Bulletin de la Société de pathologie exotique (1990)
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Bull Soc Pathol Exot · May 2011
[Severe cases of A(H1N1)v2009 infection in Réunion Island in 2009 and 2010].
In the Southern hemisphere, Réunion Island acts as a sentinel for infections preferentially occurring during the austral winter that are likely to reach the Northern hemisphere a few months later. We relate the main features concerning patients that were admitted during years 2009 and 2010 in our intensive care unit with an A(H1N1)v2009 infection, mainly for acute respiratory distress. Demographic, clinical, and biological data as well as given medications and outcome were prospectively collected among all PCR-confirmed influenza-infected patients. ⋯ Through 2009 and 2010 autumn and winter periods, for several weeks, the A(H1N1)v2009 virus infection resulted in a significant increase of workload in Réunion Island ICUs. In 2010, the failure of the mass immunization campaign, particularly among the at-risk groups, led to severe cases of A(H1N1)v2009 infections, particularly among patients with comorbidities. Our data may contribute toward better management of influenza virus pandemics in the future.
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Bull Soc Pathol Exot · May 2011
Case Reports[One case of nosocomial A(H1N1)v2009 influenza in Réunion Island].
A 19-year-old patient admitted in an oncology unit for an autograft (Hodgkin disease), developed on day 20 a fatal acute respiratory failure and multiple organ failure due to an infection of the A(H1N1)v2009 virus, which was acquired in the hospital, despite partial preventive measures. At that time, the specific vaccine was not available in Réunion. We discuss the nosocomial origin of the infection. Following the epidemic wave, the vaccination rate of the general population and the hospital employees remains very low.
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Bull Soc Pathol Exot · May 2011
[Influenza A(H1N1)2009 epidemic in Réunion Island: experience in the out-patient influenza clinic, July-September 2009].
From July 6 to September 29, 2009, 380 patients were seen as out-patients for flu-like illness, and 355 files (253 women and 102 men) were available for retrospective analysis. Mean age was 32 years. 158 patients, including 22 with A(H1N1)2009 influenza had underlying medical conditions: pregnancy (N = 87), asthma (N = 37), obesity (N = 17). ⋯ A nasopharyngeal swab for influenza virus detection by PCR was performed on 118 patients including 27 pregnant women. 44 patients, including 40 A(H1N1)2009 influenza cases were tested positive. 21 patients were referred to the emergency department for further tests or treatment and 31 patients were admitted as in-patients. 20 pregnant women were referred for further obstetrical monitoring; none presented with respiratory failure or foetal distress. None of the patients were admitted to the ICU or died.
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Bull Soc Pathol Exot · May 2010
[The Global Fund to fight HIV/AIDS, TB and Malaria 5-y: evaluation policy issues].
The Global Fund to fight HIV/AIDS, Tuberculosis and Malaria (GFATM) was founded in 2002 in the context of increased political and financial commitments towards health and development, in the aftermath of the Millennium Declaration, and on track to implement the Millennium Development Goals (MDGs). As of today, the institution has mobilized over 16 billion US dollars through its partnership, and spent over 8 billion dollars through 620 contracts in 140 countries for these three diseases. Principles at inception were to accelerate and expand HIV, TB, and Malaria prevention and awareness, care, and treatment related activities, in the poorest and the most affected countries worldwide, with a special emphasis on Africa, being the continent with the highest disease burden, especially with respect to HIV/AIDS and its dreadful social and economic consequences. ⋯ Health systems' weaknesses at district level, such as human resources, laboratory commodities, and medicine shortages, are major constraints to further expansion of services and impact of funds. Issues at stake are the following: (i) soundness of the GFATM assumptions at inception with respect to national disease control strategies, especially in relation to HIV prevention, (ii) whether it belongs to the GFATM to finance health systems strengthening to start with, (iii) GFATM systems effects, (iv) misfinancing in relation to disease burden, marginalized and vulnerable groups, (v) technical expertise identification, mobilization and financing, (vi) equity of access of funding, expertise and guidance, to francophone countries in Africa. Recommendations are made to bring the attention of the GFATM Board members prior to the Replenishment Conference to be prepared in March 2010 and held in October 2010.
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Bull Soc Pathol Exot · May 2010
Comparative Study[Imported malaria in University Hospital Center of Bordeaux, France, 2000-2007. A comparison study with the French national epidemiological data].
In Western countries, France accounts for the most concerned by imported malaria. The objective of the present study was to describe the epidemiological and clinical features of imported malaria in adults attending the University Hospital Center (UHC) ofBordeaux and to compare these findings with the French national epidemiological data. A retrospective analysis of all patients aged over 15 years with parasitologically confirmed malaria in patients recruited between January 1, 2000 and December 31, 2007 has been performed. ⋯ Atovaquone-proguanil (AP) combination therapy wasmore frequently used in Bordeaux compared to the national data (64 versus 20%). This AP combination treatment was the most frequently prescribed for uncomplicated malaria, whereas intravenous quinine was mainly used for complicated malaria and for patients with vomiting. The lack of CPL, the diagnosis or therapeutic delay, and the lethality of malaria among travellers infected by malaria imported from SA argue for the implementation of continuing medical training and health education targeted at travellers from France to high malaria-endemic areas such as SA, Madagascar, and Comoros.