RESUMEN
The aim of this study was to determine the incidence of congenital toxoplasmosis (CT) and to assess the performances of prenatal and neonatal diagnoses. From 1994-2005, in Toulouse University Hospital, France, amniocentesis was performed on 352 pregnant women who were infected during pregnancy. All women were treated with spiramycin and pyrimethamine-sulfadoxine when prenatal diagnosis was positive. Among the 275 foetuses with follow-up, 66 (24%) were infected. The transmission rates of Toxoplasma gondii were 7%, 24% and 59% in the first, second and third trimesters, respectively. The sensitivity and specificity of PCR on amniotic fluid (AF) were 91% and 99.5%, respectively. One case was diagnosed by mouse inoculation with AF and six cases were diagnosed by neonatal or postnatal screening. The sensitivity and specificity of PCR on placentas were 52% and 99%, respectively. The sensitivity of tests for the detection of specific IgA and IgM in cord blood was 53% and 64%, respectively, and specificity values were 91% and 92%. In conclusion, PCR performed on AF had the highest levels of sensitivity and specificity for the diagnosis of CT. This permits an early diagnosis of most cases and should be recommended.
Asunto(s)
Complicaciones Parasitarias del Embarazo/diagnóstico , Toxoplasma , Toxoplasmosis Congénita/diagnóstico , Amniocentesis , Animales , Anticuerpos Antiprotozoarios/sangre , ADN Protozoario/análisis , Combinación de Medicamentos , Ensayo de Inmunoadsorción Enzimática , Femenino , Francia/epidemiología , Hospitales Universitarios , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Incidencia , Recién Nacido , Reacción en Cadena de la Polimerasa , Valor Predictivo de las Pruebas , Embarazo , Complicaciones Parasitarias del Embarazo/epidemiología , Diagnóstico Prenatal , Pirimetamina/uso terapéutico , Sensibilidad y Especificidad , Espiramicina/uso terapéutico , Sulfadoxina/uso terapéutico , Toxoplasma/genética , Toxoplasma/inmunología , Toxoplasmosis Congénita/tratamiento farmacológico , Toxoplasmosis Congénita/epidemiologíaRESUMEN
A seroepidemiologic study of human T cell lymphotrophic virus type-1 (HTLV-1) and human immunodeficiency virus (HIV) infections was carried out in Martinique among 467 pregnant women receiving prenatal care at the Martinique Department for the Protection of Motherhood and Childhood. A seroprevalence rate of 1.93% was found for HTLV-1 infection. No HIV serum marker was observed. Given the epidemiology of these viral diseases, it is suggested that serologic status should be determined for all pregnant women on this island. A further, large-scale, prospective survey of HIV seroprevalence in Martinique should be performed to confirm the results of the present study.
Asunto(s)
Infecciones por VIH/epidemiología , VIH/inmunología , Infecciones por HTLV-I/epidemiología , Virus Linfotrópico T Tipo 1 Humano/inmunología , Complicaciones Infecciosas del Embarazo/epidemiología , Adolescente , Adulto , Western Blotting , Ensayo de Inmunoadsorción Enzimática , Femenino , Anticuerpos Anti-VIH/sangre , Infecciones por VIH/sangre , Anticuerpos Anti-HTLV-I/sangre , Infecciones por HTLV-I/sangre , Humanos , Martinica/epidemiología , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Estudios SeroepidemiológicosRESUMEN
The incidence of dengue increased sharply in Martinique from the end of 1995 into 1996. Virological tests performed jointly on 36 serum samples by the Pasteur Institute in French Guyana and the Center for Disease Control in Puerto Rico led to identification of serogroups 1, 2, and 4 for six dengue virus. Between January 1995 and December 1996, the Departmental Hygiene Laboratory of Martinique carried out screening tests to detect specific IgM by the immunocapture method (MAC ELISA) in patients with suspected dengue. Results were positive in 701 of the 2,143 patients tested (32.7%). Symptoms were studied in 421 of these positive cases. The most frequent presentation was a flu-like syndrome with hyperalgia. Nausea, vomiting, joint pain, and retroocular pain were frequent. At least one clinical sign of coagulation disturbance was noted in 83 patients (19.7%). Dengue hemorrhagic syndrome was diagnosed according to the criteria of the World Health Organization in six patients including one who developed circulatory collapse and died. This fatality was the first to be reported in Martinique. The incidence of typical dengue as well as of the hemorrhagic form is probably underestimated in Martinique because specific serological tests are not routinely requested and application of WHO criteria for diagnosis of hemorrhagic forms is often impractical.
Asunto(s)
Dengue/epidemiología , Adolescente , Adulto , Niño , Preescolar , Virus del Dengue/aislamiento & purificación , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Martinica/epidemiología , Persona de Mediana Edad , Estudios Retrospectivos , Pruebas Serológicas , Dengue Grave/epidemiologíaRESUMEN
A comparison by stool examination of the prevalence of the most common digestive parasitic diseases was made between the years 1968, 1972 (results from the former Pasteur Institute of Martinique) and 1995 (results from the Departmental Laboratory of Hygiene of Martinique). This study shows that the outstanding characteristic of the dramatic decrease in the prevalence of soil-transmitted helminthiasis and intestinal schistosomiasis can be noted as early as the beginning of the seventies. An hypothesis of explanation would point to the combination of a general improvement in hygiene (due to economic growth) and an increase in drug use given the availability of efficient and well-tolerated anthelmintics, and for intestinal schistosomiasis, the impact of urbanization along with the growing scarcity of the intermediate host snail, especially as of 1983 thanks to an ecological control programme.
Asunto(s)
Parasitosis Intestinales/epidemiología , Animales , Antihelmínticos/uso terapéutico , Vectores de Enfermedades , Heces/parasitología , Helmintiasis/epidemiología , Helmintiasis/prevención & control , Helmintiasis/transmisión , Humanos , Parasitosis Intestinales/prevención & control , Parasitosis Intestinales/transmisión , Martinica/epidemiología , Esquistosomiasis/epidemiología , Esquistosomiasis/prevención & control , Esquistosomiasis/transmisión , Caracoles , SueloRESUMEN
The authors report the 3 first cases of human syngamosis due to Mammomonogamus sp. in La Guadeloupe (French West Indies). After a review of the papers published on the previous 79 world-wide cases, they point out that this parasitic disease is restricted to the West Indies/South America area, and discuss the problem of the contamination mode; they claim that chronic cough is a constant signal symptom which suggests syngamosis in subjects who are native from, or have travelled in the endemic area.
Asunto(s)
Infecciones por Strongylida/epidemiología , Adulto , Femenino , Humanos , Indias OccidentalesRESUMEN
The examination of women's 2,550 sera in Martinique (French West Indies) showed the infestation by Toxoplasma gondii was very important, for 81.5% of this population sample have fluorescent antibodies, and 84.5% haemagglutinating antibodies. Moreover, the rates of infestation observed in northern localities of the island are significantly higher than in southern ones: the intervention of climatic factors favoring the survival of the oocysts in the external environmental has to be considered, seeing that the feeding habits are identical in the whole island.