Case report: French West Indies - a tourist destination at risk for Plasmodium falciparum transmission?
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We report a case of P. falciparum infection observed in Paris and presumably acquired in Guadeloupe, a French Caribbean island where malaria has been considered to be eradicated since 1970. (+info)
Tuberculosis in the Caribbean: using spacer oligonucleotide typing to understand strain origin and transmission.
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We used direct repeat (DR)-based spacer oligonucleotide typing (spoligotyping) (in association with double-repetitive element polymerase chain reaction, IS6110-restriction fragment length polymorphism [RFLP], and sometimes DR-RFLP and polymorphic GC-rich sequence-RFLP) to detect epidemiologic links and transmission patterns of Mycobacterium tuberculosis on Martinique, Guadeloupe, and French Guiana. In more than a third of the 218 strains we typed from this region, clusters and isolates shared genetic identity, which suggests epidemiologic links. However, because of limited epidemiologic information, only 14.2% of the strains could be directly linked. When spoligotyping patterns shared by two or more isolates were pooled with 392 spoligotypes from other parts of the world, new matches were detected, which suggests imported transmission. Persisting foci of endemic disease and increased active transmission due to high population flux and HIV-coinfection may be linked to the recent reemergence of tuberculosis in the Caribbean. We also found that several distinct families of spoligotypes are overrepresented in this region. (+info)
Type 2 diabetes mellitus: association study of five candidate genes in an Indian population of Guadeloupe, genetic contribution of FABP2 polymorphism.
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We studied by PCR-RFLP 6 polymorphisms in these 5 candidate genes: Ala54Thr in the fatty acid binding protein 2 gene (FABP2), A to G substitution in the uncoupling protein type 1 gene (UCP1), Asp905Tyr in the protein phosphatase type 1 gene (PP1G), Trp64Arg in the human beta 3 adrenergic receptor gene (beta 3AR) and 2 RFLP sites of the vitamin D receptor (VDR) gene (VDRTaq1 and VDRApa1). This study was conducted among 89 cases and 100 controls matched according to age, gender and absence of first degree family link (11 triplets with 2 controls for 1 case and 78 pairs with 1 control for 1 case). Cases and controls were taken among a sample of 429 individuals selected for the study of the prevalence of diabetes in this ethnic group from Guadeloupe. By conditional logistic regression analysis, there was a significant relation (p = 0.02) between the Ala54Thr FABP2 polymorphism and Type 2 DM. Multivariate analysis discriminate the FABP2 polymorphism (p = 0.10), a triglyceridemia over 2 g/l (p < 10(-3)) and high blood pressure (p = 10(-2)) as variables associated with Type 2 DM in this population. These findings suggest that FABP2 does not represent a major gene for Type 2 DM in this migrant Indian population living in Guadeloupe, but seems to be related to the metabolic insulin resistance syndrome. (+info)
Cardiovascular risk factors associated with diabetes in an Indian community of Guadeloupe. A case control study.
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Indians of Guadeloupe have an especially high prevalence type 2 diabetes mellitus and a particular susceptibility to coronary heart disease. This case-control study conducted from September 15 to 24, 1997, analysed cardiovascular risk factors associated with diabetes and particularly dyslipidaemia in the Indian community of Guadeloupe. The 172 subjects included 86 diabetic patients of Indian origin and 86 age- and sex-matched non-diabetic controls. All subjects underwent a physical examination by the same observer. Obesity and hypertension were assessed, and fasting lipid concentrations were measured. The body mass index and waist-to-hip ratio were higher among patients than controls: 27.8 vs 25.1 Kg/m2 (p < 0.001) and 0.94 vs 0.90 (p < 0.001). Mean arterial systolic and diastolic pressures were higher for patients than controls (p < 0.001). Median HDL-cholesterol was 1.23 mmol/L for patients vs 1.4 mmol/L for controls (p < 0.001), and median triglycerides were 2.0 vs 1.3 mmol/L (p < 0.001). Mean apolipoprotein B was 1.40 +/- 0.36 g/L for patients vs 1.23 +/- 0.35 g/L for controls (p < 0.001). Our results show slight hypertension, central obesity, a lower plasma HDL-cholesterol concentration, a higher triglyceride concentration, and a higher apolipoprotein B concentration for diabetics. These data would appear to have important implications for the prevention of cardiovascular disease in this population. (+info)
A molecular epidemiological study of Mycobacterium simiae isolated from AIDS patients in Guadeloupe.
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A molecular epidemiological study of Mycobacterium simiae strains isolated from AIDS patients in Guadeloupe was performed by the random amplification of polymorphic DNA (RAPD) and pulsed-field gel electrophoresis (PFGE) of DraI- or XbaI-digested bacterial DNAs. A comparison of RAPD profiles suggested a similarity of banding patterns within a group of patients (two clusters of two and three patients), but the available epidemiological and clinical information did not support this finding. PFGE, on the other hand, showed that all the patients were contaminated with individual isolates. Combined numerical analysis performed by compiling the PFGE patterns obtained after XbaI and DraI digestions of bacterial DNAs suggested the occurrence of polyclonal infection in three of nine patients. Our results do not support a common source of M. simiae infection in Guadeloupe. (+info)
Lipid profile in an adult population in Guadeloupe.
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The purpose of this study was to provide data on lipid distribution and to investigate the association between hypercholesterolemia and other factors. A cross-sectional survey of insured subjects in an Health Center of Guadeloupe in 1999. Data from a consecutive series of 1 010 individuals aged 18 years and older, collected during a 3 month-period, were used. Standardized interviews and measurements of blood lipid abnormalities and other cardiovascular risk factors were carried out. Overall, 27% had elevated total cholesterol (TC) levels above 200 mg/dL, 11.7% had TC levels above 240 mg/dL, 18.1% had LDL-C levels above160 mg/dL, 12.5% had HDL-C below 35 mg/dL and 2.7% had triglyceride levels above 200 mg/dL. Isolated low HDL-C was found in 22% of the subjects and 10.8% had both TC above 240 mg/dL and LDL-C above 160 mg/dL. Only 22% of the subjects with high TC were aware of their diagnosis and 5% were treated. The risk of having hypercholesterolemia above 200 mg/dL was independently and significantly higher in case of hypertension, age above 45 in men or 55 in women, body mass index above 30 and familial history of dyslipidemia. These findings document the first report on dyslipidemia in Guadeloupe. It showed that the prevalence of hypercholesterolemia and hypertriglyceridemia was lower than in developed countries, but markedly higher than in Africa. Modifications of lifestyle and adapted therapeutics are necessary to decrease cardiovascular mortality. (+info)
Rickettsia africae, a tick-borne pathogen in travelers to sub-Saharan Africa.
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BACKGROUND: African tick-bite fever occurs after contact with ticks that carry Rickettsia africae and that parasitize cattle and game. Sporadic reports suggest that this infection has specific clinical and epidemiologic features. METHODS: We studied patients who were tested for a rickettsial disease after returning from a visit to Africa or Guadeloupe. To assess the value of the microimmunofluorescence assay, Western blotting, and cross-adsorption assays, we compared the results of these tests in 39 patients in whom African tick-bite fever had been confirmed by the polymerase-chain reaction assay, cell culture, or both; 50 patients with documented R. conorii infection; and 50 blood donors. These diagnostic criteria were then applied to 376 additional patients who had returned from southern Africa and 2 who had returned from Guadeloupe and whose serum was being tested for rickettsial disease. RESULTS: In the 39 patients with direct evidence of R. africae infection, the combination of microimmunofluorescence assay, Western blotting, and cross-adsorption assays showing antibodies specific for R. africae had a sensitivity of 0.56; however, each test had a positive predictive value and a specificity of 1.0. An additional 80 patients were found to have an R. africae infection on the basis of these serologic criteria. Infections with R. africae were acquired by visitors to 11 African countries and Guadeloupe. The illness was generally mild and was characterized by a rash in 46 percent of the patients; the rash was usually maculopapular or vesicular and rarely purpuric. Ninety-five percent of patients had an inoculation eschar or eschars, and 54 percent of these patients had multiple eschars, a finding that is unusual in patients with rickettsial infection. CONCLUSIONS: In this series, R. africae was the cause of nearly all cases of tick-bite rickettsiosis in patients who became ill after a trip to sub-Saharan Africa. (+info)
Guadeloupean parkinsonism: a cluster of progressive supranuclear palsy-like tauopathy.
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An unusually high frequency of atypical Parkinson syndrome has been delineated over the last 5 years in the French West Indies. Postural instability with early falls, prominent frontal lobe dysfunction and pseudo-bulbar palsy were common and three-quarters of the patients were L-dopa unresponsive. One-third of all patients seen had probable progressive supranuclear palsy (PSP). This new focus of atypical parkinsonism is reminiscent of the one described in Guam and may be linked to exposure to tropical plants containing mitochondrial complex I inhibitors (quinolines, acetogenins, rotenoids). Two hundred and twenty consecutive patients with Parkinson's syndrome seen by the neurology service at Pointe a Pitre, Guadeloupe University Hospital were studied. Currently accepted operational clinical criteria for Parkinson's syndromes were applied. The pathological findings of three patients who came to autopsy are reported. Fifty-eight patients had probable PSP, 96 had undetermined parkinsonism and 50 had Parkinson's disease, 15 had amyotrophic lateral sclerosis with parkinsonism and one had probable multiple system atrophy. All three PSP patients in whom post-mortem study was performed had early postural instability, gaze palsy and parkinsonian symptoms, followed by a frontolimbic dementia and corticobulbar signs. Neuropathological examination showed an accumulation of tau proteins, predominating in the midbrain. There was an exceptionally large accumulation of neuropil threads in Case 1. Biochemical studies detected a major doublet of pathological tau at 64 and 69 kDa in brain tissue homogenates. All cases were homozygous for the H1 tau haplotype, but no mutation of the tau gene was observed. Clinical, neuropathological and biochemical features were compatible with the diagnosis of PSP, although some unusual pathological features were noted in Case 1. A cluster of cases presenting with atypical parkinsonism is reported. Guadeloupean parkinsonism may prove to be a tauopathy identical or closely related to PSP. (+info)