Background:
The Amazon basin is one of the seven major geographical areas where
scorpionism is recorded. In French Guiana, 90 stings per 100,000 inhabitants
are registered per year. As the severity of cases is higher in children,
descriptive studies are needed to have a better understanding of this
pathology. The aim of the present study is to describe pediatric scorpionism
in French Guiana.
Methods:
We conducted a monocentric descriptive retrospective study on scorpion
stings in all pediatric patients admitted to Cayenne General Hospital from
January 1, 2002 to December 31, 2018.
Results:
In this survey, 132 patients were included. Of them, 63% were male. Patients
with general signs of envenomation were younger and lighter (p = 0.04). The
picture was “one sting” (95.3%) by a “big” (47.6%), “black” (60%) and “small
pincer” (58%) scorpion on the extremity of the body (84%). Stings occurred
mainly during the day, while patients changed clothes. There was no
envenomation during night. The monthly evaluation highlights that the number
of stings and percentage of general signs of envenomation were closely
connected to a composite variable including the variation of the level of
rivers (p = 0.005). Cardiac symptoms were recorded in 82% of cases with
general signs of envenomation. The presence of pulmonary; ear, nose, and
throat (ENT); or gastrointestinal symptoms are related to major envenomation
(p = 0.001, p = 0.01, and p = 0.02 respectively). Leukocytosis and glycemia
increased according to the envenomation grade whereas serum potassium and
alkaline reserve decreased. Forty-six patients needed hospitalization and
seven of them required intensive care. No patient died nor presented
sequelae at discharge from the hospital.
Conclusion:
Pediatric scorpionism in French Guiana is closely associated with child
activities and climatic conditions. Severe envenomation presented most of
the time with cardiac, pulmonary, and gastrointestinal symptoms.
Tonate virus (TONV) is an arbovirus discovered in 1973 in French Guiana (FG) belonging to the Venezuelan equine encephalitis virus complex, Alphavirus genus. Only few publications and cases have been reported in FG. The objectives of the present study were to describe the clinical picture of TONV and to compare its presentation with that of dengue virus (DENV). A retrospective study was performed in Cayenne hospital from 2003 to 2016 including all patients exclusively positive for TONV IgM and not for other alphaviruses. They were classified as high probability: typical clinical picture of arbovirus infection (i.e., fever, chills, headaches, muscle, and joint pains) and IgM seroconversion; medium probability: typical clinical picture + single positive IgM on a unique serum sample without control; and low probability: atypical clinical picture of infection and single positive IgM. Only patients with high and medium probability were included in the analysis and compared with a gender-and age-matched control group of DENV diagnosed by NS1 antigen (two controls per case). During the study period, 45 cases of TONV were included and compared with 90 cases of DENV. Twenty-eight (62.2%) were men; the median age was 34 years (IQ [22-49]). In the bivariate analysis, variables significantly associated with TONV versus DENV were the presence of cough (33.3% versus 10.3%) and anemia (32.5% versus 11.1%) and the absence of nausea (4.4% versus 32.2%), rash (2.2% versus 27.4%), fatigue (17.8% versus 41.0%), anorexia (6.7% versus 30.1%), muscle pain (42.2% versus 61.4%), headache (53.3% versus 70.8%), leukopenia (9.8% versus 44.4), and lymphopenia (42.5% versus 89.9%). There were no cases with severe neurological involvement, and there were no deaths. Tonate virus may be evoked as a cause of fever in patients living or returning from the Amazonian area. Positive TONV IgM does not prove the diagnosis and should not preclude from searching for alternative infectious diagnoses.
Optimized elimination strategies are needed to control transmission of malaria. As part of an elimination campaign, active detection of asymptomatic Plasmodium carriers by highly sensitive methods is deemed necessary. Asymptomatic carriage leads to complex scientific, ethical, and operational issues regarding individual or collective detection and treatment. To address this issue, a crosssectional study was carried out in French Guiana to determine the prevalence of asymptomatic Plasmodium carriage during an inter-epidemic season in the whole population of a neighborhood of Saint-Georges-de-l'Oyapock, along the Brazilian border. Fifty-eight participants out of 63 residents were screened. The median age was 23.3 years (range: 2 months-72 years), with a male/female sex-ratio of 0.56. The majority of the participants (74%, N = 43/58) reported a history of malaria, 12% (N = 7/58) during the past 12 months. All rapid diagnostic tests for malaria were negative. Among the 58 participants, malaria prevalence detected by nested-PCR (Polymerase Chain Reaction) was 3.6% (N = 2/56). Two asymptomatic carriers of Plasmodium were identified: one child with Plasmodium vivax and one adult with Plasmodium falciparum. These two carriers were treated and did not develop malaria within the eight months following the diagnosis. This study confirmed the presence of asymptomatic parasitaemias outside hyperendemic areas. However, the benefits of such an active detection and patient treatment to eliminate malaria in French Guiana need to be evaluated at a larger scale.
Background: In emergency departments (EDs), the staff continually face stressful situations requiring staff to adopt various coping strategies. Aims: The study aimed to assess work-related stress in ED during the COVID-19 outbreak. Method: The study was a monocentric investigation based on a questionnaire survey that elicits general information and uses the Karasek model to analyse the data. Findings: A total of 117 forms were collected for analysis. The score for decision latitude (or autonomy and skills at work) was 70 (IQR: 64–74) and the score for psychological demand was 25 (IQR: 23-27). The score for social support by the management team was 11 (IQR: 9–12) and the score for social support by colleagues 12 (IQR: 10–12). Of the total number of respondents, job strain was assessed as affecting 24.8%. Conclusion: The study shows high levels of stress among the ED workforce. The findings indicate that it is imperative to develop simple management tools that are capable of measuring the internal causes of stress in order to develop an adapted wellness programme in ED.
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