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Underestimation of Leptospirosis Incidence in the French West Indies

Authors :
Sylvie Cassadou
Martine Ledrans
Pascale Bourhy
Philippe Quénel
Martina Escher
Claude Flamand
Jacques Rosine
Mathieu Picardeau
Institut de Veille Sanitaire (INVS)
Cellule de l'Institut de Veille Sanitaire en régions Antilles Guyane
Cellule Interrégionale d'Epidémiologie Antilles-Guyane
Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE]
Unité d'Epidémiologie
Institut Pasteur de la Guyane
Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)
Centre National de Référence de la Leptospirose-Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose-Biologie des Spirochètes
Institut Pasteur [Paris]
Institut de recherche, santé, environnement et travail (Irset)
Université d'Angers (UA)-Université de Rennes 1 (UR1)
Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
CIRE Antilles-Guyane - Gourbeyre
Centre Collaborateur FAO/OMS pour l'épidémiologie de la leptospirose
Centre National de Référence de la Leptospirose - National Reference Center Leptospirosis (CNR)
Biologie des Spirochètes / Biology of Spirochetes
CIRE Antilles-Guyane - Fort de France
The authors received specific funding only from the Institut de Veille Sanitaire, their institution. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Conceived and designed the experiments: SC JR CF ME ML PB MP PQ. Performed the experi- ments: SC JR ME PB. Analyzed the data: SC JR CF. Contributed reagents/materials/analysis tools: PB MP. Wrote the paper: SC JR CF ME ML PB MP PQ. Organized and strenghtened the partners network: PQ ML.
Jean-Baptiste Adrien, Hélène Bazus, Sylvie Boa, Fabrice Boulard, André Cabié, Arnaud Duthilly, Emilie Gaubert-Maréchal, Stéphanie Guyomard, Cécile Herrmann, Patrick Hoche- dez, Isabelle Lamaury, Claude Olive, Marion Petit-Sinturel, Raphaelle Théodose, the public health nurses of the CVAGS, all the General Practitionners of the two sentinel networks in Guadeloupe and Martinique, the ambulatory labs, the hospital labs, the hospital medical staffs, the Pasteur Institute of Guadeloupe, the Pasteur Institute of Paris and Jude Sweeney for the revision of the English text.
Institut Pasteur [Paris] (IP)
École des Hautes Études en Santé Publique [EHESP] (EHESP)
Source :
PLoS Neglected Tropical Diseases, Vol 10, Iss 4, p e0004668 (2016), PLoS Neglected Tropical Diseases, PLoS Neglected Tropical Diseases, Public Library of Science, 2016, 10 (4), pp.e0004668. ⟨10.1371/journal.pntd.0004668⟩, PLoS Neglected Tropical Diseases, 2016, 10 (4), pp.e0004668. ⟨10.1371/journal.pntd.0004668⟩
Publication Year :
2016
Publisher :
Public Library of Science (PLoS), 2016.

Abstract

BACKGROUND:Leptospirosis is a neglected zoonosis affecting mainly tropical and subtropical regions worldwide, particularly South America and the Caribbean. As in many other countries, under-reporting of cases was suspected in the French West Indies because of inadequate access to diagnostic tests for the general population. METHODOLOGY/PRINCIPAL FINDINGS:In order to estimate the real incidence of leptospirosis in Guadeloupe and Martinique, a study was performed in 2011 using the three prevailing available biological tests for diagnosis: Microscopic Agglutination Test (MAT), IgM ELISA and PCR. The study investigated inpatients and outpatients and used active case ascertainment from data provided by a general practitioners' sentinel network. The epidemiology of the disease was also described in terms of severity and demographic characteristics. Leptospirosis incidence was estimated at 69.4 (95%CI 47.6-91.1) and 60.6 (95%CI 36.3-85.0) annual cases per 100,000 inhabitants in Guadeloupe and Martinique, respectively, which was 3 and 4 times higher than previous estimations. CONCLUSION/SIGNIFICANCE:Inclusion of PCR and IgM ELISA tests for diagnosis of leptospirosis resulted in improved sensitivity in comparison with MAT alone. Our results highlighted the substantial health burden of the disease in these two territories and the importance of access to appropriate laboratory tests. Based on our results, PCR and IgM ELISA tests have now been included in the list of tests reimbursed by the national system of social security insurance in France. Our results also underline the relevance of implementing an integrated strategy for the surveillance, prevention and control of leptospirosis in the French West Indies.

Details

Language :
English
ISSN :
19352735 and 19352727
Volume :
10
Issue :
4
Database :
OpenAIRE
Journal :
PLoS Neglected Tropical Diseases
Accession number :
edsair.doi.dedup.....ddc1b0291c66f5a0c232008f7b000d66
Full Text :
https://doi.org/10.1371/journal.pntd.0004668⟩