pôle Femme Mère Enfant, Centre Hospitalier Universitaire de la Réunion.,Institut National de la Santé et de la Recherche Médical (INSERM) Centre for Clinical Investigation (CIC1410), Centre Hospitalier Universitaire de la Réunion, Saint Pierre.,Unité Mixte 134 PIMIT "Processus Infectieux en Milieu Insulaire Tropical" (Centre National de la Recherche Scientifique 9192, INSERM U1187, Institut Recherche et Développement 249), Université de la Réunion, CYROI "Cyclotron Réunion-océan Indien", Sainte Clotilde, Reunion
| | - Evelyn S C Koay
- Molecular Diagnostic Centre, Department of Laboratory Medicine National University Hospital, and.,Department of Pathology, National University of Singapore
| | - Tze Ping Loh
- Molecular Diagnostic Centre, Department of Laboratory Medicine National University Hospital, and
| | - Ziad Memish
- Ministry of Health, Riyadh, Kingdom of Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | | | - Maria E Oliva
- Department of Infection Control, Hospital San Martín de Paraná, Entre Ríos, Argentina
| | - Barbara A Rath
- Department of Pediatrics, Charité University Medical Center, and
| | - Brunhilde Schweiger
- National Reference Centre Influenza at Robert Koch Institute, Berlin, Germany
| | - Julian W Tang
- Molecular Diagnostic Centre, Department of Laboratory Medicine National University Hospital, and.,University Hospitals Leicester, and.,Department of Infection, Immunity and Inflammation, University of Leicester, United Kingdom
| | - Dat Tran
- Division of Infectious Diseases, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Canada
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Abstract
Congenital Zika virus infection is associated with severe brain anomalies and impaired function. To determine outcomes, we followed 2 affected children for ≈30 months. For 1 who was symptomatic at birth, transient hepatitis developed. However, neurodevelopment for both children was age appropriate.
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Zemali N, Gérardin P, Bactora M, Camuset G, Bertolotti A, Pagès F, Picot S, Michault A, Tortosa P, Jaubert J. Séroprévalence des rickettsioses dans une région d’outre-mer. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jaubert J, Atiana L, Devos P, Somon-Payet C, Robillard P, Bertolotti A, Larrieu S, Picot S, Boukerrou M, Gérardin P. Séroprévalence de la fièvre Q chez les accouchées. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mboussou Y, Jaubert J, Naze F, Folio C, Randrianaivo H, Camuset G, Larrieu S, Picot S, Boukerrou M, Gérardin P. Complications périnatales associées à la fièvre Q. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mas C, Gérardin P, Chirpaz E, Carbonnier M, Mussard C, Samperiz S, Ramful D. Follow-up at two years of age and early predictors of non-compliance in a cohort of very preterm infants. Early Hum Dev 2017; 108:1-7. [PMID: 28342385 DOI: 10.1016/j.earlhumdev.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 01/12/2017] [Accepted: 03/03/2017] [Indexed: 11/17/2022]
Abstract
AIM To examine the rates of follow-up at two years of age and perinatal factors associated with non-compliance in an observational population-based cohort of very preterm children enrolled in a routine follow-up program. METHOD Data review of infants born between 2008 and 2012 in the Observatoire de La Grande Prématurité, Reunion Island cohort. All singletons born alive before 33weeks of gestational age and resident on the island at two years of age were included. Patients were considered compliant if they were timely evaluated between 20-28months of age, or non-compliant if they were not evaluated or evaluated after 28months of age. RESULTS Of the 802 survivors (mean gestational age of 30.3±2.0months, mean birthweight of 1364±396g), 468 (58.4%) were examined between 20-28months, 119 (14.8%) after 28months of age, and 215 (26.8%) were never evaluated, respectively. In multivariate analysis, factors associated with non-compliance were higher parity (>2), past history of preterm delivery, maternal diabetes (preexisting or gestational), appropriate for gestational status, and centre of birth. CONCLUSION Sustainable follow-up of vulnerable neonates remains a challenge in clinical practice. Early predictors of non-compliance can be used to define individualized and local follow-up strategies in these infants at high risk for developmental disabilities.
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Affiliation(s)
- Claire Mas
- Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, 97405 Saint-Denis Cedex, La Réunion, France.
| | - Patrick Gérardin
- Pôle Femme Mère Enfant, CHU Réunion, Saint Pierre, Reunion, France ; Centre d'Investigation Clinique (INSERM CIC1410) Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France.
| | - Emmanuel Chirpaz
- Unité de Soutien Méthodologique, Centre Hospitalier Félix Guyon, 97405 Saint Denis Cedex, La Réunion, France.
| | - Magali Carbonnier
- Neonatal Intensive Care Unit, CHU Réunion, 97448 Saint Pierre Cedex, Réunion Island, France.
| | - Corinne Mussard
- Pôle Femme Mère Enfant, CHU Réunion, Saint Pierre, Reunion, France ; Centre d'Investigation Clinique (INSERM CIC1410) Epidémiologie Clinique, CHU Réunion, Saint Pierre, Reunion, France.
| | - Sylvain Samperiz
- Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, 97405 Saint-Denis Cedex, La Réunion, France.
| | - Duksha Ramful
- Neonatal and Pediatric Intensive Care Unit, Félix Guyon Hospital, CHU de La Réunion, 97405 Saint-Denis Cedex, La Réunion, France.
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