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Article ; Online: Bothrops (Fer-de-lance) snakebites in the French departments of the Americas (Martinique and Guyana): Clinical and experimental studies and treatment by immunotherapy.

Resiere, Dabor / Kallel, Hatem / Florentin, Jonathan / Houcke, Stephanie / Mehdaoui, Hossein / Gutiérrez, José María / Neviere, Remi

PLoS neglected tropical diseases

2023 Volume 17, Issue 2, Page(s) e0011083

Abstract: Snakebite envenomation is a relevant medical hazard in French Guiana and Martinique, two French territories in the Americas. All snakebite envenomations in Martinique are inflicted by the endemic viperid species Bothrops lanceolatus, whereas Bothrops ... ...

Abstract	Snakebite envenomation is a relevant medical hazard in French Guiana and Martinique, two French territories in the Americas. All snakebite envenomations in Martinique are inflicted by the endemic viperid species Bothrops lanceolatus, whereas Bothrops atrox is responsible for the majority of snakebites in French Guiana, although other venomous snake species also occur in this South American territory. This review summarizes some of the key aspects of the natural history of these species, as well as of their venom composition, the main clinical manifestations of envenomations, and their treatment by antivenoms. B. atrox venom induces the typical set of clinical manifestations characteristic of Bothrops sp. venoms, i.e., local tissue damage and systemic alterations associated with coagulopathies, hemorrhage, hemodynamic alterations, and acute kidney injury. In the case of B. lanceolatus venom, in addition to some typical features of bothropic envenomation, a unique and severe thrombotic effect occurs in some patients. The pathogenesis of this effect remains unknown but may be related to the action of venom components and inflammatory mediators on endothelial cells in the vasculature. A monospecific antivenom has been successfully used in Martinique to treat envenomations by B. lanceolatus. In the case of French Guiana, a polyvalent antivenom has been used for some years, but it is necessary to assess the preclinical and clinical efficacy against viperid venoms in this country of other antivenoms manufactured in the Americas.
MeSH term(s)	Animals ; Snake Bites/drug therapy ; Snake Bites/epidemiology ; Bothrops ; Antivenins/therapeutic use ; Guyana ; Martinique ; Endothelial Cells ; Immunotherapy ; Crotalid Venoms
Chemical Substances	Antivenins ; Crotalid Venoms
Language	English
Publishing date	2023-02-28
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0011083
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Article ; Online: Mortality Trend of Severe COVID-19 in Under-Vaccinated Population Admitted to ICU in French Amazonia.

Matheus, Séverine / Houcke, Stéphanie / Lontsi Ngoulla, Guy Roger / Higel, Nicolas / Ba, Abesetou / Cook, Fabrice / Gourjault, Cyrille / Nkontcho, Flaubert / Demar, Magalie / Nacher, Mathieu / Djossou, Félix / Hommel, Didier / Résiere, Dabor / Pujo, Jean Marc / Kallel, Hatem

Tropical medicine and infectious disease

2024 Volume 9, Issue 1

Abstract: 1) Background: Until December 2021, French Guiana (FG), located in South America, faced four consecutive COVID-19 epidemic waves. This study sought to analyze the mortality trend of severe COVID-19 patients admitted to the referral ICU of FG. (2) ... ...

Abstract	(1) Background: Until December 2021, French Guiana (FG), located in South America, faced four consecutive COVID-19 epidemic waves. This study sought to analyze the mortality trend of severe COVID-19 patients admitted to the referral ICU of FG. (2) Methods: We conducted a prospective, observational, and non-interventional study in ICU at Cayenne Hospital. We included 383 patients older than 18 admitted with SARS-CoV-2-related pneumonia hospitalized from May 2020 to December 2021. The study covers three periods. Period 1 (Waves 1 and 2, original variant), period 2 (Wave 3, Gamma variant), and period 3 (Wave 4, Delta variant). (3) Results: The median age was 63 years (52-70). Frailty was diagnosed in 36 patients over 70 (32.4%). Only 4.8% of patients were vaccinated. The median ICU LOS was 10 days (6-19). Hospital mortality was 37.3%. It was 30.9% in period 1, 36.6% in period 2 (
Language	English
Publishing date	2024-01-05
Publishing country	Switzerland
Document type	Journal Article
ISSN	2414-6366
ISSN (online)	2414-6366
DOI	10.3390/tropicalmed9010015
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Article ; Online: Clinical and Epidemiological Characteristics of Severe Acute Adult Poisonings in French Amazonia: Urgent Need for a Toxicovigilance Monitoring Framework.

Pujo, Jean Marc / Simon, Yann / Lontsi Ngoulla, Guy Roger / Signaté, Boubacar / Mutricy, Rémi / Frémery, Alexis / Burin, Antoine / Toffol, Bertrand de / Ben Amara, Ibtissem / Houcke, Stephanie / Nasri, Amina / Resiere, Dabor / Kallel, Hatem

Toxics

2024 Volume 12, Issue 3

Abstract: Background: Acute poisonings (AP) are a significant public health problem, accounting for a high number of emergency department visits and thousands of deaths worldwide. This study aimed to assess the epidemiology of AP in an adult population admitted ... ...

Abstract	Background: Acute poisonings (AP) are a significant public health problem, accounting for a high number of emergency department visits and thousands of deaths worldwide. This study aimed to assess the epidemiology of AP in an adult population admitted to Cayenne Hospital (French Guiana) and to investigate the clinical and sociodemographic characteristics. Methods: We conducted a monocentric retrospective study from January 2010 to December 2022, including patients over eighteen years of age who had been admitted to the emergency department of Cayenne Hospital for acute poisoning. Results: We included 425 patients. The median age was 34 years (IQR: 25-47). The sex ratio (M/F) was 0.52. A psychiatric disorder was found in 41.9% of patients. The Poisoning Severity Score (PSS) on admission was 1 or 2 for 84% of patients, and the mortality rate was 3.9%. The main involved toxicants were psychotropic drugs (43.1%), benzodiazepines (34.8%), and paracetamol (25.6%). The most lethal toxic was paraquat (5.2%). Intoxication was due to intentional self-poisoning in 84.2% of cases. Independent factors associated with severe poisoning (PSS 3 or 4) were chloroquine, neuroleptics, or paraquat poisoning; metabolic acidosis; and hyperglycemia (>5.5 mmol/L). The mortality rate was 3.9%, and the most involved toxic in death was paraquat. Conclusion: This study shows the frequent and deadly use of paraquat in APs in French Guiana. Urgent attention should be given to establishing a toxicovigilance monitoring framework and an antipoison center in the region.
Language	English
Publishing date	2024-03-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2733883-6
ISSN	2305-6304 ; 2305-6304
ISSN (online)	2305-6304
ISSN	2305-6304
DOI	10.3390/toxics12030200
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Article ; Online: Effect of the time to antivenom administration on recovery from snakebite envenoming-related coagulopathy in French Guiana.

Houcke, Stéphanie / Pujo, Jean Marc / Vauquelin, Segolene / Lontsi Ngoula, Guy Roger / Matheus, Severine / NkontCho, Flaubert / Pierre-Demar, Magalie / Gutiérrez, José María / Resiere, Dabor / Hommel, Didier / Kallel, Hatem

PLoS neglected tropical diseases

2023 Volume 17, Issue 4, Page(s) e0011242

Abstract: Background: Snakebite (SB) envenoming is an acute emergency requiring an early care delivery. We aimed to search for the time to reach healthcare facilities in various regions of French Guiana (FG) and to assess the impact of time to antivenom (AV) on ... ...

Abstract	Background: Snakebite (SB) envenoming is an acute emergency requiring an early care delivery. We aimed to search for the time to reach healthcare facilities in various regions of French Guiana (FG) and to assess the impact of time to antivenom (AV) on the correction of coagulation parameters in these patients. Methodology: This is a prospective observational study conducted in Cayenne General Hospital between January 1st, 2016, and July 31st, 2022. We included all patients hospitalized for SB envenoming less than 48h after the bite, and receiving antivenom (AV). We assessed the time lapse between SB and medical attention and the time needed to return of the coagulation parameters to normal. Principal findings: Overall, 119 patients were investigated, and 48.7% were from remote areas. The median time from SB to AV therapy was 09:15 h (05:32-17:47). The time was longer in patients from remote rural locations. AV was dispensed within the first six hours after the SB in 45 cases (37.8%). Time from SB to reaching normal plasma fibrinogen concentration was 23:27 h (20:00-27:10) in patients receiving AV≤6h vs. 31:23 h (24:00-45:05) in those receiving AV>6h (p<0.001). Whereas, the time from AV administration to reach normal fibrinogen dosage was similar in the two groups. Conclusions: Patients from rural settings in FG suffer from a delay in AV administration after SB envenoming leading to an extended time in which patients are coagulopathic. Once AV is administered, clotting parameters recover at a similar rate. Supplying remote healthcare facilities with AV and with medical teams trained on its use should be planned.
MeSH term(s)	Humans ; Antivenins/therapeutic use ; Snake Bites/complications ; Snake Bites/drug therapy ; French Guiana ; Treatment Outcome ; Blood Coagulation Disorders/drug therapy ; Blood Coagulation Disorders/etiology ; Fibrinogen
Chemical Substances	Antivenins ; Fibrinogen (9001-32-5)
Language	English
Publishing date	2023-04-24
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0011242
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Article ; Online: Antimicrobial Susceptibility of Community-Acquired Urine Bacterial Isolates in French Amazonia.

NkontCho, Flaubert / Sainte-Rose, Vincent / Abboud, Philippe / Portecop, Patrick / Pujo, Jean Marc / Cook, Fabrice / Walter, Gaelle / Mounier, Roman / Resiere, Dabor / Houcke, Stephanie / Demar, Magalie / Kallel, Hatem / Djossou, Felix

The American journal of tropical medicine and hygiene

2023 Volume 108, Issue 5, Page(s) 927–935

Abstract: Bacterial resistance in community-acquired urinary tract infections (UTIs) is increasing worldwide. Our study aimed to assess the microbiological epidemiology and antimicrobial susceptibility patterns of community-acquired urine bacterial isolates in ... ...

Abstract	Bacterial resistance in community-acquired urinary tract infections (UTIs) is increasing worldwide. Our study aimed to assess the microbiological epidemiology and antimicrobial susceptibility patterns of community-acquired urine bacterial isolates in French Amazonia. Our study is retrospective. It was conducted from January 2015 to December 2019 in the microbiology laboratory of the Cayenne General Hospital (French Guiana). It includes all positive urine samples from adult (> 18 years) outpatients (N = 2,533). Isolated microorganisms were Gram-negative rods in 83.9%, mainly Enterobacterales (98.4%). The main isolated bacteria were Escherichia coli (58.7%) and Klebsiella pneumoniae (13.3%). Among the isolated E. coli, 37.2% were susceptible to amoxicillin, 77.9% to amoxicillin/clavulanic acid, 94.9% to cefotaxime, 78.9% to ofloxacin, and 98.9% to nitrofurantoin. In 106 cases (5.1%), isolated Enterobacterales were extended-spectrum β-lactamase producers (5% of E. coli and 8.9% of K. pneumoniae). Overall, high levels of cross- and co-resistance were registered. The main isolated Gram-positive bacteria was Staphylococcus saprophyticus (28.9%). It was resistant to oxacillin in 52.5% of cases and susceptible to nitrofurantoin in 99.1% of cases. Patients with S. saprophyticus were young women in almost all cases. In conclusion, the most isolated microorganisms from outpatient urinalyses were E. coli and K. pneumoniae. They showed a high resistance rate to amoxicillin, but they were susceptible to the most remaining antibiotics. S. saprophyticus was isolated mainly in young women and was resistant to oxacillin in half of the cases. Interestingly, nitrofurantoin was active against most isolated organisms and can be considered as empirical treatment in uncomplicated UTIs.
MeSH term(s)	Adult ; Humans ; Female ; Nitrofurantoin ; Escherichia coli ; Retrospective Studies ; Microbial Sensitivity Tests ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/epidemiology ; Urinary Tract Infections/microbiology ; Community-Acquired Infections/epidemiology ; Amoxicillin-Potassium Clavulanate Combination ; Oxacillin
Chemical Substances	Nitrofurantoin (927AH8112L) ; Anti-Bacterial Agents ; Amoxicillin-Potassium Clavulanate Combination (74469-00-4) ; Oxacillin (UH95VD7V76)
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.22-0242
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Article ; Online: Emerging Maripa Hantavirus as a Potential Cause of a Severe Health Threat in French Guiana.

Matheus, Séverine / Houcke, Stéphanie / Lontsi Ngoula, Guy Roger / Lecaros, Pablo / Pujo, Jean Marc / Higel, Nicolas / Ba, Absetou / Cook, Fabrice / Djahi, Patrick / Resiere, Dabor / Hommel, Didier / Lavergne, Anne / Kallel, Hatem

The American journal of tropical medicine and hygiene

2023 Volume 108, Issue 5, Page(s) 1014–1016

Abstract: We describe the clinical parameters and management of nine confirmed cases of hantavirus pulmonary syndrome reported in French Guiana since 2008. All patients were admitted to Cayenne Hospital. Seven patients were men and the mean age was 48 years (range, ...

Abstract	We describe the clinical parameters and management of nine confirmed cases of hantavirus pulmonary syndrome reported in French Guiana since 2008. All patients were admitted to Cayenne Hospital. Seven patients were men and the mean age was 48 years (range, 19-71 years). Two phases characterized the disease. The prodromal phase was characterized by fever (77.8%), myalgia (66.7%), and gastrointestinal symptoms (vomiting and diarrhea; 55.6%) starting, on average, 5 days before the illness phase, which was characterized by respiratory failure in all patients. Five patients died (55.6%) and the length of stay in the intensive care unit was 19 days (range, 11-28 days) for survivors. Detection of two back-to-back recent cases highlights the reason to screen for hantavirus infection during the nonspecific phase of the disease, in particular when concomitant pulmonary infection and digestive disorders are observed. Specific longitudinal serological surveys must also be used to identify other potential clinical forms of the disease in French Guiana.
MeSH term(s)	Male ; Humans ; Middle Aged ; Female ; French Guiana/epidemiology ; Hantavirus Pulmonary Syndrome/diagnosis ; Hantavirus Pulmonary Syndrome/epidemiology ; RNA Viruses ; Hospitals ; Orthohantavirus
Language	English
Publishing date	2023-03-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2942-7
ISSN	1476-1645 ; 0002-9637
ISSN (online)	1476-1645
ISSN	0002-9637
DOI	10.4269/ajtmh.22-0390
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Article ; Online: From strongyloidiasis to disseminated mucormycosis: the story of an HTLV-1-infected migrant.

Autier, Brice / Chesnay, Adélaïde / Mayence, Claire / Houcke, Stéphanie / Guégan, Hélène / Demar, Magalie / Blanchet, Denis

Journal of travel medicine

2020 Volume 28, Issue 6

MeSH term(s)	Animals ; Human T-lymphotropic virus 1 ; Humans ; Mucormycosis/diagnosis ; Mucormycosis/drug therapy ; Strongyloides stercoralis ; Strongyloidiasis/diagnosis ; Strongyloidiasis/drug therapy ; Transients and Migrants
Language	English
Publishing date	2020-12-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa229
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Article ; Online: Accuracy of SD Malaria Ag P.f/Pan® as a rapid diagnostic test in French Amazonia.

Pujo, Jean Marc / Houcke, Stéphanie / Lemmonier, Sarah / Portecop, Patrick / Frémery, Alexis / Blanchet, Denis / Djossou, Felix / Kallel, Hatem / Demar, Magalie

Malaria journal

2021 Volume 20, Issue 1, Page(s) 369

Abstract: Background: French Guiana (FG) is a French overseas territory where malaria is endemic. The current incidence rate is 0.74‰ inhabitants, and Plasmodium vivax is widely predominating even though Plasmodium falciparum is still present due to imported ... ...

Abstract	Background: French Guiana (FG) is a French overseas territory where malaria is endemic. The current incidence rate is 0.74‰ inhabitants, and Plasmodium vivax is widely predominating even though Plasmodium falciparum is still present due to imported cases mainly from Africa. In FG, rapid diagnostic test (SD Malaria Ag P.f/Pan®) is based on the detection of pan-pLDH, PfHRP2, and PfHRP3 antigens, while in South America, the share of deletion of PfHRP2 gene is significantly increasing. Accordingly, the study questions the reliability of RDTs in the Amazonian context. Methods: The study is retrospective. It is conducted over 4 years and analysed 12,880 rapid diagnostic tests (RDTs) compared to concomitant Blood Film Tests (BFTs) sampled for malaria diagnosis. Results: The global assessment of the accuracy of SD Malaria Ag P.f/Pan® in the diagnostic of malaria shows both Positive and Negative Predictive Values (PPV and NPV) higher than 95%, except for PPV in the diagnosis of malaria to P. falciparum (88%). Overall, the concordance rate between RDT and BFT (positive/positive; negative/negative) was 99.5%. The PPV of the RDT in the follow-up of patients diagnosed with P. falciparum was the lowest during the first 28 days. The PPV of the RDT in the follow-up of patients diagnosed with P. vivax was the lowest during the first 21 days. The global sensitivity of SD Malaria Ag P.f/Pan® test was, on average, 96% (88.2-100) for P. falciparum and 93% (90.6-94.2) for P. vivax. The global specificity was 99.8% (99.5-100) for all included species. Conclusion: SD Malaria Ag P.f/Pan® is a reliable rapid test used for the first-line diagnosis in remote healthcare centres. The test results should be interpreted in the light of patient's recent medical history and the date of arrival to FG.
MeSH term(s)	Diagnostic Tests, Routine/statistics & numerical data ; French Guiana ; Malaria, Falciparum/diagnosis ; Malaria, Vivax/diagnosis ; Plasmodium falciparum/isolation & purification ; Plasmodium vivax/isolation & purification ; Reproducibility of Results ; Retrospective Studies
Language	English
Publishing date	2021-09-17
Publishing country	England
Document type	Journal Article
ISSN	1475-2875
ISSN (online)	1475-2875
DOI	10.1186/s12936-021-03902-z
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Article ; Online: Critical care medicine in the French Territories in the Americas: Current situation and prospects.

Kallel, Hatem / Resiere, Dabor / Houcke, Stéphanie / Hommel, Didier / Pujo, Jean Marc / Martino, Frederic / Carles, Michel / Mehdaoui, Hossein

Revista panamericana de salud publica = Pan American journal of public health

2021 Volume 45, Page(s) e46

Abstract: Hospitals in the French Territories in the Americas (FTA) work according to international and French standards. This paper aims to describe different aspects of critical care in the FTA. For this, we reviewed official information about population size ... ...

Abstract	Hospitals in the French Territories in the Americas (FTA) work according to international and French standards. This paper aims to describe different aspects of critical care in the FTA. For this, we reviewed official information about population size and intensive care unit (ICU) bed capacity in the FTA and literature on FTA ICU specificities. Persons living in or visiting the FTA are exposed to specific risks, mainly severe road traffic injuries, envenoming, stab or ballistic wounds, and emergent tropical infectious diseases. These diseases may require specific knowledge and critical care management. However, there are not enough ICU beds in the FTA. Indeed, there are 7.2 ICU beds/100 000 population in Guadeloupe, 7.2 in Martinique, and 4.5 in French Guiana. In addition, seriously ill patients in remote areas regularly have to be transferred, most often by helicopter, resulting in a delay in admission to intensive care. The COVID-19 crisis has shown that the health care system in the FTA is unready to face such an epidemic and that intensive care bed capacity must be increased. In conclusion, the critical care sector in the FTA requires upgrading of infrastructure, human resources, and equipment as well as enhancement of multidisciplinary care. Also needed are promotion of training, research, and regional and international medical and scientific cooperation.
Language	English
Publishing date	2021-04-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1376934-0
ISSN	1680-5348 ; 1020-4989
ISSN (online)	1680-5348
ISSN	1020-4989
DOI	10.26633/RPSP.2021.46
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Article ; Online: Capillary leak-syndrome triggered by Maripa virus in French Guiana: case report and implication for pathogenesis.

Kallel, Hatem / Matheus, Séverine / Mayence, Claire / Houcke, Stéphanie / Mathien, Cyrille / Lavergne, Anne / Hommel, Didier

BMC infectious diseases

2019 Volume 19, Issue 1, Page(s) 260

Abstract: Background: We report hereby a severe case of Hantavirus Pulmonary Syndrome" (HPS) induced by Maripa virus in French Guiana and describe the mechanism of severity of the human disease.: Case presentation: A 47-year- old patient started presenting a ... ...

Abstract	Background: We report hereby a severe case of Hantavirus Pulmonary Syndrome" (HPS) induced by Maripa virus in French Guiana and describe the mechanism of severity of the human disease. Case presentation: A 47-year- old patient started presenting a prodromic period with fever, dyspnea, cough and head ache. This clinical presentation was followed by a rapid respiratory, hemodynamic and renal failure leading to admission in the ICU. Biological exams revealed an increased haematocrit level with a paradoxical low protein level. Echocardiographic and hemodynamic monitoring showed a normal left ventricular function with low filling pressures, an elevated extravascular lung water index and pulmonary vascular permeability index. These findings were compatible with a capillary leak-syndrome (CLS). Conclusions: The severity of HPS caused by the virus Maripa in French Guiana can be explained by the tropism of hantavirus for the microvascular endothelial cell leading to a CLS.
MeSH term(s)	Capillary Leak Syndrome/diagnosis ; Capillary Leak Syndrome/etiology ; Capillary Leak Syndrome/physiopathology ; French Guiana ; Hantavirus/isolation & purification ; Hantavirus/pathogenicity ; Hantavirus Pulmonary Syndrome/complications ; Hantavirus Pulmonary Syndrome/diagnosis ; Hantavirus Pulmonary Syndrome/physiopathology ; Humans ; Middle Aged
Keywords	covid19
Language	English
Publishing date	2019-03-15
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-019-3887-5
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