Background Scabies and its complications are a public health problem in the low- and middle-income countries of the Western Pacific region. However, no data are available for the relatively wealthy French territory of New Caledonia. This study aimed to determine the incidence of scabies and its association with skin and soft tissue infection (SSTI) in Loyalty Islands Province (LIP) (20,000 inhabitants), New Caledonia. Methodology/Principal findings This retrospective observational study reviewed cases of scabies and SSTI extracted from the electronic health record databases of LIP clinics for the period 2004–2018. Data were validated through double sampling. The overall scabies incidence rate (IR) and scabies IRs by sex and age group were calculated. Scabies seasonality was evaluated. For children <5 years, the presence of SSTI was compared between the 3-month period preceding scabies diagnosis/treatment and the 3-month period preceding the 1-year anniversary of scabies diagnosis/treatment (self-matching). A total of 16,843 scabies cases were extracted using a detection algorithm with a sensitivity of 96.7% and a specificity of 99.9%. From 2004 to 2018, the average overall scabies IR was 5.9% and the average scabies IR in children <1 year was 18.4%. Almost two-thirds of children aged 14 years had a history of scabies. Females were more affected, especially in the 20–39 age group (sex ratio>2). A strong seasonality was observed, with a 30% increase in winter. In children <5 years, SSTIs were 4.3 times more frequent in the 3 months preceding the scabies diagnosis than in the 3 months preceding the 1-year anniversary of scabies treatment (p<0.001). Conclusions Although health care is much better in New Caledonia than in neighboring countries, scabies is highly endemic in LIP. The disease is especially common in children <2 years and is associated with many SSTIs in children <5 years. Mass drug administration should be considered.
Dear Editor, Toxic seaweed dermatitis (TSD) is caused by exposure to toxins from the marine cyanobacterium Lyngbya majuscula (LM). In October 2017, several cases of genital lesions following sea bathing in Chateaubriand Bay, New Caledonia, were suggestive of an outbreak of TSD.A case of TSD was defined by onset of dermatitis within 72 h of bathing in Chateaubriand Bay, with no obvious
Objectives To investigate whether lactate dehydrogenase D (LDHD) gene deficiency causes juvenile-onset gout. Methods We used whole exome sequencing (WES) for two families and a targeted gene-sequencing panel for an isolated patient. D-lactate dosages were analyzed by using ELISA. Results We demonstrated linkage of juvenile-onset gout to homozygous carriage of 3 rare distinct LDHD variants in 3 different ethnicities. In a Melanesian family, the variant was [NM_153486.3: c(206 C > T); rs1035398551] and, as compared with non-homozygotes, homozygotes had higher hyperuricemia (p= 0.02), lower fractional clearance of urate (FCU) (p= 0.002) and higher levels of D-lactate in blood (p-0.04) and urine (p= 0.06). In a second, Vietnamese, family, very severe juvenile-onset gout was linked to homozygote carriage of an undescribed LDHD variant (NM_153486.3: c.1363dupG) leading to a frameshift followed by a stop codon, p.(AlaGly432fsTer58). Finally, a Moroccan man, with early-onset and high D-lactaturia, whose family was unavailable for testing, was homozygous for another rare LDHD variant [NM_153486.3: c.752C>T, p.(Thr251Met)]. Conclusion Rare, damaging LDHD variants can cause autosomal recessive early-onset gout. the diagnosis of which can be suspected by measuring high D-lactate levels in the blood and/or urine.
Toxic seaweed dermatitis is caused by toxins of the marine cyanobacterium Lyngbya majuscula after sea bathing in some tropical area. This rarely described irritant dermatitis results in papular and bullous lesions, mainly in the genital area but severe ocular lesions can occur.
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