Background The chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic and potentially incapacitating rheumatic musculoskeletal disorders known as chronic chikungunya arthritis (CCA). We conducted a prospective cohort study of CHIKV-infected subjects during the 2013 chikungunya outbreak in Martinique. The aim of this study was to assess the prevalence of CCA at 12 months and to search for acute phase factors significantly associated with chronicity. Methodology/Principal findings A total of 193 patients who tested positive for CHIKV RNA via qRT-PCR underwent clinical investigations in the acute phase (<21 days), and then 3, 6, and 12 months after inclusion. The Asian lineage was identified as the circulating genotype. A total of 167 participants were classified as either with or without CCA, and were analyzed using logistic regression models. The overall prevalence of CCA at 12 months was 52.1% (95%CI: 44.5-59.7). In

BackgroundThe Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance.MethodsThis is an observational monocentric study conducted within the prison’s health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance.ResultsIn 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload.ConclusionsHIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.

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50Background 51 The chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic rheumatic 52 musculoskeletal disorders, named chronic chikungunya (CHIKC+), which may be long-term 53 incapacitating. A chikungunya outbreak occurred in 2013 in La Martinique. We constituted the first 54 prospective cohort study of CHIKV-infected subjects in the Caribbean to assess the prevalence of 55 CHIKC+ at 12 months and to search for factors present at the acute stage significantly associated with 56 chronicity. 57 58 Methodology/Principal findings 59 A total of 193 patients who tested positive for RT-PCR CHIKV, were submitted to clinical 60 investigations in the acute phase (<21 days), and 3, 6, and 12 months after their inclusion. A total of 61 167 participants could be classified as either suffering or not from CHIKC+. They were analyzed using 62 logistic regression models. At 12 months, the overall prevalence of CHIKC+ was 52.1% (95%CI: 44.5-63 59.7). In univariate analysis, age (OR: 1.04; 95% CI: 1.02-1.07; p=0.0003), being male (OR: 0.51; 64 95%CI: 0.27-0.98; p=0.04), headache (OR: 1.90; 95%CI: 1.02-3.56; p=0.04), vertigo (OR: 2.06; 95%CI: 65 1.05-4.03; p=0.04), vomiting (OR: 2.51; 95%CI: 1.07-5.87; p = 0.03), urea (OR: 1.33; 95%CI: 1.05-1.70; 66 p=0.02) were associated with CHIKC+. In final multivariate logistic regression models for 167 67 participants, predictors of CHIKC+ were age (OR 1.06; 95%CI: 1.03-1.08; p<0.0001), male sex (OR: 68 0.40; 95%CI: 0.19-0.84; p=0.015), vertigo (OR: 2.46; 95%CI: 1.16-5.20; p=0.019), hypotension (OR 69 4.72; 95% -CI: 1.19-18.79; p=0.028), recoloration time >3 seconds (OR: 3.79; 95%-CI: 1.01-14.25). 70 71