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Beaumont AL, Doumbia A, Château N, Meynard JL, Pacanowski J, Valin N, Cadranel J, Lalande V, Verdet C, Lassel L, Pialoux G, Fain O, Morgand M, Lacombe K, Surgers L. Why are people still dying of drug-susceptible TB in Paris in the 21 st century? Int J Tuberc Lung Dis 2022; 26:142-149. [PMID: 35086626 DOI: 10.5588/ijtld.21.0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Although the burden of TB is lower in France than in low-income countries, patients continue to die from TB in Paris. Our goal was to describe TB-related deaths and to identify associated risk factors.METHODS: We conducted a retrospective cohort study in two hospitals in Paris between 2013 and 2018. All patients with drug-susceptible TB were included and followed until end of treatment. The primary outcome was death. We performed univariate and multivariate analysis using Cox proportional hazard model.RESULTS: Of the 523 patients included, 362 were men (median age 37 years), of whom 24 patients died (4.5%). The final survival model concluded that age (HR 1.1 for each additional year), not living in one´s own accommodation (HR 5.9), being born in France (HR 8.0), being alcoholic (HR 4.2), having a history of cancer (HR 7.1) or meningeal or miliary TB (HR 8.2) were associated with a higher risk of death.CONCLUSION: The rate of TB-associated death is unacceptably high for a curable disease. To note, patients born in France were much more at risk of death than immigrants. We believe raising awareness among healthcare professionals is a potentially easy and efficient lever for improving care.
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Affiliation(s)
- A-L Beaumont
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - A Doumbia
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - N Château
- Institut Pierre Louis d´Epidémiologie et de Santé Publique, UMR-S 1136, Institut national de la santé et de la recherche médicale, F-75012, Sorbonne Université, Paris, France
| | - J-L Meynard
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - J Pacanowski
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - N Valin
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - J Cadranel
- Service de Pneumologie, Hôpital Tenon, F-75020, GHU AP-HP, Sorbonne Université, Paris, France
| | - V Lalande
- Service de Bactériologie-Hygiène, Hôpital Saint-Antoine, F-75012, GHU AP-HP, Sorbonne Université, AP-HP, Paris, France
| | - C Verdet
- Service de Bactériologie-Hygiène, Hôpital Saint-Antoine, F-75012, GHU AP-HP, Sorbonne Université, AP-HP, Paris, France
| | - L Lassel
- Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, F-75020, GHU AP-HP, Sorbonne Université, Paris, France
| | - G Pialoux
- Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, F-75020, GHU AP-HP, Sorbonne Université, Paris, France
| | - O Fain
- Service de Médecine Interne, Hôpital Saint-Antoine, GHU AP-HP, Sorbonne Université, F-75012, Paris, France
| | - M Morgand
- Service de Médecine Interne, Hôpital Saint-Antoine, GHU AP-HP, Sorbonne Université, F-75012, Paris, France
| | - K Lacombe
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France, Institut Pierre Louis d´Epidémiologie et de Santé Publique, UMR-S 1136, Institut national de la santé et de la recherche médicale, F-75012, Sorbonne Université, Paris, France
| | - L Surgers
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F-75012, Groupes hospitalo-universitaires (GHU), Assistance Publique - Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France, Institut Pierre Louis d´Epidémiologie et de Santé Publique, UMR-S 1136, Institut national de la santé et de la recherche médicale, F-75012, Sorbonne Université, Paris, France
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Kyrychenko T, Valin N, Chiarabini T, Bonneton M, Lacombe K. Prise en charge des jeunes fréquentant un CeGIDD, quels sont les défis à relever ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bonneton M, Surgers L, Lalande V, Valin N, Lacombe K. Chlamydia trachomatis devrait-il faire l’objet d’un dépistage systématique chez les migrants ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.298] [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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Surgers L, Boyd A, Rougier H, Chiarabini T, Valin N, Decré D, Royer G, Decousser J, Girard P, Lacombe K. Entérobactéries productrices de BLSE : une nouvelle infection sexuellement transmissible ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.429] [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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Torres E, Tran C, Valin N, Le Marec F, Pifaut C, Lacombe K, Meynard J. Évaluation des connaissances sur le tabagisme chez les patients vivant avec le VIH. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.463] [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: 11/15/2022]
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Zaarouri Y, Valin N, Marchot O, Lacombe K. Comment optimiser le nombre d’hospitalisations de jour annuelles des patients infectés par le VIH ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.466] [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: 11/30/2022]
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Siguier M, Mera R, Pialoux G, Ohayon M, Cotte L, Valin N, Ghosn J, Cua E, Pintado C, Chas J, Barriere G, Durand F, Molina JM. First year of pre-exposure prophylaxis implementation in France with daily or on-demand tenofovir disoproxil fumarate/emtricitabine. J Antimicrob Chemother 2020; 74:2752-2758. [PMID: 31219561 DOI: 10.1093/jac/dkz220] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In January 2016, the French Medicine Agency initiated a Temporary Recommendation for Use (TRU) to allow the use of oral intake of tenofovir disoproxil fumarate and emtricitabine for pre-exposure prophylaxis (PrEP) in adults at high risk of HIV. We report the results of the first year of PrEP implementation in France. METHODS Data were collected by physicians using a secured web subject-monitoring interface, with two forms: an initiation form, with patients' baseline characteristics, and an HIV seroconversion form. Univariate and adjusted multivariate analysis using a logistic regression model were performed to identify baseline factors associated with on-demand PrEP regimen prescription. RESULTS From 4 January 2016 to 28 February 2017, 3405 subjects were enrolled, with 2774 initiation forms completed; 98.1% were male and 96.9% were MSM. An on-demand regimen was prescribed to 57% of subjects. Older age (OR for participants older than 50 years = 1.76, 95% CI 1.35-2.3, P < 0.001) and site of prescription (OR of former IPERGAY sites = 2.28, 95% CI 1.84-2.83, P < 0.001) were associated with on-demand prescription. Those reporting sexually transmitted infection (STI) and condomless anal sex with at least two different partners were less likely to receive on-demand PrEP (OR = 0.68, 95% CI 0.57-0.82 and 0.75, 95% CI 0.57-0.98, respectively; P < 0.05 for all). Four breakthrough HIV infections were reported during the study, in the context of PrEP interruption or acute infection at the time of PrEP initiation. CONCLUSIONS In a real-life setting in France, PrEP was used, either daily or on-demand, mostly by MSM, with breakthrough infections being rare.
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Affiliation(s)
- M Siguier
- Hôpital Saint-Louis, Department of Infectious Diseases and University Paris Diderot, Paris, France
| | - R Mera
- Gilead Sciences, Epidemiology, Foster City, CA, USA
| | - G Pialoux
- Hôpital Tenon, Department of Infectious Diseases, Paris, France
| | | | - L Cotte
- Hôpital Croix Rousse, Department of Infectious Diseases, Lyon, France
| | - N Valin
- Hôpital Saint-Antoine, Department of Infectious Diseases, Paris, France
| | - J Ghosn
- Hôtel Dieu, Department of Infectious Diseases, Paris, France
| | - E Cua
- Hôpital L'Archet, Department of Infectious Diseases, Nice, France
| | - C Pintado
- Hôpital Saint-Louis, Department of Infectious Diseases and University Paris Diderot, Paris, France
| | - J Chas
- Hôpital Tenon, Department of Infectious Diseases, Paris, France
| | - G Barriere
- Gilead Sciences S.A.S., Boulogne-Billancourt, France
| | - F Durand
- Gilead Sciences S.A.S., Boulogne-Billancourt, France
| | - J M Molina
- Hôpital Saint-Louis, Department of Infectious Diseases and University Paris Diderot, Paris, France
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Stabler S, Paccoud O, Duchesne L, Valin N, Chiarabini T, Decré D, Lalande V, Girard P, Lacombe K, Surgers L. Mise en oeuvre d’un dépistaGe optimisé pour préveniR les risques INFectieux dans la population migrante : Étude MIGRINF. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.297] [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: 11/13/2022]
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Boukli N, Valin N, Lalande V, Charabini T, Lopez-Zaragoza J, Girard P, Morand-Joubert L. Intérêt et limites de l’utilisation des TROD Multiplex VIH/syphilis en CeGIDD. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Duchâteau C, Torres E, Roger M, Julien J, Séraphin M, Valin N, Girard P. Rôle de l’infirmière au sein d’un CeGIDD : plus qu’une préleveuse ! Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.014] [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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Badoro B, Valin N, Berion O, Fonquernie L, Cury N, Debuc E, Girard PM, Lacombe K, Surgers L. Évaluation de la consultation post urgence en hôpital de jour de maladies infectieuses et tropicales. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Duchâteau C, Torres E, Pifaut C, Le Marec F, Valin N, Girard P. Journée du 1 er décembre : un exemple d’organisation de prévention et de lutte contre le VIH/IST. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.014] [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: 12/01/2022]
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Valin N, Fonquernie L, Bollens D, Lefebvre B, Bideault H, Krause J, Girard P. Rétention des personnes ayant consulté dans un hôpital parisien pour le suivi de la PrEP. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.357] [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: 10/14/2022]
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Fonquernie L, Lacombe K, Brucker M, Picard O, Pacanowski J, Valin N, Campa P, Meyohas M, Girard P. Le switch d’antirétroviraux en pratique clinique dans un centre parisien entre 2011 et 2016 : progressisme ou conservatisme ? Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.349] [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: 11/30/2022]
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15
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Rondeau P, Valin N, Decré D, Bottero J, Picard O, Girard P, Surgers L. Chlamydia, faut-il dépister les hommes ? Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fonquernie L, Valin N, Brucker M, Bottero J, Surgers L, Fournier S, Girard P. VIH-01 - Typologie des nouveaux patients VIH dépistés annuellement et suivis dans un centre parisien entre 2010 et 2015 : évolution et perspectives. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30546-7] [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: 11/24/2022]
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Rouveix E, Greffe S, Chansombat M, Reimann E, Fonquernie L, Simon A, Valin N, Tubiana R, Meyohas MC, Bouvet E. COL 3-03 - Tolérance de l’association fixe de tenofovir/emtricitabine/cobicistat/elvitegravir utilisée en traitement après expositions à risque de transmission virale. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30268-2] [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: 11/15/2022]
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Heard I, Tondeur L, Arowas L, Parent Du Chatelet I, Demazoin M, Falguières M, Bouvet E, Rondinaud E, Simon A, Tosini W, Sednaoui P, Schmit JL, Biendo M, Caillon P, Florence S, Valin N, Boukli N, Triller O, Shojaei T, Spenatto N, Delmas C, Decre D, Lalande V, Houette A, Oria F, Fresse A, Montfort L, Dhotte P. COL 5-03 - Statut vaccinal et infection génitale par les HPV en France. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30278-5] [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: 11/27/2022]
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Surgers L, Valin N, Carbonne B, Bingen E, Lalande V, Pacanowski J, Meyohas MC, Girard PM, Meynard JL. Evolving microbiological epidemiology and high fetal mortality in 135 cases of bacteremia during pregnancy and postpartum. Eur J Clin Microbiol Infect Dis 2012; 32:107-13. [PMID: 22907333 DOI: 10.1007/s10096-012-1724-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 08/02/2012] [Indexed: 01/31/2023]
Abstract
The outcome of bacterial bloodstream infections during pregnancy has greatly improved over the last few decades. However, there are no recent data on the characteristics of bacteremia in pregnant women. The aim of this study was to describe clinical and microbiological features of bacteremia and to assess maternal and fetal outcome. This retrospective study was conducted in the obstetrics departments of five teaching hospitals in Paris, France, from 2005 to 2009. The incidence of bacteremia was 0.3%. The most common sources of bacteremia were chorioamnionitis (47%) and the most common pathogen isolated was Escherichia coli. Empirical antimicrobial therapy was inappropriate in 29% of bacteremia cases, mostly (65%) when secondary to infection with an aminopenicillin-resistant microorganism. Bacteremia during pregnancy was associated with a 10% fetal mortality. Bacteremia during pregnancy is a rare occurrence, but it is associated with an unexpectedly poor fetal outcome and a high mortality rate.
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Affiliation(s)
- L Surgers
- Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France.
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Valin N, Chouaïd C. La tuberculose en France en 2010 : épidémiologie, clinique et microbiologie. Rev Mal Respir 2012; 29:267-76. [DOI: 10.1016/j.rmr.2011.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 07/18/2011] [Indexed: 11/29/2022]
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Pavie J, Porcher R, Torti C, Medrano J, Castagna A, Valin N, Rusconi S, Ammassari A, Ghosn J, Delaugerre C, Molina JM, Franzetti M, Lascoux-Combes C, Lorenzini P, Carosi G, Albini L, Nasta P, Quiros-Roldan E, Castelnuovo F, Rachline A. Efficacy and safety of a switch to unboosted atazanavir in combination with nucleoside analogues in HIV-1-infected patients with virological suppression under antiretroviral therapy. J Antimicrob Chemother 2011; 66:2372-8. [DOI: 10.1093/jac/dkr316] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Valin N, Pacanowski J, Lacombe K, Denoeud L, Girard PM, Meynard JL. H-23 Caractéristiques des « unmasking variant of TB-IRIS » parmi 102 cas de tuberculose chez des patients infectés par le VIH. Med Mal Infect 2009. [DOI: 10.1016/s0399-077x(09)74396-3] [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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Ursu R, Voillery D, Valin N, Roblin F, Bossi PH, Delattre JY. Méningite chronique à méningocoque de l’adulte. Rev Neurol (Paris) 2009; 165:605-9. [DOI: 10.1016/j.neurol.2008.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 08/18/2008] [Accepted: 08/26/2008] [Indexed: 11/16/2022]
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Mattioni S, Valin N, Cracco C, Thellier M, Danis M, Caumes E. Fatal relapse of disseminated strongyloidiasis in an HIV-positive patient, despite ivermectin treatment. Ann Trop Med Parasitol 2008; 102:693-8. [PMID: 19000386 DOI: 10.1179/136485908x337616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
There are no established guidelines for the treatment of disseminated strongyloidiasis in immunosuppressed patients, and many different treatment regimens have been used. Here, the case of a 48-year-old, HIV-positive, Congolese man, who was hospitalized for disseminated tuberculosis but developed life-threatening disseminated strongyloidiasis, is described. This patient died, with relapsing disseminated strongyloidiasis, 3 months after being treated with ivermectin. The reasons for this poor outcome and the various treatment options for strongyloidiasis in HIV-infected patients are discussed.
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Affiliation(s)
- S Mattioni
- Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Service de Maladies Infectieuses et Tropicales, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France
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Valin N, Flahault A, Lassau F, Janier M, Massari V. Study of partner-related and situational risk factors for symptomatic male urethritis. Eur J Epidemiol 2007; 22:799-804. [PMID: 17902028 DOI: 10.1007/s10654-007-9184-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 02/12/2007] [Accepted: 09/12/2007] [Indexed: 11/25/2022]
Abstract
During the last decade, the incidence of male urethritis stopped declining in France. Risk factors associated with unprotected intercourse have been extensively studied in men who have sex with men, but not in men in general. The purpose of the study was to determine major risk factors for urethritis among men and to describe the sociodemographic and medical characteristics of this population in 2005. We conducted a prospective case-crossover study of sexual behaviors among men with acute urethritis attending at general practitioners or sexually transmitted infection (STI) clinics in France. Each patient filled out a selfcompleted questionnaire focusing on sociodemographic characteristics, and on sexual behaviors for the month before urethritis onset and for the preceding 3 months. The doctor reported medical information on a separate questionnaire. Between January and September 2005, 121 cases of male urethritis, defined as recent-onset pain on micturition and/or purulent or mucoid discharge, were included. Median age was 33 years, 22.3% were MSM, 55.1% were single, and 72.0% had at least high school education. Conditional logistic regression analysis showed that intercourse with only casual partners or with both casual and steady partners (OR = 2.6, CI 95%: 0.8-8.7, and OR = 8.7, CI 95%: 2.7-28.0), as well as inconsistent condom use (OR = 5.8, CI 95%: 1.7-19.2) significantly increased the risk of male urethritis. STI prevention campaigns should continue to focus on consistent condom use and should not neglect men over 30 years of age.
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Affiliation(s)
- N Valin
- INSERM U707, 27 rue Chaligny, 75571 Paris cedex 12, France.
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Valin N, Hejblum G, Malet P, Antoun F, Chouaid C. 55 Prise en charge, filières de soins et issues de traitement des patients tuberculeux de l’Est parisien en 2004. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Valin N, Dieng AB, Chippaux JP, Le Hesran JY, Gaye O, Garcia A. Low malaria morbidity in a cohort of Senegalese children with free access to health structures. Parasite 2006; 13:79-81. [PMID: 16605072 DOI: 10.1051/parasite/2006131079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
We report the impact of the free access to health facilities on malaria morbidity in children from two to 15 years old, during a malaria transmission season in Niakhar, Senegal. Between July and December 2002, 227 malaria attacks occured in 566 children. Only one case of severe malaria was observed and no death has been reported. Our results demonstrate furthermore that easier access to health facilities and to early treatment is playing a key role in malaria control.
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Affiliation(s)
- N Valin
- Institut de Recherche pour le Développement (IRD), Unité de Recherche (UR) 010 : Santé de la mère et de l'enfant en milieu tropical, Dakar, Sénégal
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Valin N, Antoun F, Chouaïd C, Renard M, Dautzenberg B, Lalande V, Ayache B, Morin P, Sougakoff W, Thiolet JM, Truffot-Pernot C, Jarlier V, Decludt B. Outbreak of tuberculosis in a migrants' shelter, Paris, France, 2002. Int J Tuberc Lung Dis 2005; 9:528-33. [PMID: 15875924] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
SETTING An overcrowded 362-bed migrants' shelter in Paris, France. OBJECTIVES To investigate an outbreak of tuberculosis (TB), to identify a common source of contamination and to prevent further transmission. METHODS The outbreak was identified by radiographic screening and an active search for undeclared hospital treated cases, completed by strain phenotyping and a search for contact cases. RESULTS Between October 2001 and October 2002, 56 cases of active TB were identified, 30 by radiological screening and 20 by contacting neighbouring hospitals. All cases involved men, with a median age of 30 years. Pulmonary involvement was present in 54% of cases, and nine patients were sputum smear-positive. Thirty-four of the 37 phenotyped strains clustered together. CONCLUSION The grouping of the cases in time and place, the large number of cases with early-stage disease and the identical RFLP banding patterns of most of the isolates indicate that this outbreak results from transmission that occurred in France. This report underlines the need for public health departments in industrialised countries to maintain effective anti-tuberculosis control programmes.
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Affiliation(s)
- N Valin
- Institut de Veille Sanitaire, Saint-Maurice, France
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