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Teiti I, Aubry M, Fernandes-Pellerin S, Patin E, Madec Y, Boucheron P, Vanhomwegen J, Torterat J, Lastère S, Olivier S, Jaquaniello A, Roux M, Mendiboure V, Harmant C, Bisiaux A, Rijo de León G, Liu D, Bossin H, Mathieu-Daudé F, Gatti C, Suhas E, Chung K, Condat B, Ayotte P, Conte E, Jolly N, Manuguerra JC, Sakuntabhai A, Fontanet A, Quintana-Murci L, Cao-Lormeau VM. Unravelling the determinants of human health in French Polynesia: the MATAEA project. Front Epidemiol 2023; 3:1201038. [PMID: 38455935 PMCID: PMC10911015 DOI: 10.3389/fepid.2023.1201038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/15/2023] [Indexed: 03/09/2024]
Abstract
Background French Polynesia is a French overseas collectivity in the Southeast Pacific, comprising 75 inhabited islands across five archipelagoes. The human settlement of the region corresponds to the last massive migration of humans to empty territories, but its timeline is still debated. Despite their recent population history and geographical isolation, inhabitants of French Polynesia experience health issues similar to those of continental countries. Modern lifestyles and increased longevity have led to a rise in non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and cardiovascular diseases. Likewise, international trade and people mobility have caused the emergence of communicable diseases (CDs) including mosquito-borne and respiratory diseases. Additionally, chronic pathologies including acute rheumatic fever, liver diseases, and ciguatera, are highly prevalent in French Polynesia. However, data on such diseases are scarce and not representative of the geographic fragmentation of the population. Objectives The present project aims to estimate the prevalence of several NCDs and CDs in the population of the five archipelagoes, and identify associated risk factors. Moreover, genetic analyses will contribute to determine the sequence and timings of the peopling history of French Polynesia, and identify causal links between past genetic adaptation to island environments, and present-day susceptibility to certain diseases. Methods This cross-sectional survey is based on the random selection of 2,100 adults aged 18-69 years and residing on 18 islands from the five archipelagoes. Each participant answered a questionnaire on a wide range of topics (including demographic characteristics, lifestyle habits and medical history), underwent physical measurements (height, weight, waist circumference, arterial pressure, and skin pigmentation), and provided biological samples (blood, saliva, and stool) for biological, genetic and microbiological analyses. Conclusion For the first time in French Polynesia, the present project allows to collect a wide range of data to explore the existence of indicators and/or risk factors for multiple pathologies of public health concern. The results will help health authorities to adapt actions and preventive measures aimed at reducing the incidence of NCDs and CDs. Moreover, the new genomic data generated in this study, combined with anthropological data, will increase our understanding of the peopling history of French Polynesia. Clinical trial registration https://clinicaltrials.gov/, identifier: NCT06133400.
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Affiliation(s)
- Iotefa Teiti
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, French Polynesia
| | - Maite Aubry
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, French Polynesia
| | | | - Etienne Patin
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
| | - Yoann Madec
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris, France
| | - Pauline Boucheron
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris, France
| | - Jessica Vanhomwegen
- Environment and Infectious Risk Unit, Laboratory for Urgent Response to Biological Threats, Institut Pasteur, Paris, France
| | - Jérémie Torterat
- Institut de la Statistique de la Polynésie Française, Papeete, French Polynesia
| | - Stéphane Lastère
- Clinical Laboratory, Centre Hospitalier de la Polynésie Française, Pirae, French Polynesia
| | - Sophie Olivier
- Clinical Laboratory, Institut Louis Malardé, Papeete, French Polynesia
| | - Anthony Jaquaniello
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
- Institut Pasteur, Data Management Core Facility, Paris, France
| | - Maguelonne Roux
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
- Institut Pasteur, Université de Paris, Bioinformatics and Biostatistics Hub, Paris, France
| | - Vincent Mendiboure
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris, France
| | - Christine Harmant
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
| | - Aurélie Bisiaux
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
| | - Gaston Rijo de León
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
| | - Dang Liu
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
| | - Hervé Bossin
- Laboratory of Research in Medical Entomology, Institut Louis Malardé, Paea, French Polynesia
| | - Françoise Mathieu-Daudé
- Laboratory of Research in Medical Entomology, Institut Louis Malardé, Paea, French Polynesia
- UMR MIVEGEC-Infectious Diseases and Vectors, University of Montpellier, CNRS, IRD, Montpellier, France
| | - Clémence Gatti
- Laboratory of Marine Biotoxins, UMR241-Ecosystèmes Insulaires Océaniens (EIO) (IFREMER, ILM, IRD, UPF), Institut Louis Malardé, Papeete, French Polynesia
| | - Edouard Suhas
- Unit on non-Communicable Diseases, UMR241-Ecosystèmes Insulaires Océaniens (EIO) (IFREMER, ILM, IRD, UPF), Institut Louis Malardé, Papeete, French Polynesia
| | - Kiyojiken Chung
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, French Polynesia
| | - Bertrand Condat
- Department of Gastroenterology, Centre Hospitalier de la Polynésie Française, Pirae, French Polynesia
| | - Pierre Ayotte
- Centre de Toxicologie du Québec, Institut National de Santé Publique du Québec, QC, Canada
| | - Eric Conte
- Maison des Sciences de l’Homme du Pacifique, Université de la Polynésie Française, Punaauia, French Polynesia
| | - Nathalie Jolly
- Center for Translational Sciences, Institut Pasteur, Paris, France
| | - Jean-Claude Manuguerra
- Environment and Infectious Risk Unit, Laboratory for Urgent Response to Biological Threats, Institut Pasteur, Paris, France
| | - Anavaj Sakuntabhai
- Functional Genetics of Infectious Diseases Unit, Department of Global Health, Institut Pasteur, Paris, France
| | - Arnaud Fontanet
- Institut Pasteur, Université Paris Cité, Epidemiology of Emerging Diseases Unit, Paris, France
- PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | - Lluis Quintana-Murci
- Institut Pasteur, Université Paris Cité, CNRS UMR2000, Human Evolutionary Genetics Unit, Paris, France
- Chair Human Genomics and Evolution, Collège de France, Paris, France
| | - Van-Mai Cao-Lormeau
- Laboratory of Research on Emerging Viral Diseases, Institut Louis Malardé, Papeete, French Polynesia
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Boucheron P, Zietsman A, Pontac J, Hansen R, Anderson BO, Togawa K, Macharia PM, Foerster M, Schüz J, dos-Santos-Silva I, McCormack V. Analysis of the Breast Cancer Journey in Namibia. JAMA Netw Open 2023; 6:e2341402. [PMID: 37921764 PMCID: PMC10625043 DOI: 10.1001/jamanetworkopen.2023.41402] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/23/2023] [Indexed: 11/04/2023] Open
Abstract
Importance Breast cancer (BC) is the leading cancer among women in Namibia. Examining the BC journey in this multiracial country where inequalities remain large is needed to inform effective interventions to reduce BC mortality. Objective To describe the entire BC journey of Namibian women by race, utilizing the World Health Organization Global Breast Cancer Initiative (GBCI) framework. Design, Setting, and Participants This cohort study used the Namibian subset of the African Breast Cancer-Disparities in Outcomes prospective cohort. Participants were all Namibian residents with confirmed incident BC who presented at the main national public oncology center of the Windhoek Central Hospital (WCH). Follow-up started from recruitment (September 8, 2014, to October 5, 2016) and ended up to 3 years after diagnosis (December 13, 2014, to September 27, 2019). Data analysis was conducted from June 2022 to August 2023. Exposures Participants' self-reported ethnicities were aggregated into 3 population groups: Black, mixed ancestry, and White. Main Outcomes and Measures Three-year overall survival (OS) was examined using Cox models, and summary statistics were used to describe women's BC journey, including GBCI pillar key performance indicators: (1) early stage (TNM I or II) diagnosis (population benchmark ≥60%), (2) prompt diagnosis, ie, 60 days or less to first health care practitioner visit (population benchmark 100%), and (3) completion of recommended multimodal treatment (MT, ie, surgery plus chemotherapy) (population benchmark ≥80%). Results Of 405 women, there were 300 (74%) Black (mean [SD] age, 53 [15] years), 49 (12%) mixed ancestry (mean [SD] age, 53 [7] years), and 56 (14%) White (mean [SD] age, 59 [12] years) patients. Three-year OS was lowest in Black women (60% [95% CI, 54%-66%]; mixed ancestry: 80% [95% CI, 65%-89%]; White: 89% [95% CI, 77%-95%]), who had lower prevalence of early stage diagnosis (Black: 37% [95% CI, 31%-42%]; mixed ancestry and White: 75% [95% CI, 66%-83%]) and timely diagnosis (Black: 60% [95% CI, 54%-66%]; mixed ancestry and White: 77% [95% CI, 69%-85%]), while MT completion (Black: 53% [95% CI, 46%-59%]; mixed ancestry and White: 63% [95% CI, 50%-73%]) was low in all women. Conclusions and Relevance In this cohort study of 405 Namibian residents with BC, marked racial disparities in survival were paralleled by inequities all along the BC journey. To improve BC survival, interventions are needed to promote earlier diagnosis in Black Namibian women and to increase MT initiation and completion in all women.
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Affiliation(s)
- Pauline Boucheron
- International Agency for Research on Cancer, Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Annelle Zietsman
- AB May Cancer Centre, Windhoek Central Hospital, Windhoek, Namibia
| | - Johanna Pontac
- AB May Cancer Centre, Windhoek Central Hospital, Windhoek, Namibia
| | - Rolf Hansen
- Cancer Association of Namibia, Windhoek, Namibia
| | | | - Kayo Togawa
- International Agency for Research on Cancer, Environment and Lifestyle Epidemiology Branch, Lyon, France
- National Cancer Centre Institute for Cancer Control, Division of Population Data Science, Tokyo, Japan
| | - Peter M. Macharia
- Population Health Unit, Kenya Medical Research Institute–Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Milena Foerster
- International Agency for Research on Cancer, Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer, Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Isabel dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Valerie McCormack
- International Agency for Research on Cancer, Environment and Lifestyle Epidemiology Branch, Lyon, France
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Boucheron P, Anele A, Offiah AU, Zietsman A, Galukande M, Parham G, Pinder LF, Anderson BO, Foerster M, Schüz J, Dos-Santos-Silva I, McCormack V. Reproductive history and breast cancer survival: Findings from the African breast cancer-Disparities in outcomes cohort and implications of Africa's fertility transition on breast cancer prognosis. Int J Cancer 2023; 152:1804-1816. [PMID: 36545890 PMCID: PMC10070810 DOI: 10.1002/ijc.34411] [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: 08/19/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Reproductive characteristics are known risk factors for breast cancer but, other than recent birth, their role as prognostic factors is less clear, and has not been studied in Sub-Saharan Africa (SSA). In this setting, we examined whether reproductive factors independently influence breast cancer survival in a subset of the African Breast Cancer-Disparities in Outcomes cohort study. In 1485 women with incident breast cancer recruited between 2014 and 2017, we examined birth cohort changes in reproductive factors, and used Cox models to examine whether reproductive characteristics were associated with all-cause mortality after adjusting for confounders (age, stage, treatment, HIV, and social factors). Four years after diagnosis, 822 (56%) women had died. Median parity was 4 (IQR = 2, 6) and 209 (28%) of premenopausal women had had a recent birth (<3 years prior to cancer diagnosis). Each pregnancy was associated with a 5% increase (95% CI: 2%, 8%) in mortality rates, which held among postmenopausal women (5%, [1%-9%]). Pre-menopausal women with a recent birth had 52% (20%, 92%) higher mortality rates. Fertility trends by birth cohort showed declining parity, increasing age at first birth and declining age at last birth, however the impact of these population-level changes on future average survival was predicted to be very small (<3% absolute gain).
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Affiliation(s)
- Pauline Boucheron
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | | | - Awa U Offiah
- Abia State University Teaching Hospital, Aba, Nigeria
| | - Annelle Zietsman
- AB May Cancer Centre, Windhoek Central Hospital, Windhoek, Namibia
| | - Moses Galukande
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Groesbeck Parham
- Department of Obstetrics and Gynaecology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Benjamin O Anderson
- University of Washington, Seattle, Washington, USA.,World Health Organization, Geneva, Switzerland
| | - Milena Foerster
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
| | - Valerie McCormack
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
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Demers PA, DeMarini DM, Fent KW, Glass DC, Hansen J, Adetona O, Andersen MH, Freeman LEB, Caban-Martinez AJ, Daniels RD, Driscoll TR, Goodrich JM, Graber JM, Kirkham TL, Kjaerheim K, Kriebel D, Long AS, Main LC, Oliveira M, Peters S, Teras LR, Watkins ER, Burgess JL, Stec AA, White PA, DeBono NL, Benbrahim-Tallaa L, de Conti A, El Ghissassi F, Grosse Y, Stayner LT, Suonio E, Viegas S, Wedekind R, Boucheron P, Hosseini B, Kim J, Zahed H, Mattock H, Madia F, Schubauer-Berigan MK. Carcinogenicity of occupational exposure as a firefighter. Lancet Oncol 2022; 23:985-986. [PMID: 35780778 DOI: 10.1016/s1470-2045(22)00390-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Paul A Demers
- International Agency for Research on Cancer, Lyon, France
| | | | - Kenneth W Fent
- International Agency for Research on Cancer, Lyon, France
| | | | - Johnni Hansen
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | - David Kriebel
- International Agency for Research on Cancer, Lyon, France
| | | | - Luana C Main
- International Agency for Research on Cancer, Lyon, France
| | - Marta Oliveira
- International Agency for Research on Cancer, Lyon, France
| | - Susan Peters
- International Agency for Research on Cancer, Lyon, France
| | - Lauren R Teras
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Anna A Stec
- International Agency for Research on Cancer, Lyon, France
| | - Paul A White
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Aline de Conti
- International Agency for Research on Cancer, Lyon, France
| | | | - Yann Grosse
- International Agency for Research on Cancer, Lyon, France
| | | | - Eero Suonio
- International Agency for Research on Cancer, Lyon, France
| | - Susana Viegas
- International Agency for Research on Cancer, Lyon, France
| | | | | | - Bayan Hosseini
- International Agency for Research on Cancer, Lyon, France
| | - Joanne Kim
- International Agency for Research on Cancer, Lyon, France
| | - Hana Zahed
- International Agency for Research on Cancer, Lyon, France
| | - Heidi Mattock
- International Agency for Research on Cancer, Lyon, France
| | - Federica Madia
- International Agency for Research on Cancer, Lyon, France
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Foerster M, McCormack V, Anderson BO, Boucheron P, Zietsman A, Cubasch H, Joffe M, Anele A, Offiah S, Galukande M, Parham G, Pinder LF, Ginsburg O, Schüz J, Dos-Santos-Silva I, Kantelhardt EJ. Treatment guideline concordance, initiation, and abandonment in patients with non-metastatic breast cancer from the African Breast Cancer-Disparities in Outcomes (ABC-DO) cohort in sub-Saharan Africa: a prospective cohort study. Lancet Oncol 2022; 23:729-738. [PMID: 35550274 PMCID: PMC10036870 DOI: 10.1016/s1470-2045(22)00198-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 01/26/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Comprehensive breast cancer management is essential to achieve high breast cancer survival; however, detailed reports of the treatment regimens received by patients are scarce in sub-Saharan Africa where survival is low. We aimed to examine treatment initiation, guideline concordance, and abandonment in patients with non-metastatic breast cancer in sub-Saharan Africa from the African Breast Cancer-Disparities in Outcomes (ABC-DO) prospective cohort. METHODS The ABC-DO prospective cohort study recruited women (aged ≥18 years) with newly diagnosed invasive breast cancer in eight hospitals across five sub-Saharan African countries (Namibia, Nigeria, Uganda, South Africa, and Zambia). We analysed treatments received by women who were classified as non-metastatic (M0) at the initial presentation. Data on surgery, radiotherapy, and systemic therapies were obtained from medical records and a self-reported follow-up questionnaire at 6 months after the diagnosis, follow-up calls every 3 months, and a baseline questionnaire. Initiation, completion, and abandonment of treatment modalities and combined therapy regimens were examined overall, by country-specific groups, and by clinical factors relevant for guideline-based treatment. FINDINGS Of 2313 women recruited into the ABC-DO study between Sept 10, 2014, and Dec 31, 2017, 2226 had histologically or clinically confirmed breast cancer. Of these 2226 women, 510 were excluded from the present analysis because 378 had metastatic disease, 37 were prevalent cases (defined as those previously diagnosed with breast cancer >2 years before baseline), 82 had unknown TNM stage, and 13 were White or Asian women in South Africa (number was too small for analysis). After a median follow-up of 5·2 years (IQR 4·6-5·9), 1163 (68%) of 1716 women underwent breast cancer surgery. Surgery and systemic therapy (ie, multimodality treatment) with radiotherapy was initiated in 370 (36%) of 1028 women with localised tumours versus 156 (23%) of 688 women with locally advanced tumours, whereas multimodality treatment without radiotherapy was initiated in 386 (38%) versus 167 (24%) women, respectively. Of 1530 patients requiring chemotherapy (which excludes 105 who died within 6 months after baseline), 1013 (66%) initiated treatment of neoadjuvant chemotherapy or surgery within 3 months after baseline, which was adequately completed by 359 (35%) of 1013 women, marginally completed by 284 (28%), abandoned by 200 (20%), and unknown in 151 (15%). 19 (2%) women died within 6 months after chemotherapy initiation. Of 1375 women in whom endocrine therapy was indicated, this treatment was initiated in 920, and lasted at least 3 years in 367 (40%) women. Treatment disparities between country-specific groups were substantial for all therapy regimens. INTERPRETATION A high proportion of patients with non-metastatic breast cancer did not initiate, did not fully complete, or abandoned treatment with surgery, systemic therapy, radiotherapy, or an appropriate combination of these, highlighting the need for improved treatment access and completion in sub-Saharan Africa to potentially prevent premature breast cancer deaths. FUNDING National Institutes of Health (National Cancer Institute), Susan G Komen, and the International Agency for Research on Cancer.
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Affiliation(s)
- Milena Foerster
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France.
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Pauline Boucheron
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Herbert Cubasch
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | | | - Groesbeck Parham
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Leeya F Pinder
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Ophira Ginsburg
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Eva J Kantelhardt
- Department of Gynaecology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Chasimpha S, McCormack V, Cubasch H, Joffe M, Zietsman A, Galukande M, Parham G, Pinder LF, Anele A, Adisa CA, Offiah AU, Anderson BO, Boucheron P, Foerster M, Schüz J, Dos-Santos-Silva I. Disparities in breast cancer survival between women with and without HIV across sub-Saharan Africa (ABC-DO): a prospective, cohort study. Lancet HIV 2022; 9:e160-e171. [PMID: 35245508 PMCID: PMC9031563 DOI: 10.1016/s2352-3018(21)00326-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/13/2021] [Accepted: 12/07/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Studies have shown increased mortality among women living with HIV diagnosed with breast cancer compared with HIV-negative women with breast cancer. We aimed to examine how this HIV differential varies by patient or breast tumour characteristics. METHODS The African Breast Cancer-Disparities in Outcomes (ABC-DO) study is a prospective cohort of women (aged ≥18 years) with incident breast cancer recruited consecutively at diagnosis (2014-17) from hospitals in Namibia, Nigeria, South Africa, Uganda, and Zambia. Detailed clinical and epidemiological data, including self-reported or tested HIV status, were collected at baseline. Participants were actively followed up via telephone calls every 3 months. The primary outcome was all-cause mortality, assessed in all women who had at least one updated vital status after baseline interview. Using Cox regression, we examined differences in overall survival by HIV status in the cohort, and across country and patient subgroups, adjusted for age, tumour grade, and tumour stage at cancer diagnosis. FINDINGS Between Sept 8, 2014, and Dec 31, 2017, we recruited 2154 women with primary breast cancer, 519 of whom were excluded due to their countries having small numbers of women with HIV for comparison. Among the remaining 1635 women, 313 (19%) were living with HIV, 1184 (72%) were HIV negative, and 138 (9%) had unknown HIV status. At breast cancer diagnosis, women with HIV were younger and had lower body-mass index (BMI) than their HIV-negative counterparts, but had similar tumour stage, grade, and receptor subtypes. At the end of the follow-up (Jan 1, 2019), a higher proportion of women with HIV (137 [44%] of 313) had died than had HIV-negative women (432 [37%] of 1184). Crude 3-year survival was 9% lower for women with HIV (46% [95% CI 40-53]) than for HIV-negative women (55% [52-59]; hazard ratio (HR) 1·41 [1·15-1·74]). The HIV survival differential did not differ by age, BMI, tumour subtype, or tumour grade, but was stronger in women with non-metastatic disease (3-year survival 52% HIV-positive vs 63% HIV-negative women, adjusted HR 1·65 [1·30-2·10]), whereas women with metastatic cancer had low survival, regardless of HIV status. INTERPRETATION The larger survival deficit among women with HIV with non-metastatic breast cancer calls for a better understanding of the reasons underlying this differential (eg, biological mechanisms, health behaviours, detrimental HIV-breast cancer treatment interactions, or higher HIV background mortality) to inform strategies for reducing mortality among this patient group. FUNDING Susan G Komen, International Agency for Research on Cancer, National Cancer Institute, and UK-Commonwealth Scholarships.
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Affiliation(s)
- Steady Chasimpha
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
| | - Valerie McCormack
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Herbert Cubasch
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa; Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; Non-Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa
| | - Maureen Joffe
- Non-Communicable Diseases Research Division, Wits Health Consortium, Johannesburg, South Africa; Non-Communicable Diseases Research Division, University of Witwatersrand, Johannesburg, South Africa; MRC Developmental Pathways to Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Annelle Zietsman
- AB May Cancer Centre, Windhoek Central Hospital, Windhoek, Namibia
| | - Moses Galukande
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Groesbeck Parham
- Department of Obstetrics and Gynaecology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Leeya F Pinder
- Department of Obstetrics and Gynaecology, Women and Newborn Hospital, Lusaka, Zambia; Department of Obstetrics and Gynaecology, University of Washington, Seattle, WA, USA
| | - Angelica Anele
- Breast Oncology Unit, Federal Medical Centre, Owerri, Nigeria
| | | | | | - Benjamin O Anderson
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
| | - Pauline Boucheron
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Milena Foerster
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Joachim Schüz
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer, Lyon, France
| | - Isabel Dos-Santos-Silva
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Foerster M, Kantelhardt E, Boucheron P, dos-Santos-Silva I, McCormack V. Abstract P3-12-17: Breast cancer treatment related survival gains in the African breast cancer - Disparities in outcomes study. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-12-17] [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] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer (BC) survival in Low and Middle Income Countries (LMICs), and particularly Sub Saharan Africa (SSA), is low and incidence rates are increasing. Accordingly, an almost 90% increase in annual BC mortality is projected to occur until 2040. The WHO Breast Cancer Global Initiative named comprehensive breast cancer treatment as one of three main pillars to reduce BC mortality. Here, we present the urgently needed up-to-date benchmark estimates of treatment effects on BC survival in SSA using data from the African Breast Cancer Disparities in Outcomes (ABC-DO) study.Methods: Since 2014 the hospital-recruited ABC-DO cohort follows-up women diagnosed with BC in five SSA countries. Socio-demographic, diagnostic, treatment and mortality data were obtained from medical records and via three-monthly follow-up calls with the patient. Cox proportional hazard models were fitted to estimate 5-year overall survival related to treatment initiation (surgery or systemic therapy) and treatment completion as time varying variates (surgery and systemic therapy completed) stratified by country and ethnicity and separate for localised and regional tumours. All models were adjusted for age, tumour grade, tumour size, node positivity, HIV status, and socioeconomic status. Results: Of 1699 ABC-DO women with invasive non-metastatic BC, 89% initiated BC treatment (from 72% in Nigeria to 100% in South African white women). Potentially curative treatment (surgery plus systemic therapy) was initiated by 63%, 22% initiated systemic treatment and 5 % only surgery. Initiated systemic therapy was completed by 49% of patients (from 16% in Nigeria to 70 % in South African black women). Median time to first treatment was 1.4 (IQR: 0.8–3) months and differed between countries (from 1.1 (0.6–1.7) in Namibian non-black to 3 (1.5–4.3) in Uganda). After 5 years, 49% (0.44 (CI: 0.31 – 0.62) ) of women initiating any treatment and 59% (0.39 (0.27 – 0.56) of women receiving surgery and initiating systemic treatment were still alive compared to 20% of women receiving no treatment. Conclusion: Timely and comprehensive BC treatment are needed to increase the very low survival rates in SSA.
Citation Format: Milena Foerster, Eva Kantelhardt, MD, Pauline Boucheron, Isabel dos-Santos-Silva, PhD, Valerie McCormack, the ABC-DO study team. Breast cancer treatment related survival gains in the African breast cancer - Disparities in outcomes study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-12-17.
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Affiliation(s)
- Milena Foerster
- International Agency for Research on Cancer, 69372 LYON cedex 08, France
| | | | - Pauline Boucheron
- International Agency for Research on Cancer, 69372 LYON cedex 08, France
| | | | - Valerie McCormack
- International Agency for Research on Cancer, 69372 LYON cedex 08, France
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Lailler G, Boucheron P, Regnault N, Gabet A, Deneux-Tharaux C, Kretz S, Grave C, Mounier-Vehier C, Tsatsaris V, Plu-Bureau G, Blacher J, Olié V. Impact of type and duration of hypertensive disorders of pregnancy on the onset of permanent hypertension in France (2010–2018): The nationwide CONCEPTION study. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.199] [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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Boucheron P, Anele A, Zietsman A, Galukande M, Parham G, Pinder LF, Andersson TML, Anderson BO, Foerster M, Schüz J, Dos Santos Silva I, McCormack V. Self-reported arm and shoulder problems in breast cancer survivors in Sub-Saharan Africa: the African Breast Cancer-Disparities in Outcomes cohort study. Breast Cancer Res 2021; 23:109. [PMID: 34819118 PMCID: PMC8611842 DOI: 10.1186/s13058-021-01486-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background Arm and shoulder problems (ASP), including lymphedema, were common among women with breast cancer in high-income countries before sentinel lymph node biopsy became the standard of care. Although ASP impair quality of life, as they affect daily life activities, their frequency and determinants in Sub-Saharan Africa remain unclear.
Methods All women newly diagnosed with breast cancer at the Namibian, Ugandan, Nigerian, and Zambian sites of the African Breast Cancer-Disparities in Outcomes (ABC-DO) cohort study were included. At each 3-month follow-up interview, women answered the EORTC-QLQ-Br23 questionnaire, including three ASP items: shoulder/arm pain, arm stiffness, and arm/hand swelling. We estimated the cumulative incidence of first self-reported ASP, overall and stratified by study and treatment status, with deaths treated as competing events. To identify determinants of ASP, we estimated cause-specific hazard ratios using Cox models stratified by study site. Results Among 1476 women, up to 4 years after diagnosis, 43% (95% CI 40–46), 36% (33–38) and 23% (20–25), respectively, self-reported having experienced arm/shoulder pain, stiffness and arm/hand swelling at least once. Although risks of self-reported ASP differed between sites, a more advanced breast cancer stage at diagnosis, having a lower socioeconomic position and receiving treatment increased the risk of reporting an ASP. Conclusion ASP are very common in breast cancer survivors in Sub-Saharan Africa. They are influenced by different factors than those observed in high-income countries. There is a need to raise awareness and improve management of ASP within the African setting. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01486-9.
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Affiliation(s)
- Pauline Boucheron
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France.
| | | | - Annelle Zietsman
- AB May Cancer Centre, Windhoek Central Hospital, Windhoek, Namibia
| | - Moses Galukande
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Groesbeck Parham
- Department of Obstetrics and Gynaecology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Benjamin O Anderson
- University of Washington, Seattle, WA, USA.,World Health Organization, Geneva, Switzerland
| | - Milena Foerster
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Joachim Schüz
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | | | - Valerie McCormack
- International Agency for Research On Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
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Boucheron P, Lailler G, Moutengou E, Regnault N, Gabet A, Deneux-Tharaux C, Kretz S, Grave C, Mounier-Vehier C, Tsatsaris V, Plu-Bureau G, Blacher J, Olié V. Hypertensive disorders of pregnancy and onset of chronic hypertension in France: the nationwide CONCEPTION study. Eur Heart J 2021; 43:3352-3361. [PMID: 34643681 DOI: 10.1093/eurheartj/ehab686] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 04/20/2021] [Revised: 07/23/2021] [Accepted: 09/14/2021] [Indexed: 12/20/2022] Open
Abstract
AIMS Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and foetal morbidity and mortality. We aimed to estimate the impact of HDP on the onset of chronic hypertension in primiparous women in the first years following childbirth. METHODS AND RESULTS This nationwide cohort study used data from the French National Health Data System (SNDS). All eligible primiparous women without pre-existing chronic hypertension who delivered between 2010 and 2018 were included. Women were followed up from six weeks post-partum until onset of hypertension, a cardiovascular event, death, or the study end date (31 December 2018). The main outcome was a diagnosis of chronic hypertension. We used Cox models to estimate hazard ratios (HRs) of chronic hypertension for all types of HDP. Overall, 2 663 573 women were included with a mean follow-up time of 3.0 years. Among them, 180 063 (6.73%) had an HDP. Specifically 66 260 (2.16%) had pre-eclampsia (PE) and 113 803 (4.27%) had gestational hypertension (GH). Compared with women who had no HDP, the fully adjusted HRs of chronic hypertension were 6.03 [95% confidence interval (CI) 5.89-6.17] for GH, 8.10 (95% CI 7.88-8.33) for PE (all sorts), 12.95 (95% CI 12.29-13.65) for early PE, 9.90 (95% CI 9.53-10.28) for severe PE, and 13.17 (95% CI 12.74-13.60) for PE following GH. Hypertensive disorders of pregnancy exposure duration was an additional risk factor of chronic hypertension for all PE subgroups. Women with HDP consulted a general practitioner or cardiologist more frequently and earlier. CONCLUSION Hypertensive disorders of pregnancy exposure greatly increased the risk of chronic hypertension in the first years following delivery.
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Affiliation(s)
- Pauline Boucheron
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
| | - Grégory Lailler
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
| | - Elodie Moutengou
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
| | - Nolwenn Regnault
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
| | - Amélie Gabet
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
| | - Catherine Deneux-Tharaux
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France.,Université de Paris, Paris, France
| | - Sandrine Kretz
- Centre de diagnostic et de thérapeutique, Hôtel Dieu, AP-HP, 1 Parvis Notre-Dame, Paris 75004, France
| | - Clémence Grave
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
| | - Claire Mounier-Vehier
- CHU Lille, Institut Cœur-Poumon, Médecine Vasculaire et HTA, 2 Av. Oscar Lambret, Lille 59000, France
| | - Vassilis Tsatsaris
- Université de Paris, Paris, France.,Maternité Port-Royal, FHU PREMA, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Geneviève Plu-Bureau
- Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), INSERM, Paris, France.,Université de Paris, Paris, France.,Unité de gynécologie médicale, APHP, Hôpital Port-Royal Cochin, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France
| | - Jacques Blacher
- Université de Paris, Paris, France.,Centre de diagnostic et de thérapeutique, Hôtel Dieu, AP-HP, 1 Parvis Notre-Dame, Paris 75004, France
| | - Valérie Olié
- Santé publique France, 12 Rue du Val d'Osne, Saint-Maurice 94410, France
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Boucheron P, Lu Y, Yoshida K, Zhao T, Funk AL, Lunel-Fabiani F, Guingané A, Tuaillon E, van Holten J, Chou R, Bulterys M, Shimakawa Y. Accuracy of HBeAg to identify pregnant women at risk of transmitting hepatitis B virus to their neonates: a systematic review and meta-analysis. Lancet Infect Dis 2020; 21:85-96. [PMID: 32805201 DOI: 10.1016/s1473-3099(20)30593-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/10/2020] [Accepted: 07/10/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) involves neonatal immunoprophylaxis, with a birth dose of hepatitis B vaccine and immune globulin, and provision of peripartum antiviral prophylaxis in highly viraemic women. However, access to assays to quantify HBV DNA levels remains inadequate in resource-poor settings. This study was commissioned by WHO and aimed to identify the HBV DNA threshold for MTCT, to assess the sensitivity and specificity of hepatitis B e antigen (HBeAg) testing to identify pregnant women with HBV DNA levels above this threshold, and to predict MTCT of HBV infection on the basis of HBeAg testing. METHODS For this systematic review and meta-analysis, we searched the PubMed, EMBASE, Scopus, CENTRAL, CNKI, and Wanfang databases for studies of pregnant women with chronic HBV infection without concurrent antiviral therapy, published between Jan 1, 2000, and April 3, 2019. Studies were eligible for inclusion if MTCT in mother-child pairs could be stratified by different levels of maternal HBV DNA during pregnancy, if maternal HBeAg status could be stratified by HBV DNA level, and if the MTCT status of infants could be stratified by maternal HBeAg status during pregnancy. Studies that selected pregnant women on the basis of HBeAg serostatus or HBV DNA levels were excluded. Aggregate data were extracted from eligible studies by use of a pre-piloted form; study authors were contacted to clarify any uncertainties about potential duplication or if crucial information was missing. To pool sensitivities and specificities of maternal HBeAg to identify highly viraemic women and to predict MTCT events, we used the DerSimonian-Laird bivariate random effects model. This study is registered with PROSPERO, CRD42019138227. FINDINGS Of 9007 articles identified, 67 articles (comprising 66 studies) met the inclusion criteria. The risk of MTCT despite infant immunoprophylaxis was negligible (0·04%, 95% CI 0·00-0·25) below a maternal HBV DNA level of 5·30 log10 IU/mL (200 000 IU/mL) and increased above this threshold. The pooled sensitivity of HBeAg testing to identify HBV DNA levels of 5·30 log10 IU/mL or greater in pregnant women was 88·2% (83·9-91·5) and pooled specificity was 92·6% (90·0-94·5). The pooled sensitivity of HBeAg testing in predicting MTCT of HBV infection despite infant immunoprophylaxis was 99·5% (95% CI 91·7-100) and pooled specificity was 62·2% (55·2-68·7). INTERPRETATION Maternal HBV DNA of 5·30 log10 IU/mL or greater appears to be the optimal threshold for MTCT of HBV infection despite infant immunoprophylaxis. HBeAg is accurate to identify women with HBV DNA levels above this threshold and has high sensitivity to predict cases of immunoprophylaxis failure. In areas where HBV DNA assays are unavailable, HBeAg can be used as an alternative to assess eligibility for antiviral prophylaxis. FUNDING World Health Organization.
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Affiliation(s)
- Pauline Boucheron
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Ying Lu
- Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
| | - Kyoko Yoshida
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tianshuo Zhao
- School of Public Health, Peking University, Beijing, China
| | - Anna L Funk
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Alice Guingané
- Département d'Hépato-gastroentérologie, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Edouard Tuaillon
- Département de Bactériologie-Virologie, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Judith van Holten
- Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
| | - Roger Chou
- Oregon Health & Science University, Portland, OR, USA
| | - Marc Bulterys
- Global Hepatitis Programme, World Health Organization, Geneva, Switzerland; US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France.
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Boucheron P, Bhopal S, Verma D, Roy R, Kumar D, Divan G, Kirkwood B. Observed feeding behaviours and effects on child weight and length at 12 months of age: Findings from the SPRING cluster-randomized controlled trial in rural India. PLoS One 2020; 15:e0237226. [PMID: 32790783 PMCID: PMC7425856 DOI: 10.1371/journal.pone.0237226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/20/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Child undernutrition results in poor growth in early childhood, undermines optimal development and increases the risk of mortality. Responsive feeding has been promoted as a key intervention for improving nutritional status, however measurement of this remains difficult and has rarely considered child behaviour. We therefore developed a new observed feeding tool to assess both child and caregiver behaviours, as well as their interaction during feeding, and investigate the effect of these on children anthropometric measures at 12-months of age in rural India. METHODS Our study was nested within the SPRING cluster-randomized controlled trial in Rewari, North India. Outcomes were children length-for-age (LAZ), weight-for-length (WLZ) and weight-for-age (WAZ) Z scores at 12 months of age, based on the WHO Child Growth standards. Trained non-specialists live-coded feeding episodes using the newly designed tool. Scores were then created using principal components analysis representing child behaviour, caregiver behaviour and caregiver-child interaction. Mixed effects linear regression was used to assess associations between feeding behaviours and anthropometric outcomes. RESULTS 857 children had a meal observation and were included. Anthropometric status was poor (mean length-for-age -1.59 (SD = 1.11); mean weight-for-length -0.58 (0.95); mean weight-for-age -1.22 (1.04)). There were positive linear differences in weight-for-length per unit increase in caregiver responsive behaviours score (adjusted β-coeff = 0.006, 95%CI = (0.001, 0.011), p = 0.01), in length-for-age and weight-for-age per unit increase in child responsive behaviours score (respectively adjusted β-coeff = 0.004, 95%CI = (0.001, 0.007), p = 0.02, and adjusted β-coeff = 0.003, 95%CI = (0.00001, 0.006), p = 0.049), and in both weight-for-length and weight-for-age per unit increase in caregiver-child interaction score (respectively adjusted β-coeff = 0.007, 95%CI = (0.003, 0.012), p = 0.001, and adjusted β-coeff = 0.005, 95%CI = (0.001, 0.011), p = 0.01). No association was seen between child behaviours and weight-for-length, caregiver behaviours and length and caregiver-child interaction and length. CONCLUSIONS We found that trained non-specialists could assess feeding episodes using a newly designed checklist. Further, child and caregiver behaviours were associated with weight and length at only 12 months of age, a reminder of the importance of interventions to improve responsive feeding quality as we strive towards achievement of the sustainable development goals.
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Affiliation(s)
- Pauline Boucheron
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sunil Bhopal
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Reetabrata Roy
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Child Development Group, Sangath, New Delhi, India
| | - Divya Kumar
- Child Development Group, Sangath, New Delhi, India
| | - Gauri Divan
- Child Development Group, Sangath, New Delhi, India
| | - Betty Kirkwood
- Maternal & Child Health Intervention Research Group, Department of Population Health, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Shah R, Boucheron P, Mandaliya K, Kattamaiyo A, Chevaliez S, Shimakawa Y, Songok E, Lemoine M. Hepatitis C virus infection in people who inject drugs in Africa. Lancet Infect Dis 2020; 20:282-283. [PMID: 32112757 DOI: 10.1016/s1473-3099(20)30049-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 01/17/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Rajiv Shah
- Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Queen Elizabeth the Queen Mother Wing, St Mary's Campus, Imperial College, London W2 1NY, UK
| | - Pauline Boucheron
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Kishor Mandaliya
- Pathology, International Centre for Reproductive Health Kenya, Mombasa, Kenya
| | - Alex Kattamaiyo
- Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Stéphane Chevaliez
- National Reference Center for Viral Hepatitis B, C and D, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France
| | - Yusuke Shimakawa
- Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - Elijah Songok
- The KEMRI Graduate School Training Centre, Kenya Medical Research Institute, Nairobi, Kenya
| | - Maud Lemoine
- Faculty of Medicine, Department of Metabolism, Digestion and Reproduction, Division of Digestive Diseases, Queen Elizabeth the Queen Mother Wing, St Mary's Campus, Imperial College, London W2 1NY, UK.
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Emery S, Boucheron P, Jacek C, de Champs Léger H. [What recourse in the event of the identification of a precarious subject?]. Rev Prat 2020; 70:392-394. [PMID: 32877091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
What recourse in the event of the identification of a precarious subject? People in situation of deprivation have multiple and complex needs. Their healthcare management needs to be global and multidisciplinary, requiring the coordination of various medical and social workers. Identify available structures, their methods of access, is the first step for healthcare professionals who receive a vulnerable person: they can be medical, social or associative. The institutional sites allow to identify a part of these structures.
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Affiliation(s)
- Sophie Emery
- Service de consultations PASS - médecine sociale, hôpital Corentin Celton, Hôpitaux Universitaires Paris Ouest, APHP, Issy-les-Moulineaux, France
| | - Pauline Boucheron
- Service de consultations PASS - médecine sociale, hôpital Corentin Celton, Hôpitaux Universitaires Paris Ouest, APHP, Issy-les-Moulineaux, France
| | - Camille Jacek
- Service de consultations PASS - médecine sociale, hôpital Corentin Celton, Hôpitaux Universitaires Paris Ouest, APHP, Issy-les-Moulineaux, France
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Grave C, Boucheron P, Rudant J, Mikaeloff Y, Tubert-Bitter P, Escolano S, Hocine MN, Coste J, Weill A. Seasonal influenza vaccine and Guillain-Barré syndrome: A self-controlled case series study. Neurology 2020; 94:e2168-e2179. [PMID: 32098853 DOI: 10.1212/wnl.0000000000009180] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/22/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the risk of Guillain-Barré syndrome (GBS) following seasonal influenza vaccination based on French nationwide data. METHODS All cases of GBS occurring in metropolitan France between September 1 and March 31 from 2010 to 2014 were identified from the French national health data system. Data were analyzed according to the self-controlled case series method. The risk period started 1 day after the patient received vaccine (D1) until 42 days after vaccination (D42). The incidence of GBS during this risk period was compared to that of the control period (D43-March 31). The incidence rate ratio (IRR) was estimated after adjusting for seasonality and presence or not of acute infections. RESULTS Between September and March, of the 2010/2011 to 2013/2014 influenza vaccination seasons, 3,523 cases of GBS occurred in metropolitan France and were included in the study. Among them, 15% (527 patients) had received influenza vaccination. A total of 140 patients developed GBS during the 42 days following influenza vaccination. The crude risk of developing GBS was not significantly increased during the 42 days following influenza vaccination (IRR, 1.02; 95% confidence interval [CI], 0.83-1.25; p = 0.85). This result remained nonsignificant after adjustment for calendar months and the incidence of acute gastrointestinal and respiratory tract infections (IRR, 1.10; 95% CI, 0.89-1.37; p = 0.38). In contrast, the risk of GBS was fourfold higher after acute respiratory tract infection (IRR, 3.89; 95% CI, 3.52-4.30; p < 0.0001) or gastrointestinal infection (IRR, 3.64; 95% CI, 3.01-4.40; p < 0.0001). CONCLUSIONS No association between seasonal influenza vaccination and GBS was shown during the 42 days following vaccination.
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Affiliation(s)
- Clémence Grave
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France.
| | - Pauline Boucheron
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Jérémie Rudant
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Yann Mikaeloff
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Pascale Tubert-Bitter
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Sylvie Escolano
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Mounia N Hocine
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Joël Coste
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
| | - Alain Weill
- From the Department of Studies in Public Health (C.G., P.B., J.R., J.C., A.W.), French National Health Insurance, Paris; Assistance Publique-Hôpitaux de Paris (Y.M.), Unité de Rééducation Neurologique Infantile, Hôpital Bicêtre; CESP, Faculté de Médecine-Université Paris-Sud (Y.M.), Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, Villejuif; Biostatistics and Pharmacoepidemiology (P.T.-B., S.E.), Inserm U1181 (B2PHI), UVSQ, University Paris Saclay, Institut Pasteur; and Laboratoire Modélisation (M.N.H.), Epidémiologie et Surveillance des Risques Sanitaires, Conservatoire National des Arts et Métiers, Paris, France
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Grave C, Boucheron P, Rudant J, Mikaeloff Y, Tubert-Bitter P, Escolano S, Hocine M, Coste J, Weill A. Vaccination antigrippale et risque de syndrome de Guillain-Barré : étude par la méthode d’analyse des séries de cas à partir des données du Système national des données de santé (2010–2014). Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.01.055] [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: 10/27/2022] Open
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Pernot S, Boucheron P, Péré H, Lucas ML, Veyer D, Fathallah N, de Parades V, Pavie J, Netter J, Collias L, Taieb J, Grabar S, Weiss L. Comparison of anal cancer screening strategies including standard anoscopy, anal cytology, and HPV genotyping in HIV-positive men who have sex with men. Br J Cancer 2018; 119:381-386. [PMID: 30026613 PMCID: PMC6068120 DOI: 10.1038/s41416-018-0176-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 02/17/2018] [Revised: 06/11/2018] [Accepted: 06/18/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is no consensus on screening strategy of high-grade intraepithelial neoplasia (HGAIN). Guidelines range from clinical examination with digital anorectal examination followed by standard anoscopy (SA), to anal cytology (Pap)+/- HPV genotyping. We compared screening strategy yields based on Pap, SA, and HPV-16 genotyping alone or in combination in HIV-MSM. METHODS Pap, SA, and HPV-16 genotyping were performed in all HIV-MSM attending a first anal cancer screening consultation in Paris, France. High-resolution anoscopy, the gold standard to detect HGAIN, was performed in the case of HPV-16 positivity or abnormal cytology. Yield was defined as the number of patients with HGAIN relative to the total number of patients screened. RESULTS On 212 patients, the complete strategy (SA + Pap + HPV genotyping) yield (12.7%) was significantly higher than that of SA (3.3%, p < 0.001) and HPV-16 alone (6.6%, p < 0.05). Although none of the other strategies were significantly different from the complete strategy, Pap + HPV-16 and Pap + SA had closer yields (about 11%), with OR = 0.83 (95% CI [0.44;1.57]) and 0.87 (95% CI [0.46;1.64]), respectively. CONCLUSIONS Pap combined with HPV-16 genotyping or SA tended towards higher yields compared to Pap alone, and closer to that of the complete strategy.
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Affiliation(s)
- Simon Pernot
- Department of Hepato-Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, APHP, Paris, France.
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Pauline Boucheron
- Department of Biostatistics and Epidemiology, Cochin-Hôtel Dieu Hospital, APHP, Paris, France
| | - Hélène Péré
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Virology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Marie-Laure Lucas
- Department of Clinical Immunology, Georges Pompidou European Hospital, APHP, Paris, France
| | - David Veyer
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Virology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Nadia Fathallah
- Department of Proctology, Saint-Joseph Hospital, Paris, France
| | | | - Juliette Pavie
- Department of Clinical Immunology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Jeanne Netter
- Department of Hepato-Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Lio Collias
- Department of Clinical Immunology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Julien Taieb
- Department of Hepato-Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, APHP, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Sophie Grabar
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Biostatistics and Epidemiology, Cochin-Hôtel Dieu Hospital, APHP, Paris, France
| | - Laurence Weiss
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
- Department of Clinical Immunology, Georges Pompidou European Hospital, APHP, Paris, France.
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