Leprosy in French Guiana 2007–2014: a re‐emerging public health problem

Graille, Jean; Blaizot, Romain; Darrigade, A.-S.; Sainte‐Marie, D.; Schaub, Roxane; Couppié, Pierre

doi:10.1111/bjd.18334

Cited by 6 publications

(19 citation statements)

References 2 publications

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“…In French Guiana, only 22% of new cases from the period 2007-2014 were considered autochthonous. Some 56% of the cases originated from Brazil, mainly among illegal gold miners [31], who are subject to harsh living conditions, poor health, and poor access to health care [32]. Similar conclusions were recently drawn in Guyana, which has seen a re-emergence of leprosy following human migration from endemic regions [33].…”

Section: The Guiana Shieldsupporting

confidence: 53%

Leprosy Transmission in Amazonian Countries: Current Status and Future Trends

et al. 2020

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Purpose of Review Leprosy is one of the first pathologies described in the history of mankind. However, the ecology, transmission, and pathogenicity of the incriminated bacilli remain poorly understood. Despite effective treatment freely distributed worldwide since 1995, around 200,000 new cases continue to be detected yearly, mostly in the tropics. This review aims to discuss the unique characteristics of leprosy in Amazonian countries, which exhibit a very heterogeneous prevalence among human and animal reservoirs. Recent Findings Groundbreaking discoveries made in the last 15 years have challenged the dogmas about leprosy reservoirs, transmission, and treatment. The discovery of a new leprosy causative agent in 2008 and the scientific proof of zoonosis transmission of leprosy by nine-banded armadillos in the southern USA in 2011 challenged the prospects of leprosy eradication. In the Amazonian biome, nine-banded and other armadillo species are present but the lack of large-scale studies does not yet allow accurate assessment of the zoonotic risk. Brazil is the second country in the world reporting the highest number of new leprosy cases annually. The disease is also present, albeit with different rates, in all neighboring countries. Throughout the Amazonian biome, leprosy is mainly found in hyperendemic foci, conducive to the emergence and transmission of drug-resistant strains. Summary The deepening of current knowledge on leprosy reservoirs, transmission, and therapeutic issues, with the One Health approach and the help of molecular biology, will allow a better understanding and management of the public health issues and challenges related to leprosy in Amazonia.

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Section: The Guiana Shieldsupporting

confidence: 53%

Leprosy Transmission in Amazonian Countries: Current Status and Future Trends

et al. 2020

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“…The sex ratio was almost equal (2376 women, 50.1%). The population was rather young, with a median age of 22 3–31 . Underage patients (<18) formed the largest group (59.6%).…”

Section: Resultsmentioning

confidence: 99%

Spectrum of skin diseases in Maroon villages of the Maroni area, French Guiana

et al. 2022

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Background Due to their genetic characteristics and their high exposure to infectious diseases, Maroons are likely to suffer from a specific spectrum of skin diseases. However, skin disorders have never been explored in this population. We aimed to describe all skin diseases in Maroon villages of the Maroni region in French Guiana. Methods This retrospective study concerned all patients who consulted in the remote health centers of Apatou, Grand‐Santi, Papaichton, and Maripasoula between October 5, 2017, and June 30, 2020. We included all patients registered with a skin disorder (International Classification of Diseases) in the medical database. We excluded patients whose diagnosis was invalidated after cross‐checking by a dermatologist. Results A total of 4741 patients presented at least one skin disease, for 6058 different disorders. Nonsexually transmitted infections represented 71.6% of all diagnoses, followed by inflammatory diseases (9.8%) and bites/envenomations (4.6%). The three most frequent conditions were scabies, abscesses, and impetigo. Besides scabies, neglected tropical diseases (NTDs) were still prevalent as we reported 13 cases of leprosy and 63 cutaneous leishmaniasis. Atopic dermatitis (AD) represented only 2.5% of our diagnoses. Conclusions With the exception of AD, which was less frequent among Maroons, these results are similar to those previously reported in Amerindians. Therefore, a common exposure to rainforest pathogens seems to induce a common spectrum of skin diseases dominated by infections. The high prevalence of NTDs requires specific public health actions.

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“…French Guiana is a South American territory of almost 300,000 inhabitants of diverse origins were leprosy is a re-emerging public health problem, with a prevalence rate of 1 / 10,000 inhabitants from 2007 to 2014 [6]. HIV prevalence is also high, affecting about 1% of the population [7].…”

Section: Introductionmentioning

confidence: 99%

Leprosy as immune reconstitution inflammatory syndrome in patients living with HIV: Description of French Guiana’s cases over 20 years and systematic review of the literature

et al. 2022

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Background HIV infection is highly prevalent in French Guiana, a territory where leprosy is also endemic. Since the introduction of Highly Active Antiretroviral Treatment (HAART) in the management of HIV, leprosy has been reported as part of the immune reconstitution inflammatory syndrome (IRIS). Methodology/Principal findings We aimed to present a general description of these forms of leprosy as IRIS, highlighting clinical and therapeutic specificities. A retrospective study was conducted in French Guiana, including patients living with HIV (PLHIV) with advanced infection (CD4 < 200/mm3) and developing leprosy or a leprosy reaction within six months of HAART initiation, from 2000 to 2020. Clinical, histological and biological data were collected for all these patients. Six patients were reported in French Guiana. A systematic review of the literature was conducted, and its results were added to an overall analysis. Overall, seventy-three PLHIV were included. They were mainly men (74%), aged 22–54 years (median 36 years), mainly from Brazil (46.5%) and India (32.8%). Most leprosy cases (56.2%) were borderline tuberculoid (BT). Leprosy reactions were frequent (74%), mainly type 1 reaction (T1R) (68.5%), sometimes intense with ulceration of skin lesions (22%). Neuritis was observed in 30.1% of patients. The outcome was always favorable under multidrug therapy (MDT), continuation of HAART and additional corticosteroid therapy in case of neuritis or ulceration. There was no relapse. Conclusion Leprosy as IRIS in PLHIV mainly presents as a BT leprosy in a T1R state, sometimes with ulcerated skin lesions. Response to MDT is usually good. Systemic corticosteroids are necessary and efficient in case of neuritis.

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Leprosy in French Guiana 2007–2014: a re‐emerging public health problem

Cited by 6 publications

References 2 publications

Leprosy Transmission in Amazonian Countries: Current Status and Future Trends

Leprosy Transmission in Amazonian Countries: Current Status and Future Trends

Spectrum of skin diseases in Maroon villages of the Maroni area, French Guiana

Leprosy as immune reconstitution inflammatory syndrome in patients living with HIV: Description of French Guiana’s cases over 20 years and systematic review of the literature

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