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Lahouati M, Cazanave C, Labadie A, Gohier P, Guirlé L, Desclaux A, Gigan M, Malvy D, Pedeboscq S, Xuereb F, Duvignaud A. Outcomes of targeted treatment in immunocompromised patients with asymptomatic or mild COVID-19: a retrospective study. Sci Rep 2023; 13:15357. [PMID: 37717101 PMCID: PMC10505186 DOI: 10.1038/s41598-023-42727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/14/2023] [Indexed: 09/18/2023] Open
Abstract
The aim of this study was to describe the outcomes of targeted COVID-19 treatments in immunocompromised patients with asymptomatic or mild COVID-19 during the period of expansion of the different Omicron subvariants in France. A retrospective monocentric observational study was performed. All immunocompromised patients aged 18 or more, with asymptomatic SARS-CoV-2 infection or mild COVID-19, and who had received a targeted treatment with sotrovimab, tixagevimab/cilgavimab, nirmatrelvir/ritonavir or remdesivir at the Bordeaux University Hospital from 1st January 2022 to 31st December 2022 were eligible. The primary outcomes of interest was defined as a composite of either (i) progression to moderate (WHO-Clinical Progression Scale at 4 or 5) or severe COVID-19 (WHO-CPS ≥ 6), or (ii) the occurrence of COVID-19-related death. The secondary outcomes of interest were the components of the primary outcome. Outcomes were collected until day 30 after targeted treatment administration or at discharge for patients still hospitalised in relation with COVID-19 at day 30. 223 immunocompromised patients received targeted treatment for asymptomatic SARS-CoV-2 infection or mild COVID-19: 114 received sotrovimab, 50 tixagevimab/cilgavimab, 49 nirmatrelvir/ritonavir, and 10 remdesivir. Among 223 treated patients, 10 (4.5%) progressed to moderate or severe disease: three patients (1.3%) progressed to moderate COVID-19 and 7 (3.1%) patients progressed to severe disease. Among them, 4 (1.8%) died of COVID-19. More than 95% of immunocompromised patients with asymptomatic SARS-CoV-2 infection or mild COVID-19 treated by targeted therapies during the Omicron subvariants era did not progress to moderate or severe disease.
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Affiliation(s)
- M Lahouati
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France.
- Inserm, UMR 1034, Biology of Cardiovascular Diseases, Université de Bordeaux, Pessac, France.
| | - C Cazanave
- Service des maladies infectieuses et tropicales, CHU de Bordeaux, 33076, Bordeaux, France
| | - A Labadie
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - P Gohier
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - L Guirlé
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - A Desclaux
- Service des maladies infectieuses et tropicales, CHU de Bordeaux, 33076, Bordeaux, France
| | - M Gigan
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - D Malvy
- Service des maladies infectieuses et tropicales, CHU de Bordeaux, 33076, Bordeaux, France
- Inserm UMR 1219, IRD EMR 271, Bordeaux Population Health, Université de Bordeaux, 33076, Bordeaux, France
| | - S Pedeboscq
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - F Xuereb
- Service de Pharmacie Clinique, Hôpital Pellegrin, Centre Hospitalo-Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
- Inserm, UMR 1034, Biology of Cardiovascular Diseases, Université de Bordeaux, Pessac, France
| | - A Duvignaud
- Service des maladies infectieuses et tropicales, CHU de Bordeaux, 33076, Bordeaux, France
- Inserm UMR 1219, IRD EMR 271, Bordeaux Population Health, Université de Bordeaux, 33076, Bordeaux, France
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Devos S, Bonnet F, Hessamfar M, Neau D, Vareil MO, Leleux O, Cazanave C, Rouanes N, Duffau P, Lazaro E, Dabis F, Wittkop L, Barger D, Blanco P, Bouchet S, Breilh D, Desjardin S, Gaborieau V, Gimbert A, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Pellegrin I, Perrier A, Petrov-Sanchez V, Bernard N, Bronnimann D, Chaussade H, Dondia D, Faure I, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Nguyen D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Labasse-Depis M, Lacassin F, Barret A, Castan B, Koffi J, Saunier A, Zabbe JB, Dumondin G, Beraud G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Ngo Bell C, Carpentier C, Tumiotto C, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lai WH, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M. Tobacco, alcohol, cannabis, and illicit drug use and their association with CD4/CD8 cell count ratio in people with controlled HIV: a cross-sectional study (ANRS CO3 AQUIVIH-NA-QuAliV). BMC Infect Dis 2023; 23:16. [PMID: 36624391 PMCID: PMC9830769 DOI: 10.1186/s12879-022-07963-6] [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: 05/30/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND To evaluate drug use (alcohol, tobacco, cannabis and other drugs) and its association with mean CD4/CD8 T cell count ratio, a marker of chronic inflammation, in virally suppressed people living with HIV-1 (PLWH) in Nouvelle Aquitaine, France. METHODS A multi-centric, cross-sectional analysis was conducted in 2018-19 in the QuAliV study-ANRS CO3 AQUIVIH-NA cohort. Tobacco, alcohol, cannabis, and other drug use (poppers, cocaine, amphetamines, synthetic cathinones, GHB/GBL) were self-reported. CD4 and CD8 T cell counts and viral load measures, ± 2 years of self-report, and other characteristics were abstracted from medical records. Univariable and multivariable linear regression models, adjusted for age, sex, HIV risk group, time since HIV diagnosis, and other drug use were fit for each drug and most recent CD4/CD8 ratio. RESULTS 660 PLWH, aged 54.7 ± 11.2, were included. 47.7% [315/660] had a CD4/CD8 ratio of < 1. Their mean CD4/CD8 ratio was 1.1 ± 0.6. 35% smoked; ~ 40% were considered to be hazardous drinkers or have alcohol use disorder; 19.9% used cannabis and 11.9% other drugs. Chemsex-associated drug users' CD4/CD8 ratio was on average 0.226 (95% confidence interval [95% CI] - 0.383, - 0.070) lower than that of non-users in univariable analysis (p = 0.005) and 0.165 lower [95% CI - 0.343, 0.012] in multivariable analysis (p = 0.068). CONCLUSIONS Mean differences in CD4/CD8 ratio were not significantly different in tobacco, alcohol and cannabis users compared to non-users. However, Chemsex-associated drug users may represent a population at risk of chronic inflammation, the specific determinants of which merit further investigation. TRIAL REGISTRATION NUMBER NCT03296202.
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Affiliation(s)
- Sophie Devos
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Fabrice Bonnet
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Mojgan Hessamfar
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Didier Neau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Marc-Olivier Vareil
- grid.418076.c0000 0001 0226 3611Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, 13 Avenue de l’interne Jacques Loëb, BP 8, 64109 Bayonne Cedex, France
| | - Olivier Leleux
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Charles Cazanave
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service des Maladies Infectieuses et Tropicales, INSERM, U1219, Pl. Amélie Raba Léon, U121933000 Bordeaux, France
| | - Nicolas Rouanes
- Centre Hospitalier de Périgueux, Service de Médecine Polyvalente, 80 Av. Georges Pompidou, 22400 Périgueux, France
| | - Pierre Duffau
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France ,grid.4444.00000 0001 2112 9282Univ. Bordeaux, Department of Immunology, CNRS, ImmunoConcEpT, UMR 5164, 33000 Bordeaux, France
| | - Estibaliz Lazaro
- grid.42399.350000 0004 0593 7118CHU de Bordeaux, Service de Médecine Interne, 1 Avenue de Magellan, 33600 Pessac, France
| | - François Dabis
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.42399.350000 0004 0593 7118CHU de Bordeaux, COREVIH Nouvelle Aquitaine, INSERM, U1219, 1 Rue Jean Burguet, 33000 Bordeaux, France
| | - Linda Wittkop
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.7429.80000000121866389Univ. Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-P 1401, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,Univ. Bordeaux, INSERM, INRIA, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France ,grid.508062.90000 0004 8511 8605CHU de Bordeaux, Service d’information médicale, INSERM, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
| | - Diana Barger
- grid.7429.80000000121866389Univ. Bordeaux, INSERM, BPH, U1219, 146, rue Léo Saignat-CS61292, 33076 Bordeaux Cedex, France
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Blanc P, Bonnet F, Leleux O, Perrier A, Bessede E, Pereyre S, Cazanave C, Neau D, Vareil MO, Lazaro E, Duffau P, Saunier A, André K, Wittkop L, Vandenhende MA, Blanco P, Bonnet F, Bouchet S, Breilh D, Cazanave C, Desjardin S, Gaborieau V, Gimbert A, Hessamfar M, Lacaze-Buzy L, Lacoste D, Lafon ME, Lawson-Ayayi S, Lazaro E, Leleux O, Le Marec F, Le Moal G, Malvy D, Marchand L, Mercié P, Neau D, Pellegrin I, Perrier A, Petrov-Sanchez V, Vareil MO, Wittkop L, Bernard N, Bonnet F, Bronnimann D, Chaussade H, Dondia D, Duffau P, Faure I, Hessamfar M, Mercié P, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende MA, Barthod L, Cazanave C, Dauchy FA, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Neau D, Nguyen D, Malvy D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Lazaro E, Pellegrin JL, Rivière E, Viallard JF, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Vareil MO, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Gerard Y, Labasse-Depis M, Lacassin F, Barret A, Courtault C, Castan B, Koffi J, Rouanes N, Saunier A, Zabbe JB, Dumondin G, Gaborieau V, Gerard Y, Beraud G, Le Moal G, Catroux M, Garcia M, Giraud V, Martellosio JP, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Bell CN, Pasdeloup T, Pasdeloup T, Blanco P, Pellegrin I, Carpentier C, Pellegrin I, Bellecave P, Lafon ME, Tumiotto C, Bouchet S, Breilh D, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau MJ, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lawson-Ayayi S, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M, Leleux O, Perrier A, Peyrouny-Mazeau A. Severe bacterial non-AIDS infections in persons with HIV: the epidemiology and evolution of antibiotic resistance over an 18-year period (2000-2017) in the ANRS CO3 AquiVih-Nouvelle-Aquitaine cohort. Clin Infect Dis 2023; 76:1814-1821. [PMID: 36610063 DOI: 10.1093/cid/ciac978] [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: 05/13/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Severe non-AIDS bacterial infections (SBIs) are one of the leading causes of hospital admissions among persons with HIV (PWH) in regions with high ART coverage. METHODS This large prospective cohort study of PWH examined the types of infections, bacterial documentation, and evolution of antibiotic resistance among PWH hospitalized with SBIs over an 18-year period. RESULTS Between 2000 and 2017, 459 PWH had at least one SBI with bacterial documentation. Among the 847 SBIs, there were 280 cases of bacteremia, 269 cases of pneumonia, and 240 urinary tract infections. The 1025 isolated bacteria included Enterobacteriaceae (n = 394; mainly Escherichia coli), Staphylococcus aureus (n = 153) and Streptococcus pneumoniae (n = 82). The proportion of S. pneumoniae as the causative agent in pneumonia and bacteremia decreased sharply over time, from 34% to 8% and from 21 to 3%, respectively.The overall antibiotic resistance of S. aureus and S. pneumoniae decreased progressively but it increased for Enterobacteriaceae (from 24% to 48% for amoxicillin-clavulanate, from 4 to 18% for cefotaxime, and from 5% to 27% for ciprofloxacin). Cotrimoxazole prophylaxis was associated with higher nonsusceptibility of S. pneumoniae to amoxicillin and erythromycin, higher nonsusceptibility of Enterobacteriaceae to beta-lactams and fluoroquinolones, and a higher risk of extended-spectrum β-lactamase producing Enterobacteriaceae. CONCLUSIONS The bacterial resistance pattern among PWH between 2014 and 2017 was broadly similar to that in the general population, with the exception of a higher resistance profile of Enterobacteriaceae to fluoroquinolones. The use of cotrimoxazole as prophylaxis was associated with an increased risk of antibiotic resistance.
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Affiliation(s)
- Peggy Blanc
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Fabrice Bonnet
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Olivier Leleux
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Adélaïde Perrier
- Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Emilie Bessede
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Sabine Pereyre
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, UMR 5234 Fundamental Microbiology and Pathogenicity, F-33000 Bordeaux, France
| | - Charles Cazanave
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Didier Neau
- Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Marc-Olivier Vareil
- Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, F-64109 Bayonne, France
| | - Estibaliz Lazaro
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital du Haut-Lévêque, F-33600 Pessac, France
| | - Pierre Duffau
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Immunologie Clinique, Hôpital Saint-André, UMR 5164, F-33000 Bordeaux, France.,Université de Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, F-33000 Bordeaux, France
| | - Aurélie Saunier
- Centre Hospitalier de Périgueux, Service de Médecine Interne, F-24000 Périgueux, France
| | - Katell André
- Centre Hospitalier de Dax, Service de Maladies Infectieuses, F-40100 Dax, France
| | - Linda Wittkop
- Université de Bordeaux, INSERM, Institut Bergonié, BPH, U1219, CIC-EC 1401, F-33000, Bordeaux, France.,INRIA SISTM Team, F-33405, Talence, France.,Centre Hospitalier Universitaire de Bordeaux, Service d'information médicale, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France.,Université de Bordeaux, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France
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Marcellin F, Brégigeon-Ronot S, Ramier C, Protopopescu C, Gilbert C, Di Beo V, Duvivier C, Bureau-Stoltmann M, Rosenthal E, Wittkop L, Salmon-Céron D, Carrieri P, Sogni P, Barré T, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Zaegel-Faucher O, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar M, Paccalin J, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, J.Zelie, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallées M, Esterle L, Gilbert C, Gillet S, Guillochon Q, Khan C, Knight R, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Barré T, Ramier C, Sow A, Lions C, Di Beo V, Bureau M, Wittkop L. Depressive symptoms after hepatitis C cure and socio-behavioral correlates in aging people living with HIV (ANRS CO13 HEPAVIH). JHEP Rep 2022; 5:100614. [DOI: 10.1016/j.jhepr.2022.100614] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
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Barré T, Mercié P, Lions C, Miailhes P, Zucman D, Aumaître H, Esterle L, Sogni P, Carrieri P, Salmon-Céron D, Marcellin F, Salmon D, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin MA, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque AM, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Levier A, Usubillaga R, Terris B, Tremeaux P, Katlama C, Valantin MA, Stitou H, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Zaegel O, Laroche H, Tamalet C, Callard P, Bendjaballah F, Le Pendeven C, Marchou B, Alric L, Metivier S, Selves J, Larroquette F, Rio V, Haudebourg J, Saint-Paul MC, De Monte A, Giordanengo V, Partouche C, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Garipuy D, Ferro-Collados MJ, Nicot F, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Molina JM, Bertheau P, Chaix ML, Delaugerre C, Maylin S, Bottero J, Krause J, Girard PM, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Reigadas S, Lacoste D, Bonnet F, Bernard N, Hessamfar M, J, Paccalin F, Martell C, Pertusa MC, Vandenhende M, Mercié P, Pistone T, Receveur MC, Méchain M, Duffau P, Rivoisy C, Faure I, Caldato S, Bellecave P, Tumiotto C, Pellegrin JL, Viallard JF, Lazzaro E, Greib C, Majerholc C, Brollo M, Farfour E, Devoto JP, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Augustin-Normand C, Scholtes C, Le-Thi TT, Van Huyen PCMD, Buisson M, Waldner-Combernoux A, Mahy S, Rousseau AS, Martins C, Galim S, Lambert D, Nguyen Y, Berger JL, Hentzien M, Brodard V, Partisani M, Batard ML, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Fischer P, Gantner P, Fafi-Kremer S, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi FZ, Braik O, Bayoud R, Gatey C, Pietri MP, Le Baut V, Rayana RB, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Tezkratt S, Barré T, Rojas TR, Baudoin M, Di Beo MSV, Nishimwe M. HCV cure: an appropriate moment to reduce cannabis use in people living with HIV? (ANRS CO13 HEPAVIH data). AIDS Res Ther 2022; 19:15. [PMID: 35292069 PMCID: PMC8922772 DOI: 10.1186/s12981-022-00440-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thanks to direct-acting antivirals, hepatitis C virus (HCV) infection can be cured, with similar rates in HCV-infected and HIV-HCV co-infected patients. HCV cure is likely to foster behavioral changes in psychoactive substance use, which is highly prevalent in people living with HIV (PLWH). Cannabis is one substance that is very commonly used by PLWH, sometimes for therapeutic purposes. We aimed to identify correlates of cannabis use reduction following HCV cure in HIV-HCV co-infected cannabis users and to characterize persons who reduced their use. METHODS We used data collected on HCV-cured cannabis users in a cross-sectional survey nested in the ANRS CO13 HEPAVIH cohort of HIV-HCV co-infected patients, to perform logistic regression, with post-HCV cure cannabis reduction as the outcome, and socio-behavioral characteristics as potential correlates. We also characterized the study sample by comparing post-cure substance use behaviors between those who reduced their cannabis use and those who did not. RESULTS Among 140 HIV-infected cannabis users, 50 and 5 had reduced and increased their use, respectively, while 85 had not changed their use since HCV cure. Cannabis use reduction was significantly associated with tobacco use reduction, a decrease in fatigue level, paying more attention to one's dietary habits since HCV cure, and pre-HCV cure alcohol abstinence (p = 0.063 for alcohol use reduction). CONCLUSIONS Among PLWH using cannabis, post-HCV cure cannabis reduction was associated with tobacco use reduction, improved well-being, and adoption of healthy behaviors. The management of addictive behaviors should therefore be encouraged during HCV treatment.
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Ba I, Desclaux A, Diop M, Ndiaye I, Thiam M. [Ensuring continuity of care at the time of COVID-19: challenges for the Dakar Integrated Support Center for Addictions]. Med Trop Sante Int 2021; 1:V3RB-PV49. [PMID: 35685392 PMCID: PMC9128414 DOI: 10.48327/v3rb-pv49] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The COVID-19 pandemic has an impact on health systems, whose modes of adaptation and response on the ground are still poorly documented and are evolving. The Dakar Integrated Support Center for Addictions (CEPIAD) has been implementing risk reduction since 2014, particularly with drug users. The COVID-19 pandemic and related public health measures were an obstacle to its attendance by patients, in particular due to movement restriction. In addition to the implementation of individual and collective preventive measures in the center, CEPIAD has experimented "take-home" for methadon that is generally provided daily through directly observed treatment. The center has also taken care of amnestied incarcerated cannabis users. Several aspects of this experience, perceived positively, could be relevant outside the pandemic context.
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Affiliation(s)
- I. Ba
- Centre de prise en charge intégrée des addictions de Dakar (CEPIAD), Sénégal,Université Cheikh Anta Diop de Dakar, Sénégal,*
| | - A. Desclaux
- Centre régional de recherche et de formation à la prise en charge du VIH et des maladies infectieuses (CRCF), CHUN de Fann, Dakar, Sénégal,Institut de recherche pour le développement, TransVIHMI, Dakar, Sénégal,Projet CODISOCS: Consommateurs de drogues injectables et dynamiques sociales au Sénégal, ANRS 12383
| | - M. Diop
- Institut de recherche pour le développement, TransVIHMI, Dakar, Sénégal,Projet CODISOCS: Consommateurs de drogues injectables et dynamiques sociales au Sénégal, ANRS 12383
| | - I. Ndiaye
- Centre de prise en charge intégrée des addictions de Dakar (CEPIAD), Sénégal,Université Cheikh Anta Diop de Dakar, Sénégal
| | - M.H. Thiam
- Centre de prise en charge intégrée des addictions de Dakar (CEPIAD), Sénégal,Service de psychiatrie, Centre hospitalier national universitaire de Fann (CHNUF), Dakar, Sénégal
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Leitao J, Martin L, Desclaux A, Dutronc H, Neau D, Dauchy FA. Experience of ultrasound performed by infectiologists, an innovating approach for the management of patients. Infect Dis Now 2020; 51:451-455. [PMID: 34366081 DOI: 10.1016/j.idnow.2020.10.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/25/2020] [Accepted: 10/30/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Ultrasound imaging has many clinical applications, but there is a lack of data about its use by infectiologists. The aim of this study was to describe ultrasound performed routinely by infectiologists and to assess the diagnostic performance of ultrasound with aspirate and fluid analysis in prosthetic joint infections. METHODS Retrospective study between 1st June 2019 and 1st June 2020 in an infectious and tropical diseases unit in a tertiary University Hospital. RESULTS One hundred and thirty-one ultrasounds were performed on 127 patients by the infectious diseases team. These included 64 musculoskeletal ultrasounds (31 in native joints and 33 in prosthetic joints including 15 knees, 13 hips and 5 spacers) and 33 led to a fluid aspirate. Fourteen lung ultrasounds were done, 11 confirmed pneumopathy and 7 resulted in pleural puncture. Twenty-three vascular ultrasounds were done, 17 to insert a catheter, and four to perform a blood test. Five ultrasounds explored adenopathy, of which one node tuberculosis and one Bartonella infection were diagnosed. In prosthetic joint infections, sensitivity and specificity of ultrasound with fluid aspirate and analysis were respectively 100% and 100% for the knee and 40% and 100% for the hip. CONCLUSION Ultrasound performed by infectiologists is useful and contributes to a faster diagnosis. Furthermore, the specificity of ultrasound with aspirate and fluid analysis is very high in prosthetic joint infection. Ultrasound training courses should be considered for infectiologists including residents.
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Affiliation(s)
- J Leitao
- Service de maladies infectieuses et tropicales, Centre de référence Infections ostéo-articulaires complexes, Hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France.
| | - L Martin
- Service de maladies infectieuses et tropicales, Centre de référence Infections ostéo-articulaires complexes, Hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - A Desclaux
- Service de maladies infectieuses et tropicales, Centre de référence Infections ostéo-articulaires complexes, Hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - H Dutronc
- Service de maladies infectieuses et tropicales, Centre de référence Infections ostéo-articulaires complexes, Hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - D Neau
- Service de maladies infectieuses et tropicales, Centre de référence Infections ostéo-articulaires complexes, Hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - F-A Dauchy
- Service de maladies infectieuses et tropicales, Centre de référence Infections ostéo-articulaires complexes, Hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
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Perez S, Dauchy FA, Salvo F, Quéroué M, Durox H, Delobel P, Chambault R, Ade M, Cazanave C, Desclaux A, Fabre T, Dutronc H. Severe adverse events during medical and surgical treatment of hip and knee prosthetic joint infections. Infect Dis Now 2020; 51:346-350. [PMID: 33096203 DOI: 10.1016/j.medmal.2020.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/02/2020] [Accepted: 10/14/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The management of prosthetic joint infection requires a complex treatment procedure and can be associated with complications. However, the occurrence of severe adverse events during this intervention has been poorly evaluated. PATIENTS AND METHODS A 5-year multicentric retrospective study including patients from 3 hospitals in the South-Western France referral center for complex bone and joint infections (Crioac GSO) and treated for hip or knee prosthetic joint infection with 1 or 2-stage implant exchanges. The objective was to describe grade≥3 adverse events, according to the CTCAE classification, occurring within 6 weeks after surgery and to identify their associated factors. RESULTS One hundred and eighteen patients were identified. We observed 71 severe events in 50 patients (42.3%; 95% confidence interval [CI95%]: 33.8-51.4%). Sixteen severe events were an evolution of the infection. The remaining 55 others (47 grade 3 and 8 grade 4) occurred in 41 patients (34.7%; CI95%: 26.8-43.7%). They were distributed as follows: 27 (49.1%) medical complications, 21 (38.2%) surgical complications and 7 (12.7%) antibiotic-related complications. The main identified risk factor was a two-stage prosthetic exchange with OR=3.6 (CI95% [1.11-11.94], P=0.032). Obesity was limit of significance with OR=3.3 (CI95% [0.9-12.51], P=0.071). Infection with coagulase negative Staphylococcus was a protective factor with OR=0.3 (CI95% [0.12-0.99], P=0.047). CONCLUSION Severe adverse events are frequent following prosthetic exchange for PJI (34.7%) and are related to the high frequency of comorbidities in this population and to the complex surgical procedures required. The risk factor significantly associated with these events was a two-stage exchange.
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Affiliation(s)
- S Perez
- Infectious and tropical disease service, Bordeaux CHU, hôpital Pellegrin, place Amélie Raba-Léon, 33076 Bordeaux, France
| | - F-A Dauchy
- Infectious and tropical disease service, Bordeaux CHU, hôpital Pellegrin, place Amélie Raba-Léon, 33076 Bordeaux, France; South Western France referral center for complex bone and joint infections (Crioac GSO), France
| | - F Salvo
- Medical pharmacology service, Bordeaux CHU, Bordeaux, France
| | - M Quéroué
- Informatic unit, medical information service, Bordeaux CHU, Bordeaux, France
| | - H Durox
- South Western France referral center for complex bone and joint infections (Crioac GSO), France; Infectious and tropical disease service, Limoges CHU, Limoges, France
| | - P Delobel
- South Western France referral center for complex bone and joint infections (Crioac GSO), France; Infectious and tropical disease service, Toulouse CHU, Toulouse, France
| | - R Chambault
- Hospital Pharmacy, Toulouse CHU, Toulouse, France
| | - M Ade
- Hospital Pharmacy, Toulouse CHU, Toulouse, France
| | - C Cazanave
- Infectious and tropical disease service, Bordeaux CHU, hôpital Pellegrin, place Amélie Raba-Léon, 33076 Bordeaux, France
| | - A Desclaux
- Infectious and tropical disease service, Bordeaux CHU, hôpital Pellegrin, place Amélie Raba-Léon, 33076 Bordeaux, France
| | - T Fabre
- South Western France referral center for complex bone and joint infections (Crioac GSO), France; Orthopedic surgery service, Bordeaux CHU, Bordeaux, France
| | - H Dutronc
- Infectious and tropical disease service, Bordeaux CHU, hôpital Pellegrin, place Amélie Raba-Léon, 33076 Bordeaux, France; South Western France referral center for complex bone and joint infections (Crioac GSO), France.
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Ducours M, Desclaux A, Dutronc H, Dauchy FA, Abi-Chahla ML, Pointillart V, Wirth G. About three cases of Mycobacterium bovis bone and joint infections after BCG therapy. Infect Dis Now 2020; 51:211-213. [PMID: 33038440 DOI: 10.1016/j.medmal.2020.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/03/2020] [Accepted: 09/28/2020] [Indexed: 11/18/2022]
Affiliation(s)
- M Ducours
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France.
| | - A Desclaux
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - H Dutronc
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - F A Dauchy
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - M L Abi-Chahla
- Centre Hospitalier Universitaire de Bordeaux, Service de chirurgie plastique, reconstructrice et esthétique - Brulés - Chirurgie de la main, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - V Pointillart
- Centre Hospitalier universitaire de Bordeaux, Service orthopédique et traumatologique, unité de chirurgie du rachis, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - G Wirth
- Centre Hospitalier Universitaire de Bordeaux, Service des Maladies Infectieuses et Tropicales, Hôpital Pellegrin, F-33000 Bordeaux, France
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Lahouati M, Mériglier E, Martin L, Bouchet S, Desclaux A, Bonnet F. COVID-19 infection also occurs in patients taking hydroxychloroquine. J Antimicrob Chemother 2020; 75:2014-2015. [PMID: 32417904 PMCID: PMC7239161 DOI: 10.1093/jac/dkaa193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- M Lahouati
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France.,CHU de Bordeaux, Hôpital Saint-André, Service de Pharmacie Clinique, F-33000 Bordeaux, France
| | - E Mériglier
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France
| | - L Martin
- CHU de Bordeaux, Hôpital Pellegrin, Service de Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France
| | - S Bouchet
- CHU de Bordeaux, Hôpital Pellegrin, Service de Pharmacologie, F-33000 Bordeaux, France
| | - A Desclaux
- CHU de Bordeaux, Hôpital Pellegrin, Service de Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France
| | - F Bonnet
- CHU de Bordeaux, Hôpital Saint-André, Service de Médecine Interne et Maladies Infectieuses, F-33000 Bordeaux, France.,Université de Bordeaux, Bordeaux Population Health, INSERM U1219, F-33000 Bordeaux, France
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Ducours M, Puges M, Desclaux A, Barthod L, Peuchant O, Cazanave C. Haemophilus spp., an emerging multidrug-resistant sexually transmitted pathogen. Med Mal Infect 2020; 50:734-737. [PMID: 32569798 DOI: 10.1016/j.medmal.2020.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/21/2020] [Accepted: 06/15/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the characteristics of patients with a positive urethral sample for Haemophilus spp. MATERIAL AND METHODS We performed a retrospective study from January 2018 to July 2019 at the Bordeaux university hospital (France) of all urethral samples positive for Haemophilus spp. RESULTS Haemophilus spp. was isolated in 10 urethral samples from nine patients. The mean age was 33.8 years. Most patients reported having unprotected sex. Haemophilus parainfluenzae was isolated in nine samples, and Haemophilus influenzae in one sample. Antibiotic susceptibility tests were performed in five samples; Haemophilus spp. was always resistant to amoxicillin and tetracycline. One patient had persistent symptoms after treatment for a multidrug-resistant Haemophilus parainfluenzae strain. CONCLUSION Haemophilus spp. is a rare pathogen of urethritis. Its responsibility should be considered in case of persistent symptoms. The emergence of multidrug-resistant Haemophilus spp. is becoming problematic.
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Affiliation(s)
- M Ducours
- Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France.
| | - M Puges
- Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - A Desclaux
- Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - L Barthod
- Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - O Peuchant
- USC EA 3671, infections humaines à mycoplasmes et à chlamydiae, University Bordeaux, 33000 Bordeaux, France; Centre national de référence des infections sexuellement transmissibles bactériennes, centre hospitalier de Bordeaux, 33000 Bordeaux, France
| | - C Cazanave
- Service des maladies infectieuses et tropicales, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France; USC EA 3671, infections humaines à mycoplasmes et à chlamydiae, University Bordeaux, 33000 Bordeaux, France; Centre national de référence des infections sexuellement transmissibles bactériennes, centre hospitalier de Bordeaux, 33000 Bordeaux, France
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Marcellin F, Di Beo V, Aumaitre H, Mora M, Wittkop L, Duvivier C, Protopopescu C, Lacombe K, Esterle L, Berenger C, Gilbert C, Bouchaud O, Poizot-Martin I, Sogni P, Salmon-Ceron D, Carrieri P, Wittkop L, Sogni P, Esterle L, Trimoulet P, Izopet J, Serfaty L, Paradis V, Spire B, Carrieri P, Valantin M, Pialoux G, Chas J, Poizot-Martin I, Barange K, Naqvi A, Rosenthal E, Bicart-See A, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Neau D, Morlat P, Bani-Sadr F, Meyer L, Boufassa F, Autran B, Roque A, Solas C, Fontaine H, Costagliola D, Piroth L, Simon A, Zucman D, Boué F, Miailhes P, Billaud E, Aumaître H, Rey D, Peytavin G, Petrov-Sanchez V, Lebrasseur-Longuet D, Salmon D, Usubillaga R, Sogni P, Terris B, Tremeaux P, Katlama C, Valantin M, Stitou H, Simon A, Cacoub P, Nafissa S, Benhamou Y, Charlotte F, Fourati S, Poizot-Martin I, Zaegel O, Laroche H, Tamalet C, Pialoux G, Chas J, Callard P, Bendjaballah F, Amiel C, Le Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Selves J, Larroquette F, Rosenthal E, Naqvi A, Rio V, Haudebourg J, Saint-Paul M, De Monte A, Giordanengo V, Partouche C, Bouchaud O, Martin A, Ziol M, Baazia Y, Iwaka-Bande V, Gerber A, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados M, Selves J, Nicot F, Gervais A, Yazdanpanah Y, Adle-Biassette H, Alexandre G, Peytavin G, Lascoux-Combe C, Molina J, Bertheau P, Chaix M, Delaugerre C, Maylin S, Lacombe K, Bottero J, Krause J, Girard P, Wendum D, Cervera P, Adam J, Viala C, Vittecocq D, Goujard C, Quertainmont Y, Teicher E, Pallier C, Lortholary O, Duvivier C, Rouzaud C, Lourenco J, Touam F, Louisin C, Avettand-Fenoel V, Gardiennet E, Mélard A, Neau D, Ochoa A, Blanchard E, Castet-Lafarie S, Cazanave C, Malvy D, Dupon M, Dutronc H, Dauchy F, Lacaze-Buzy L, Desclaux A, Bioulac-Sage P, Trimoulet P, Reigadas S, Morlat P, Lacoste D, Bonnet F, Bernard N, Hessamfar, J M, Paccalin F, Martell C, Pertusa M, Vandenhende M, Mercié P, Malvy D, Pistone T, Receveur M, Méchain M, Duau P, Rivoisy C, Faure I, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Bellecave P, Tumiotto C, Pellegrin J, Viallard J, Lazzaro E, Greib C, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Brollo M, Farfour E, Boué F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Abgrall S, Favier M, Deback C, Lévy Y, Dominguez S, Lelièvre J, Lascaux A, Melica G, Billaud E, Raffi F, Allavena C, Reliquet V, Boutoille D, Biron C, Lefebvre M, Hall N, Bouchez S, Rodallec A, Le Guen L, Hemon C, Miailhes P, Peyramond D, Chidiac C, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Valour F, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Augustin-Normand C, Scholtes C, Le-Thi T, Piroth L, Chavanet P, Duong Van Huyen M, Buisson M, Waldner-Combernoux A, Mahy S, Binois R, Simonet-Lann A, Croisier-Bertin D, Salmon Rousseau A, Martins C, Aumaître H, Galim S, Bani-Sadr F, Lambert D, Nguyen Y, Berger J, Hentzien M, Brodard V, Rey D, Partisani M, Batard M, Cheneau C, Priester M, Bernard-Henry C, de Mautort E, Gantner et S Fafi-Kremer P, Roustant F, Platterier P, Kmiec I, Traore L, Lepuil S, Parlier S, Sicart-Payssan V, Bedel E, Anriamiandrisoa S, Pomes C, Touam F, Louisin C, Mole M, Bolliot C, Catalan P, Mebarki M, Adda-Lievin A, Thilbaut P, Ousidhoum Y, Makhoukhi F, Braik O, Bayoud R, Gatey C, Pietri M, Le Baut V, Ben Rayana R, Bornarel D, Chesnel C, Beniken D, Pauchard M, Akel S, Caldato S, Lions C, Ivanova A, Ritleg AS, Debreux C, Chalal L, Zelie J, Hue H, Soria A, Cavellec M, Breau S, Joulie A, Fisher P, Gohier S, Croisier-Bertin D, Ogoudjobi S, Brochier C, Thoirain-Galvan V, Le Cam M, Carrieri P, Chalouni M, Conte V, Dequae-Merchadou L, Desvallees M, Esterle L, Gilbert C, Gillet S, Knight R, Lemboub T, Marcellin F, Michel L, Mora M, Protopopescu C, Roux P, Spire B, Tezkratt S, Barré T, Baudoin M, Santos M, Di Beo V, Nishimwe M, Wittkop L. Patient-reported symptoms during direct-acting antiviral treatment: A real-life study in HIV-HCV coinfected patients (ANRS CO13 HEPAVIH). J Hepatol 2020; 72:588-591. [PMID: 31924411 DOI: 10.1016/j.jhep.2019.10.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 01/26/2023]
Affiliation(s)
- Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Vincent Di Beo
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Hugues Aumaitre
- Infectious and Tropical Disease Unit, Perpignan Hospital Center, Perpignan, France
| | - Marion Mora
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Linda Wittkop
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France; CHU de Bordeaux, Pole de santé publique, F-33000 Bordeaux, France
| | - Claudine Duvivier
- AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, IHU Imagine, Université de Paris, INSERM, U1016, Institut Cochin, CNRS, UMR8104, Paris, France; Institut Pasteur, Medical Center of Institut Pasteur, Necker-Pasteur Infectiology Center, Paris, France
| | - Camelia Protopopescu
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Karine Lacombe
- Infectious and Tropical Disease Unit, Paris Public Hospitals, Saint-Antoine Hospital, Paris, France; UMR S1136, Pierre Louis Epidemiology and Public Health Institute, Pierre and Marie Curie University, Paris, France
| | - Laure Esterle
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Cyril Berenger
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Camille Gilbert
- Univ. Bordeaux, ISPED, Inserm, Bordeaux Population Health Research Center, Team MORPH3EUS, UMR 1219, CIC-EC 1401, F-33000 Bordeaux, France
| | - Olivier Bouchaud
- Infectious and Tropical Disease Unit, Paris Publics Hospitals, Avicenne Hospital, Bobigny, France; Paris 13 Nord University, Bobigny, France
| | - Isabelle Poizot-Martin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; APHM Sainte-Marguerite, Clinical Immunohematology Unit, Aix Marseille University, Marseille, France
| | - Philippe Sogni
- Université Paris Descartes, Paris, France; INSERM U-1223, Institut Pasteur, Paris, France; Service d'Hépatologie, hôpital Cochin, Assistance Publique - Hôpitaux de Paris, France
| | - Dominique Salmon-Ceron
- Université Paris Descartes, Paris, France; Service Maladies infectieuses et tropicales, AP-HP, Hôpital Cochin, Paris, France
| | - Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Économiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France; ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
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Puges M, Bérard X, Ruiz J, Debordeaux F, Desclaux A, Stecken L, Pereyre S, Hocquelet A, Bordenave L, Pinaquy J, Cazanave C. Retrospective Study Comparing WBC scan and 18F-FDG PET/CT in Patients with Suspected Prosthetic Vascular Graft Infection. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.06.056] [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: 10/26/2022]
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Pistone T, Lambert Y, Grard G, Blaizot R, Desclaux A, Tumiotto C, Duvignaud A, Lafon M, Leparc-Goffart I, Malvy D. Incidence d’infection par le virus Zika (ZKV) et défaut de performance des tests Elisa chez des voyageurs français ayant visité l’Amérique latine et/ou les Caraïbes durant l’été 2016. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.288] [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: 10/26/2022]
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Zabbé J, Ouattara E, Duvignaud A, Desclaux A, Malvy D, Pistone T. Immunogénicité des schémas courts de prophylaxie vaccinale pré-exposition de la rage chez les voyageurs : revue de la littérature et étude pilote d’évaluation d’un schéma court en 2 doses j0–j7 par voie intramusculaire. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.323] [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: 10/26/2022]
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Perez S, Dauchy FA, Salvo F, Pugès M, Desclaux A, Cazanave C, Blangis M, Fabre T, Dutronc H. Evènements indésirables sévères au cours de la prise en charge médico-chirurgicale des infections de prothèses de hanche et de genou. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.229] [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: 10/26/2022]
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Hémar V, Desclaux A, Lafon M, Neau D. Analyse rétrospective d’une série de méningites à Herpes simplex virus de 2010 à 2018. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Deborde M, Pereyre S, Puges M, Bébéar C, Desclaux A, Hessamfar M, Le Roy C, Le Marec F, Dabis F, Cazanave C. High prevalence of Mycoplasma genitalium infection and macrolide resistance in patients enrolled in HIV pre-exposure prophylaxis program. Med Mal Infect 2019; 49:347-349. [PMID: 30914213 DOI: 10.1016/j.medmal.2019.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 05/15/2018] [Revised: 06/26/2018] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Limited data on Mycoplasma genitalium infection has been reported among PrEP users. The aim of this study was to estimate the prevalence and macrolide resistance of M. genitalium infection among enrollees in a French PrEP program. PATIENTS AND METHODS M. genitalium infection screening was systematically and prospectively proposed to patients of the Bordeaux PrEP program (between January 2016 and February 2017). Macrolide resistance was evaluated in M. genitalium-positive patients. RESULTS Among 89 clients, M. genitalium infection prevalence was 10% (mainly asymptomatic) with a high rate of macrolide resistance (58%). CONCLUSIONS Because of a high level of macrolide resistance, a systematic search for M. genitalium macrolide resistance associated-mutations may be recommended in PrEP users before initiating the antibiotic therapy.
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Affiliation(s)
- M Deborde
- Infectious and tropical diseases department, Pellegrin hospital, Bordeaux university hospital, 33000 Bordeaux, France
| | - S Pereyre
- USC EA 3671, Mycoplasma and chlamydia human infections, Bordeaux university, 33000 Bordeaux, France; USC EA 3671, Mycoplasma and chlamydia human infections, French National Institute for Agricultural Research, 33000 Bordeaux, France; Bacteriological laboratory, Bordeaux university hospital, 33000 Bordeaux, France
| | - M Puges
- Infectious and tropical diseases department, Pellegrin hospital, Bordeaux university hospital, 33000 Bordeaux, France
| | - C Bébéar
- USC EA 3671, Mycoplasma and chlamydia human infections, Bordeaux university, 33000 Bordeaux, France; USC EA 3671, Mycoplasma and chlamydia human infections, French National Institute for Agricultural Research, 33000 Bordeaux, France; Bacteriological laboratory, Bordeaux university hospital, 33000 Bordeaux, France
| | - A Desclaux
- Infectious and tropical diseases department, Pellegrin hospital, Bordeaux university hospital, 33000 Bordeaux, France
| | - M Hessamfar
- Inserm U1219 - Bordeaux population health, institute for public health, epidemiology, and development (ISPED), Bordeaux university, 33000 Bordeaux, France; COREVIH Aquitaine, Bordeaux university hospital, 33000 Bordeaux, France; Infectious diseases and internal medicine department, Saint-André hospital, Bordeaux university hospital, 33000 Bordeaux, France
| | - C Le Roy
- USC EA 3671, Mycoplasma and chlamydia human infections, Bordeaux university, 33000 Bordeaux, France; USC EA 3671, Mycoplasma and chlamydia human infections, French National Institute for Agricultural Research, 33000 Bordeaux, France
| | - F Le Marec
- Inserm U1219 - Bordeaux population health, institute for public health, epidemiology, and development (ISPED), Bordeaux university, 33000 Bordeaux, France
| | - F Dabis
- Inserm U1219 - Bordeaux population health, institute for public health, epidemiology, and development (ISPED), Bordeaux university, 33000 Bordeaux, France; COREVIH Aquitaine, Bordeaux university hospital, 33000 Bordeaux, France
| | - C Cazanave
- Infectious and tropical diseases department, Pellegrin hospital, Bordeaux university hospital, 33000 Bordeaux, France; USC EA 3671, Mycoplasma and chlamydia human infections, Bordeaux university, 33000 Bordeaux, France; USC EA 3671, Mycoplasma and chlamydia human infections, French National Institute for Agricultural Research, 33000 Bordeaux, France.
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Desclaux A, Malan MS, Egrot M, Sow K, Akindès F. Surveillance in the field: Over-identification of Ebola suspect cases and its contributing factors in West African at-risk contexts. Glob Public Health 2018; 14:709-721. [PMID: 30319027 DOI: 10.1080/17441692.2018.1534255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
During an Ebola outbreak, the WHO recommends that health professionals consider people as suspect cases (SCs) when they show key signs such as the sudden onset of high fever or specific symptoms after having had contact with a suspect or confirmed Ebola case. SCs should then get care, be isolated and be reported to health authorities until the Ebola virus disease is confirmed through a lab test. This exploratory study aims to understand this identification process in the field based on a qualitative analysis of the diagnosis and therapeutic itineraries of 19 SCs in Cote d'Ivoire and Senegal (2014-2015). Results indicate that the main criteria for SC identification at the field level were fever (understood broadly) and provenance from a highly affected country (applied indiscriminately). WHO criteria were not followed in at least 9 of the 19 cases. Several medical, social and cultural factors favour over-identification of people as SCs, including relativism in defining 'high fever', placism, humanitarian or securitarian bias, issues in categorising SC's contact cases, and the context of fear. To avoid undue categorisation and its possible harmful social effects, the WHO definition should be implemented more carefully in various contexts and with greater consideration for ethical issues, while prioritising diagnosis strategies with higher specificity.
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Affiliation(s)
- A Desclaux
- a TransVIHMI, IRD, INSERM , Université de Montpellier , Montpellier , France
| | - M S Malan
- b Chaire Unesco de bioéthique , Université Alassane Ouattara , Bouaké , Côte d'Ivoire
| | - M Egrot
- c Mivegec, IRD, Chaire Unesco de Bioéthique , Université Alassane Ouattara , Bouaké , Côte d'Ivoire
| | - K Sow
- d Centre Régional de Recherche et de Formation à la prise en charge , CHNU de Fann , Dakar , Sénégal
| | - F Akindès
- b Chaire Unesco de bioéthique , Université Alassane Ouattara , Bouaké , Côte d'Ivoire
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Vareil M, Wille H, Kassab S, Le-Cornec C, Puges M, Desclaux A, Lafon ME, Tumiotto C, Cazanave C, Neau D. Clinical and biological features of enteroviral meningitis among adults and children and factors associated with severity and length of stay. J Clin Virol 2018; 104:56-60. [PMID: 29738895 DOI: 10.1016/j.jcv.2018.04.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/27/2018] [Accepted: 04/30/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Enterovirus (EV) meningitis is the most common form of meningitis. Clinical and biological manifestations may be non-specific, leading to prolonged and costly investigations. OBJECTIVES To determine the different aspects of EV meningitis and the variables associated with length of stay (LOS) in hospital independently of patients' age. STUDY DESIGN Single center retrospective study of all EV PCR positive CSF samples during 3.5 years in Bordeaux University Hospital, France. RESULTS 172 patients were included. 65 were under 3 years old and 49 over 18 years old. 10% of patients had severe forms of the disease. 47 patients (27.3%) had normal CSF count and in 63 patients (36.6%) polynuclear cells predominated in CSF. Procalcitonin, Hoens' score or PCR in stool samples appeared as good markers for enteroviral diagnosis. Time elapsed before PCR results was associated with LOS (p = .002) and should help in limiting investigations in case of aseptic meningitis. CONCLUSION Rapid availability of EV PCR reduces LOS for patients and contributes to diminish unnecessary procedures and further tests.
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Affiliation(s)
- Mo Vareil
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Department of Infectious Diseases, Centre Hospitalier de la Côte Basque, 13 av. Interne J. Loeb, Bayonne, 64109 Bayonne Cedex, France; Bordeaux University Hospital, France.
| | - H Wille
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Department of Infectious Diseases, Centre Hospitalier de la Côte Basque, 13 av. Interne J. Loeb, Bayonne, 64109 Bayonne Cedex, France; Bordeaux University Hospital, France
| | - S Kassab
- Laboratory of Virology, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - C Le-Cornec
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - M Puges
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - A Desclaux
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - M E Lafon
- Laboratory of Virology, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - C Tumiotto
- Laboratory of Virology, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - C Cazanave
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
| | - D Neau
- Department of Infectious and Tropical Diseases, Bordeaux University Hospital, Place Amélie Raba-Léon 33000 Bordeaux, France; Bordeaux University Hospital, France
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Keita A, Toure A, Sow M, Raoul H, Magassouba N, Delaporte E, Etard JF, Abel L, Ayouba A, Baize S, Bangoura K, Barry A, Barry M, Cissé M, Delaporte E, Delmas C, Desclaux A, Diallo S, Diallo M, Diallo M, Étard JF, Etienne C, Faye O, Fofana I, Granouillac B, Hébert E, Izard S, Kassé D, Keita A, Koivugui L, Kpamou C, Lacarabaratz C, Leroy S, Marchal C, Levy Y, Magassouba N, March L, Msellati P, Niane H, Peeters M, Pers YM, Raoul H, Sacko S, Savané I, Sow M, Taverne B, Touré A, Traoré F. Extraordinary long-term and fluctuating persistence of Ebola virus RNA in semen of survivors in Guinea: implications for public health. Clin Microbiol Infect 2017; 23:412-413. [DOI: 10.1016/j.cmi.2016.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 09/01/2016] [Accepted: 11/02/2016] [Indexed: 11/16/2022]
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Sow S, Desclaux A, Taverne B. Ebola en Guinée : formes de la stigmatisation des acteurs de santé survivants. ACTA ACUST UNITED AC 2016; 109:309-313. [DOI: 10.1007/s13149-016-0510-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 05/19/2016] [Indexed: 11/27/2022]
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Lanièce C, Sow K, Desclaux A. [Security agents on the front line against Ebola: roles, perceptions and knowledge in Fann Teaching Hospital, Dakar, Senegal]. ACTA ACUST UNITED AC 2016; 109:303-308. [PMID: 27260507 DOI: 10.1007/s13149-016-0493-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/22/2016] [Indexed: 11/27/2022]
Abstract
Security agents are on the front line when patients arrive at health facilities, giving them a potential role to play in an Ebola virus disease (EVD) outbreak. The position of security agents within health services is poorly documented. A survey was conducted to clarify their understanding of Ebola pathology, to assess their need for information and to determine their role in patient management. The survey included both qualitative and quantitative aspects. 80 security agents of the Fann teaching hospital (Dakar) completed questionnaires, and 11 were interviewed. Qualitative analysis was performed with Dedoose and the quantitative analysis using Excel. The results show that security agents' activities go beyond their mission of security and control. They are involved in informing, orienting and assisting patients and those accompanying them in the hospital. The security agents have basic knowledge of EVD, but overestimate the risk of transmission. They want to be more informed and to have access to protective material. These results suggest that these professionals should be taken into account when developing response strategies to Ebola outbreaks. Their knowledge of and protection against the disease must be strengthened. Non-health professionals working in health facilities should be trained in order to be able to relay information to the public.
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Affiliation(s)
- C Lanièce
- TransVIHMI (UMI 233 IRD, U 1175 INSERM), Institut de recherche pour le développement, Montpellier, Dakar, Sénégal.
- Centre régional de recherche et de formation à la prise en charge de Fann, Dakar, Sénégal.
- Département de socio-anthropologie, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal.
- Réseau ouest-africain Anthropologie des Epidémies, Dakar, Sénégal.
| | - K Sow
- TransVIHMI (UMI 233 IRD, U 1175 INSERM), Institut de recherche pour le développement, Montpellier, Dakar, Sénégal
- Centre régional de recherche et de formation à la prise en charge de Fann, Dakar, Sénégal
- Département de socio-anthropologie, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
- Réseau ouest-africain Anthropologie des Epidémies, Dakar, Sénégal
| | - A Desclaux
- TransVIHMI (UMI 233 IRD, U 1175 INSERM), Institut de recherche pour le développement, Montpellier, Dakar, Sénégal
- Centre régional de recherche et de formation à la prise en charge de Fann, Dakar, Sénégal
- Département de socio-anthropologie, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
- Réseau ouest-africain Anthropologie des Epidémies, Dakar, Sénégal
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Desclaux A, Ndione AG, Badji D, Sow K. [Ebola contacts' surveillance: social impact and ethical issues in Senegal]. ACTA ACUST UNITED AC 2016; 109:296-302. [PMID: 26850106 PMCID: PMC7096822 DOI: 10.1007/s13149-016-0477-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/22/2015] [Indexed: 11/24/2022]
Abstract
Quarantine has been widely used during the Ebola outbreak in West Africa mainly to control transmission chains. This measure raises ethical issues that require documentation of the modalities of quarantine at the field level and its social effects for contact persons. In Senegal, 74 people were in contact with the Ebola case coming from Guinea in September 2014. Of these, 34 members of the case's household were contained together at home and monitored by officers. The remaining 40 health care workers from two facilities were dispersed in their family households and monitored by telephone or during doctors' visits. The study is based on in-depth interviews with 43 adult contacts about their experiences and perceptions, with additional observation for interpretation and contextualization.Containment at home was applied differently to contacts who lived with patient zero than to professional health care contacts. No coercion was used at first since all contacts adhered to surveillance, but some of them did not fully comply with movement restrictions. Contacts found biosafety precautions stigmatizing, especially during the first days when health workers and contacts were feeling an acute fear of contagion. The material support that was provided-food and money-was necessary since contacts could not work nor get resources, but it was too limited and delayed. The relational support they received was appreciated, as well as the protection from stigmatization by the police and follow-up workers. But the information delivered to contacts was insufficient, and some of them, including health workers, had little knowledge about EVD and Ebola transmission, which caused anxiety and emotional suffering. Some contacts experienced the loss of their jobs and loss of income; several could not easily or fully return to their previous living routines.Beyond its recommendations to enhance support measures, the study identifies the ethical stakes of quarantine in Senegal regarding informed consent and individual autonomy, non-maleficence and benevolence, and equity and adaptation to specific situations. Nevertheless, the balance between preventive benefits and individual inconveniences of quarantine should still be evaluated from a public health perspective.
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Affiliation(s)
- A Desclaux
- IRD UMI 233, INSERM U 1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France. .,Centre régional de recherche et de formation à la prise en charge de Fann, Dakar, Sénégal.
| | - A G Ndione
- Département de socio-anthropologie, Université Cheikh Anta Diop de Dakar, Dakar, Sénégal
| | - D Badji
- Réseau ouest-africain sciences humaines et sociales Ébola, Dakar, Sénégal
| | - K Sow
- Centre régional de recherche et de formation à la prise en charge de Fann, Dakar, Sénégal
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Desclaux A, Montespan C, Austin S, Rayne F, Aknin C, Ragues J, Della-Corte MF, Wodrich H, Lafon ME. BKV-HCMV co-culture model in MRC5 cells. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.206] [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: 10/23/2022]
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Desclaux Sall C, Desclaux A. [Child and Ebola disease. A day of study and discussion, Dakar, October 1st 2014]. Med Sante Trop 2015; 25:125-129. [PMID: 26038986 DOI: 10.1684/mst.2015.0435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- C Desclaux Sall
- Institut de recherche pour le développement, UMI TransVIHMI, Dakar, Sénégal
| | - A Desclaux
- Centre régional de recherche et de formation à la prise en charge du VIH et des maladies associées de Fann (CRCF), Dakar, Sénégal
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Desclaux A, Boye S, Sow K, Ndoye T. [Experience of people living with HIV (PLHIV) on chronic disease: a typology]. ACTA ACUST UNITED AC 2014; 107:244-5. [PMID: 24610687 DOI: 10.1007/s13149-014-0347-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 01/27/2014] [Indexed: 11/30/2022]
Abstract
While discourses focus on the "normalization" of the situation of people with long term antiretroviral treatment, this qualitative analysis aimed at considering more accurately the diversity of their experiences. Five profiles were identified: patients who became experts, patients in medical difficulty, patients dominated by financial insecurity, people who live an almost normal life and people suffering from social disqualification.
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Affiliation(s)
- A Desclaux
- IRD (Institut de recherche pour le développement), TRANSVIHMI, UMI 233, Dakar, Sénégal,
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Coutherut J, Desclaux A. [Disclosing HIV status: the experience of PLHIV after 10 years of ARV treatment in Senegal]. ACTA ACUST UNITED AC 2014; 107:266-72. [PMID: 24595887 DOI: 10.1007/s13149-014-0343-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 12/05/2013] [Indexed: 11/25/2022]
Abstract
Rates of HIV status disclosure observed in Africa, especially to partners, are too low for an optimal implementation of preventive strategies. Access to antiretroviral drugs appears to have facilitated disclosure in the short term, but knowledge is insufficient about long-term practices. A study held with 185 people living with HIV (PLHIV) examined factors associated with disclosure in general and with partners over 10 years of antiretroviral treatment in Dakar. Two third of PLHIV disclosed their status to at least one person, and 56% with their partners. The main results concern factors associated with disclosure to partners (having a child, knowing one's partner status) which are different from factors associated to disclosure in general (duration of ART treatment, secondary or higher education level, being a member of an association). After ten years, 44% of people still living in couple has not disclosed (no significant differences by sex and marital regime). These results invite to regularly offer counselling to PLHIV during follow-up.
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Affiliation(s)
- J Coutherut
- CHU Nantes, 5, rue du Professeur Boquien, 44000, Nantes, France,
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Desclaux A, Boye S, Taverne B. [The social relegation of widows living with HIV in the time of ART in Senegal]. ACTA ACUST UNITED AC 2014; 107:273-8. [PMID: 24563114 DOI: 10.1007/s13149-014-0334-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 01/14/2014] [Indexed: 11/30/2022]
Abstract
While prolonged widowhood is unusual in Senegalese society, some women living with HIV receiving antiretroviral therapy for ten years remained widows. Are they maintained in this situation for refusing or being unable to remarry? To understand the conditions and the reasons for this lack of "matrimonial normalization", a qualitative interview study was conducted in Dakar with 31 widows. Their living conditions are mostly marked by economic difficulties, dependence on host families, and responsibilities visà-vis their children. They refuse to remarry, regret not being able to, or wish to without success, despite the existence locally of social forms of marital union that would respond to their situation. The refusal to disclose their HIV status combined with self-stigma prevent them from improving their condition. This form of social vulnerability that remains beyond the restoration of health is ignored by public policy and HIV/AIDS community based organizations claims. It should be acknowledged and considered for defending PLWAs' rights.
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Affiliation(s)
- A Desclaux
- IRD (Institut de recherche pour le développement), TRANSVIHMI, UMI 233, Dakar, Sénégal,
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Desclaux A, Badji M, Sarr SC, Ahouanto M. [New ethical issues about pharmaceuticals in Western and Central Africa]. Med Sante Trop 2014; 24:10-13. [PMID: 24681413 DOI: 10.1684/mst.2014.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- A Desclaux
- IRD, UMI 233 TransVIHMI, Centre de recherche et de formation à la prise en charge de Fann (CRCF), Dakar, Sénégal
| | - M Badji
- Centre Droit, éthique et santé, faculté des sciences juridiques, université Cheikh-Anta-Diop de Dakar, Dakar, Sénégal
| | - S C Sarr
- Ministère de la Santé et de l'Action sociale, Dakar, Sénégal
| | - M Ahouanto
- Hôpital Bichat Claude Bernard, Paris, France
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Doutrelon C, Desclaux A, Ribeiro E, Greib C, Lazaro E, Pellegrin JL, Viallard JF. Localisation prostatique et pulmonaire du syndrome d’hyperIgG4 : à propos d’un cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.290] [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: 10/26/2022]
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Desclaux A, Ribeiro E, Greib C, Lazaro E, Viallard JF, Pellegrin JL. Lymphome B diffus à grandes cellules intravasculaire de localisation rénale : intérêt du TEP-scanner. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Levoir L, Petit H, Desclaux A, Trochut E, Ragot C, Constant C, Jeanne M, Assal A. Drépanocytose et décès par hémolyse retardée. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.225] [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: 10/26/2022]
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Raffray L, Desclaux A, Duffau P, Longy-Boursier M, Dieval C, Mercié P. Fièvre récurrente : penser à la maladie de Caroli. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.194] [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]
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Desclaux A, Milleliri JM. Scientific Meeting at the Dakar (Senegal) site of the French National Agency for AIDS Research (ANRS), 31 May 2012. Med Sante Trop 2012; 22:mst.2012.0050. [PMID: 22971461 DOI: 10.1684/mst.2012.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- A Desclaux
- IRD unité TransVIHMI UMI 233, Dakar, Sénégal
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Kouanda S, Bocoum FY, Doulougou B, Bila B, Yameogo M, Sanou MJ, Sawadogo M, Sondo B, Msellati P, Desclaux A. User fees and access to ARV treatment for persons living with HIV/AIDS: implementation and challenges in Burkina Faso, a limited-resource country. AIDS Care 2011; 22:1146-52. [PMID: 20824567 DOI: 10.1080/09540121003605047] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Access to antiretroviral (ARV) treatment remains a crucial problem for patients living with HIV/AIDS (PLWHA) in limited-resources countries. Some African countries have adopted the principle of providing ARV free of charge, but Burkina Faso opted for a direct out-of-pocket payment at the point of care delivery, with subsidized payments and mechanisms for the poorest populations to receive these services free of charge. Our objectives were to determine the proportion of PLWHA who pay for ARV and to identify the factors associated with ARV access in Burkina Faso. A cross-sectional study was performed in 13 public health facilities, 10 Nongovernmental Organizations and association health facilities, and three faith-based health facilities. In each facility, 20 outpatients receiving ARV were interviewed during a routine clinic visit. A multivariate analysis by logistic regression was performed. Among the expected 520 patients receiving ARV, 499 (96.0%) were surveyed. The majority of patients (79%) did not pay for their ARV treatment, thereby limiting cost recovery from patient payments. In a multivariate analysis, level of education and income were associated with free access to ARV. Patients with no education more frequently received free ARV than those who had received some level of education (OR 2.7, 95% CI [1.3-5.6]). Patients without any income or with less than US$10 per month were more likely to receive free ARV (OR 2.6 [95% CI 1.3-5.2]) than those who earned more than US$10 per month. However, 16% of patients without any income and 21% of those without employment paid for ARV, and the costs of drugs for opportunistic infections, food, and transport remained a burden for 85%, 91%, and 74%, respectively, of those who did not pay for ARV. Free access to a minimum care package for every PLWHA would enhance access to ARV.
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Affiliation(s)
- S Kouanda
- Institut de recherche en sciences de la sante, Ouagadougou, BP, Burkina Faso.
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Desclaux A. [Medical research-ethics applied to social sciences: relevance, limits, issues and necessary adjustments]. Bull Soc Pathol Exot 2008; 101:77-84. [PMID: 18543697] [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: 05/26/2023]
Abstract
Social sciences are concretely concerned by the ethics of medical research when they deal with topics related to health, since they are subjected to clearance procedures specific to this field. This raises at least three questions: - Are principles and practices of medical research ethics and social science research compatible? - Are "research subjects" protected by medical research ethics when they participate in social science research projects? - What can social sciences provide to on-going debates and reflexion in this field? The analysis of the comments coming from ethics committees about social science research projects, and of the experience of implementation of these projects, shows that the application of international ethics standards by institutional review boards or ethics committees raises many problems in particular for researches in ethnology anthropology and sociology. These problems may produce an impoverishment of research, pervert its meaning, even hinder any research. They are not only related to different norms, but also to epistemological divergences. Moreover, in the case of studies in social sciences, the immediate and differed risks, the costs, as well as the benefits for subjects, are very different from those related to medical research. These considerations are presently a matter of debates in several countries such as Canada, Brasil, and USA. From another hand, ethics committees seem to have developed without resorting in any manner to the reflexion carried out within social sciences and more particularly in anthropology Still, the stakes of the ethical debates in anthropology show that many important and relevant issues have been discussed. Considering this debate would provide openings for the reflexion in ethics of health research. Ethnographic studies of medical research ethics principles and practices in various sociocultural contexts may also contribute to the advancement of medical ethics. A "mutual adjustment" between ethics of medical research and social sciences is presently necessary: it raises new questions open for debate.
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Affiliation(s)
- A Desclaux
- CReCSS (Centre de recherche Cultures, Santé, Sociétés, Aix-en-Provence cedex.
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Abstract
Sickness is defined by culture: each society has its own way of labelling, explaining and treating symptoms. In the case of childhood diarrhea, each population selects some signs and considers them as symptoms, defines a limit between normal and pathologic, arranges symptoms in order to build syndromes that make up a local nosology. Examples from Thailand, China, Algeria, Nicaragua and Burkina Faso show the diversity of popular beliefs about diarrhea. These beliefs depend upon the epidemiological context, but they do not reflect it exactly: thus in Burkina Faso, AIDS has not been integrated in popular beliefs about childhood diarrhea. The examples discussed in this article show how popular beliefs evolve, especially under the influence of biomedicine. Moreover, every individual understands differently the popular nosology according to his (or her) social status and to the level of his (her) knowledge. To the unity of biomedical knowledge responds a great diversity of popular beliefs. In France, contemporary popular beliefs about childhood diarrhea have been seldom studied by social sciences. They seem to be close to biomedical knowledge and share some essential elements with it, but they also show some features--such as the belief that diarrhea is benign when simultaneous to teething--that relate them to popular beliefs which have been described in other cultures. By describing and analysing these popular beliefs, medical anthropology makes it possible to adapt medicine to local knowledges.
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Desclaux A. [10 years' research in the social sciences on AIDS in Burkina Faso. Elements for prevention]. Sante 1997; 7:127-34. [PMID: 9273119] [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: 02/05/2023]
Abstract
The first cases of AIDS in Burkina Faso were reported in 1986. During the past ten years, there have been several types of research conducted in Burkina Faso in the field of social sciences, including KABP, focus groups, and ethnographic studies. This article reviews approximately 100 publications and presents the results most relevant to prevention. Although general knowledge of the disease, its transmission and means of protection has improved, part of the population remains poorly informed; erroneous ideas remain prevalent and certain concepts, for example asymptomatic infection, are ignored. Young women in rural areas have the poorest knowledge. Understanding the information is conditioned by underlying perceptions of blood and physiology, the "components of the person", pre-existent and sexually transmitted diseases, and modes of transmission. Research on sexuality has elucidated the age at which individuals become sexually active, and paramatrimonial practices. The prevalence of STD is high. STD are mostly treated by traditional practitioners or by automedication. Family planning is insufficiently developed. AIDS prevention should be integrated into wider considerations of reproductive health. The popular perception that "Others" are responsible for bringing AIDS into the country has often been reinforced by health messages. Consequently, people do not sufficiently consider themselves vulnerable to HIV infection. The populations that are most vulnerable, for various reasons that have been analysed, include young girls and women, married women, prostitutes, truck drivers, and young men from rural areas. The message "Fidelity or condom" has been widely used. However, it has hindered the generalisation of the use of condoms, because asking for a condom consequently implies distrust of the partner. The interpretation of fidelity is diverse, and many people who choose this means of prevention believe erroneously that they are protected. Studies of the social impact of AIDS reveal fragmentation of society, reactions causing social exclusion and discriminative practices, and no social visibility of HIV infected persons. After ten years of preventive actions, the prevalence of HIV is still increasing, evidence of the failure of the preventive strategies. It is no longer sufficient to see prevention as the transfer of knowledge from professionals to the population. Preventive strategies such as voluntary testing and the participation of HIV+ persons in informative actions need to be developed. Prevention should be understood on new bases. The concept of "vulnerability" might help the definition of in-depth actions and also focus interventions. The idea of developing social cohesion to confront the epidemic may help avoid some of the adverse consequences of previous actions. Do these concepts conform to current AIDS prevention attitudes? To answer this question, social scientists should study the ideologies, knowledge, beliefs, and practices of institutions and professionals working in the field of AIDS prevention.
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Affiliation(s)
- A Desclaux
- Sociétés d'Afrique et sida, Université de Bordeaux II, France
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