BackgroundSince 2013, 3 successive arbovirus outbreaks, dengue (DENV), chikungunya (CHIKV), and Zika virus, have occurred in French Guiana (FG). The primary objective of this study was to describe the socioeconomic indicators of the first patients infected with CHIKV during the outbreak of 2014. The secondary objective was to compare those patients with patient infected by DENV and with the local population.MethodsA monocentric, retrospective, case-control study was conducted in Cayenne hospital in FG comparing a group of patients infected with CHIKV in 2014 with a group infected with DENV in 2013. Children aged less than 15 years and pregnant women were excluded.ResultsA total of 168 CHIKV patients were compared with 168 DENV patients. Factors associated with CHIKV were living in poor neighborhoods (82% vs 44%; odds ratio [OR], 5.81; 95% confidence interval [CI], 3.35–10.2), having a precarious status (54% vs 33%; OR, 2.37; 95% CI, 1.49–3.78), and being born abroad (70% vs 35%; OR, 4.35; 95% CI, 2.69–7.06).ConclusionsThe present results suggest that early in the epidemic, the populations most at risk for CHIKV infection were the most socially vulnerable populations in the poorest neighborhoods, whereas DENV appeared to have affected a richer population and richer areas.
Quantification of chromium in whole blood has been performed by ICP-quadrupole MS. The spectrometer was equipped with a dynamic reaction cell (DRC) with ammonia as reaction gas. The rejection parameter q (RPq) of the DRC and the flow rate of ammonia (NH3) were optimized and set at 0.7 and 0.6 mL min(-1), respectively. Blood was diluted 1:51 (v/v) with an aqueous solution containing 0.1 mg L(-1) NH4OH, 0.1 g L(-1) EDTA, 5 mg L(-1) n-butanol, and 0.1 per thousand Triton X100. Non-spectral matrix effects observed when using the DRC were confirmed by use of vanadium. External calibration with blank and standard solutions prepared in purified water led to biased results for quality control samples. Standard addition calibration was therefore used and its validity verified. By comparing the slopes and calculating residues, it was proved that the plot obtained with standard additions and the plot obtained from blood samples of different concentrations were aligned down to 0.05 microg L(-1) after dilution.
Background French Guiana is used as a drug trafficking pipeline of cocaine to Europe. The number of arrests for transporting cocaine in corpore has increased exponentially in recent years. Since 2010, Cayenne Hospital's emergency care unit has applied a medical management protocol system for body‐packers. Our objective was to describe the epidemiology of body‐packers and to evaluate medical management. Method A retrospective descriptive study was performed among patients hospitalized in Cayenne Hospital for transporting cocaine in corpore between January 2010 and November 2015. In addition, a qualitative study including interviews of body‐packers imprisoned in Rémire‐Montjoly prison was conducted in April 2016. Result A total of 282 patients were included in the study. The median age was 24 years and the sex ratio M/W was to 4/1. Among them, 3.5% showed signs of severity (9 with pre‐existing condition and 1 with severe form). No surgery or deaths were reported. Ten endoscopies were performed because of the delay in evacuation without complications. Approximately 28% of patients had urinary screening, of which 60.7% were positive. The median length of stay was 1.8 days. Prolonged length of stay was significantly associated with the presence of gastrointestinal symptoms, hypoglycemia, or having swallowed a minimum of 10 pellets. Conclusion This study led to a change in the management of body‐packers in the hospital setting in Guiana. A computed tomography scan at discharge became more prevalent. Endoscopy has emerged as an effective and safe alternative to surgery. Despite the increase in the number of patients treated, it should be noted that there were few complications and no deaths in our cohort.
Validation of the determination of lead in whole blood by ICP-quadrupole MS has been performed. Blood was 1 : 45 v/v diluted in an aqueous solution containing 0.1 mg l 21 NH 4 OH, 0.1 g l 21 EDTA, 5 mg l 21 n-butanol and 0.1% Triton X 100. It was verified that a synthetic matrix made of 7.5 g l 21 NaCl and 0.5 g l 21 CaCl 2 behaved similarly to the whole blood and to QC samples. Limits of detection and of quantitation were determined by plotting the RSD of the net signal as a function of the concentration, and were 0.01 and 0.1 mg l 21 , respectively, which was below the lowest Pb concentration in blood, i.e., 0.2 mg l 21 after dilution. Uncertainty of the centroid of the calibration graph was preferred to the evaluation of the linearity with ANOVA to validate the calibration procedure. At 95% confidence level, a warning limit was set up at 5% uncertainty, while rejection was decided on for 20% uncertainty. Internal standardization based on the use of 187 Re provided improvement in the uncertainty and the reproducibility. Intra-and inter-day reproducibilities were evaluated. Good agreement was observed between the concentrations obtained by ICP-MS and GF-AAS.
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