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In France, immigrants’ excess of mortality was higher than natives’ during the Spring 2020 lockdown. Were immigrants in frontline jobs and more exposed to Covid-19? Based on a nationally representative survey, we model the probability to work in a frontline job according to migratory status, taking sociodemographic and occupational characteristics into account. Compared to natives (Metropolitan France), being an African immigrant was associated to higher probability to work in a frontline job [adjusted odds ratio (aOR) = 1.82 (1.23–2.71)], as well as being born in French Overseas Departments [aOR = 1.64 (1.23–2.18)], reflecting racial division of work and higher Sars-Cov-2 exposure of immigrant and minority populations.

Introduction : Migrant children and adolescents and children of migrants are more vulnerable and face an increased risk of internalized disorders such as depression. Furthermore, the experience of depression, its symptoms, and the way of understanding them varies across migrant’s cultures and situations. These variations may hinder the treatment of depression. The aim of this study was to explore the experience of depression in migrant children and adolescents : what are their symptoms ? how do they comprehend what is happening to them and how do parents and mental health professionals comprehend what happens to their children/patients ?Methods : Qualitative meta-synthesis of fourteen studies (seven qualitative studies and seven case-reports) included using a systematic search of PubMed, Embase, Scopus and PsycInfo. The studies’ quality was assessed using the Critical Appraisal Tool (CASP) for qualitative studies and the Joanna Briggs Institute (JBI) check-list for case reports. Articles were analyzed by themes.Results : The analysis identifies six themes describing the experience of depression among migrant adolescents : 1) The vulnerability factors underlying depressive suffering include pre-migratory (traumatic events, bereavements), peri-migratory (ruptures, losses) and post-migratory (discrimination, parentification, intra-familial conflicts) factors ; 2) The subjective experience of depression is marked by a combination of symptoms associated with a form of depression that is common in the West and symptoms associated with forms of depression that are more common in other cultures (e.g. somatic complaints, social isolation, persecution ideas) ; 3) The patient’s etiological hypotheses to give some meaning to their suffering are of two types : organic hypotheses that give a physical substrate to moral pain, and cultural hypotheses calling for the solicitation of a traditional care network ; 4) Attitudes adopted in response to suffering include avoidance, coping strategies, efforts to hide one's suffering from parents and health professionals, and seeking support from peers ; 5) Investment in care is constrained by the risk of discontinuity and by the shame or cultural stigmatization associated with sharing a psychological suffering outside of the family ; 6) The construction of a mixed bicultural, hybrid, mixed identity is weakened by breaks in cultural transmission and by intergenerational conflicts.Discussion-Conclusion : The threat of losing their connections both at the interpersonal level (connection to family, peers, community) and at the intra-subjective level (construction of identity), is inherently linked to how depression is experienced by migrant adolescents. We propose to adapt Brandenberger's 3C model (communication, continuity of care, confidence) to the care of young migrants in order to promote a therapeutic alliance, to foster the construction of a coherent sense of bicultural identity and to specifically support the family system., RésuméIntroduction : Les enfants et adolescents migrants et enfants de migrants présentent de multiples facteurs de vulnérabilité entraînant une augmentation du risque de troubles internalisés tels que la dépression. Par ailleurs, l’expérience de la dépression, ses symptômes et la manière dont ils sont compris varient selon la culture et la situation des migrants. Ces variations peuvent entraver le traitement de la dépression. L’objectif de cette étude est d’explorer l’expérience de la dépression chez les enfants et les adolescents migrants : quels sont leurs symptômes ? Comment comprennent-ils ce qui leur arrive, et comment les parents et les professionnels de santé mentale comprennent-ils ce qui arrive à leurs enfants/patients ?Méthodes : Métasynthèse de quatorze études (sept études qualitatives et sept case-reports) inclus à l’aide d’une recherche systématique sur PubMed, Embase, Scopus et PsycInfo. La qualité des études a été évaluée à l’aide du Critical Appraisal Tool (CASP) pour les études qualitatives, et de la Joanna Briggs Institute (JBI) check-list pour les case-reports. Les articles ont été soumis à une analyse thématique.Résultats : L’analyse dégage six thèmes décrivant l’expérience de la dépression chez les adolescents migrants : 1) Les facteurs de vulnérabilité faisant le lit de la souffrance dépressive incluent des facteurs pré-migratoires (évènements traumatiques, deuils), péri-migratoires (ruptures, pertes) et post-migratoires (discrimination, parentification, conflits intra-familiaux) ; 2) L’expérience subjective de la dépression est marquée par l’association de symptômes associés à une forme de dépression classique en Occident et de symptômes associés à des formes de dépression plus fréquemment retrouvées dans d’autres cultures (par ex. plaintes somatiques, isolement social, idées de persécution) ; 3) Les hypothèses étiologiques des patients donnant du sens à leur souffrance sont de deux ordres : les hypothèses organiques qui donnent un substrat physique à la douleur morale, et les hypothèses culturelles invitant à la sollicitation d’un réseau de soin traditionnel ; 4) Les attitudes adoptées en réaction à la souffrance incluent des stratégies d’évitement et de coping, des efforts pour cacher sa souffrance à ses parents et aux professionnels de santé, et la recherche d’un soutien auprès des pairs ; 5) L’investissement dans les soins est marqué par le risque de discontinuité et l’ambivalence à partager avec des étrangers à la famille une souffrance psychique vécue comme honteuse ou culturellement stigmatisante ; 6) La construction d’une identité biculturelle métissée est fragilisée par les ruptures de transmission culturelle et par les conflits intergénérationnels.Discussion – Conclusion : La menace de rupture du lien est centrale dans le vécu de la dépression de l’adolescent migrant tant sur le plan interpersonnel (lien à la famille, aux pairs, à la communauté) que sur le plan intra-subjectif (construction identitaire). Nous proposons d’adapter le modèle des 3C de Brandenberger (communication, continuité des soins, confiance) dans la prise en charge des jeunes migrants afin de promouvoir l’alliance thérapeutique, de favoriser l’élaboration des conflits identitaires et de prendre en charge spécifiquement le système familial.

Objective: this study explores the eating habits of pregnant Sri Lankan women with gestational diabetes mellitus and aims to learn about their diet in order to detect in a better way dietary errors. And how they integrate the diabetic diet into their everyday life and their understanding of gestational diabetes and the associated medical, psychological and cultural risks. Materials and methods: we carried out a multicentric qualitative study in maternity hospitals (Lariboisière hospital, Saint-Denis hospital center, Robert Ballanger intermunicipal hospital), between February 2019 and February 2020. This study, which consisted of a semi-directive interview conducted in their mother language (Tamil), focused on Sri Lankan patients who had been diagnosed with gestational diabetes and had already started their diet. Results: the analysis of our interviews revealed that the food culture of Sri Lankan women plays an important role in the monitoring of diabetic diet. Foetal well-being, maintenance of glycemic standards and the potentiel need for insulin were motivating factors for good adherence to gestational diabetes. Poor understanding of the language, their new life in a foreign country and the distance from relatives are obstacles to the successful continuation of their new eating habits. Conclusion: in association with culture, many factors are involved in the management of gestational diabetes mellitus by Sri Lankan women. Understanding these factors and providing appropriate educational therapy to our population, could be beneficial in the management of gestational diabetes mellitus and the prevention of type 2 diabetes.; Objectifs : cette étude s’intéresse aux habitudes alimentaires des femmes enceintes sri-lankaises ayant un diabète gestationnel et a pour objectif de connaître leur régime alimentaire afin de mieux dépister les erreurs diététiques qu’elles commettent. Il conviendra également d’évaluer leur observance du régime diabétique et leur compréhension du diabète gestationnel et des risques associés sur le plan médical, psychologique et culturel. Matériel et méthodes : nous avons réalisé une étude qualitative multicentrique dans trois maternités (hôpital Lariboisière, centre hospitalier de Saint-Denis, hôpital intercommunal Robert Ballanger), entre février 2019 et février 2020. Cette étude, qui consiste en un entretien semi-directif conduit dans leur langue maternelle (Tamoule), s’est concentrée sur des patientes sri-lankaises ayant eu un diagnostic de diabète gestationnel et ayant déjà débuté leur régime alimentaire. Résultats : l’analyse de nos entretiens a mis en évidence que la culture alimentaire des femmes sri-lankaises joue un rôle important dans le suivi du régime alimentaire diabétique. Le bien- être fœtal, le respect des normes glycémiques et le recours à l’insuline ont été des facteurs motivant la bonne observance des conseils diététiques dus au diabète gestationnel. La mauvaise compréhension de la langue, leur nouvelle vie dans un pays étranger et l’éloignement des proches sont des barrières à la bonne poursuite de leurs nouvelles habitudes alimentaires. Conclusion : en association avec la culture, de nombreux facteurs entrent en jeu dans la prise en charge du diabète gestationnel par les femmes sri-lankaises. La compréhension de ces facteurs et l’instauration d’un outil d’éducation thérapeutique adapté à notre population pourraient être bénéfiques pour la prise en charge du diabète gestationnel et permettre ainsi la prévention du diabète de type 2.

The health of migrants is a complex issue in public health. In French Guyana, as elsewhere, globalization, through migrants in particular, has transformed the care of diseases previously geographically distant. In this context, the borders now concern the entire territory and not just the peripheries. These borders contribute to the aggravation of the migrants health determinants through the complex and sometimes risky paths that they generate. Transboundary areas are also areas of high vulnerability. However, these cross-border spaces and routes can also constitute health resources, in the original interfaces that they can produce in terms of cooperation promoting shared screening and monitoring programs.FRONTIÈRES : PROBLÈMES OU RESSOURCES EN SANTÉ POUR LES MIGRANTS ? EXEMPLE DE LA GUYANE. La santé des migrants représente un enjeu complexe en santé publique. En Guyane comme ailleurs, la globalisation, au travers des migrants notamment, a transformé les prises en charge sanitaires de pathologies qui étaient jusqu’alors géographiquement bien éloignées. Dans ce contexte, les frontières intéressent dorénavant l’ensemble du territoire et non plus seulement les périphéries. Ces frontières participent à l’aggravation des déterminants en santé des migrants du fait des parcours complexes et parfois risqués qu’elles engendrent. Les espaces transfrontaliers représentent également des zones de grande vulnérabilité. Cependant, ces espaces et parcours transfrontaliers peuvent aussi constituer des ressources en santé dans les interfaces originales qu’elles peuvent produire en termes de coopération promouvant des programmes partagés de dépistage et de suivi.

The health of migrants is a complex issue in public health. In French Guyana, as elsewhere, globalization, through migrants in particular, has transformed the care of diseases previously geographically distant. In this context, the borders now concern the entire territory and not just the peripheries. These borders contribute to the aggravation of the migrants health determinants through the complex and sometimes risky paths that they generate. Transboundary areas are also areas of high vulnerability. However, these cross-border spaces and routes can also constitute health resources, in the original interfaces that they can produce in terms of cooperation promoting shared screening and monitoring programs., La santé des migrants représente un enjeu complexe en santé publique. En Guyane comme ailleurs, la globalisation, au travers des migrants notamment, a transformé les prises en charge sanitaires de pathologies qui étaient jusqu’alors géographiquement bien éloignées. Dans ce contexte, les frontières intéressent dorénavant l’ensemble du territoire et non plus seulement les périphéries. Ces frontières participent à l’aggravation des déterminants en santé des migrants du fait des parcours complexes et parfois risqués qu’elles engendrent. Les espaces transfrontaliers représentent également des zones de grande vulnérabilité. Cependant, ces espaces et parcours transfrontaliers peuvent aussi constituer des ressources en santé dans les interfaces originales qu’elles peuvent produire en termes de coopération promouvant des programmes partagés de dépistage et de suivi.

International audience; BACKGROUND: Diphtheria is re-emerging in Europe. A total of 36 cases were reported in Europe in 2015 versus 53 cases between 2000 and 2009.PATIENTS: We report two cases of Corynebacterium diphtheriae infection in a French hospital in 2016: a cutaneous infection with negative toxin testing in a French traveller, and a respiratory diphtheria carriage with positive toxin testing in an Afghan refugee diagnosed with pulmonary tuberculosis. The vaccination history of the Afghan patient could not be retrieved.; Introduction : La diphtérie est une maladie réémergente en Europe. En 2015, 36 cas ont été rapportés contre 53 cas de 2000 à 2009.Patients : Nous rapportons deux cas d’infection à Corynebacterium diphtheriae survenus en 2016 dans un hôpital français : une infection cutanée avec recherche de toxine négative chez un voyageur et un portage respiratoire avec recherche de toxine positive chez un réfugié afghan atteint d’une tuberculose pulmonaire. L’histoire vaccinale était inconnue pour le patient afghan.

International audience; In France, HIV prevention within Maghrebi or French of Maghrebi origin has been seldom studied. The purpose of this study is to compare the recourse to HIV test according to nationality and origin. Data were from the 2010 SIRS cohort, which included 3,006 households representative of the Paris metropolitan area. Results of the study show comparatively low HIV testing rate among Maghrebi and French of Maghrebi origin compared to French with French parents.

International audience; This study aimed to compare the relative survival of patients with invasive breast cancer between women from French Guiana (a French territory in South America) and metropolitan France. No study hadever compared survival of breast cancer on the basis of immigrant status in France. Our study underlined that access to care for migrants is challenging whichwgenerates health inequalities. Background The prognosis of breast cancer in French Guiana is worse than in France with 23 deaths per 100 incident cases against 17 per 100 in metropolitan France. This study aimed to compare relative survival of patients with invasive breast cancer (IBC) between women from French Guiana and metropolitan France and to determine risk factors influencing breast cancer survival in French Guiana.Materials and methods Data were collected from the Cancer registry of French Guiana. We comparedthe relative survival of women with IBC between French Guiana and metropolitan France. We used Cox's proportional hazard regression to evaluate the effect of prognostic factors on cancer-specific mortality in French Guiana. Results We included all 269 cases of IBC in women diagnosed in French Guiana between 2003 and 2009. The overall 5-year relative survival rate of patients with IBC was 79% in French Guiana and 86% in metropolitan France. The place of birth (foreign country versus French territory), the tumor stage at the time of diagnosis, the mode of diagnosis (symptoms versus screening), the presence of hormone receptors in the tumor and the histologic type were the variables associated with survival differences. None of the other study variables were significantly associated with prognosis. Conclusion Access to care for migrants is challenging,which leads to health inequalities. Early detection through prevention programs is crucial to increaseIBC survival notably for foreign-born patients.

Alan closing his departing speech at LMCB in 2006 by featuring his lab. Image by Ione Karney. ![][1] Alan Hall died of a heart attack during his regular Sunday morning jog on May 3rd in New York City, where he had lived with his wife Eileen. Alan's untimely and unexpected death happened just a couple of weeks before his 63rd birthday, which he would undoubtedly have celebrated with his two children and two young grandchildren. Before joining the Sloane Kettering Institute as chair of the cell biology program in 2006, most of Alan's career was spent in the UK. After graduating from Oxford, he stayed in town to start his PhD with Jeremy Knowles, but he received his first exposure to US science quite unintentionally when Jeremy announced he was relocating to Harvard after two months. Over his four years in Harvard, Alan perfected his training in biochemistry. He then did a two‐year postdoc with Charles Weissmann (University of Zurich) where he developed his molecular biology skills and helped clone interferon. It was only after joining the Institute of … [1]: /embed/graphic-1.gif

Polycystic echinococcosis due to Echinococcus vogeli is a rare parasitic infection that occurs in rural areas of Central and South America. Only molecular identification performed on formalin-fixed paraffin-embedded liver tissue samples gave an unequivocal diagnosis of this disease in a Paraguayan immigrant in Argentina.

International audience; In contrast to the situation in many European countries, the mortality of immigrants in France has been little studied. The main reasons for the lack of studies are based on ethical and ideological considerations. The objective of this study is to explore mortality by country of birth in Metropolitan (i.e. 'mainland') France. Complete mortality data were used to study the relative risks of mortality of the foreign- and locally-born populations by gender, age and cause of death for the period 2004-2007 in Metropolitan France. Analyses were conducted by countries of birth grouped into geographic areas and by the Human Development Index (HDI). The differentials in mortality between foreign-born and locally-born populations were not homogeneous. The figures varied by age (higher foreign-born mortality for the young; lower mortality for migrants aged 15-64 years), gender (female migrants more frequently had higher relative mortality than men migrants), country of birth (Eastern European-born migrants had higher mortality, while those born in Morocco, Central Asia, 'other Asian countries' and America had lower mortality) and cause of death (migrant mortality was higher overall for deaths caused by infectious diseases and diabetes, and lower for violent death and neoplasm). Moreover, mortality relative risks for male, violent deaths and cancer were positively associated with country-of-birth HDI, while female mortality and infectious disease mortality were negatively associated with country-of-birth HDI. Some important caveats have to be considered because the study did not control for individuals socioeconomic position in France, or length of residence in the host country. A strong healthy migrant effect was suggested and its intensity varies with age and gender (which may reflect different reasons for migration). For some specific causes of death, a lifestyle effect seems to explain mortality differentials. The associations between HDI and mortality show that mortality trends are partly related to the educational, sanitary and economic conditions of the country of birth. Further studies would enrich the differential analysis of mortality by country of birth by contributing additional detailed data on socioeconomic and living conditions in the host country as well as in the country of origin.

To the Editor: Eleven years of molecular epidemiologic data allowed the Spanish Multidrug-resistant Tuberculosis (MDR TB) Surveillance Network to identify a specific MDR Mycobacterium tuberculosis strain that had been imported into Spain from Equatorial Guinea (1). Our study brings to light the potential dissemination of this strain (named MDR-TBEG) in Equatorial Guinea, a country where little is known about the extent and features of TB or MDR TB. It also highlights that MDR strains can spread across continents, and thus MDR TB’s emergence in any country becomes a global problem. Ten MDR M. tuberculosis isolates obtained from 10 patients from Equatorial Guinea were detected in Spain during 2000 through 2008. Evidence of clonality was found within the 10 isolates because all exhibited identical genetic profiles defined by different molecular epidemiology methods (2,3) and mutations involved in drug resistance (Figure). Notably, none of the remaining 504 MDR isolates in the Spanish database matched SIT177, a spoligotype belonging to the Latin American–Mediterranean 9 (LAM9) subfamily (4). Figure Genetic profile of the multidrug-resistant tuberculosis Equatorial Guinea (MDR-TBEG) strain. RFLP, restriction fragment length polymorphism; SIT, spoligotype international type; LAM, Latin American-Mediterranean; MIRU-VNTR, mycobacterial interspersed ... The data routinely collected for all cases of MDR TB have been previously described (1). All 10 patients in the study were from Equatorial Guinea, a small African country on the Gulf of Guinea with a population of ≈500,000, an MDR TB rate >2.0% (5) of all combined (new and previously treated) TB cases, and an estimated adult HIV prevalence rate of 3.2% (www.who.int/globalatlas/predefinedReports/EFS2008/full/EFS2008_GQ.pdf). The MDR TB isolates were collected within a 9-year period (Technical Appendix): 1 in 2000, 2 in 2001, 3 in 2003, 1 in 2004, 2 in 2007, and 1 in 2008. According to their hospitals of origin, the patients were geographically dispersed in 6 different Spanish cities. We found that the interval between the patients’ arrival in Spain to the initiation of anti-TB treatment was

International audience; OBJECTIVES: Lack of information is a frequent complaint with regard to physicians dealing with prenatal diagnosis (PD). The aim of the study was to find out how information on PD was perceived by patients and if they considered that they had been correctly informed by their physicians. METHODS: We conducted a prospective study in Lariboisi? Hospital (Paris) with 86 patients undergoing prenatal diagnosis between 2001 and 2003. A 23-item questionnaire was given to patients after delivery or termination of pregnancy (TP). RESULTS: Fifty patients out of 86 answered the questionnaire. Twelve patients out of 50 underwent a TP. Information on foetal anomaly was insufficient for 11 patients out of 50 (22%). Some patients found the information too technical; others would like to see photos to illustrate the anomalies and the possible surgical repairs to be performed. Information was insufficient for one in four patients concerning maternal serum screening for Down's syndrome. Information before amniocentesis was considered sufficient by 9 out of 10 patients. Information on the risks of TP was not given or not understood by 10 out of 12 patients. CONCLUSION: Information on prenatal diagnosis could be improved by using simple and accessible language, supported by written documents and photos for certain anomalies. More information should be given in cases of abstract anomalies and should be adapted to the social, ethnic and cultural background of the patient.