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1. Prospective Comparison of Saliva and Nasopharyngeal Swab Sampling for Mass Screening for COVID-19

Author

Mathieu Nacher, Mayka Mergeay-Fabre, Denis Blanchet, Orelie Benoit, Tristan Pozl, Pauline Mesphoule, Vincent Sainte-Rose, Véronique Vialette, Bruno Toulet, Aurélie Moua, Mona Saout, Stéphane Simon, Manon Guidarelli, Muriel Galindo, Barbara Biche, William Faurous, Laurie Chaizemartin, Aniza Fahrasmane, Devi Rochemont, Nicolas Vignier, Astrid Vabret, and Magalie Demar

Subjects
COVID-19, saliva, sensitivity, PCR, nasopharyngeal, Medicine (General), R5-920
Abstract

Current testing for COVID-19 relies on reverse-transcriptase polymerase chain reaction from a nasopharyngeal swab specimen. Saliva samples have advantages regarding ease and painlessness of collection, which does not require trained staff and may allow self-sampling. We enrolled 776 persons at various field-testing sites and collected nasopharyngeal and pooled saliva samples. One hundred sixty two had a positive COVID-19 RT-PCR, 61% were mildly symptomatic and 39% asymptomatic. The sensitivity of RT-PCR on saliva samples vs. nasopharygeal swabs varied depending on the patient groups considered or on Ct thresholds. There were 10 (6.2%) patients with a positive saliva sample and a negative nasopharyngeal swab, all of whom had Ct values

Published
2021
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2. Diagnostic accuracy and acceptability of molecular diagnosis of COVID-19 on saliva samples relative to nasopharyngeal swabs in tropical hospital and extra-hospital contexts: The COVISAL study.

Author

Mathieu Nacher, Mayka Mergeay-Fabre, Denis Blanchet, Orelie Benois, Tristan Pozl, Pauline Mesphoule, Vincent Sainte-Rose, Véronique Vialette, Bruno Toulet, Aurélie Moua, Mona Saout, Stéphane Simon, Manon Guidarelli, Muriel Galindo, Barbara Biche, William Faurous, Laurie Chaizemartin, Aniza Fahrasmane, Devi Rochemont, Fode Diop, Moussa Niang, Jean Pujo, Nicolas Vignier, Dominique Dotou, Astrid Vabret, and Magalie Demar

Subjects
Medicine, Science
Abstract

A prospective study was conducted among different intra and extra-hospital populations of French Guiana to evaluate the performance of saliva testing compared to nasopharyngeal swabs. Persons aged 3 years and older with mild symptoms suggestive of COVID-19 and asymptomatic persons with a testing indication were prospectively enrolled. Nasopharyngeal and salivary samples were stored at 4°C before analysis. Both samples were analyzed with the same Real-time PCR amplification of E gene, N gene, and RdRp gene. Between July 22th and October 28th, 1159 persons were included, of which 1028 were analyzed. When only considering as positives those with 2 target genes with Ct values

Published
2021
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3. Vitamin D Deficiency in Patients with Diabetes in French Guiana: Epidemiology and Relation with Microvascular and Macrovascular Complications

Author

Elise Girard, Mathieu Nacher, John Bukasa-Kakamba, Aniza Fahrasmane, Antoine Adenis, Mickael Massicard, Kinan Drak Alsibai, Bertrand De Toffol, Raissa Bekima, Liliane Thelusme, Diana Okambabelle, Magalie Demar, Jean M. Aurelus, and Nadia Sabbah

Subjects
vitamin D deficiency, diabetes complications, French Guiana, angina pectoris, Nutrition. Foods and food supply, TX341-641
Abstract

Vitamin D (VD) insufficiency is common among patients with diabetes in French Guiana. The study aimed to evaluate the prevalence of VD deficiency in the different type of diabetes encountered and to analyze the relationship between VD deficiency and diabetes complications. Methods: An observational study was conducted between May 2019 and May 2020 in French Guiana, based on data from the CODIAM study (Diabetes Cohort in French Amazonia), describing the characteristics of patients with diabetes mellitus. Among 600 patients enrolled with diabetes, 361 had an available VD assay. Results: The mean 25(OH)VD (hydroxycalciferol) level was 27.9 ng/mL. The level of VD was inversely proportional to the HbA1c (glycated hemoglobin) level. Patients with angina pectoris had a greater proportion of deficiencies VD < 20 ng/mL than those without angina. By contrast, patients with retinopathy had higher vitamin D concentrations than those without retinopathy. There was no association between vitamin D and arteriopathy, stroke, nephropathy and polyneuropathy. VD deficiency was more frequent in women, and in patients with a high school education. Conclusion: The prevalence of VD deficiency was high in patients with diabetes in French Guiana, emphasizing the importance of VD supplementation.

Published
2021
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4. Incidence of infantile Pompe disease in the Maroon population of French Guiana

Author

Narcisse Elenga, Alain Verloes, Yajaira Mrsic, Célia Basurko, Roxane Schaub, Emma Cuadro-Alvarez, Rémi Kom-Tchameni, Gabriel Carles, Véronique Lambert, Rachida Boukhari, Aniza Fahrasmane, Anne Jolivet, Mathieu Nacher, and Jean-François Benoist

Subjects
Pediatrics, RJ1-570
Abstract

Objectives The aim of this study was to describe the epidemiology of infantile Pompe disease (IPD) in French Guiana, a French overseas territory, by combining a retrospective case records study and a prospective anonymous genotyping in a sample of mothers followed in the two major maternity units of French Guiana.Methods We identified 19 newborns with IPD born within a 13-year-period in French Guiana, corresponding to 1/4528 births. All children were born within the African-American Maroon (Bushinengue) community originating from slaves who settled along the Maroni river in the 19th century. We also performed an anonymised screening for all women in postpartum, in the two main maternity units of French Guiana.Results Genetic investigations revealed that all patients with IPD were homozygotes or compound heterozygotes for two known pathogenic variations: c.2560C>T p.(Arg854*) that has already been reported in African-Americans and c.1942G>A p.(Gly648Ser), a rare previously considered to be variant. We identified no heterozygotes among 453 mothers of various ethnicities in Cayenne, but 15 heterozygotes among 425 mothers (1/27) in Saint-Laurent-du-Maroni (95% CI 1/45 to 1/17), all from the Maroon community, which corresponds to an expected IPD incidence in Maroons of 1/1727 (95% CI 1/1156 to 1/8100).Conclusion The incidence of IPD in the Maroon community is roughly 50 times higher than elsewhere in the world. The presence of only two different variants in all affected patients is compatible with a double founder effect in a relatively small population that has seldom mixed with other regional populations in the past and therefore has a reduced pool of genotypes.

Published
2018
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5. Diagnostic accuracy and acceptability of molecular diagnosis of COVID-19 on saliva samples relative to nasopharyngeal swabs in tropical hospital and extra-hospital contexts: The COVISAL study

Author

Stéphane Simon, Mathieu Nacher, Devi Rochemont, Laurie Chaizemartin, Aurélie Moua, Muriel Galindo, Magalie Demar, Nicolas Vignier, Astrid Vabret, Bruno Toulet, Mayka Mergeay-Fabre, Manon Guidarelli, Pauline Mesphoule, Dominique Dotou, Denis Blanchet, Orelie Benois, Vincent Sainte-Rose, Fode Diop, William Faurous, Mona Saout, Moussa Niang, Barbara Biche, Aniza Fahrasmane, Véronique Vialette, Tristan Pozl, and Jean Marc Pujo

Subjects
Male, Saliva, Viral Diseases, Physiology, Diagnostic accuracy, Artificial Gene Amplification and Extension, Polymerase Chain Reaction, Medical Conditions, Positive predicative value, Nasopharynx, Medicine and Health Sciences, Medicine, Prospective cohort study, Child, Virus Testing, Multidisciplinary, Middle Aged, Hospitals, Body Fluids, French Guiana, Infectious Diseases, COVID-19 Nucleic Acid Testing, Child, Preschool, Female, medicine.symptom, Anatomy, Research Article, Adult, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Adolescent, Science, Research and Analysis Methods, Asymptomatic, Microbiology, Sensitivity and Specificity, Saliva testing, Diagnostic Medicine, Internal medicine, Virology, Viral Nucleic Acid, Humans, Molecular Biology Techniques, Molecular Biology, Aged, Tropical Climate, business.industry, Biology and Life Sciences, Covid 19, Reverse Transcriptase-Polymerase Chain Reaction, Patient Acceptance of Health Care, Viral Replication, Mild symptoms, Age Groups, People and Places, Population Groupings, business
Abstract

A prospective study was conducted among different intra and extra-hospital populations of French Guiana to evaluate the performance of saliva testing compared to nasopharyngeal swabs. Persons aged 3 years and older with mild symptoms suggestive of COVID-19 and asymptomatic persons with a testing indication were prospectively enrolled. Nasopharyngeal and salivary samples were stored at 4°C before analysis. Both samples were analyzed with the same Real-time PCR amplification of E gene, N gene, and RdRp gene. Between July 22th and October 28th, 1159 persons were included, of which 1028 were analyzed. When only considering as positives those with 2 target genes with Ct values

Published
2021

6. Prospective comparison of saliva and nasopharyngeal swab sampling for mass screening for COVID-19

Author

Mathieu Nacher, Mayka Mergeay-Fabre, Denis Blanchet, Orelie Benoit, Tristan Pozl, Pauline Mesphoule, Vincent Sainte-Rose, Véronique Vialette, Bruno Toulet, Aurélie Moua, Mona Saout, Stéphane Simon, Manon Guidarelli, Muriel Galindo, Barbara Biche, William Faurous, Laurie Chaizemartin, Aniza Fahrasmane, Devi Rochemont, Nicolas Vignier, Astrid Vabret, and Magalie Demar

Subjects
medicine.medical_specialty, Saliva, Coronavirus disease 2019 (COVID-19), Dentistry, Saliva sample, Asymptomatic, Saliva testing, Internal medicine, Medicine, Sampling (medicine), Mass screening, saliva, lcsh:R5-920, business.industry, nasopharyngeal, COVID-19, Nasopharyngeal swab (specimen), General Medicine, Brief Research Report, sensitivity, PCR, medicine.symptom, lcsh:Medicine (General), business, Contact tracing
Abstract

Current testing for COVID-19 relies on reverse-transcriptase polymerase chain reaction from a nasopharyngeal swab specimen. Saliva samples have advantages regarding ease and painlessness of collection, which does not require trained staff and may allow self-sampling. We enrolled 776 persons at various field-testing sites and collected nasopharyngeal and pooled saliva samples. One hundred sixty two had a positive COVID-19 RT-PCR, 61% were mildly symptomatic and 39% asymptomatic. The sensitivity of RT-PCR on saliva samples vs. nasopharygeal swabs varied depending on the patient groups considered or on Ct thresholds. There were 10 (6.2%) patients with a positive saliva sample and a negative nasopharyngeal swab, all of whom had Ct values

Published
2020

7. Air Drep-A Retrospective Study Evaluating the Influence of Weather Conditions and Viral Epidemics on Vaso-Occlusive Crises in Patients with Sickle Cell Disease Living in French Guiana

Author

Marie-Claire Parriault, Michaël Parisot, Narcisse Elenga, Mathieu Nacher, Stéphanie Rogier, Claire Cropet, and Aniza Fahrasmane

Subjects
medicine.medical_specialty, Multivariate analysis, Health, Toxicology and Mutagenesis, lcsh:Medicine, vaso-occlusive crisis (VOC), Disease, Anemia, Sickle Cell, Article, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, Influenza, Human, flu outbreak, Medicine, Humans, In patient, 030212 general & internal medicine, Epidemics, Weather, climate, Retrospective Studies, Home prevention, business.industry, Medical record, lcsh:R, Public Health, Environmental and Occupational Health, Outbreak, Retrospective cohort study, Patient management, French Guiana, Hospitalization, Emergency medicine, Multivariate Analysis, Disease Progression, sickle cell disease, business, Emergency Service, Hospital
Abstract

(1) Objectives: French Guiana is the French territory most affected by sickle cell disease (SCD). This study investigates the associations between different environmental factors relative to climate, infectious outbreaks, and emergency visits or weekly hospital admissions for vaso-occlusive crisis (VOC). The identification of risk factors would lead to better patient care and patient management, and more targeted prevention and therapeutic education for patients with SCD in French Guiana. (2) Methods: This study was performed using data collected from the medicalized information system and emergency medical records of Cayenne General Hospital, between 1 January 2010 and 31 December 2016. ARIMA models were used to investigate the potential impact of weather conditions and flu epidemics on VOC occurrence. (3) Results: During the study period, 1739 emergency visits were recorded among 384 patients, of which 856 (49.2%) resulted in hospitalization, 811 (46.6%) resulted in hospital discharge, and 72 (4.2%) in another orientation. Decreased temperature and decreased humidity were both independent factors associated with an increase of VOC cases (p = 0.0128 and p = 0.0004, respectively). When studying severe VOC (leading to hospitalization, with or without prior emergency visit), 2104 hospital admissions were recorded for 326 patients. The only factor associated with severe VOC, in the multivariate analysis, was flu epidemics (p = 0.0148). (4) Conclusions: This study shows a link between climate, flu epidemics, and VOC in French Guiana. Patient&rsquo, s awareness of risks related to climate and flu epidemics should be encouraged, as home prevention measures can help avoid painful crises. Moreover, physicians should encourage patients to get immunized for influenza every year.

Published
2019

8. Incidence of infantile Pompe disease in the Maroon population of French Guiana

Author

Mathieu Nacher, Jean François Benoist, Rémi Kom-Tchameni, Véronique Lambert, Roxane Schaub, Narcisse Elenga, Alain Verloes, Yajaira Mrsic, Célia Basurko, Emma Cuadro-Alvarez, Aniza Fahrasmane, Anne Jolivet, Gabriel Carles, Rachida Boukhari, Service de Pédiatrie [Cayenne, Guyanne Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Neuroprotection du Cerveau en Développement / Promoting Research Oriented Towards Early Cns Therapies (PROTECT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité fonctionnelle de génétique clinique, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Sorbonne Paris Cité (USPC), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne, Guyane] (COREVIH), Département de Biochimie [AP-HP Hôpital Robert Debré], AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), This work was supported by the European Regional Development Fund (ERDF), grant N°1990/sgar-de/2013., Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), and CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG)

Subjects
0301 basic medicine, medicine.medical_specialty, Population, Ethnic group, 030105 genetics & heredity, Compound heterozygosity, Maroon, 03 medical and health sciences, 0302 clinical medicine, metabolic, Epidemiology, medicine, genetics, education, Genotyping, education.field_of_study, Incidence (epidemiology), 3. Good health, Geography, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pediatrics, Perinatology and Child Health, Original Article, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030217 neurology & neurosurgery, Founder effect, Demography
Abstract

International audience; Objectives:The aim of this study was to describe the epidemiology of infantile Pompe disease (IPD) in French Guiana, a French overseas territory, by combining a retrospective case records study and a prospective anonymous genotyping in a sample of mothers followed in the two major maternity units of French Guiana.Methods:We identified 19 newborns with IPD born within a 13-year-period in French Guiana, corresponding to 1/4528 births. All children were born within the African-American Maroon (Bushinengue) community originating from slaves who settled along the Maroni river in the 19th century. We also performed an anonymised screening for all women in postpartum, in the two main maternity units of French Guiana.Results:Genetic investigations revealed that all patients with IPD were homozygotes or compound heterozygotes for two known pathogenic variations: c.2560C>T p.(Arg854*) that has already been reported in African-Americans and c.1942G>A p.(Gly648Ser), a rare previously considered to be variant. We identified no heterozygotes among 453 mothers of various ethnicities in Cayenne, but 15 heterozygotes among 425 mothers (1/27) in Saint-Laurent-du-Maroni (95% CI 1/45 to 1/17), all from the Maroon community, which corresponds to an expected IPD incidence in Maroons of 1/1727 (95% CI 1/1156 to 1/8100).Conclusion:The incidence of IPD in the Maroon community is roughly 50 times higher than elsewhere in the world. The presence of only two different variants in all affected patients is compatible with a double founder effect in a relatively small population that has seldom mixed with other regional populations in the past and therefore has a reduced pool of genotypes.

Published
2018

9. Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas

Author

Yoann Madec, Cécile Herrmann-Storck, Arnaud Fontanet, Bruno Hoen, Caroline Callier, Raymond Césaire, Dominique Rousset, Alice Monthieux, Cédric Laouénan, Manon Boullard, Anna L. Funk, Maylis Douine, S. Stegmann-Planchard, Benoit Tressières, Bruno Schaub, Fatiha Najioullah, Jean-Luc Voluménie, Eustase Janky, André Cabié, Gabriel Carles, Kinda Schepers, Samson Yassinguezo, Sylvie Cassadou, Vanessa Ardillon, Philippe Kadhel, Mathieu Nacher, Catherine Ryan, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université des Antilles et de la Guyane (UAG), Maison de la Femme de la Mère et de l'Enfant [CHU de la Martinique] (MFME [Fort de France]), CHU de la Martinique [Fort de France], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université des Antilles et de la Guyane - UFR des sciences médicales (UAG UFR SM), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre Hospitalier Louis Constant Fleming, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale (CGH), Institut Pasteur [Paris] (IP)-Réseau International des Instituts Pasteur (RIIP), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Supported by the French Ministry of Health (Soutien Exceptionnel à la Recherche et à l’Innovation), by a grant (ANR-10-LABX-62-IBEID) from Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases project, by the ZIKAlliance consortium (the European Union’s Horizon 2020 Research and Innovation Program), and by INSERM. This study is part of the ZIKAlliance consortium project., We thank the women who participated in this study, all the physicians, midwives, clinical research assistants, health officers, and epidemiologists who helped conduct this study in each of the French territories in the Americas: Myriam Atine, Lyderic Aubert, Marie Barrau, Kebe Beavogui, Christelle Celeste, Joelle Colat-Peyron, Elvire Couchy, Véronique Davidas, Lucetta Delver, Jacqueline Dubois, Stanie Gaete, Dorothée Harrois, Marie-Laure Lalanne-Mistrih, Mathilde Melin, Marie-France Mirane, Francelise Nadessein, Marie-Josée Pelczar, Véronique Plantier, Céline Rocquet, Magdalena Saint-Marc, Patrick Saint-Martin, Valérie Soter, Ingrid Soubdhan, Jennifer Taillefond, Lambo Velonasy, and Véronique Walter (Guadeloupe), Nicole Ambroisine, Gilda Belrose, Alain Blateau, Patricia Blondel, Isabelle Calmont, Valérie Decatrelle, Michèle Gueneret, Eugénie Jolivet, Isabelle Komla-Soukha, Corinne Plavonil, Marie-andrée Pyram, and Jean-Luc Voluménie (Martinique), Antoine Adenis, Audrey Andrieu, Luisiane Carvalho, Sandy Dabrowski, Céline Delorme, Maryvonne Dueymes, Aniza Fahrasmane, Arthur Felix, Hélène Hilderal, Anne Jolivet, Justine Krajewsky, Véronique Lambert, Thomas Lemaitre, Myriam Livain, Jérémie Pasquier, Marion Petit-Sinturel, Céline Pomar, Léo Pomar, and Stéphanie Rogier (French Guiana), and David Baud (University of Lausanne, Switzerland) and Rebecca Grant (Institut Pasteur de Paris, France) for their critical review of an earlier version of the manuscript., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), Jonchère, Laurent, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-CHU de la Martinique [Fort de France], and Réseau International des Instituts Pasteur (RIIP)-Institut Pasteur [Paris]

Subjects
0301 basic medicine, Microcephaly, [SDV]Life Sciences [q-bio], Chromosome Disorders, MESH: Amniotic Fluid, Zika virus, Cohort Studies, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, MESH: Martinique, ZikV Infection, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, Prospective cohort study, Guadeloupe, MESH: Cohort Studies, MESH: Chromosome Disorders, MESH: Middle Aged, biology, Zika Virus Infection, Obstetrics, MESH: Infant, Newborn, Pregnancy Outcome, Gestational age, MESH: Congenital Abnormalities, General Medicine, Middle Aged, French Guiana, 3. Good health, [SDV] Life Sciences [q-bio], Fetal Diseases, MESH: Fetal Diseases, MESH: Young Adult, Cohort, Female, Pregnancy Trimesters, Adult, medicine.medical_specialty, Adolescent, MESH: Zika Virus, Article, MESH: Microcephaly, Congenital Abnormalities, Young Adult, 03 medical and health sciences, MESH: Zika Virus Infection, MESH: French Guiana, Humans, MESH: Guadeloupe, Martinique, MESH: Pregnancy Complications, Infectious, Pregnancy outcomes, MESH: Adolescent, Fetus, MESH: Humans, business.industry, Infant, Newborn, MESH: Adult, Zika Virus, Amniotic Fluid, medicine.disease, biology.organism_classification, MESH: Pregnancy Outcome, Confidence interval, 030104 developmental biology, business, MESH: Female, MESH: Pregnancy Trimesters
Abstract

International audience; BACKGROUND:The risk of congenital neurologic defects related to Zika virus (ZIKV) infection has ranged from 6 to 42% in various reports. The aim of this study was to estimate this risk among pregnant women with symptomatic ZIKV infection in French territories in the Americas.METHODS:From March 2016 through November 2016, we enrolled in this prospective cohort study pregnant women with symptomatic ZIKV infection that was confirmed by polymerase-chain-reaction (PCR) assay. The analysis included all data collected up to April 27, 2017, the date of the last delivery in the cohort.RESULTS:Among the 555 fetuses and infants in the 546 pregnancies included in the analysis, 28 (5.0%) were not carried to term or were stillborn, and 527 were born alive. Neurologic and ocular defects possibly associated with ZIKV infection were seen in 39 fetuses and infants (7.0%; 95% confidence interval, 5.0 to 9.5); of these, 10 were not carried to term because of termination of pregnancy for medical reasons, 1 was stillborn, and 28 were live-born. Microcephaly (defined as head circumference more than 2 SD below the mean for sex and gestational age) was detected in 32 fetuses and infants (5.8%), of whom 9 (1.6%) had severe microcephaly (more than 3 SD below the mean). Neurologic and ocular defects were more common when ZIKV infection occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001).CONCLUSIONS:Among pregnant women with symptomatic, PCR-confirmed ZIKV infection, birth defects possibly associated with ZIKV infection were present in 7% of fetuses and infants. Defects occurred more frequently in fetuses and infants whose mothers had been infected early in pregnancy. Longer-term follow-up of infants is required to assess any manifestations not detected at birth. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT02916732 .).

Published
2018

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