Search Results (171)

This study aimed to determine the prevalence of type 1 diabetes mellitus (T1DM) in French Guiana and describe the social profiles of the patients. We conducted a multicenter cross-sectional study of children under 18 years who were diagnosed with type 1 diabetes and followed up from 2002 to 2021. Over a 20-year period, 48 children under 18 years with type 1 diabetes living in French Guiana were included in the study, out of a total of 59 cases. There were 26 girls and 22 boys. The median age at diagnosis was 8.52 years [IQR 6–12]. The incidence rate was 5.9 per 100,000 people in children aged 0–18 years. The 5–9-year age group was the most affected 43.7% (95% CI 38–51%). Of these children, 56.2% (95% confidence interval 40–70%) lived in single-parent households, and 35% (95% CI 23–57%) of the parents had a primary education. Of the children, 29% (95% CI 21–42%) were from families with no resources. Diabetes was diagnosed by ketoacidosis in 56% (95% CI 38–74%) of the patients. Forty percent (95% CI 35–66%) of the patients had an HbA1c > 9%. There was an imbalance in the prevalence of children with higher Hba1c (>9%), with 18.7% (95% CI 10–29%, p < 0.001) of children whose parents had a low level of education having an Hba1c > 9% compared with only 6% (95% CI 3–10%) of children whose parents had a university degree, and a marked imbalance in the prevalence of children with High Hba1c (>9%) among children from single-parent families (22.9%, 95% CI 17–30%) compared with children whose parents lived in couples (8%, 95% CI 5–12%). The 10–14-year age group (18.7%, 95% CI 11–25%) had the highest imbalance in the prevalence of poor diabetes control between children whose parents had lower versus higher education levels. Diabetic retinopathy and diabetic nephropathy were the only reported complications. The multivariate analysis showed that a low level of parental education (Odds ratio 2.9 [95% CI 2.1–4.5], p < 0.001) and single-parent families (Odds ratio 3.1 [95% CI 2.6–4.3], p < 0.001) were predictors of poor control of T1DM. However, the lack of social insurance coverage at diagnosis was not associated with poor T1DM control (p = 0.4). In conclusion, these sociodemographic factors should be considered when caring for children with T1DM in French Guiana. Full article

Anopheles darlingi is a major malaria vector in South America. Understanding its population dynamics is critical for designing effective vector control strategies. While various Anopheles collection methods exist, they may sample distinct populations. Microsatellite genotyping across nine loci was performed to characterize An. darlingi populations, which were collected in French Guiana between 6:30 p.m. and 7:00 a.m. using human landing catch (HLC) or Mosquito Magnet^® (MM) traps. Traps were arranged in a 3 × 3 Latin square design to minimize possible effects of geographical position. Pairwise F_ST index and discriminant analyses of principal components (DAPC) were used to make comparisons. A total of 431 An. darlingi were analyzed. No significant genetic differentiation was observed between collection methods or time slots (F_ST values non-significant, p > 0.25), with DAPC revealing a single genetic cluster. Despite documented phenotypic variations, no significant population structure was detected among An. darlingi sampled in a rural village in French Guiana via collection methods or time slots. These findings confirm that mosquitoes collected with these various methods or time slots are suitable for the molecular studies of An. darlingi in French Guiana. In this context, Mosquito Magnet^® traps could also represent an alternative to the now controversial human landing catch. Full article

The Amazonian forests located within the Guiana Shield store above-average levels of biomass per hectare. However, considerable uncertainty remains regarding carbon stocks in this region, mainly due to limited inventory data and the lack of spatial datasets that account for factors influencing variation among forest types. The present study investigates the spatial distribution of original total forest biomass in the state of Amapá, located in the northeastern Brazilian Amazon. Using data from forest inventory plots, we applied geostatistical interpolation techniques (kriging) combined with environmental variables to generate a high-resolution map of forest biomass distribution. The stocks of biomass were associated with different forest types and land uses. The average biomass was 536.5 ± 64.3 Mg ha⁻¹ across forest types, and non-flooding lowland forest had the highest average (619.1 ± 38.3), followed by the submontane (521.8 ± 49.8) and the floodplain (447.6 ± 45.5) forests. Protected areas represented 84.1% of Amapá’s total biomass stock, while 15.9% was in agriculture and ranching areas, but the average biomass is similar between land-use types. Sustainable-use reserves stock more biomass (40%) than integral-protection reserves (35%) due to the higher average biomass associated with well-structured forests and a greater density of large trees. The map generated in the present study contributes to a better understanding of carbon balance across multiple spatial scales and demonstrates that forests in this region contain the highest carbon stocks per hectare (260.2 ± 31.2 Mg ha⁻¹, assuming that 48.5% of biomass is carbon) in the Amazon. To conserve these stocks, it is necessary to go further than merely maintaining protected areas by strengthening the protection of reserves, restricting logging activities in sustainable-use areas, promoting strong enforcement against illegal deforestation, and supporting the implementation of REDD+ projects. These actions are critical for avoiding substantial carbon stock losses and for reducing greenhouse-gas emissions from this region. Full article

Background/Objectives: This study aimed to estimate the proportion of pediatric emergency admissions related to sickle cell disease. Methods: This is a cross-sectional study. The data were collected over a period of 9 years, from 1 January 2014 to 31 December 2022. Results: We recorded 858 emergency department visits related to sickle cell disease out of a total of 135,000 pediatric emergency department visits, giving a prevalence of 6.4 per 1000 children aged up to 18 years. The median age was 12 years (8–16) years. The average waiting time in the emergency department for children with sickle cell disease was 2 h (±1) in 2014 and 45 min (±15) in 2022. Children with sickle cell anemia were more likely than others to have been seen by a consultant in an emergency department. The most commonly associated pathology was asthma, with a frequency of 17%. The risk factors for hospitalization were an age between 5 and 10 years and a severe form of sickle cell disease. Conclusions: The treatment of pain and fever were often delayed. This leads us to suggest that systematic prior communication between the pediatric hematologist and the emergency physician is crucial. However, there is a need to define best practices for the management of children with sickle cell disease presenting to the emergency department with a fever. Full article

Snakebite represents a significant public health challenge in Central and South America, with Lachesis (Bushmaster) species posing unique clinical challenges due to their severe envenomation effects arising from a combination of potent venom and copious venom yields. Using in vitro coagulation assays, we analyzed the coagulotoxic venom effects from four distinct localities: L. muta from Surinam and French Guiana and L. stenophrys from Costa Rica and Panama. This study examined the venom’s impact on human plasma and fibrinogen and evaluated the efficacy of two regionally available antivenoms (PoliVal-ICP and Antivipmyn-Tri) in neutralizing the pathophysiological effects. Our results demonstrated a remarkable consistency in the pseudo-procoagulant venom activity (also known as: thrombin-like) across different species and localities. Antivenom efficacy testing revealed that both the PoliVal-ICP and Antivipmyn-Tri antivenoms effectively neutralized the venom effects across localities for both species, with the ICP antivenom showing the highest neutralization capacity. These toxicology findings highlight the biochemical conservation of venom composition across Lachesis species which underpins effective cross-neutralization in antivenom treatment. Full article

Cetacean morbillivirus (CeMV) is a major threat to cetaceans worldwide, causing individual deaths and outbreaks of mass mortality. Based on partial sequences of the viral phosphoprotein, CeMV is subclassified into seven strains and two distinct lineages. To date, only CeMV-1 strains, including the dolphin morbillivirus (DMV), have been completely sequenced. The CeMV-2 lineage was first reported in Guiana dolphins (Sotalia guianensis) in Brazil and was associated with an unusual mortality event in 2017–2018. Here we provide the nearly complete Guiana dolphin morbillivirus (GDMV) genome sequence, representing the first within the CeMV-2 lineage. GDMV was isolated using Vero.DogSLAMtag cells, the viral RNA was extracted, and deep sequencing analysis was performed. Gaps in the viral genome were completed by Sanger sequencing. The final genome length was 15,607 nucleotides covering 99.3% of the DMV reference genome, including full sequences of the six structural proteins encoded by morbillivirus. The sequence similarity was 74–77.9% to other CeMV strains, with highest identity to the DMV. The complete L protein amino acid sequence comparison-based taxonomy indicates that GDMV is a distinct morbillivirus species; however, as GDMV and CeMV-1 strains infect a similar host spectrum, our findings support that GDMV represents a new CeMV-2 lineage. Full article

Background: Dengue virus type 2 (DENV2) is endemic to hyperendemic in the French territories of the Americas (FTAs), including French Guiana, Guadeloupe, Martinique, Saint-Barthelemy, and Saint-Martin. In 2023–2024, French Guiana, Martinique, and Guadeloupe experienced unprecedented dengue epidemics partly associated with this serotype. In response, we conducted a retrospective study of the diversity of DENV2 strains circulating in the FTAs from 2000 to 2024. Methods: To this end, we selected DENV2 samples from the collection at the National Research Center for Arboviruses in French Guiana (NRCA-FG) and sequenced them using Oxford Nanopore Technologies (ONT)-based next-generation sequencing (NGS). Results: Phylogenetic analysis revealed that (i) the 77 DENV2 sequences from the FTAs belong to two distinct genotypes—Asian American and Cosmopolitan; (ii) from the 2000s up to the 2019 epidemic in French Guiana, all sequenced strains belonged to the Asian American genotype; (iii) and from 2019 to 2020, strains circulating in Martinique and Guadeloupe belonged to the Cosmopolitan genotype, specifically the Indian subcontinent sublineage, while (iv) strains from the 2023–2024 outbreak in Martinique, Guadeloupe, and French Guiana fall within a distinct sublineage of the same genotype—Other Cosmopolitan. Additionally, we analyzed amino acid (AA) changes in FTA sequences compared to the Dengvaxia^® and Qdenga^® vaccines. The analysis of amino acid changes in FTA sequences compared to the vaccines (Dengvaxia^® and Qdenga^®) identified 42 amino acid changes in the prM/E regions (15 in the prM region and 27 in the E region) relative to CYD-2 Dengvaxia^® and 46 amino acid changes in the prM/E regions relative to Qdenga^®, including 16 in the prM region and 30 in the E region. Some of these AA changes are shared across multiple genotypes and sublineages, with 8 substitutions in the prM region and 18 in the E region appearing in both analyses. This raises questions about the potential impact of these changes on vaccine efficacy. Conclusion: Overall, these findings provide a current overview of the genomic evolution of DENV2 in the FTA, which is crucial for developing more effective prevention and control strategies and for selecting future vaccines tailored to circulating strains. Full article

The present study investigates the potential capacity of fungi for the use in mercury (Hg) leaching and immobilization during the dissolution of cinnabar ore, the updated understanding of the mechanisms involved, and the evaluation of Hg absorption by these fungal strains. Two fungal strains are isolated from Hg-polluted soils in French Guiana and identified as Trichoderma koningiopsis and Talaromyces verruculosus. These fungal strains possess a high capacity for Hg resistance. The Hg concentrations causing 50% growth reduction (EC₅₀) are 5.9 and 1.5 ppm for T. koningiopsis and T. verruculosus, respectively. The results of medium-culture-containing cinnabar ore show that these fungal strains remove over 99% of the Hg content in the culture media by the end of the experiment. Fungal biomass decreases with increasing mercury concentration. The production of organic acids by fungi is observed for both fungal strains, leading to an acidic pH in the medium culture. Oxalic and citric acids are preferentially produced to dissolve Fe from minerals, which may impact Hg leaching. The results of this study provide evidence that the two fungi seem to have potential use for the bioremediation of Hg during the dissolution of cinnabar ores through biosorption mechanisms. Full article

Anesthesiology, the medical specialty that deals with the management of vital functions in patients undergoing surgery, has played an important role in the successful development of cardiac interventions worldwide. Tracing the historical roots of cardiac anesthesia and critical care from its inception in the late 1950s, a paradigm shift in perioperative care has been driven by a better understanding of the mechanisms of organ dysfunction in stressful conditions and technological advances regarding surgical approach, patient monitoring, and organ protection. Although progress in cardiac anesthesia and critical care lagged a little behind in Caribbean territories, successful achievements have been accomplished over the last forty years. Compared with Western countries, the greater prevalence of obesity, diabetes mellitus, and hypertension as well as specific diseases such as cardiac amyloidosis, sickle cell anemia, rheumatic heart disease, and tropical infections may reduce a patient’s physiologic reserve and increase the operative risk among the multi-ethnic population living in the French West Indies and Guiana. So far, cardiac anesthesiologists at the University Hospital of Martinique have demonstrated their abilities in implementing evidence-based clinical care processes and adaptating to efficiently working in a complex environment interacting with multiple partners. Attracting specialized physicians in dedicated cardiac surgical centers and the creation of a regional health network supported by governmental authorities, insurance companies, and charitable organizations are necessary to solve the unmet needs for invasive cardiac treatments in the Caribbean region. Full article

Brazilian garimpeiros are a highly hard-to-reach and mobile population, with little access to basic hygiene and health services, and have been crossing the border to work irregularly in gold mines in French Guiana since the 1990s. This study aimed to characterize this population and identify their main health problems. A cross-sectional study was carried out in the municipality of Oiapoque-AP, with two surveys: before (2018) and after (2019) the implementation of Malakit. Individuals were recruited from resting places and given a questionnaire regarding demographic variables, history and knowledge of malaria, and health issues in the mines. Simultaneously, a clinical evaluation was performed. The garimpeiros were mainly men from Maranhão, Pará, and Amapá, with a low educational level and who had worked on average for 10 years in the mining sites. The study population mentioned numerous health problems: malaria, followed by leishmaniasis, flu, body aches, headaches, and digestive problems. Other diseases mentioned were skin diseases, bat bites, hepatitis, and HIV infection. This vulnerable population is constantly subjected to heavy routines and exposed to different diseases and infections that can spread across borders. Knowledge of this is essential for developing public health policies that can be integrated into specific epidemiological situations. Full article

Background/Objectives: The overall incidence of asthma in children with sickle cell disease in French Guiana is unknown. Asthma is common in children with sickle cell disease and is associated with increased morbidity and mortality. This study aimed to describe the impact of asthma on the occurrence of acute chest syndrome in children with sickle cell disease who were followed up in French Guiana. Methods: We performed a multicenter nested case-control study between January 2012 and December 2022. Our study population consisted of children, aged between 6 months and 18 years, who were diagnosed with sickle cell disease at birth and hospitalized at least once for acute chest syndrome during the study period. Results: A total of 588 children were followed up for sickle cell disease. Of these, 390 had sickle cell disease, 180 had SC, and 18 had Sβ + thalassemia. Of the 390-sickle cell disease, we identified 35 who also had asthma, giving an estimated prevalence of asthma of 8.9% among children with sickle cell disease in French Guiana. Only asthma was significantly associated with acute chest syndrome (p < 0.001). Conclusions: The prevalence of asthma in children with sickle cell disease is underestimated. Asthma is an independent risk factor for acute chest syndrome. Given the seriousness of asthma in children with sickle cell disease, systematic screening for asthma in children with sickle cell disease has been implemented. This screening, which will be evaluated after one year, will help to better characterize asthmatic children with sickle cell disease and improve their care. Full article

We present the results of our expeditionary studies of the water structure on a section across the Guiana basin in the western part of the Atlantic Ocean in January 2022. The section corresponds to almost the shortest distance between South America’s continental slope and the Mid-Atlantic Ridge. We identified various water masses corresponding to the study area, determined their physical and chemical properties, and located their boundaries regarding the position of their properties’ maximal vertical gradients. Particular attention was paid to the components of North Atlantic Deep Water (NADW). On the section, we identified four NADW components: upper NADW with salinity maximum and minimum in silicate, two middle NADWs determined by different extremes in dissolved oxygen, and lower NADW with maximum oxygen and minimum phosphate. The lower boundary of NADW corresponds approximately to the isotherm θ = 1.6–1.8 °C. The proportion of Antarctic Bottom Water (AABW) was calculated for the bottom layer; its maximal amount was about 40% on the section. Full article

Few studies have focused on the infectious complications in kidney transplant recipients in tropical regions, particularly in the Caribbean. The primary objective of this study was to determine the incidence of bacterial, fungal, and parasitic infections in kidney transplant recipients in the French Caribbean and French Guiana. We included all patients who received a kidney transplant at the University Hospital of Guadeloupe between January 2014 and October 2016, with post-transplant follow-up in the French Caribbean. A total of 91 patients were included, of whom 57 developed an infectious event during follow-up. When infections were documented (94/111), bacterial infections were the most frequent (79/94), followed by fungal (11/94) and parasitic infections (4/94). Four cases of nocardiosis were identified (4/79). Phaeohyphomycosis was the most common fungal infection (7/11). In a multivariate analysis, the female gender and diabetes mellitus at the time of transplant were significantly associated with a higher risk of infection. This study is the first to describe the epidemiology of infections in kidney transplant recipients in the Caribbean and to analyze the potential risk factors. We reported a similar profile of bacterial infections to that which were observed in the European and American studies. However, we found a higher incidence of tropical infections, such as nocardiosis and phaeohyphomycosis, which highlights the need for heightened awareness among healthcare teams to ensure earlier and more appropriate treatment. Further studies focusing on these rare tropical infections are necessary to better understand their risk factors Full article

Muddy coastlines cover much of the world’s shores, yet studies on the interaction between mud-affected coasts and estuaries are limited. This study focuses on the Mahury River estuary and its interaction with the muddy coast of the Guianas, primarily fed by the Amazon. A coupled wave–current–sediment transport model is developed to analyze the sediment exchange in an environment with strong interactions between the waves and the fluid mud. Simulations explore how seasonal changes in waves, mud availability, and tides affect sediment fluxes. The main processes influencing suspended particulate matter (SPM) and sediment transport are well emulated, notwithstanding the complexity of the ambient muddy environment. The results show that during the rainy season, strong wave damping and wave refraction zones cause high SPM resuspension in shallow waters (<5 m). In contrast, during the dry season, wave influence shifts to the estuary mouth. Erosion and sedimentation patterns indicate that ebb currents associated with neap tides during the rainy season represent the most favourable conditions for the alongshore migration of mud banks. Neaptide ebb currents also contribute to sedimentation during the dry season but only in the estuary mouth and the nearby coastal area. The abundance of mud leads to an extension of the estuary’s intertidal area during the dry season. Full article

On 27 May 2024, the Cuban Ministry of Health reported the first outbreak of Oropouche fever on the island. The etiologic agent, Oropouche virus (OROV), is a poorly understood arbovirus that has been known since the 1960s and represents a public health burden in Latin America. We report the whole-genome characterization of the first European OROV isolate from a returning traveler from Cuba with Oropouche fever-like symptoms. The isolate was obtained from the patient’s serum; whole-genome sequencing was performed by next-generation sequencing, followed by phylogenetic analysis and genetic variability studies. The analysis showed that the most closely related sequence was from the French Guiana 2020 outbreak. Interestingly, our isolate is a reassortant virus, included in a highly supported monophyletic clade containing recent OROV cases (Brazil 2015–Colombia 2021), separated from the other four previously known genotypes. More deeply, it was found to be included in a distinct branch containing the sequences of the Brazil 2022–2024 outbreak. The reassortment event involved the S and L segments, which have high similarity with sequences belonging to a new cluster (here defined as OROV_SCDC_2024), while the M segment shows high similarity with older sequences. These results likely describe the viral strain responsible for the current outbreak in Cuba, which may also reflect the ongoing outbreak in Latin America. Further studies are needed to understand how OROV evolves towards traits that facilitate its spread and adaptation outside its original basin, and to track its spread and evolution in the European continent. Full article