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PubMed1985

Field trials of preventive regimens in Thailand and French Polynesia.

Field demonstration trials of preventive agents or methods are needed so that the effectiveness and acceptability of such methods can be evaluated when used as part of the prevailing system and life style in a particular community. Agents so tested should have already been shown in a clinical trial to have a positive effect. Field demonstration trials differ from clinical trials in having no traditional control group; the study is not 'blind'; there is no special supervision and there is no special selection of participants. Results of two field demonstration trials, one in a population in Thailand with moderate but increasing caries severity and the other in French Polynesia, where caries severity is very high, are reported. The trials compared the effectiveness of various chewing gum formulations with the effectiveness of a fortnightly supervised sodium fluoride rinse. One gum formulation contained fluoride and was sweetened with sucrose or xylitol and sorbitol, the other was fluoride free and was sweetened with xylitol and sorbitol. The important information from these field trials is that a fluoride-containing chewing gum sweetened with xylitol/sorbitol appears to be effective in controlling caries experience even in communities apparently experiencing an increase of the disease; and that the apparent effectiveness was achieved in a field situation subject to all the problems of a programme not under a rigid clinical trial type of control. The fluoride-containing chewing gum-sucrose regime, in both the trials, and the non-fluoride chewing gum-xylitol/sorbitol regime in the French Polynesia trial failed to exhibit any notable preventive effect.

Adolescent↗
PubMedDate not supplied

[Hepatic amebiasis in French Polynesia. 16 cases in 2 years].

Asymptomatic amebiasis in known for long ago in French Polynesia; the presence of Entamoeba histolytica cyst carriers have been shown by several parasitological investigations. But, until now, no hepatic amebiasis case has been reported in this geographical area. An homogeneous series of 16 cases of hepatic amebiasis is reported here. The diagnosis was made by hepatic ultrasonography and confirmed by immunology (Indirect immunofluorescent tests gave always a positive reaction for a dilution of 1/512 or more). Clinical, biological and radiological signs are well known in tropical pathology. Therapy was always conducted with metronidazol by the authors. From the epidemiological point of view, 14 out of 16 cases come from Tuamotu Archipelago. This epidemiological fact appears important enough to carry out systematically hepatic ultrasonography and amebic++ serology for every patient evacuated from this Archipelago to Tahiti. Hence it must be kept in mind the possibility of hepatic amebiasis not only in people living in French Polynesia but also, for the ones coming from over there but living in France.

Adolescent↗
PubMedDate not supplied

[Polynesia, myth and depression (author's transl)].

The author emphasizes the frequency of depressive conditions in French Polynesia, prevailing in Europeans but affecting also the natives. This frequency, looking paradoxal, incites him to analyse the "Southern Seas Myth", which a possible causal factor. Following the XVIIIth century discovery, the Myth grew and is still flourishing. Polynesia is viewed as the "lost paradise" at last recovered, its inhabitants as the "good savages" according to the Rousseau pattern, and their social and politic system as a new figure of the "Golden Age". Victims of this deception are: -- the European whose credulity emphasizes the Myth and who will face a deceiving reality. Conscious of its error, suffering of a narcissistic wound, he will fall into depression more especially as he is affected by a predisposing neurotic status; -- the native who is seen, according to wrong patterns, as a piece of the scene, indispensable to feed the Myth. The specificity of its past and present being, socio-cultural status and of its prospects is not understood. He suffers of a socio-cultural desintegration under the stress caused by the western civilisation shock. In the end he falls into anaclitism.

Cultural Characteristics↗
PubMed1995

Genetic differentiation of Aedes aegypti, the vector of dengue virus in French Polynesia.

In recent years the incidence of dengue fever epidemics has increased and transmission has tended to be established over a geographically expanding area, including French Polynesia. An increase in air transportation contributes to the diffusion of the dengue virus from Southeast Asia, a region considered to be a hyperendemic dengue zone, to the Pacific region. Presently, little is known about the role of the vector (Aedes aegypti) in the diffusion of the dengue fever virus. A study on the genetic structure of vector populations was conducted using allozyme polymorphism. This study showed a low level of genetic exchange between mosquito populations on different islands. It is concluded that the occurrence of dengue hemorrhagic fever in French Polynesia during the last few years was likely due to the dispersal of the dengue virus via viremic people rather than via infected vectors.

Aedes↗
PubMed1995

Evaluation of entomopathogenic bacteria against Aedes polynesiensis, the vector of lymphatic filariasis in French Polynesia.

Thirteen strains among 3 species of entomopathogenic bacteria were tested against 3 medically important mosquito species in French Polynesia. Two strains of Bacillus thuringiensis were highly toxic to Aedes polynesiensis, Aedes aegypti, and Culex quinquefasciatus. Six of 7 strains of Bacillus sphaericus tested were highly toxic to Cx. quinquefasciatus but not to the Aedes spp. Clostridium bifermentans serovar. malaysia was more toxic to Ae. polynesiensis than to the other 2 species. Entomopathogenic bacteria merit field testing for larval mosquito control in French Polynesia.

Aedes↗
PubMed1992

Histology of the reproductive tract of hybrids between gonochoristic males and parthenogenetic females of Lepidodactylus lugubris in French Polynesia (Reptilia, Gekkonidae).

Parthenogenetic populations of the gecko Lepidodactylus lugubris are widespread throughout Polynesia. They often occur parapatrically, and occasionally syntopically, with the increasingly rare bisexual populations. In these instances, a small number of hybrid individuals occur and include both "female" and "male" external phenotypes, both with greatly reduced gonads. Histological examination demonstrates that these hybrids possess small ovotestes. The differentiation of the cortical tissue is identical in both "male" and "female" hybrids, but the medullary tissue is more developed in "males." The remainder of the genital tract in "females" resembles that of fertile females in the parthenogenetic and bisexual populations. By contrast, the "male" hybrids are markedly intersexual. In one of the two specimens autopsied, the hemipenes are more or less the same size as those of bisexual males, and the sexual segment of the kidney is hypertrophied and serous. In the other hybrid "male," the hemipenes have a structure similar to that seen in females, and the sexual segment of the kidney is poorly differentiated. In both hybrid "males," the ductus deferens is extremely narrow and further reduced in its middle portion; oviducts are present and resemble those of normal or hybrid females. Thus, embryonic-like gonads are associated with complete and normal female reproductive ducts in hybrid "females." Hybrid "males" also have embryonic-like gonads and feminized genital ducts but associated with secondary sexual characters that match those of sexually active or quiescent normal males.

Animals↗
PubMed1991

Dengue surveillance in French Polynesia: an attempt to use the excess number of laboratory requests for confirmation of dengue diagnosis as an indicator of dengue activity.

The excess number of weekly laboratory requests for confirmation of dengue diagnosis over the expected number of requests forecasted by the modified Serfling method is proposed for the surveillance of dengue in French Polynesia, in addition to conventional methods. Retrospective analysis of the seasonal curves of dengue activity related to the number of laboratory requests is described for the years 1982-1987 where dengue type 4 was the only active flavivirus at the time when the forecast was initiated. By using past epidemic data, the probability of failing to recognize an increase in excess of requests as possibly epidemic was of 13.2% and 5.8%, respectively, when the criterion for epidemic increase was set respectively at 2 and 3 successive weeks during which the epidemic threshold is exceeded. A weekly surveillance was set up prospectively for 1988 using these criteria.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Prevalence of hepatitis B virus infection in the Austral archipelago, French Polynesia: identification of transmission patterns for the formulation of immunization strategies.

A sero-epidemiological survey of hepatitis B virus (HBV) infection in a randomly selected sample of 957 persons from the population of the Austral Island group in French Polynesia was conducted as a first step before developing an immunization programme strategy. Prevalence rates of HBsAg ranged from 3.09% to 27% in the different islands of the group with a weighted mean of 10.48%, while the prevalence rate for at least one marker ranged from 46.91% to 81.03% with a weighted mean of 64.12%. In the 0-11 months and 1-4 years age groups, 2.08% and 10.57%, respectively, of the children were HBsAg carriers. These findings, when compared to the mean population carrier rate of 10.48%, suggest that HBV transmission occurred mostly after the first year of life. The highest prevalence rate for HBeAg positivity was in the 5-19 years age group (more than 40% of the HBsAg carriers were HBeAg positive), suggesting that contagiousness was greatest in childhood and adolescence. HBsAg was found in 11.45% of women of child-bearing age and HBeAg in 19.09% of women positive for HBsAg. It is concluded that immunization of newborns and infants, using vaccine alone, should be the most effective strategy for reducing HBV infection in the Austral Islands archipelago.

Age Factors↗
PubMedDate not supplied

Dengue 1 epidemic in French Polynesia, 1988-1989: surveillance and clinical, epidemiological, virological and serological findings in 1752 documented clinical cases.

An epidemic of dengue 1 occurred in French Polynesia in December 1988 and June 1989. This paper records (i) the trend of the outbreak and its surveillance and (ii) the clinical, epidemiological and virological data obtained from 1752 documented cases. The epidemic reached its peak in February in Tahiti Island, 7 weeks after its recognition. Among 6034 suspect cases reported by sentinel physicians, 60.3% were < 20 years old. The illness was classical dengue. No fatality or case of dengue haemorrhagic fever/dengue with shock syndrome was reported. Of 4792 patients subjected to laboratory testing, 41% were confirmed as positive. The serological attack rate was c. 40%. The estimated number of dengue infections in the Windward Islands was about 20,000. Transmission was associated with Aedes aegypti. Study of documented cases showed a higher confirmation rate in both the civilian population < 15 years old (46.5%) and the susceptible French military population (47.6%) than in older civilians (31.1%, P < 0.05). Furthermore, primary dengue infections were predominant in both of the first 2 groups. The diagnosis was mostly confirmed (i) by virus isolation on day < 5 of illness and (ii) by detection of immunoglobulin (Ig) M on day > or = 5 of illness. The study showed that adequate surveillance of an epidemic requires both clinically and laboratory-based systems.

Dengue↗
PubMedDate not supplied

Control of bancroftian filariasis in an endemic area of Polynesia by ivermectin 400 micrograms/kg.

Community treatment with ivermectin was implemented in Opoa, French Polynesia from April 1991 to October 1993. All consenting inhabitants aged 3 years or more were treated with twice-yearly single doses of ivermectin, pregnant women excepted. A dosage of 100 microgram/kg was used for the 3 first treatments and then abandoned because it did not reduce the prevalence of microfilariae (mf) carriers. With a dosage of 400 micrograms/kg dosage, this prevalence decreased dramatically from 21% to 7%, and the mf level in carriers dropped to only 0.5% of its initial value after 3 treatments. The 400 micrograms/kg dosage was well tolerated and compliance was excellent. The twice-yearly single dose strategy with ivermectin at 400 micrograms/kg is safe and highly effective for filariasis control in an endemic area.

Animals↗
PubMedDate not supplied

[Significance of IgM titration by an immunoenzyme technic for the serodiagnosis and epidemiological surveillance of dengue in French Polynesia].

The usefulness of IgM antibody capture enzyme-linked immunosorbent assay (ELISA-IgM) for the diagnosis of dengue was studied using several groups of sera. An attempt was made to detect IgM against each dengue serotype. Of 76 paired sera from patients with dengue type 4 infection, the diagnosis was confirmed by ELISA-IgM in 74: in 47 out of 49 primary dengue infections and in all 27 secondary dengue infections. It was possible to detect IgM in 15 of the acute sera of primary infections and in 16 of the acute sera of secondary infections. In 20 patients from whom only single serum with high haemagglutination-inhibition titre (greater than or equal to 640) was available, 18 were found positive for dengue IgM. Dengue infection was also confirmed in 10 patients with dengue type 1 and in 10 patients with dengue type 2. IgM was detected in 1 of the acute sera of patients with either dengue type 1 or dengue type 2 infection. In all cases in which IgM was detected, a positive response was obtained for the homologous antigen. ELISA-IgM on sequential serum samples from 7 proven cases of dengue type 4 revealed that antibody titres greater than or equal to 400 are reached early in the second week of the illness and persist for 60 days or more at a low level (titre less than 400). An attempt was made to obtain a type-specific presumptive diagnosis by analysing the relative titre against each of the 4 antigens. It was possible to make a diagnosis of dengue type 4 in 85% and 52% of IgM-positive responses in primary and secondary infections (p less than 0.01), respectively, using paired sera from patients with known dengue type 4 infection. ELISA-IgM was shown to be of interest in the diagnosis and surveillance of dengue in French Polynesia where dengue viruses are, presently, the only known flavivirus.

Antibodies, Viral↗
PubMed1996

Cancer mortality in French Polynesia between 1984 and 1992.

A mortality study of French Polynesia in the period 1984-92, although limited by the small population living close to the test sites and the high proportion of deaths attributed to ill-defined causes, found no excess of cancer that could confidently be attributed to the 41 atmospheric test explosions in 1966-74. A study of cancer incidence is planned.

Adolescent↗
PubMed1992

Biological control of Culicidae with the copepod Mesocyclops aspericornis and larvivorous fish (Poeciliidae) in a village of French Polynesia.

The copepod Mesocyclops aspericornis Daday and the larvivorous fishes Gambusia affinis (B. & G.) and Poecilia reticulata R. & B., were released into mosquito breeding sites in Tuherahera village, Tikehau atoll, French Polynesia, to control larvae of Aedes aegypti (L.), Ae.polynesiensis Marks, Culex annulirostris Skuse and Cx quinquefasciatus Say. Treatments were completed within a week, in January 1990. Fish quickly eliminated mosquito larvae from the open breeding sites (ponds, wells). The impact of copepods in water tanks, drums and covered wells was inconsistent, apparently depending on the availability of microfaunal diet for growth of copepod nauplii. As the biting rate of adult Ae.aegypti seemed to be unaffected by the biological control of larvae, this village-scale experiment was judged to be unsuccessful as a means of vector control.

Aedes↗
PubMed1993

Ecology of the biting midge Leptoconops albiventris in French Polynesia. I. Biting cycle and influence of climatic factors.

The diurnal biting cycle of Leptoconops albiventris de Meijere (Diptera: Ceratopogonidae) is described from beaches of Nuku-Hiva, French Polynesia. Biting activity increased during the morning, diminished during the afternoon and was sufficiently intense to constitute a nuisance throughout the whole day. Correspondence Analysis indicated that climatic factors influenced biting activity. Activity was initiated by and positively associated with sunshine, whereas high temperatures, increased wind speed and rainfall were factors limiting activity. Decreased density of females during the dry season and their low capacity for dispersal were considered potentially advantageous with respect to control.

Animals↗
PubMed1992

Leprosy in French Polynesia. The possible impact of multidrug therapy on epidemiological trends.

In 1982, following the recommendations of a WHO study group, multidrug therapy (MDT) was introduced into French Polynesia to treat all patients suffering from active leprosy, and--only on request--those still on dapsone monotherapy. After 5 years, a clear-cut decrease of prevalence and mean annual detection rates for leprosy (except for detection rates among children aged less than 15 years, many of such cases being detected early by increased household contact training) has been observed. There was also a decrease in the proportion of newly detected cases with disabilities. During the 21-year period preceding the introduction of MDT into the control programme, mean annual detection rates for leprosy had remained stable, and this led to the consideration that such a decrease was due neither to the natural decline of the disease nor to the economic improvement of the country. Our results, together with the fact that, to date, the relapse rate was nil in the Polynesian patients put on MDT, strongly suggest that the implementation of MDT has resulted in a decrease of detection rates for leprosy which may be a consequence of a decrease in the transmission of the disease.

Clofazimine↗
PubMedDate not supplied

[Evaluation of 25 years of antileprosy chemotherapy in French Polynesia. Influence of age on the onset of the disease].

In French Polynesia the cases of leprosy are individually severe, like in Asia, but the endemy always stood under a relatively low level. A strong campaign of chemiotherapy has been conducted for 25 years. Unfortunatly the actions of systematic detection of new cases are not sufficient and the sanitary education is almost non existent. The territory is actualy reached by deep demographic and social upsettings and chemiotherapy used alone is not enough efficient to obtain a definitive decrease of the endemy or even to avoid, for a long time, a new increase. However a significant decrease of the age of advent of the decrease must be credited to the action of chemiotherapy.

Adolescent↗
PubMedDate not supplied

[Impact of a profound change in the structure of a society on the evolution of an endemic disease: leprosy in French Polynesia].

In French Polynesia the cases of leprosy are individually severe but the endemy itself always stood in low limits. The intensive use of modern treatments since 1950 have been making the eredication reasonably possible in the future. However the brutal demographic increase, the deep upsetting of the society and the important migrations made propitious conditions in the urbanized area for the advent of a new centre of infection. The result seems to be an increase of leprosy in the territory.

Emigration and Immigration↗
PubMedDate not supplied

[The absence of Sindbis virus from French Polynesia].

The authors report, in French Polynesia that Sindbis antigen is a good control for rubella serodiagnosis. Data are presented on Hemagglutination Inhibition from 2,032 sera, showing no evidence of any Sindbis antigen circulation.

Adolescent↗