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En France, pour bénéficier d'une prise en charge médicosociale et éducative adaptée, les enfants ayant un trouble du spectre de l'autisme doivent obtenir une orientation par la maison départementale des personnes handicapées (MDPH) et que ces notifications soient appliquées. En Guyane, les inégalités sociales et territoriales de santé sont omniprésentes. Il n'existe pourtant aucune donnée sur la prise en charge des adolescents avec un trouble du spectre de l'autisme en Guyane. L'objectif du projet était de connaître le parcours scolaire et médicosocial des enfants inclus dans le registre des troubles du spectre de l'autisme de Guyane depuis 2016 (qui vivaient en Guyane en 2016 et dont leur TSA avait été diagnostiqué avant leurs 8 ans) au moyen d'une interview téléphonique et d'un recueil de données à la MDPH. Nous avons inclus 52 jeunes âgés de 11 à 18 ans dont 40 familles jointes par téléphone. Les résultats obtenus à travers les variables recueillies montrent que, malgré un diagnostic posé avant 8 ans, seulement 29 jeunes (sur 47 renseignés) bénéficient d'une prise en charge médicosociale et éducative coïncidente avec les préconisations de la Commission des droits et de l'autonomie des personnes handicapées en cours (CDAPH). Parmi les 52 jeunes suivis, il y en avait au moins 9 – soit 17,3 % – qui ne recevaient aucune forme d'éducation. Trente et un jeunes bénéficiaient d'une prise en charge médicosociale, sanitaire et/ou éducative au moment de l'enquête contre 16 qui n'en recevaient aucune, notamment parce qu'ils étaient sur liste d'attente, depuis 5 ans en moyenne. Par ailleurs, 34 % des familles interrogées disaient ne pas être satisfaites de la prise en charge globale promulguée à leur enfant, surtout du fait du manque de personnel. En conclusion, il existe en Guyane un décalage important et mal vécu entre ce qui est recommandé aux parents pour la prise en charge de leur enfant adolescent et ce qui est en réalité possible. In France, to benefit from appropriate medical, social and educational care, children with autism spectrum disorders must obtain a referral from the Maison Départementale des Personnes Handicapées (MDPH), and these notifications must then be implemented. In French Guiana, social and territorial inequalities in health are omnipresent. However, there are no data on the care of adolescents with Autism Spectrum Disorder in French Guiana. The aim of the project was to explore the educational and medico-social pathways of children included in Guiana's autism spectrum disorder register since 2016 (who were living in Guiana in 2016 and whose ASD had been diagnosed before their 8th birthday) by means of a telephone interview and data collection at the MDPH. We included 52 young people aged 11 to 18, including 40 families contacted by telephone. The results obtained through the variables collected show that, despite a diagnosis made before the age of 8, only 29 young people (out of 47 completed) benefit from medical, social and educational care that coincides with the recommendations of the current Commission des droits et de l'autonomie des personnes handicapées (CDAPH). Of the 52 young people monitored, at least nine – or 17.3% – were not receiving any form of education. Thirty one young people were receiving medical, social, health and/or educational care at the time of the survey, compared with 16 who were not receiving any, mainly because they had been on a waiting list for an average of five years. In addition, 34% said they were not satisfied with the overall care their child received, mainly because of staff shortages. In conclusion, in French Guiana, there is a significant gap between what is recommended to parents for their teenage child's care and what is actually possible. [ABSTRACT FROM AUTHOR]

French Guiana is an overseas territory of France with marked specificities in terms of populations, socioeconomic factors, risk factors, and an access to care. In this context, the objective of the present study was to describe the epidemiology of acute coronary syndromes in French Guiana and to make comparisons with mainland France and neighbouring country. The data were obtained from a retrospective descriptive hospital-based cohort conceived to describe the incidence of acute coronary syndromes and their epidemiologic and clinical characteristics. It included patients aged 18 or more hospitalised for a first coronary syndrome in the reference centre for coronary syndromes in Cayenne French Guiana between Jan 1st 2012 and Dec 31st 2014. Overall, 266 patients were analysed. The mean age was 64 years (SD = 12.54). A majority of patients were men (sex ratio = 1.83). The proportion of patients born in an overseas French territory (44.36%) was similar to that of those born in a foreign country (43.98%), and 11.65% were born in mainland France. Only 59% of patients had regular health insurance. Moreover, 33.21% had universal medical insurance (CMU for those below a minimal income), 4.91% had state insurance (for illegal foreign patients) and 2.64% had no insurance at all. The main risk factors were high blood pressure (73.68%), diabetes (39.85%), hypercholesterolemia (40.23%), and smoking (37.97%). Overall, 82/266 patients developed an ST elevation coronary syndrome (STEMI) and 184/266 had a non-ST elevation coronary syndrome NSTEMI or unstable angina pectoris. Thrombolysis was only performed in 20.73% of patients with STEMI. Mortality at 1 month was 8/82 (9.76%) for STEMI and 2/184 (1.09%) for NSTEMI. The epidemiologic profile of acute coronary syndromes in French Guiana is different from that of mainland France and Europe to the neighbouring country Brazil. Mortality of STEMI also seems higher than in mainland France, but similar to Brazil. In a context of frequent health inequalities, interventions targeting the major risk factors, notably high blood pressure, obesity and diabetes, have the potential to significantly impact cardiovascular morbidity and mortality. [ABSTRACT FROM AUTHOR]

• No study has assessed the clinical and biological features of chikungunya virus epidemics in French Guiana. • We performed the first study suggesting the use of a clinical score to differentiate dengue virus infection (DENV) from chikungunya (CHIKV) infection. • This is a topical theme as DENV and CHIKV epidemics recently occurred in India and Brazil. External validation of this score will thus be possible. • The study sample was relatively large (162 CHIKV patients versus 452 DENV patients). Only two other studies have compared CHIKV and DENV: a study conducted in Singapore included 117 CHIKV patients and 862 DENV patients, and a study conducted in Gabon included 270 CHIKV patients and 53 DENV patients. It should be noted that both of these studies reached contradictory conclusions. Chikungunya (CHIKV) and dengue viruses (DENV) are two arboviruses with epidemic potential and similar clinical presentations. The potential life-threatening risk associated with DENV justifies an immediate biological assessment and medical follow-up which may be delayed for CHIKV. To compare the clinical variables that would help differentiate patients infected with CHIKV or DENV, and then to compute a predictive score. Retrospective case-control study comparing CHIKV-infected patients diagnosed by RT-PCR in 2014 with patients infected with DENV diagnosed by positive NS1 antigen test in 2013. Children aged < 15 years and pregnant women were excluded. Clinical and biological variables were compared, and a multivariate analysis was performed. A clinical score was developed using the β coefficients to differentiate the infections. Over the study period 168 patients infected with CHIKV were compared with 452 patients with DENV. The clinical variables independently associated with CHIKV was joint and back pain, and those associated with DENV were headache, muscle pain, nausea/vomiting, diarrhea, and hemorrhagic signs. The clinical score had 98% sensitivity for DENV and a ROC curve of 0.96. These two infections have a similar clinical presentation but the use of the proposed clinical score during the acute phase of the disease would make it possible to identify cases of DENV during a CHIKV epidemic to suggest adequate patient management. [ABSTRACT FROM AUTHOR]

Highlights • Studies on urinary tract infections are scarce in the Amazon region. • Extended-spectrum beta-lactamases (ESBL) were observed in 3.1% of Escherichia coli and 31.6% of Klebsiella pneumoniae strains isolated from UTI patients managed in the emergency department. • The susceptibility of E. coli strains to ampicillin, amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, fluoroquinolones, and furans was significantly lower than in metropolitan France. • Staphylococci sp. were involved in 18.3% of cystitis cases including 12.2% of Staphylococcus saprophyticus and 3.7% of S. aureus. Abstract Objectives Urinary tract infections (UTIs) have rarely been studied in the Amazon region. We aimed to describe the epidemiology of bacteria causing UTIs in French Guiana. Patients and methods We performed a monocenter retrospective study of adults consulting at the emergency department of Cayenne Hospital in 2014 with a diagnosis of UTI. The bacterial species and resistance profile were described. Results Two-hundred-and-eighty-nine patients presenting with UTI were included: 82 (28.4%) presented with cystitis, 166 (57.4%) with pyelonephritis, and 41 (14.2%) with male UTI. E. coli was predominant (74.1%), and had decreased susceptibility to ampicillin, amoxicillin-clavulanic acid, fluoroquinolones, co-trimoxazole, and furans compared with data from metropolitan France. Extended-spectrum beta-lactamases (ESBL) was isolated in 3.1% of E. coli and 31.6% of K. pneumoniae. Conclusions Antibiotic susceptibility in UTI is lower than reported in metropolitan France without evidence for an excessive consumption of antibiotics. [ABSTRACT FROM AUTHOR]

Background and purpose: The epidemiological characteristics of hypertension and obesity in French overseas territories (FOTs) have never been compared. Methods: This cross-sectional survey included representative population-based samples of 602, 601, 620 and 605 men and women aged more than 15 years, respectively, from four FOTs of Guadeloupe, Martinique, French Guiana, and French Polynesia. Hypertension was defined as blood pressure (BP) at least 140/90 mmHg or the current use of antihypertensive treatment. Results: The prevalence of hypertension was 29.2% in Guadeloupe, 17.9% in French Guiana, 27.6% in Martinique and 24.5% in French Polynesia. Considering the Guadeloupe population as the reference group, prevalence of hypertension was significantly lower in French Guiana (P < 0.001), even after controlling for age and sex (PU0.006). Awareness and treatment of hypertension were similar in French Guiana, Martinique and Guadeloupe (68.8-75.1% and 69.0-73.4%, respectively). Awareness was lower in French Polynesia (50.0%, adjusted P value U0.04), as was treatment of hypertension (32.4%, adjusted P value U0.001). Control of hypertension was also lower in French Polynesia (8.8%, adjusted P value U0.001) compared with the other territories (29.7-31.8%). French Polynesia had the highest prevalence of obesity (33.1%, adjusted P value < 0.001) as compared with the other territories (17.9-22.8%). It had also the largest population attributable fraction of hypertension due to obesity (35.5%) compared with Guadeloupe (13.3%), Martinique (12.3%) and French Guiana (23.6%). Conclusion: Wide variations were observed in the prevalence and the management of hypertension between these FOTs, and an especially challenging low control of hypertension was found in French Polynesia. Obesity appears a key target to prevent hypertension, particularly in French Polynesia. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. - The aim of this study is to analyse the characteristics of HIV pregnant women in French Guiana then to evaluate the HIV mother to child transmission rate (MTCT) and determine the pronostic factors associated with MTCT. Patients and method. - An epidemiological study has been led including all deliveries in French Guiana from January 1998 to December 2000. For each case a standardized questionnaire has been gathered including epidemiological, clinical and biological data and an univariate analysis has been realized. A hundred and forty-eight women have been included in the study among 135 women came for delivery. Results. - The factors associated with increased MTCT in our study were no antiretroviral therapy before delivery, the lack of follow-up during pregnancy and no antiretroviral therapy in children. The HIV mother to child transmission rate was 6,5% despite the availability of antiretroviral therapies. Discussion and conclusion. - This rate may be explained by the difficulties of follow-up in HIV infected women. Much more needs to be done to improve access to care for women coming from foreign countries. This may be indispensable to reduce the HIV mother to child transmission rate in French Guiana. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)