RESUMO
A regular implementation of prophylactic and therapeutic decision trees was organized on a consensus basis in Cayenne, French Guiana in 1990, 1995 and 2002. The updated recommendations were based on the knowledge of the in vitro chemosensitivity profiles of the local isolates, mainly coming from big rivers (Maroni and Oyapock, frontiers with Suriname and Brazil, respectively; and more recently Approuague). Most of the patients infected by Plasmodium falciparum were followed by the medical staff of the main hospitals (Cayenne and Saint-Laurent) and of the peripheral health centers in remote areas. Consequently the epidemiological situation and evolution of chemoresistance have been widely observed on a long-term (since 1994) basis in the Maroni region. Yet, we have only partial information coming from the Oyapock valley, even though an important (most of the time) illegal immigration has been developing since the 90s' leading to a notable modification of the epidemiological status of malaria in this eastern region, including a regular increase of P. vivax infections. Presently very little P. vivax chloroquine (and mefloquine) resistance has been identified but this result could lead to a real public health problem in a near future. As such, the National Reference Center on Plasmodium Chemoresistance in the French West Indies and Guiana (CNRCP-AG in French) is a unique observatory of malaria chemoresistance in the Guyanese shield which works with research laboratories of the Institut Pasteur, Paris. This network strategy offers a very attractive perspective for applications of modern tools, including the validation of chemoresistance molecular markers, for malaria control at both medical and public health levels. Some examples related to chloroquine and artemether resistance are given.
Assuntos
Antimaláricos/farmacologia , Resistência a Medicamentos , Malária Falciparum/epidemiologia , Malária Vivax/epidemiologia , Plasmodium falciparum/efeitos dos fármacos , Plasmodium vivax/efeitos dos fármacos , Sistema de Registros , Animais , Antimaláricos/uso terapêutico , Surtos de Doenças , Resistência a Medicamentos/genética , Resistência a Múltiplos Medicamentos/genética , Doenças Endêmicas , França , Guiana Francesa/epidemiologia , Guiana/epidemiologia , Humanos , Centros de Informação/organização & administração , Cooperação Internacional , Malária Falciparum/tratamento farmacológico , Malária Falciparum/parasitologia , Malária Vivax/tratamento farmacológico , Malária Vivax/parasitologia , Fitoterapia , Plasmodium falciparum/genética , Plasmodium vivax/genética , Saúde Pública , Suriname/epidemiologiaRESUMO
A malaria investigation in the 1970-1986 period in French Guiana shows an increased plasmodium index (4.6%) when compared with the data of the 1970-1979 decade (2.7%), an incidence rate of 8.6 per 1,000 inhabitants (against 6.4 previously) and always a high frequency of P. falciparum (85%). The principal vector, A. darlingi, still remains sensitive to DDT but the authors recommend an updating of the anti-vectorial program control. A longitudinal serologic survey, on the school children during two years, shows the epidemiologic value of an immunological index. Its permits to precise the annual dynamic of malaria transmission and to distinguish in French Guiana three areas: a forest area with apparently permanent transmission, an hypo-endemic area with episodic transmission and a sporadic transmission area.
Assuntos
Malária/epidemiologia , Animais , Anopheles/parasitologia , Anticorpos Antiprotozoários/isolamento & purificação , Criança , Demografia , Feminino , Guiana Francesa/epidemiologia , Humanos , Controle de Insetos , Insetos Vetores , Estudos Longitudinais , Malária/prevenção & controle , Masculino , Plasmodium falciparum/imunologia , Plasmodium falciparum/isolamento & purificaçãoRESUMO
Following the hypothesis that Leishmania parasites escape the host defence mechanisms by mimicry of human blood group antigens, conflicting reports have been published. We tested the hypothesis in American cutaneous leishmaniasis, due to L. braziliensis guyanensis, by comparing the distribution of blood groups (ABO and Rhesus) among 96 patients in French Guiana with that among 1945 healthy controls. No association between blood groups and disease was found in this study, but further studies are needed with strains of the L. mexicana complex.
Assuntos
Antígenos de Grupos Sanguíneos , Leishmaniose/sangue , Sistema ABO de Grupos Sanguíneos , Animais , Guiana Francesa , Humanos , Leishmania braziliensis , Microcomputadores , Sistema do Grupo Sanguíneo Rh-Hr , SoftwareAssuntos
Doença de Chagas/veterinária , Reservatórios de Doenças , Marsupiais/parasitologia , Triatominae/parasitologia , Animais , Animais Domésticos/parasitologia , Animais Selvagens/parasitologia , Comportamento Animal , Doença de Chagas/epidemiologia , Comportamento Alimentar , Guiana Francesa , Humanos , Mamíferos/parasitologia , População Rural , Trypanosoma cruzi/isolamento & purificaçãoRESUMO
A biochemical and immunological survey of a selected military group has been performed, before and after a jungle raid. Biochemical (total proteins, albumin, proteins electrophoresis, transferrin, haptoglobin, ceruloplasmin, orosomucoid, alpha-1 antitrypsin and alpha-2 macroglobin) and immunological (Ig G., Ig A., C 3c, C 4, specific antibodies against Leishmania) analysis of sera have been studied as well as the level of cellular immunity (Multitest scoring, macrophage cytotoxicity, interleukin-1 and prostaglandin E-2, macrophage production). The results show some modifications as a consequence of the work in tropical forest, particularly the tendency to some cellular immunity deficiency. This can be linked to several factors: nutritional balance, cutaneous infections, sustained physical activity and excessive sweating.
Assuntos
Militares , Medicina Tropical , Animais , Anticorpos Antiprotozoários/análise , Eletroforese das Proteínas Sanguíneas , Guiana Francesa , Geografia , Humanos , Hipersensibilidade Tardia/imunologia , Imunidade Celular , Leishmania braziliensis/imunologia , Estado NutricionalRESUMO
The study of relationships between Phlebotomine sandflies and different species of trees, 0 to 1.5 m above ground, was carried out in the French Guiana forest. We found that certain forest trees are more propitious than others to the development or maintenance of certain leishmaniasis vectors. Lu. umbratilis, vector of Leishmania braziliensis guyanensis, represents between 28 and 88% of samples collected on trunks. The association of Lu. umbratilis and Lu. rorotaensis represents between 58 and 98% Lu. flaviscutellata, vector of Leishmania mexicana amazonensis, frequently caught on humans, was not found on tree trunks.