RESUMO

BACKGROUND: French Guiana is the French department most affected by HIV. The situation in Western French Guiana is complicated by the transborder context and isolation of many patients. This study aims to describe the epidemiological characteristics of children born to mothers living with HIV followed in Western French Guiana. METHODS: This was a retrospective and descriptive study. All children born to HIV-infected mothers between 2014 and 2018 were included. Data were collected using a survey sheet to generate an Excel database. RESULTS: We recorded 177 newborns exposed to maternal HIV, four of whom (2.26 %) were infected. The majority of women (87 %) were of foreign origin, and only 7 % had conventional health insurance coverage. The infection was discovered during pregnancy in 20 % of women. Overall 21.71 % of newborns were preterm and 22.5 % hypotrophic. All neonates had received antiretroviral prophylaxis for four weeks, either as monotherapy (AZT) (67.43 %) or triple therapy (AZT/3TC/NVP) (25.71 %). Twenty-two neonates had at least one neonatal illness: transient respiratory distress (9 cases), asphyxia (3 cases), hyaline membrane disease (8 cases), and there were two cases with birth defects: clubfoot (1 case) and heart disease (1 case). The follow-up rate at 24 months was 65 % and 35 % of cases were lost to follow-up. The most common biological anomalies were anemia (69.14 %), hyperlacticaemia (23 %), and neutropenia (9.14 %). CONCLUSION: The prevalence of mother-to child transmission of HIV was high; a quarter of maternal infections were discovered during pregnancy. The mother's socio-economic situation was often precarious and follow-up interruptions common.

Assuntos

RESUMO

This descriptive observational study aims to describe the epidemiological profile of children hospitalized for burns in Guyana, a French district which does not have a burn treatment centre, and direct prevention towards the populations most at risk. Retrospective analysis of 665 hospitalizations was made thanks to the coding of patients aged 0 to 18, hospitalized for burns between January 2010 and December 2022 at Cayenne Hospital Centre. Univariate and multivariate descriptive analyses were carried out on age, sex, municipality of origin, date of burn, duration of hospitalization, mode of burn, location, percentage and depth of burn. A total 416 children with "burn" coding were hospitalized over this period and 358 patients were included. Burns were more common in males (58%) and in children under 6 (75%). A majority of patients were townspeople and lived on the coast (70%). 9.5% of patients were transferred to Trousseau Hospital in Paris for more specialized care. 61% of burns were caused by hot water and 16.5% by flames. Duration of hospitalization was on average 8 days and the burnt skin surface was 9.5%. Children under 2 years old living in Cayenne and its suburbs are the most at risk of burns, but the most serious burns requiring a transfer to Paris are found in children over 3 years old living on the Maroni River and playing with flammable products.

RESUMO

INTRODUCTION: French Guiana is a French overseas territory in South America, marked by poverty and inequalities. Access to different services, including healthcare, is unequal depending on where people live. Several studies showed that among adults, the most precarious individuals had greater incidences of chronic and infectious diseases. Although the median age of the population living in this territory is 25, there is no specific focus on the pediatric population although it is documented that socioeconomic inequalities have an impact on child health. The objective of this scoping review is to shed light on health challenges concerning children living in French Guiana. METHODS: A literature search was performed on PubMed to identify relevant articles, and additional references were added if within the scope of this review. RESULTS: A total of 106 publications were reviewed. Perinatal health issues were linked to a high rate of teenage pregnancies with poor medical follow-up leading to complications such as preterm deliveries and congenital malformations and abnormalities. Infectious diseases were a significant burden with worrisome vaccination coverage figures for some bacterial infections, partly explaining a high mortality rate attributable to infectious diseases. Herbicide poisoning with paraquat was reported in children, and environment-related concerns such as wild animal attacks as well as lead and mercury exposure were reported. Some children living in remote Amerindian communities had a higher suicide rate than in mainland France, and chronic diseases such as sickle cell disease were reported to have more transfusion-related complications. CONCLUSION: Children living in French Guiana have worse pediatric health indicators in comparison with children from mainland France.

Assuntos

RESUMO

BACKGROUND: This study aims to assess the neonatal outcomes related to maternal SARS-COV-2 infection. METHODS: In this study, we identified newborns born between May 14 and August 31, 2020, to mothers who were PCR-SRAS-CoV-2 positive at the time of delivery. From the cohort of 974 infants, we performed a nested case-control study. RESULTS: During the study period, 133 (13.7%) mothers were positive for SARS-CoV-2. Among the 35 pregnant women with COVID-19 symptoms (26.3%), cough was the most common symptom, present in half of the cases. Four of them have progressed to critical pneumonia requiring transfer to intensive care unit. The neonates from mothers with positive SARS-CoV-2-RT-PCR, were routinely tested for COVID-19 within the first 24 h after labor, and 3 other newborns tested in the presence of symptoms. There was no significant difference between the two groups with respect to preterm birth, meconium-stained amniotic fluid distress, and neonatal asphyxia. Most infants were breastfed at birth, regardless of their mothers' COVID-19 status. In COVID-19-positive pregnant women admitted to intensive care unit, the proportion of preterm births (OR=12.5 [1.7-90.5]), fetal death in utero (OR=25.9 [2.2-305]) and admission in neonatal intensive care unit admission (OR=13.4 [3.0-60]), appeared higher than the controls. No maternal deaths were recorded. CONCLUSIONS: Our data suggest little neonatal morbidity associated with maternal COVID-19, except for those born to mothers admitted to intensive care unit. However, under breastfeeding conditions with rigorous hygiene precautions and parental education, the risk of transmission of SARS-COV-2 virus to the newborn was very low.

Assuntos

RESUMO

Multifocal tuberculosis in a child is rare event. Here we report a case of multifocal tuberculosis revealed by spinal tuberculosis in an eleven-year-old French Guianese girl. This observation underlines the difficulties, the consequences of delay, and the necessity of an early diagnosis of this disease for children.

Assuntos

RESUMO

OBJECTIVE: Controlling vaccine-preventable infectious diseases is a public health priority in French Guiana but there is currently no epidemiological data on pediatric bacterial meningitis in this overseas department. Our aim was to describe data related to pediatric bacterial meningitis in French Guiana and compare it with that of metropolitan France. METHODS: We conducted a multicenter retrospective study from 2000 to 2010 to describe the clinical picture, biological data, epidemiology, and outcome of pediatric bacterial meningitis case patients in French Guiana. RESULTS: The median age of bacterial meningitis patients was 6months [0-15] and the sex ratio 1.06. We observed a total of 60 bacterial meningitis case patients. Most presented with pneumococcal meningitis (24 patients; 40%); 11 with Haemophilus influenzae type b meningitis (23%), five with group B streptococcal meningitis (8.5%), and five others (8.5%) with staphylococcal meningitis (three patients presented with coagulase-negative staphylococci and two with Staphylococcus aureus). Only one patient presented with group B meningococcal meningitis, an 18-month-old infant. We recorded 14 deaths (overall case fatality: 23%); eight were due to Streptococcus pneumoniae (case fatality: 33%). The overall sequelae rate was 28%. It was 32% for patients presenting with pneumococcal meningitis. We observed that 38% of children who had never been vaccinated were infected by a vaccine-preventable bacterium. We observed many differences in the distribution of the bacteria and in the patients' prognosis when comparing the French Guiana data with that of metropolitan France. CONCLUSION: Improving vaccination coverage would decrease the incidence of H. influenzae meningitis.

Assuntos