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Velut G, de Laval F, Berry M, Dufour Gaume F, André N, Epelboin L, Lavergne A, Enfissi A, Djossou F, Rousset D, Briolant S. Etiology of Acute Febrile Illnesses in Adults in the Defense Community in French Guiana. Am J Trop Med Hyg 2024; 110:819-825. [PMID: 38377600 PMCID: PMC10993844 DOI: 10.4269/ajtmh.22-0638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 06/13/2023] [Indexed: 02/22/2024] Open
Abstract
In tropical countries, acute febrile illnesses represent a complex clinical problem for general practitioners. We describe the prevalence of different etiologies of acute febrile illnesses occurring among French service members and their families, excluding children, in general practice in French Guiana. From June 2017 to March 2020, patients with a fever ≥37.8°C with a duration of less than 15 days who sought medical care at the army medical centers in Cayenne and Kourou were prospectively enrolled. Based on clinical presentation, blood, urine, nasopharyngeal, and stool samples were collected for diagnostic testing for viruses, bacteria, and parasites (by direct examination, microscopic examination of blood smears, culture, serology, or polymerase chain reaction), and standardized biological tests were systematically performed. Among 175 patients retained for analysis, fever with nonspecific symptoms was predominant (46.9%), with 10 Plasmodium vivax malaria cases, 8 dengue infections, and 6 cases of Q fever. The second most frequent cause of acute febrile illness was upper respiratory tract infections (32.0%) due to influenza virus (n = 18) or human rhinovirus (n = 10). Among the causes of acute febrile illness in French Guiana, clinicians should first consider arboviruses and malaria, as well as Q fever in cases of elevated C-reactive protein with nonspecific symptoms and influenza in cases of signs and symptoms associated with upper respiratory tract infections. Despite an expanded microbiological search, the etiology of 51.4% of acute febrile illnesses remain unknown. Further investigations will be necessary to identify the etiology of acute febrile illnesses, including new pathogens, in French Guiana.
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Affiliation(s)
- Guillaume Velut
- Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France
| | - Franck de Laval
- Centre d’Epidémiologie et de Santé Publique des Armées, Marseille, France
- Aix-Marseille Université, INSERM, Institut de Recherche pour le Développement, Economic and Social Sciences, Health Systems, and Medical Informatics, Marseille, France
| | - Morgane Berry
- Centre Médical Interarmées de Cayenne, Cayenne, French Guiana
| | | | - Nathalie André
- Direction Interarmées du Service de Santé des Forces Armées en Guyane, Cayenne, French Guiana
| | - Loïc Epelboin
- Service des Maladies Infectieuses et Tropicales, et Centre d’investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Anne Lavergne
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Antoine Enfissi
- Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Felix Djossou
- Service des Maladies Infectieuses et Tropicales, et Centre d’investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Dominique Rousset
- Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana
| | - Sébastien Briolant
- Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs – Infections Tropicales et Méditerranéennes, Marseille, France
- Institut Hospitalo-Universitaire – Méditerranée Infection, Marseille, France
- Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France
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Douine M, Lambert Y, Plessis L, Jimeno I, Galindo M, Bardon T, Le Tourneau FM, Molinié P, Vié A, Adenis A, Nacher M, Figueira da Silva A, Vreden S, Suarez-Mutis MC, Sanna A. Social determinants of health among people working on informal gold mines in French Guiana: a multicentre cross-sectional survey. BMJ Glob Health 2023; 8:e012991. [PMID: 38103896 PMCID: PMC10729274 DOI: 10.1136/bmjgh-2023-012991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023] Open
Abstract
INTRODUCTION Social determinants of health, such as living and working conditions, economical and environmental context and access to care, combine to impact the health of individuals and communities. In French Guiana (FG), the persons working in informal artisanal and small-scale gold mining in the rainforest are a particularly vulnerable population which lives in precarious conditions and far from the health system. Previous studies have demonstrated their high morbidity due to infectious diseases. This study aims to describe the social determinants of health in this specific population. METHODS This international multicentre cross-sectional survey included people working on the informal FG gold mines at the crossing points located at both borders with Suriname and Brazil. After collecting written informed consent, a structured questionnaire was administered. RESULTS From September to December 2022, 539 gold miners were included. These poorly educated migrants, mainly from Brazil (99.1%) did not have access to drinkable water (95.4%), lived in close contact with wild fauna by hunting, eating bushmeat or being bitten and were exposed to mercury by inhalation (58.8%) or ingestion (80.5%). They report frequent accidents (13.5%) and chronic treatment interruptions (26.6% of the 11.9% reporting chronic treatment). Half of them considered themselves in good health (56.4%). CONCLUSION This study shows a singular combination of adverse exposures of gold miners working in FG such as zoonoses, heavy metal poisoning, aggression of wild fauna. For ethical as well as public health reasons, actions towards health equity must be considered at different levels: individual, community, environmental, systemic and global level. As end users of minerals, we must assume our responsibilities for the well-being of the extractors by including health in political decisions to engage together in global health. TRIAL REGISTRATION NUMBER NCT05540470.
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Affiliation(s)
- Maylis Douine
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Yann Lambert
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Lorraine Plessis
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Irène Jimeno
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Muriel Galindo
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Teddy Bardon
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | | | - Perrine Molinié
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Alexandre Vié
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Antoine Adenis
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | | | - Stephen Vreden
- Foundation for the Advancement of Scientific Research in Suriname, Paramaribo, Suriname
| | | | - Alice Sanna
- Centre d'Investigation Clinique Antilles-Guyane, CIC Inserm 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
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Hernández-Mora G, Chacón-Díaz C, Moreira-Soto A, Barrantes-Granados O, Suárez-Esquivel M, Viquez-Ruiz E, Barquero-Calvo E, Ruiz-Villalobos N, Hidalgo-Montealegre D, González-Barrientos R, Demeter EA, Estrella-Morales J, Zúñiga-Pereira AM, Quesada-Gómez C, Chaves-Olarte E, Lomonte B, Guzmán-Verri C, Drexler JF, Moreno E. Virulent Brucella nosferati infecting Desmodus rotundus has emerging potential due to the broad foraging range of its bat host for humans and wild and domestic animals. mSphere 2023; 8:e0006123. [PMID: 37404031 PMCID: PMC10449500 DOI: 10.1128/msphere.00061-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/28/2023] [Indexed: 07/06/2023] Open
Abstract
Desmodus rotundus, vampire bats, transmit dangerous infections, and brucellosis is a hazardous zoonotic disease, two adversities that coexist in the subtropical and tropical areas of the American continent. Here, we report a 47.89% Brucella infection prevalence in a colony of vampire bats inhabiting the tropical rainforest of Costa Rica. The bacterium induced placentitis and fetal death in bats. Wide-range phenotypic and genotypic characterization placed the Brucella organisms as a new pathogenic species named Brucella nosferati sp. nov., isolated from bat tissues, including the salivary glands, suggesting feeding behavior might favor transmission to their prey. Overall analyses placed B. nosferati as the etiological agent of a reported canine brucellosis case, demonstrating its potential for infecting other hosts. To assess the putative prey hosts, we analyzed the intestinal contents of 14 infected and 23 non-infected bats by proteomics. A total of 54,508 peptides sorted into 7,203 unique peptides corresponding to 1,521 proteins were identified. Twenty-three wildlife and domestic taxa, including humans, were foraged by B. nosferati-infected D. rotundus, suggesting contact of this bacterium with a broad range of hosts. Our approach is appropriate for detecting, in a single study, the prey preferences of vampire bats in a diverse area, demonstrating its suitability for control strategies where vampire bats thrive. IMPORTANCE The discovery that a high proportion of vampire bats in a tropical area is infected with pathogenic Brucella nosferati and that bats forage on humans and many wild and domestic animals is relevant from the perspective of emerging disease prevention. Indeed, bats harboring B. nosferati in their salivary glands may transmit this pathogenic bacterium to other hosts. This potential is not trivial since, besides the demonstrated pathogenicity, this bacterium possesses all the required virulent arsenal of dangerous Brucella organisms, including those that are zoonotic for humans. Our work has settled the basis for future surveillance actions in brucellosis control programs where these infected bats thrive. Moreover, our strategy to identify the foraging range of bats may be adapted for exploring the feeding habits of diverse animals, including arthropod vectors of infectious diseases, and therefore of interest to a broader audience besides experts on Brucella and bats.
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Affiliation(s)
- Gabriela Hernández-Mora
- Unidad de Microbiología Médico Veterinaria, Servicio Nacional de Salud Animal (SENASA), Ministerio de Agricultura y Ganadería, Heredia, Costa Rica
| | - Carlos Chacón-Díaz
- Centro de Investigación en Enfermedades Tropicales (CIET), Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Andres Moreira-Soto
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Osvaldo Barrantes-Granados
- Unidad de Microbiología Médico Veterinaria, Servicio Nacional de Salud Animal (SENASA), Ministerio de Agricultura y Ganadería, Heredia, Costa Rica
| | - Marcela Suárez-Esquivel
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Eunice Viquez-Ruiz
- Unidad de Microbiología Médico Veterinaria, Servicio Nacional de Salud Animal (SENASA), Ministerio de Agricultura y Ganadería, Heredia, Costa Rica
| | - Elías Barquero-Calvo
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Nazareth Ruiz-Villalobos
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Daniela Hidalgo-Montealegre
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Rocío González-Barrientos
- Section of Anatomic Pathology, Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Elena A. Demeter
- Section of Anatomic Pathology, Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Josimar Estrella-Morales
- Unidad de Microbiología Médico Veterinaria, Servicio Nacional de Salud Animal (SENASA), Ministerio de Agricultura y Ganadería, Heredia, Costa Rica
| | - Ana-Mariel Zúñiga-Pereira
- Centro de Investigación en Enfermedades Tropicales (CIET), Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Carlos Quesada-Gómez
- Centro de Investigación en Enfermedades Tropicales (CIET), Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Esteban Chaves-Olarte
- Centro de Investigación en Enfermedades Tropicales (CIET), Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Bruno Lomonte
- Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Caterina Guzmán-Verri
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
| | - Jan Felix Drexler
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, Berlin, Germany
| | - Edgardo Moreno
- Programa de Investigación en Enfermedades Tropicales (PIET), Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Costa Rica
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