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Vainqueur L, Tabue-Teguo M, Bartholet S, Ruart S, Dramé M, Godaert L. [The opinion of private duty nurses in Martinique on the vaccination of elderly subjects]. Soins Gerontol 2019; 24:32-35. [PMID: 31806176 DOI: 10.1016/j.sger.2019.09.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Improving immunisation coverage for older adults is a public health issue. Since 2008, nurses have been authorised to vaccinate this population against influenza without a medical prescription. One study examined the opinions of a sample of 78 private duty nurses in Martinique on influenza and anti-tetanus vaccination of elderly populations. The majority of nurses said they were not in favour of vaccination.
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Affiliation(s)
| | - Maturin Tabue-Teguo
- Service de gériatrie, Centre hospitalier et universitaire de Guadeloupe, Pointe-à-Pitre/Abymes, BP 465, 97159 Pointe-à-Pitre Cedex, France; Université des Antilles, Campus de Fouillole, Pointe-à-Pitre, 97157 Guadeloupe, France; Inserm 1219, Équipe Sepia, Université de Bordeaux, 146, rue Léo-Saignat, 33076 Bordeaux, France
| | - Seendy Bartholet
- Site de Pierre Zobda-Quitman, Centre hospitalier et universitaire de Martinique, CS 90632, 97261 Fort-de-France Cedex, France
| | - Shelly Ruart
- Sport Sciences Department Laboratory ACTES EA3596, University of the French West Indies, Campus de Fouillole, BP 250, 97275 Pointe-à-Pitre, France
| | - Moustapha Dramé
- Site de Pierre Zobda-Quitman, Centre hospitalier et universitaire de Martinique, CS 90632, 97261 Fort-de-France Cedex, France
| | - Lidvine Godaert
- Site de Pierre Zobda-Quitman, Centre hospitalier et universitaire de Martinique, CS 90632, 97261 Fort-de-France Cedex, France.
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Dramé M, Kanagaratnam L, Hentzien M, Fanon JL, Bartholet S, Godaert L. Clinical Forms of Chikungunya Virus Infection: The Challenge and Utility of a Consensus Definition. Am J Trop Med Hyg 2019; 99:552-553. [PMID: 30076697 PMCID: PMC6090326 DOI: 10.4269/ajtmh.18-0468a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Moustapha Dramé
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | | | - Maxime Hentzien
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
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Godaert L, Bartholet S, Kanagaratnam L, Fanon JL, Dramé M. Predictive score of dengue vs. chikungunya virus infections: Difficult use in elderly patients. Med Mal Infect 2019; 49:554-555. [PMID: 31174944 DOI: 10.1016/j.medmal.2019.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/15/2019] [Indexed: 11/16/2022]
Affiliation(s)
- L Godaert
- University Hospitals of Martinique, Pierre Zobda-Quitman, Department of Geriatrics, CS 90632, 97261 Fort-de-France Cedex, Martinique, France.
| | - S Bartholet
- University Hospitals of Martinique, Pierre Zobda-Quitman, Department of Geriatrics, CS 90632, 97261 Fort-de-France Cedex, Martinique, France
| | - L Kanagaratnam
- University of Reims Champagne-Ardenne, Faculty of Medicine, EA 3797, Reims, France; University Hospitals of Reims, Robert Debra Hospital, Department of Research and Public Health, Avenue du Général Koening, 51092 Reims, France
| | - J L Fanon
- University Hospitals of Martinique, Pierre Zobda-Quitman, Department of Geriatrics, CS 90632, 97261 Fort-de-France Cedex, Martinique, France
| | - M Dramé
- University of the French West-indies, Faculty of Medicine, BP 7029, 97275 Schoelcher, Martinique, France; University Hospitals of Martinique, Pierre-Zobda-Quitman Hospital, Department of Clinical Research and Innovation, CS 90632, 97261 Fort-de-France Cedex, Martinique, France
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Godaert L, Bartholet S, Najioullah F, Andrianasolo H, Kanagaratnam L, Joachim C, Césaire R, Fanon JL, Dramé M. Long-term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans. Trop Med Int Health 2019; 24:363-370. [PMID: 30565794 DOI: 10.1111/tmi.13194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To investigate whether the long-term survival in elderly patients with prior Chikungunya virus infection (CVI) is associated with the clinical form presented in the acute phase, as defined by the WHO classification. METHODS Retrospective cohort study performed in Martinique University Hospitals. Patients who attended the emergency department for suspected CVI, and who had a positive biological diagnosis of CVI by reverse transcription-polymerase chain reaction on a plasma sample between 10 January and 31 December 2014 were eligible for inclusion. Time-to-death was the primary outcome. The independent relationship between clinical forms and time-to-death was analysed using a Cox model. RESULTS In total, 268 patients were included. Mean age was 80 ± 8 years, 53% were women. Median length of follow-up was 28 months (range: 0-39). During follow-up, 53 (19.8%) patients died. Median survival time was 13.2 months (range: 0-33.6). At the end of follow-up, death rates were 4.6% for acute clinical cases, 19.0% for atypical cases, 19.2% for severe acute cases and 23.5% for unclassifiable cases. By multivariable analysis, the clinical form of CVI at admission was found to be independently associated with long-term survival (atypical form: HR = 2.38; 95% CI = 2.15-2.62; severe acute form: HR = 2.40; 95% CI = 2.17-2.64; unclassifiable form: HR = 2.28; 95% CI = 2.06-2.51). CONCLUSION The clinical form at presentation with CVI has a significant impact on long-term survival. Management of CVI patients should be tailored according to their clinical form at admission.
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Affiliation(s)
- Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Fatiha Najioullah
- Department of Virology, University Hospitals of Martinique, Martinique, France
| | - Hanitra Andrianasolo
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | | | - Clarisse Joachim
- Cancer Registry of Martinique, University Hospitals of Martinique, Martinique, France
| | - Raymond Césaire
- Department of Virology, University Hospitals of Martinique, Martinique, France
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Moustapha Dramé
- Faculty of Medicine, University of the French West-Indies, Martinique, France.,Department of Clinical Research and Innovation, University Hospitals of Martinique, Martinique, France
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Godaert L, Bartholet S, Gazeuse Y, Brouste Y, Najioullah F, Kanagaratnam L, Césaire R, Fanon JL, Dramé M. Misdiagnosis of Chikungunya Virus Infection: Comparison of Old and Younger Adults. J Am Geriatr Soc 2018; 66:1768-1772. [PMID: 30080240 DOI: 10.1111/jgs.15492] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 04/02/2018] [Revised: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the frequency of diagnostic errors in older adults presenting to the emergency department (ED) with symptoms suggestive of Chikungunya virus infection (CVI) and to compare the rates of misdiagnosis of older and younger adults. DESIGN Cross-sectional study performed in the University Hospitals of Martinique from retrospective cases. SETTING Emergency department. PARTICIPANTS Individuals aged 65 and older who attended the ED and underwent reverse transcription polymerase chain reaction (RT-PCR) testing for CVI between January and December 2014 (n=333, mean age 80±8) were considered eligible and were compared with a randomly selected sample of younger adults (< 65) (n=143, mean age 45±13). MEASUREMENTS Misdiagnosis rates. RESULTS The rate of misdiagnosis of CVI in the ED was 30.6% in individuals aged 65 and older and 6.3% in those younger than 65 (p<.001). The overdiagnosis rate was 9.0% in individuals aged 65 and older and 3.5% in those younger than 65 (p=.04). The underdiagnosis rate was significantly higher (p<.001) in individuals aged 65 and older (21.6%) than in those younger than 65 (2.8%). CONCLUSION Misdiagnosis of CVI during an epidemic is statistically more frequent in older than younger adults because clinical presentation is often atypical in older adults. Specific diagnostic tools for older adults and better awareness of ED physicians of different presentations in different age groups could help to reduce the rate of misdiagnosis of CVI in the ED.
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Affiliation(s)
- Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Yannick Gazeuse
- Department of Emergency Medicine, University Hospitals of Martinique, Martinique, France
| | - Yannick Brouste
- Department of Emergency Medicine, University Hospitals of Martinique, Martinique, France
| | - Fatiha Najioullah
- Department of Virology, University Hospitals of Martinique, Martinique, France
| | - Lukshe Kanagaratnam
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France.,Department of Research and Public Health, University Hospital of Reims, Robert Debré Hospital, Reims, France
| | - Raymond Césaire
- Department of Virology, University Hospitals of Martinique, Martinique, France
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Moustapha Dramé
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France.,Department of Research and Public Health, University Hospital of Reims, Robert Debré Hospital, Reims, France
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Godaert L, Bartholet S, Colas S, Kanagaratnam L, Fanon JL, Dramé M. Acquired Hemophilia A in Aged People: A Systematic Review of Case Reports and Case Series. Semin Hematol 2018; 55:197-201. [PMID: 30502847 DOI: 10.1053/j.seminhematol.2018.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 08/17/2017] [Revised: 11/22/2017] [Accepted: 02/17/2018] [Indexed: 11/11/2022]
Abstract
Acquired hemophilia A (AHA) is a rare disease that requires urgent management. Currently, there is no consensus regarding optimal management in aged people. This systematic review aimed to describe diagnosis, clinical features, management, and endpoints in population aged 65 years or over with AHA. A literature search up to and including 31 May 2017 was performed in Medline, Embase, and Scopus. The search strategy on article titles comprised the following terms: "acquired" AND ("hemophilia A" OR "haemophilia A"). Filters were applied for age (65 years or older), publication type (case reports and case series), and studies including human beings only. There was no language restriction in the search strategy. Studies with no data on immunosuppressive therapy, and studies in other languages than English or French were excluded. Patient-level and study-level information was extracted. In total, 270 studies were identified by the literature search. After exclusion of duplicates, and studies presenting exclusion criteria, 80 articles including 159 cases were included in the final review. These 159 cases were 76.1 ± 7.2 years old, and were mainly men (64%). There is wide variety in the therapies used to eradicate the Factor VIII autoantibody, and efficacy is difficult to assess. The majority of patients with AHA receive immunosuppressants. Mortality is high, and likely depends on the rapidity of diagnosis and implementation of adequate management and monitoring.
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Affiliation(s)
- Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France.
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Sébastien Colas
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Lukshe Kanagaratnam
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France; Department of Research and Public Health, University Hospitals of Reims, Robert Debré Hospital, Reims, France
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Moustapha Dramé
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France; Department of Research and Public Health, University Hospitals of Reims, Robert Debré Hospital, Reims, France
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Godaert L, Bartholet S, Dorléans F, Najioullah F, Colas S, Fanon JL, Cabié A, Césaire R, Dramé M. Prognostic factors of inhospital death in elderly patients: a time-to-event analysis of a cohort study in Martinique (French West Indies). BMJ Open 2018; 8:e018838. [PMID: 29362259 PMCID: PMC5786118 DOI: 10.1136/bmjopen-2017-018838] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The primary objective was to identify predictive factors of inhospital death in a population of patients aged 65 years or older hospitalised with Chikungunya virus (CHIKV) infection. The secondary aim was to develop and validate a predictive score for inhospital death based on the predictors identified. DESIGN Longitudinal retrospective study from January to December 2014. SETTING University Hospital of Martinique. PARTICIPANTS Patients aged ≥65 years, admitted to any clinical ward and who underwent reverse transcription PCR testing for CHIKV infection. OUTCOME Independent predictors of inhospital death were identified using multivariable Cox regression modelling. A predictive score was created using the adjusted HRs of factors associated with inhospital death. Receiver operating characteristic curve analysis was used to determine the best cut-off value. Bootstrap analysis was used to evaluate internal validity. RESULTS Overall, 385 patients aged ≥65 years were included (average age: 80±8 years). Half were women, and 35 (9.1%) died during the hospital stay. Seven variables were found to be independently associated with inhospital death (concurrent cardiovascular disorders: HR 11.8, 95% CI 4.5 to 30.8; concurrent respiratory infection: HR 9.6, 95% CI 3.4 to 27.2; concurrent sensorimotor deficit: HR 7.6, 95% CI 2.0 to 28.5; absence of musculoskeletal pain: HR 2.6, 95% CI 1.3 to 5.3; history of alcoholism: HR 2.5, 95% CI 1.1 to 5.9; concurrent digestive symptoms: HR 2.4, 95% CI 1.2 to 4.9; presence of confusion or delirium: HR 2.1, 95% CI 1.1 to 4.2). The score ranged from 0 to 25, with an average of 6±6. The area under the curve was excellent (0.90; 95% CI 0.86 to 0.94). The best cut-off value was a score ≥8 points, with a sensitivity of 91% (82%-100%) and specificity of 75% (70%-80%). CONCLUSIONS Signs observed by the clinician during the initial examination could predict inhospital death. The score will be helpful for early management of elderly subjects presenting within 7 days of symptom onset in the context of CHIKV outbreaks.
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Affiliation(s)
- Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Fréderique Dorléans
- Inter-regional Epidemiology Unit (CIRE), Regional Health Agency (ARS) of Martinique, Martinique, France
| | - Fatiha Najioullah
- Department of Virology, University Hospitals of Martinique, Martinique, France
| | - Sebastien Colas
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Martinique, France
| | - André Cabié
- Department of Infectious Diseases, University Hospitals of Martinique, Martinique, France
| | - Raymond Césaire
- Department of Virology, University Hospitals of Martinique, Martinique, France
| | - Moustapha Dramé
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
- Department of Research and Public Health, University Hospital of Reims, Robert Debré Hospital, Reims, France
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Godaert L, Najioullah F, Bartholet S, Colas S, Yactayo S, Cabié A, Fanon JL, Césaire R, Dramé M. Atypical Clinical Presentations of Acute Phase Chikungunya Virus Infection in Older Adults. J Am Geriatr Soc 2017; 65:2510-2515. [PMID: 28940357 DOI: 10.1111/jgs.15004] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We aimed to determine whether the presentation of Chikungunya virus (CHIKV) infection differs between older and younger adults with regard to clinical form during the acute phase defined by the World Health Organization: acute clinical, atypical, and severe acute. DESIGN Cross-sectional, retrospective. SETTING University Hospital of Martinique. PARTICIPANTS Individuals aged 65 and older (n = 267, mean age 80.4 ± 87.9) who attended the emergency department with a positive biological diagnosis of CHIKV (reverse transcriptase polymerase chain reaction) between January and December 2014 and a randomly selected sample of individuals younger than 65 (n = 109, mean age 46.2 ± 12.7). RESULTS Typical presentation was present in 8.2% of older adults and 59.6% of younger individuals (P < .001), atypical presentation in 29.6% of older adults and 5.6% of younger individuals (P < .001), and severe presentation in 19.5% of older adults and 17.4% of younger individuals (P = .65). One hundred fourteen (42.7%) of the older group and 19 (17.4%) of the younger group could not be classified in any category (absence of fever, absence of joint pain, or both) (P < .001). CONCLUSION Only 8.2% of the older adults presenting in the acute phase of CHIKV have typical forms, suggesting that the most-frequent clinical presentation of CHIKV in older adults differs from that in younger individuals.
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Affiliation(s)
- Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Fatiha Najioullah
- Department of Virology, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Sébastien Colas
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Sergio Yactayo
- Department of Pandemic and Epidemic Diseases, World Health Organization, Geneva, Switzerland
| | - André Cabié
- Department of Infectious Diseases, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Raymond Césaire
- Department of Virology, University Hospitals of Martinique, Fort-de-France, Martinique
| | - Moustapha Dramé
- Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France.,Department of Research and Public Health, University Hospital of Reims, Robert Debré Hospital, Reims, France
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Godaert L, Bartholet S, Najioullah F, Hentzien M, Fanon JL, Césaire R, Dramé M. Screening for Chikungunya virus infection in aged people: Development and internal validation of a new score. PLoS One 2017; 12:e0181472. [PMID: 28817648 PMCID: PMC5560672 DOI: 10.1371/journal.pone.0181472] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to derive and validate a score for Chikungunya virus (CHIKV) infection screening in old people admitted to acute care units. Methods This study was performed in the Martinique University Hospitals from retrospective cases. Patients were aged 65+, admitted to acute care units for suspected CHIKV infection in 2014, with biological testing using Reverse Transcription Polymerase Chain Reaction (RT-PCR). RT-PCR was used as the gold standard. A screening score was created using adjusted odds ratios of factors associated with positive RT-PCR derived from a multivariable logistic regression model. A ROC curve was used to determine the best cut-off of the score. Bootstrap analysis was used to evaluate its internal validity. Results In all, 687 patients were included, 68% with confirmed CHIKV infection, and 32% with laboratory-unconfirmed CHIKV infection. Mean age was 80±8 years, 51% were women. Four variables were found to be independently associated with positive RT-PCR (fever: 3 points; arthralgia of the ankle: 2 points; lymphopenia: 6 points; absence of neutrophil leucocytosis: 10 points). The best cut-off was score ≥12; sensitivity was 87% (83%-90%) and specificity was 70% (63%-76%). Conclusion This score shows good diagnostic performance and good internal validation and could be helpful to screen aged people for CHIKV infection.
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Affiliation(s)
- Lidvine Godaert
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique, France
- * E-mail:
| | - Seendy Bartholet
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique, France
| | - Fatiha Najioullah
- Department of Virology, University Hospitals of Martinique, Fort-de-France, Martinique, France
| | - Maxime Hentzien
- University Hospital of Reims, Robert Debré Hospital, Department of Infectious Diseases, Reims, France
| | - Jean-Luc Fanon
- Department of Geriatrics, University Hospitals of Martinique, Fort-de-France, Martinique, France
| | - Raymond Césaire
- Department of Virology, University Hospitals of Martinique, Fort-de-France, Martinique, France
| | - Moustapha Dramé
- University of Reims Champagne-Ardenne, Faculty of Medicine, Reims, France
- University Hospital of Reims, Robert Debré Hospital, Department of Research and Public Health, Reims, France
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