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PubMed1993

Tuberculosis in leprosy patients detected between 1902 and 1991 in French Polynesia.

From 1902 onward, notification and follow up of leprosy patients has been systematic in French Polynesia. Since 1960, a tuberculosis control program and a register has also been implemented. From 1902 to 1959, 673 cases of leprosy were detected [346 multibacillary (MB), 138 paucibacillary (PB), and 179 unclassified due to the loss of medical files by the time of classification which was done during the 1980s]. Of these 673 cases, 89 (13.2%) died from tuberculosis, giving a mean annual death rate of tuberculosis in leprosy patients of 232 per 100,000. Mortality from tuberculosis in leprosy patients detected between 1901 and 1930 was 20.7%, and decreased to 8.04% in patients detected from 1931 to 1959. In total, it was estimated that 26.4% of the leprosy cases had developed tuberculosis. From 1960 to 1991, 350 new cases of leprosy were detected (141 MB, 209 PB). Of them, 12 (3.4%) developed tuberculosis (7 before detection of leprosy, 5 after detection of leprosy). The dramatic decrease of the proportion of leprosy patients who developed tuberculosis between the periods 1902-1959 (26.4%) and 1960-1991 (3.4%) might be related to the important decline of the tuberculosis situation since 1960. From 1902 to 1959, mortality from tuberculosis occurred significantly more frequently in MB patients (13%) than in PB patients [4%, relative risk (RR) = 3.21, p = 0.003]. From 1960 to 1991, the incidence of tuberculosis seemed more frequent in MB patients (RR = 2.96, p = 0.07) whatever the sequence of detection of the two diseases. Our study suggests that lepromatous patients could share factors of susceptibility to mycobacterial diseases with patients developing tuberculosis.

Adult↗
PubMed2000

Spatial distribution and coexistence of monogenean gill parasites inhabiting two damselfishes from Moorea island in French Polynesia.

The ectoparasite fauna of two damselfishes, Stegastes nigricans and Dascyllus aruanus, from Moorea Island in French Polynesia was investigated. Gills of these damselfishes were infected with congeneric Monopisthocotylea Monogenea belonging to the genus Haliotrema. Stegastes nigricans were found to harbour a guild of three Haliotrema species whereas only one species inhabited D. aruanus. Microhabitat distribution, inter- and intraspecific competition and interspecific associations on the gill were studied. Observations on site preference revealed no spatial segregation between the three congeneric species inhabiting the gills of S. nigricans. Juvenile and adult monogeneans of that guild occurred on the same microhabitat. The dominant species Haliotrema sp. 1 did not expand on the microhabitat when the intensity of infection increased. Interspecific association tests revealed positive and negative associations. Haliotrema sp. 4 expanded its distribution on the gills of Dascyllus aruanus when the intensity of infection increased suggesting the likelihood of intraspecific competition. Juvenile and adult monogeneans of Haliotrema sp. 4 appeared to segregate as a result of intraspecific competition. This competition may exist to enhance resource availability when the gill habitat is limited. Overlaps between niche breadth and species microhabitat were revealed for monogenean species inhabiting S. nigricans. Interspecific competition did not appear to play an important role in the distribution of S. nigricans congeneric ectoparasites. Reinforcement of reproductive barriers may have led to the avoidance of hybridization.

Analysis of Variance↗
PubMed2000

Cancer incidence in French Polynesia 1985-95.

OBJECTIVE: To describe the variations in cancer incidence in the population born in French Polynesia (FP) according to the archipelago of birth and to compare this incidence with that of Hawaiians and Maoris. METHODS: Study of data from the Cancer Registry of FP, evacuation files, insurance records, hospital and pathology laboratory files. RESULTS: The overall world standardized cancer incidence in FP during the 1985-95 period in the populations born and living in FP was 246 per 105 person-years (PY) among women and 244 per 105 PY among men. The overall cancer incidence was similar to that in Hawaiians, but 25% lower than in Maoris. Digestive tract cancer incidence was a third that of these two reference populations, whereas that of pharynx, larynx and thyroid cancers was approximately twice as high. The overall cancer incidence rate increased between the period 1985-89 and the period 1990-95 in women, but was stable in men. Colorectal cancer incidence was highest in inhabitants born on the Windward Islands. Women born on the Austral Islands had a higher thyroid and liver cancer incidence and a lower breast cancer incidence. CONCLUSIONS: Further studies are needed to elucidate the variations observed between FP archipelagos, Maoris and Hawaiians.

Adult↗
PubMed1992

[Epidemiologic surveillance of tuberculosis in French Polynesia between 1960 and 1990].

A monitoring and prevention policy for tuberculosis has been implemented in French Polynesia in 1960. Between 1960 and 1990, case-notification rate decreased dramatically from 568 to 30 per 100,000 with an average annual decrease rate of 9.1%. Cumulative case-notification rates calculated over the 30-year period for the 5 archipelagoes constituting the territory vary significantly: the highest rate has been observed in Gambier Islands. Sex ratio for the whole period was 1.1. The annual incidence rate, according to age-groups has been computerized using actuarial method. A cohort-effect is observed: given an age of individuals, the incidence rate becomes lower when shifting from an older cohort to a younger one. Also, an age-effect is to be emphasized: there is a decreasing trend of the rate in each cohort when the age of the individuals amid the cohort increases. The proportion of smear-positive tuberculosis cases increased from 38% in 1976 to 54% in 1990. A 0.57% annual risk of infection (ARI) has been estimated for 1977, and a 0.41% ARI for 1989. Tuberculosis mortally rate is documented since 1985, and varies between 10.8 and 2.1 per 100,000 since that year.

Adolescent↗
PubMedDate not supplied

[Dental caries and its prevention in French Polynesia].

For some years, a global program for prevention of dental caries is carried on in french Polynesia. Polynesian populations were, more than a century ago, almost totally free of dental caries. This disorder suddenly appeared and reached, in a couple of decennia, a frequency and an intensity rarely observed in other countries. Ten years ago, with support of WHO, the Public health department of the territory organized a dental hygiene service for school children; positive results can already be observed.

Dental Caries↗
PubMed2002

Integrated control of peridomestic larval habitats of Aedes and Culex mosquitoes (Diptera: Culicidae) in atoll villages of French Polynesia.

An integrated larval mosquito control program was carried out in Tiputa village on Rangiroa atoll of French Polynesia. Mosquito abundance before and after treatment was compared with the abundance in an untreated village. Mosquito larval habitats consisted of large concrete or polyurethane cisterns, wells, and 200-liter drums. Depending on the target species, larval habitat category, its configuration, and purpose (drinking consumption or not), abatement methods consisted of sealing the larval habitats with mosquito gauze, treating them with 1% Temephos, covering the water with a 10-cm thick layer of polystyrene beads or introducing fish (Poecillia reticulata Rosen & Bailey). All premises of the chosen village were treated and a health education program explained basic mosquito ecology and the methods of control. A community health agent was trained to continue the control program at the end of the experiment. Entomological indices from human bait collections and larval surveys indicated that mosquito populations were reduced significantly, compared with concurrent samples from the untreated control village, and that mosquito control remained effective for 6 mo after treatment. Effects of the treatment were noticed by the inhabitants in terms of a reduction in the number of mosquito bites. In the Polynesian context, such control programs may succeed in the long-term only if strong political decisions are taken at the village level, if a community member is designated as being responsible for maintaining the program, and if the inhabitants are motivated sufficiently by the mosquito nuisance to intervene.

Aedes↗
PubMed1998

Changing clinical and biological manifestations of dengue during the dengue-2 epidemic in French Polynesia in 1996/97--description and analysis in a prospective study.

In August 1996 dengue-2 virus was detected in French Polynesia for the first time since 1976. A prospective study was conducted from November 1996 to April 1997. Each time one of 7 physicians suspected dengue, the patient was enrolled and epidemiological, clinical and biological data were recorded. Dengue diagnosis was confirmed by virus isolation and IgM detection. The aims of this study were to find clinical and biological predictive factors constituting a specific profile of dengue (DF) and dengue haemorrhagic fever (DHF/DSS) and to assess the possibility of diagnosing dengue at primary health care level using clinical criteria and basic laboratory parameters. Of 298 clinically suspect cases, 196 (66%) were confirmed as dengue. The association of macular rash, pruritus, low platelet count and leukopenia was statistically predictive of dengue but not clinically, since these four signs occur in many other viral infections. As the prevalence of clinical and biological manifestations varied over time in our study, a specific profile useful for dengue diagnosis cannot be defined. With six cases of DHF, the morbidity of this dengue-2 outbreak was very low despite the sequential infection scheme DEN-3/DEN-2. The clinical expression of dengue could depend on a specific virus strain circulating in a specific population in a particular place, with varying virulence over time.

Adolescent↗
PubMed1993

Low predictive value of PGL-I serology for the early diagnosis of leprosy in family contacts: results of a 10-year prospective field study in French Polynesia.

In 1983, a cohort study to follow up the family contacts of leprosy cases was implemented in French Polynesia to assess the usefulness and applicability of phenolic glycolipid-I (PGL-I) serology in a leprosy control program. A total of 1201 contacts (666 females, 535 males) have been included in the study. The IgM anti-PGL-I seroprevalence determined on the initial sera was 17%. It was significantly higher among females than males (20% vs 15%, p = 0.02). From 1983 to 1992, 4 out of 204 (2%) anti-PGL-I seropositive contacts developed the disease (1 indeterminate, 1 BT, 1 BL, 1 LL) compared with 10 out of 997 (1%) seronegative contacts (4 indeterminate, 3 BT, 1 BB, 2 TT). Of these 10 patients, only 3 (2 indeterminate, 1 BT) converted to seropositivity when leprosy was diagnosed. The risk of developing leprosy was not significantly higher among seropositive than among seronegative groups (2% vs 1%, p = 0.2). A PGL-I circulating antigen test performed on 216 selected sera at entry into the trial showed a higher antigen prevalence when the antibody level was higher. PGL-I antigen was detectable in 5 of 12 patients tested prior to diagnosis (1 LL, 1 BL, 3 indeterminate). The median time to externalize the disease was not significantly different among antibody-positive and -negative contacts (17 vs 25 months, p = 0.3). The relative risk of developing leprosy for contact individuals was 30.8 times that of noncontacts, and 15% of the total new cases detected between 1983 and 1992 emerged from the study population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2004

Childhood malignancies in French Polynesia during the 1985-1995 period.

We report an estimation of the incidence of childhood cancer among natives of French Polynesia (FP) during the 1985-1995 period. Our data were acquired from the Cancer Registry of FP and through an extensive investigation of other potential sources of information. The mean population of children between 1985 and 1995 was estimated to be 63 401 inhabitants, 32 487 of whom were boys and 30 914 girls, born and residing in FP. During the 1985-1995 period, 87 incident cases of childhood cancer were recorded among inhabitants born in FP or of an unknown place of birth (n = 2). Childhood cancer incidence had attained 125 cases/million child years and was very similar among girls (126 x 10(-6)) and boys (123 x 10(-6)), this incidence being slightly lower than among other populations of similar ethnic origin: Standardized Incidence Ratio (SIR) = 0.8 (95% CI: 0.7-1.0) when compared with New Zealand Maoris and SIR = 0.8 (95% CI: 0.6-1.0) when compared with natives from Hawaii. For both sexes considered together, the most frequent cancer type was leukaemia, followed by central nervous system (CNS) malignancies, neuroblastoma, and non-Hodgkin's lymphoma (NHL). Only one case of gonadal and germ cell tumours and one case of carcinoma were reported. Childhood cancer incidence was predominant among children living in the Windward, Leeward and Marquesas Islands and the Tuamotu-Gambier archipelago, but lower in the Austral Islands. The incidence of acute non-lymphocytic leukaemia (ANLL) decreased from 3.3 x 10(-5) between 1985 and 1989, an unexpectedly high incidence, to 0.8 x 10(-5) between 1990 and 1995.

Adolescent↗
PubMed1987

Seroepidemiological study on 724 household contacts of leprosy patients in French Polynesia using disaccharide-octyl-BSA as antigen.

A seroepidemiological surveillance of a contact population was started in 1984 in French Polynesia. The ELISA test was used to measure IgM anti-ND-O-BSA in the sera. Specific antibody levels were higher in healthy Polynesians than in normal individuals living in a nonendemic country. The positive threshold of the reaction was fixed according to this background activity in healthy Polynesians. Under these conditions, 100% of the multibacillary patients were detected as seropositive as compared to 5% of the paucibacillary group. In the population of 724 household contacts tested and observed for 2 years: 93 (12.8%) were seropositive, with 8 (1.1%) showing activity equivalent to multibacillary patients (1 of these 8 individuals developed a lepromatous form of leprosy); 631 (87%) were seronegative and 3 developed a paucibacillary form of the disease (2 BT, 1 I) without any antibody increase. Among those four contacts who developed leprosy, three were related to a multibacillary index case. These data suggest that this test may be useful for the prediction of multibacillary leprosy. A long-term surveillance of this high-risk population will be able to evaluate the diagnostic and prognostic value of the serological assay.

Antibodies, Bacterial↗
PubMed2002

[Isotopic composition of the delta-18O--delta-13C from the otoliths of reef fish from Taiaro (Tuamotu, French Polynesia): isotopic and biological implications].

Nuclei (larval stage) and outer parts (adult stage) of fish otoliths from the Taiaro closed lagoon (French Polynesia) and adjacent ocean have been analysed for the C-O isotopic compositions. delta 18O values of the nuclei of both populations indicate that isotopic equilibrium is reached. This implies that the lagoonal fish population has done its complete biological cycle in the lagoon and represents an adaptation in a closed system. delta 18O values of the outer parts show a slight isotopic disequilibrium (< 0.2@1000) interpreted in term of vital effect. All the delta 13C values exhibit a strong isotopic disequilibrium related to metabolic activity.

Animals↗
PubMed1998

Parasite diversity/host age and size relationship in three coral-reef fishes from French Polynesia.

The parasite communities of three coral-reef fish species (Stegastes nigricans, Dascyllus aruanus and Cephalopholis argus) were on Tiahura reef, French Polynesia. The age and growth of each fish was analysed by otolith increment counts and a significant correlation between these variables was found. Stegastes nigricans was parasitised by six adult parasite species, D. aruanus by two adult parasite species and C. argus by five adult parasite species. The most common parasite species were found in all fish size classes. Ectoparasites showed a positive relationship between their abundance and host body length for all three reef fish species. A positive relationship was found only between host size and parasite abundance for common endoparasite species. Parasite species richness, Brillouin's diversity index, and host size and age were positively related. Finally, we discuss the influence of different biological (host diet, host immune response, parasite life-cycle) and ecological factors on parasite community structure in these three reef fishes. Host diet quality seems to be one of the major factors affecting the endoparasite community structure in these reef fishes. Ectoparasite communities seem to be influenced more by biological factors such as, for example, host immunity for the caligid larvae or parasite life-cycle for the gnathiid praniza larvae. In addition, the effect of ecological factors such as cleaning symbiosis on these ectoparasites cannot be dismissed.

Aging↗
PubMed1991

[Respective importance of vertical and horizontal transmission of hepatitis B in the Australian archipelago (French Polynesia). Preliminary results of the vaccination of newborns].

A seroepidemiological survey of hepatitis B was conducted in 1988 in the Austral archipelago (French Polynesia) in a randomly selected sample of 957 persons, has showed an infection rate (at least one positive marker) with HBV of 64.1% for the entire archipelago. Among women of child-bearing age, HBs Ag carriage rate was 11.45% of whom 19.1% were so HBe Ag carriers. Among infants HBs Ag carriage rate was 2.1% and among juveniles it was 10.6%. In this area horizontal transmission of HBV is essential. An immunization program was implemented in August 1988 using a recombinant vaccine (GenHevac BTM). At one year of the program, 97% of the children had received at least one dose of vaccine, 90% had HBs-antibodies titer higher than 10 mUI/ml, 96% had seroconverted for at least one of the two antibodies (anti-HBs and/or anti-preS2) and any of them was neither HBs Ag carrier nor anti-HBc IgM antibodies carrier. Finally, among 7 neonates whose mother were positive for both HBs Ag and HBe Ag, 6 were immunes and the last one, aged of 1 month (one dose received only), was not HBs Ag carrier. These preliminary results show that vaccination with GenHevac BTM to be immunogenic and effective in field conditions.

Adolescent↗
PubMed1993

[Presence of gregarine (Protozoa sporozoa) parasite of black-lipped pearl oysters Pinctada margaritifera (L.,1758) (Mollusca bivalvia) in French Polynesia].

High death rates have been recorded in populations of Pinctada margaritifera (natural or reared stocks) in atolls in the Tuamotu Archipelago (French Polynesia). An histological study of the oysters from the concerned areas revealed the occurrence of a protist of which ultrastructural features correspond to those of Gregarinea. It is still premature to establish a link between the presence of the Gregarine and recent deaths of pearl oysters.

Animals↗
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↗
PubMed2000

Prospective study of the duration and magnitude of viraemia in children hospitalised during the 1996-1997 dengue-2 outbreak in French Polynesia.

The magnitude and duration of viraemia in children admitted to the hospital with dengue was studied during a dengue 2 outbreak in French Polynesia in 1996-1997. Forty-nine patients from whom at least 3 plasma samples were available were included in the study. Based on analysis of IgG-ELISA and haemagglutination inhibition assay, 21 of these were primary and 28 were secondary infections. According to World Health Organization criteria, 42 were dengue fever and 7 were dengue haemorrhagic fever. Virus was detectable by reverse transcription-PCR in all patients for at least the first 3 days of the onset of fever, but was never detected after the 6th day (mean duration = 4.4 days). Plasma virus titers ranged from 1.7-5.6 Log(10) TCID(50)/ml. A significant difference was not observed in the magnitude and duration of viraemia in patients with primary versus secondary infections. The severity of the illness, however, was correlated with both criteria.

Antibodies, Viral↗
PubMed2005

[The history of lymphatic filarlasis control programme in French Polynesia: lessons from a 50 years effort].

With a mean prevalence of microfilariaemia superior to 15% in the four archipelagos of the territory French Polynesia was confronted with a huge public health problem of Wuchereria bancrofti - associated filarias during the 50s. Supported by a strong US sponsoring, a large scale control campaign based on diethylcarbamazine (DEC) distribution was launched and led to the method of spaced doses (the most useful protocol being one annual DEC dose). Progressively applied to the whole Polynesian population since 1974, this very innovative programme had generated the idea of a possible eradication of the parasitosis. Meanwhile at laboratory level important progress in Immunology (mainly the validation of rapid diagnosis tests detecting a specific antigenemia) and later in Molecular Biology (with the main application being the follow-up of the infection status of the vector Aedes polynesiensis) questioned this optimistic concept (one lesson given by the study of Maupiti island, considered as a 0% reference island for a long time). More recently a regional WHO-sponsorized control programme, called PacELF, has for main objective the elimination of lymphatic filariasis as a public health problem in the South Pacific region near 2010. This objective argues for using a (DEC and albendazole) drug combination cumulating micro- and macro-filaricid activities. The dream of a lymphatic filariasis free Pacific is coming back again.

Biomedical Research↗
PubMed2000

[Zonation of macrobenthic communities along two bays in an insular coral reef ecosystem (Moorea, French Polynesia)].

Zonation of macrobenthic communities (corals, algae, molluscs, sponges and echinoderms) on fringing reefs was investigated in two bays in a coral reef ecosystem (Moorea, French Polynesia). Species richness, abundance and coral cover, and species richness of macroalgae increased from the bayhead to the bay entrance. For molluscs and sponges, no general trend was observed. Species richness and abundance of echinoderms increased from the head to the entrance of Opunohu Bay, but this trend was less pronounced in Cook Bay. The gradients observed for corals, macroalgae and echinoderms were correlated with one or several of the following abiotic factors: salinity, turbidity, concentration of silicates in surface waters, and concentrations of organic carbon, carbohydrates and amino acids in the sediments. These factors are associated with terrestrial run-off via river discharge that occurs at the bayheads, where the major river is located. The high degree of confinement in the bayheads allowed the establishment of only a few tolerant macrobenthic species. Although the low diversity and abundance of corals and echinoderms seem to be a characteristic of Polynesian bays, a high diversity of corals can be found in the vicinity of the bayheads in coral reefs of the western Pacific.

Animals↗