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International audience; Aedes-transmitted diseases, especially dengue, are increasing throughout the world and the main preventive methods include vector control and the avoidance of mosquito bites. A simple Premise Condition Index (PCI) categorizing shade, house, and yard conditions was previously developed to help prioritize households or geographical areas where resources are limited. However, evidence about the accuracy of the PCI is mixed. The current study aimed to contribute to a better understanding of the relevance by collecting data from 2,400 premises at four time points over 1 year in Kampong Cham, Cambodia. Regression models were then used to identify associations between PCI and Aedes adult female mosquitoes and pupae. In addition, receiver operating characteristic curves were used to measure the ability of PCI to identify premises in the top quartile of mosquito abundance. The density of adult Aedes females was positively associated with PCI at the household (ratio of means = 1.16 per point on the PCI scale) and cluster level (ratio of means = 1.54). However, the number of Aedes pupae was negatively associated with PCI at the household level (rate ratio = 0.74) and did not have a statistically significant association at the cluster level. Receiver operating characteristic curves suggest the PCI score had "rather low accuracy" (area under the ROC curve = 0.52 and 0.54) at identifying top-quartile premises in terms of adult female Aedes and pupae, respectively. These results suggest that caution is warranted in the programmatic use of PCI in areas of similar geography and mosquito abundance.

International audience; To control malaria in Madagascar, two primary vector control interventions are being scaled up: insecticide-treated nets and indoor residual spraying of bendiocarb, which was implemented in the Malagasy Central Highlands in 2009. The current efficacy of bendiocarb against Anopheles species was evaluated in a small-scale field trial. An experimental hut trial comparing the effectiveness of bendiocarb sprayed on five substrates (cement, wood, tin, mud, and vegetative materials) was carried out against Anopheles species in two study sites located in the eastern foothills of Madagascar. No significant difference was detected in either exophily or blood-feeding rates between treated and untreated huts. The mortality rate was significantly greater in treated huts compared to untreated huts. Efficacy up to 80% was found for 5 mo posttreatment. Although effective, bendiocarb has been used for 7 yr, and therefore an alternative insecticide may be needed to avoid the emergence of resistance.

L’espace dans lequel évolue l’enfant est d’abord sensori-moteur, il se développe jusqu’à devenir représentatif ; le dessin apparaît alors et s’organise jusqu’à l’adolescence. L’objet de cette recherche est de comprendre, à travers la clinique des enfants et des adolescents, ce qui sous-tend le processus de structuration spatiale et dans l’autre sens, ce que celle-ci renseigne de la construction du Sujet. Deux jeunes enfants pris en charge en structure de jour dévoilent le chemin parcouru jusqu’au dessin de la maison. L’espace est initialement indifférencié et bidimensionnel, il devient prolongement du corps au fur et à mesure que l’enfant se l’approprie et fait l’expérience des relations aux autres. Enfin, l’espace est habitat psychique lorsque le sujet trouve une place stable, qui s’inscrit dans le temps. La revue de la littérature sur le dessin de la maison et sa représentation dans l’espace confirme la valeur symbolique de ce thème. A l’adolescence, le jeune dessine en perspective et peut ainsi représenter le plan de chez lui. Celui-ci est apparu comme une médiation à proposer aux adolescents au cours des entretiens mais également comme un révélateur de la complexité du processus de construction spatiale. Différents dessins du plan de la maison ont été analysés. Ils mettent en lumière comment la représentation de l’espace, réactivée en cette période de crise identitaire, est révélatrice du monde psychique de l’adolescent. Le plan de chez-soi est projection du Sujet, incarné dans un corps qui prend forme et habite les lieux.

International audience; Dwellings are increasingly well insulated to save energy and this leads to higher humidity and temperature, which improves conditions for mites. Dermatophagoides antigens are the main allergens involved and tested in atopic asthma. We developed three new species-specific quantitative PCR (qPCR) methods for house dust mites (Dermatophagoides pteronyssinus and D. farinae) and storages mites (Acarus siro, Glycyphagus domesticus, Lepidoglyphus destructor). We sampled dust with electrostatic dust collectors, in the bedrooms, under beds and in the kitchens of patients with allergies (n = 24) and healthy controls (n = 18). Mite quantification was carried out with the three new qPCRs and the qPCR previously described for the Dermatophagoides genus. The qPCRs were highly specific and efficient for house dust mite species and the storage mites. Storage mite concentrations were higher than house dust mite concentrations and were higher in dwellings of patients with allergies. Consequently, allergists should test more often patients against the storage mite antigens by prick tests or IgE serology. Dampness is a major factor in storage mite development and the presence of effective mechanical ventilation can reduce storage mite concentrations four-fold. In addition, to limit exposure to dust mites, treatments should be used throughout dwellings and not only in patients' bedrooms.

Azole-resistant Aspergillus fumigatus (ARAF) has been reported in patients with chronic obstructive pulmonary disease (COPD) but has not been specifically assessed so far. Here, we evaluated ARAF prevalence in azole-naïve COPD patients and their homes, and assessed whether CYP51A mutations were similar in clinical and environmental reservoirs. Sixty respiratory samples from 41 COPD patients with acute exacerbation and environmental samples from 36 of these patient's homes were prospectively collected. A. fumigatus was detected in respiratory samples from 11 of 41 patients (27%) and in 15 of 36 domiciles (42%). Cyp51A sequencing and selection on itraconazole medium of clinical (n = 68) and environmental (n = 48) isolates yielded ARAF detection in 1 of 11 A. fumigatus colonized patients with COPD (9%) and 2 of 15 A. fumigatus-positive patient's homes (13%). The clinical isolate had no CYP51A mutation. Two environmental isolates from two patients harbored TR34/L98H mutation, and one had an H285Y mutation. Coexistence of different cyp51A genotypes and/or azole resistance profiles was detected in 3 of 8 respiratory and 2 of 10 environmental samples with more than one isolate, confirming the need for a systematic screening of all clinically relevant isolates. The high prevalence of ARAF in patients with COPD and their homes supports the need for further studies to assess the prevalence of azole resistance in patients with Aspergillus diseases in Northern France., SCOPUS: ar.j, info:eu-repo/semantics/published

Introduction: childhood asthma is a public health problem (9,8% to 13,4% of children, estimated annual cost of € 1,5 billion in France). There is an association between fungi in housing and asthma, but the causal link was not established. Methods: international literature review using Pubmed, Embase and the Cochrane Library. A reference review was selected (Tischer 2011) then we reviewed the articles published by the end of October 2014. Results: we included 38 publications and analysed the results according to the Bradford Hill's criteria for causality. Data came from 28 countries. An association between fungi and asthma was found in most studies. There were some data for a dose-response relationship. The biological mechanisms were documented. There were limited data available on temporality and experimental evidence. Discussion: strength, plausibility and biological coherence and consistency of the association have been demonstrated. Further prospective cohort and interventional studies should be conducted, in order to supplement the existing data on biological gradient, temporality and experiment. A standardized exposure measurement should be defined. There is sufficient evidence of association to recommend prevention and remediation of fungal contamination measures. Conclusion: although further studies are recommended, there is strong evidence for presumption of a causal link between fungi in housing and childhood asthma. Physicians involved in follow-up of children should consider this risk.; Introduction : l’asthme de l’enfant est un problème de santé publique (9,8% à 13,4% des enfants, coût annuel estimé à 1,5 milliards d'euros). Une association entre l’exposition aux moisissures au domicile et l’asthme existe, sans lien de causalité démontré. Méthode : Revue de la littérature internationale. Nous avons interrogé Pubmed, Embase et la Cochrane Library. Une revue de littérature de référence a été retenue (Tischer 2011) puis les articles publiés jusque octobre 2014 ont été analysés selon les méthodes d’analyse critique d’article. Résultats : nous avons inclus 38 études et analysé les résultats selon les critères de Bradford Hill. Les données étaient issues de 28 pays. Un lien entre moisissures et asthme était montré dans la majorité des études. Il existait des éléments en faveur d'un effet-dose. Les mécanismes biologiques étaient expliqués. Il existait peu de données sur la temporalité et l’effet d’interventions sur l’exposition. Discussion : force de l’association, plausibilité et cohérence biologiques, et reproductibilité étaient démontrées. Des études de cohorte et interventionnelles devraient être menées pour compléter les données expérimentales, la relation dose-effet et la temporalité de l’association. Une méthode standardisée de mesure de l'exposition doit être étudiée. Les données en faveur d’un lien sont suffisantes pour recommander la prévention et le traitement de la contamination fongique. Conclusion : des études complémentaires sont recommandées, mais la présomption d’un lien de causalité entre moisissures au domicile et asthme de l’enfant est forte. Les médecins impliqués dans le suivi des enfants doivent y prêter attention.

Twin and family studies have established the contribution of genetic factors to variation in metabolic, hematologic and immunological parameters. The majority of these studies analyzed single or combined traits into pre-defined syndromes. In the present study, we explore an alternative multivariate approach in which a broad range of metabolic, hematologic, and immunological traits are analyzed simultaneously to determine the resemblance of monozygotic (MZ) twin pairs, twin-spouse pairs and unrelated, non-cohabiting individuals. A total of 517 participants from the Netherlands Twin Register, including 210 MZ twin pairs and 64 twin-spouse pairs, took part in the study. Data were collected on body composition, blood pressure, heart rate, and multiple biomarkers assessed in fasting blood samples, including lipid levels, glucose, insulin, liver enzymes, hematological measurements and cytokine levels. For all 51 measured traits, pair-wise Pearson correlations, correcting for family relatedness, were calculated across all the individuals in the cohort. Hierarchical clustering techniques were applied to group the measured traits into sub-clusters based on similarity. Sub-clusters were observed among metabolic traits and among inflammatory markers. We defined a phenotypic profile as the collection of all the traits measured for a given individual. Average within-pair similarity of phenotypic profiles was determined for the groups of MZ twin pairs, spouse pairs and pairs of unrelated individuals. The average similarity across the full phenotypic profile was higher for MZ twin pairs than for spouse pairs, and lowest for pairs of unrelated individuals. Cohabiting MZ twins were more similar in their phenotypic profile compared to MZ twins who no longer lived together. The correspondence in the phenotypic profile is therefore determined to a large degree by familial, mostly genetic, factors, while household factors contribute to a lesser degree to profile similarity.

International audience

International audience; The Environmental Relative Moldiness Index (ERMI) is a DNA-based metric developed to describe the fungal contamination in US dwellings. Our goal was to determine if the ERMI values in dwellings in north western France were correlated with other measures of fungal contamination. Dust and air samples were obtained from 40 dwellings and analyzed by quantitative PCR and/or by culturing. These dwellings were also inspected and the amount of visible fungal growth estimated in m(2). The ERMI values in these dwellings ranged from -2.7 to 28.8 and the fungal contamination estimates ranged from 0 to 20 m(2). The 40 dwellings were divided into those with a low (8) ERMI values (n=20 in each). The average ERMI value was 15.70 for the high ERMI compared to 2.68 for the low ERMI dwellings. ERMI values were correlated (significant Kendall's tau values) with concentrations of fungi in air samples analyzed by QPCR or culturing. ERMI values were also correlated (significant Kendall's tau values) with the visible estimates of fungal contamination. Older dwellings were more likely to have higher ERMI values. These results suggest that the ERMI dust sample, which is quick and easy to collect, may be useful in making decisions about reducing fungal exposures in homes.

International audience; Lead in homes is a well-known source of childhood lead exposure, which is still of concern due to the health effects of low lead doses. This study aims to describe lead contamination in the homes of children aged 6 months to 6 years in France (without overseas). Between October 2008 and August 2009, 484 housing units were investigated. Lead in tap water and total and leachable lead levels from floor dust, outdoor soils and paint chips were measured. X-ray fluorescence measurements were carried out on non-metallic and metallic substrates. Nationwide results are provided. The indoor floor dust lead (PbD) geometric mean (GM) was 8.8 μg/m² (0.8 μg/ft²) and 6.8 μg/m² (0.6 μg/ft²) for total and leachable lead respectively; 0.21% of homes had an indoor PbD loading above 430.5 μg/m² (40 μg/ft²). The outdoor play area concentration GM was 33.5 mg/kg and 21.7 mg/kg in total and leachable lead respectively; 1.4% of concentrations were higher than or equal to 400 mg/kg. Outdoor floor PbD GM was 44.4 μg/m² (4.1 μg/ft²) that was approximately 3.2 times higher than the GM of indoor PbD. Lead-based paint (LBP) was present in 25% of dwellings, LBP on only non-metallic substrates was present in 19% of homes and on metallic substrates in 10% of dwellings. The GM of lead concentrations in tap water was below 1 μg/L; 58% of concentrations were lower than 1 μg/L and 2.9% were higher than or equal to 10 μg/L. The age cut-off for homes with lead would be 1974 for paint and 1993 for indoor floor dust. This study provides, for the first time, a look at the state of lead contamination to which children are exposed in French housing. Moreover, it provides policy makers an estimate of the number of French dwellings sheltering children where abatement should be conducted.

Background Since individual-level income is difficult to collect, investigators often rely on group-based measures derived from census data. No study has assessed the use of residential property values as an indicator of individual material circumstances. We aimed to compare two proxy indicators of material circumstances, one based on residential value and the other on median census tract income, to self-reported household income. Methods We used data from a case-control study (1996-2002), restricting analyses to 676 residents of the Island of Montreal for whom the three indicators were available. The degree of discrepancy between the residential value index, census income, and self-reported household income - each in 5 categories - was estimated, along with overall and weighted Kappas. Results When comparing residential value index and census income to self-reported household income, perfect concordance was observed for 38% and 30% of subjects, respectively; very good concordance, defined as ≤ 1 category difference, was observed for 76% and 69% of subjects, respectively. When compared to self-reported household income, overall and weighted Kappas showed stronger agreement with residential value index (weighted Kappa = 0.37, 95% CI: 0.32, 0.42) than with census income (weighted Kappa = 0.25, 95% CI: 0.20, 0.30). Conclusions A residential value index may provide a measure of material circumstances that is closer to self-reported household income than the commonly used census income. Each indicator presents advantages and disadvantages, and their choice may depend on study objectives and feasibility.

International audience; Population subgroups of the African malaria vector Anopheles gambiae have not been comprehensively characterized owing to the lack of unbiased sampling methods. In the arid savanna zone of West Africa, where potential oviposition sites are scarce, widespread collection from larval pools in the peridomestic human habitat yielded a comprehensive genetic survey of local A. gambiae population subgroups, independent of adult resting behavior and ecological preference. A previously unknown subgroup of exophilic A. gambiae is sympatric with the known endophilic A. gambiae in this region. The exophilic subgroup is abundant, lacks differentiation into M and S molecular forms, and is highly susceptible to infection with wild Plasmodium falciparum. These findings might have implications for the epidemiology of malaria transmission and control.

International audience; AIMS: The aim of our study was to compare, using real-time (Rt) PCR, quantitative levels of five fungal species in three kinds of dwellings. METHODS AND RESULTS: Three groups of homes were recruited: moisture-damaged homes (MDH, n = 30), allergic patient homes (APH, n = 25) and paired control homes (CH, n = 55). Five moulds with allergenic compounds or mycotoxin production characteristics (Cladosporium sphaerospermum, Penicillium chrysogenum, Aspergillus versicolor, Alternaria alternata and Stachybotrys chartarum) were quantified using Rt-PCR. Cycle threshold results were expressed in spore equivalent per volume or surface unit using a direct calculation based on a spore standard curve. MDH presented significantly higher amounts of DNA from C. sphaerospermum in both air and surface samples than CH (P < 0.001). APH presented slightly elevated amounts of DNA from A. versicolor in both air and surface samples, compared to CH (P < 0.05). CONCLUSION: Rt-PCR quantification of targeted fungal species is a rapid, reliable tool that could be included in a global indoor mould evaluation. SIGNIFICANCE AND IMPACT OF THE STUDY: Quantification of C. sphaerospermum using Rt-PCR can help to better target social service intervention in MDH. Quantification of A. versicolor DNA could be informative for characterization of APH.

International audience; 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.

International audience; We present a study and whole experimental tele-monitoring and medical tele-surveillance system for maintaining patients at home. The project features networked sensors, in a fully equipped apartment, operated by an advanced information and communication system based on Internet, Java, and object oriented modeling. The sensors are connected, mainly wirelessly, with a in-home software module devoted to signals analysis and detection of critical situation such as falls, sickness, sudden palsy, stroke, hypothermia, etc. This module communicates, either via modem or ethernet network, with a remote medical control station in charge of appropriate response to received information and alarms. The system is designed to be a powerful information and communication tools for medical and social workers. It offers a series of functions such as medical file management, user profiles and rights management, drafting and management of ordinances and visit notes, confidentiality of medical information, and management of scenarios of detectable events. The access to the system is allowed to authorized users only (physicians, emergentists, social workers, etc.), and is available on as much authorized computers as needed, by means of a Java applet invoked from any traditional web browsers.