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PubMed1990

[The detection of IgM antibodies to phenolglycolipid I for serodiagnosis of Hansen's disease and monitoring the contact population in Polynesia. Five year evaluation].

This study was conducted to assess the usefulness of IgM anti-PGLI antibody test, for the diagnosis of leprosy and of the subclinical infection among contact population. Even if the specificity (97.7%), sensitivity (98% for the multibacillary, but 36% for the paucibacillary) and efficiency (97.7%) of the test for the diagnosis of patients are good, its positive predictive value which is the proportion of true patients among the seropositive subjects detected in the population was very low (1.17% in Polynesia), because of the very low prevalence of leprosy. For the diagnosis of the subclinical infection, our experience based on the follow up of a population of 1,123 contacts, showed that such a control program would have low feasibility and low cost-effectiveness. After 5 years, the proportion of individuals developing the disease was not different among the seropositive than among the seronegative subjects. Finally, only 17.5% of the new cases of leprosy detected, were issued from the contact population followed. In conclusion and in a practical point of view, although this test may contribute to the diagnosis of patients, it is not likely useful neither for the diagnosis nor for the prognosis of leprosy in a population.

Antibodies, Bacterial↗
PubMedDate not supplied

[Health problems in an insular territory: the EVASANS in French Polynesia].

During the past three decades, French Polynesia has experienced a tremendous economic boom: GDP has multiplied by 30 in thirty years, whereas the population has only doubled in size. Health resources may nowadays be compared to those of a developed country. But as the "territory" is composed of a large number of islands, the availability of services is very uneven. The "Iles sous le Vent" are well staffed and well equipped, but other islands are under privileged. The small population of several small islands does not justify the permanent presence of a medical doctor. In this context, a system of health air-lifting was established. The system is classified into three groups: non-emergencies (scheduled for a later date), emergencies (immediate airlifting), and extreme emergencies (immediate airlifting with a doctor on board). Patients are airlifted to another island in the "territory" (mainly to Papeete, Tahiti), to New Zealand, or to France. The cost of this system (known as EVASANS) is extremely high. It raises the issue of improving local health care facilities and of promoting preventive medicine.

Delivery of Health Care↗
PubMedDate not supplied

[Infection with the human immunodeficiency virus (HIV) in French Polynesia].

HIV case finding tests are performed since three years in French Polynesia. Ratio of seropositivity is 2.4/10,000 inhabitants. The 45 seropositive patients found in three years belong to groups at risk (homosexual males; multi-transfusion recipients; addicts). As far as donors are concerned, no seropositivity was actually observed through the 16,881 tests carried out in 30 months. Outbreak of HIV seems to be recent in Tahiti.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Polynesian origins and affinities: globin gene variants in eastern Polynesia.

Analysis of copy number variants of the duplicated alpha-, zeta-, and gamma-globin genes in eastern Polynesians revealed a high frequency of both triplicated-zeta-gene chromosomes and a specific alpha thalassemia deletion. This deletion and a novel restriction-enzyme-site polymorphism associated with a zeta zeta zeta chromosome are found only in Melanesians and Polynesians. Analysis of alpha-globin restriction-enzyme haplotypes indicated further similarities to Melanesians but suggested an additional non-Melanesian genetic component in eastern Polynesia. Several globin gene alleles showed evidence of marked frequency fluctuations due to genetic drift.

Alleles↗
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↗
PubMedDate not supplied

[Filarian elephantiasis in French Polynesia (Wuchereria bancrofti var. pacifica). Health study on 274 subjects. I Epidemiological and Clinical aspects].

Twenty-five years after the fight started against Wuchereria bancrofti var. pacifica in French Polynesia and which was based upon mass chimiotherapy by diethylcarbamazine (Banocide), a survey realized in 1975 and 1976 among 274 patients with elephantiasis allows us to give precise details of the local clinical and epidemiological aspects. Since 1950 the number of clinical cases varies along with the parasitological incidence, but with a certain delay which is explained by the late and irreversible elephantiasis characteristics. The overall prevalence is actually low. However the occurrence of new cases, although very rare, is still possible. Among sick patients the lymphangitic crisis frequency whose aspect lead to evoke a bacterial participation, is low. Women are less frequently and less severely involved than men. Localisations are essentially restricted to the lower limbs. Several limbs are involved in approximately 50 0/0 of the cases. The scrotum involvement is rare, the one of the breast is found only once. Among men we can notice a 33 0/0 incidence of associated hydroceles. A past history of chyluria is not rare.

Adult↗
PubMedDate not supplied

[Filarian elephantiasis in French Polynesia (Wuchereria bancrofti var. pacifica). II. Biological aspects].

Realized in French Polynesia among 274 patients with elephantiasis, this survey studied the microfilaremia, the eosinophily, the immunoglobulin titers and the antifilarian antibodies (done by passive hemagglutination) for Wuchereria bancrofti var. pacifica. Patients with elephantiasis seldom have circulating microfilariae in their blood. Hypereosinophily is frequent but rarely high. It is similar to the one patients with microfilaremia. There is a trend towards neutropenia during lymphangitic crisis that occur on an elephantiasis limb. The IgE titer is clearly increased, the IgG one is lesser elevated. The mean values are identical to those encoutered among microfilariae asymptomatic cariers. On the other hand the serodiagnosis is more frequently positive among elephantiasic patients.

Adult↗
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↗
PubMedDate not supplied

[Epidemiological aspects and diagnosis of 60 cases of leptospiroses in French Polynesia].

60 cases of leptospiroses were diagnosed in Polynesia by blood culture and immunological test. Fever and pains are prevailing signs. Among 3 patients, presence of leptospires is revealed on the 43th, 54th and 90th days. The following serogroups are found: Icterohaemorrhagiae 69.7%, Canicola 13%, Pomona 4%, Australis 2%. 85% of the patients come from Tahiti and 15% from "Sousle-Vent" Islands and Tuamotou. Walking bare foot on wet ground in areas where numerous rodents are found is a source of contamination. The procedure of blood cultures plays a prominent part.

Adult↗
PubMedDate not supplied

[Inventory of the parasites of domestic animals in French Polynesia. 1st list].

After a parasitological survey in French Polynesia a first list of parasites of domestic animals has been drawn up. 42 helminthes and 23 protozoan parasites have been found in seven species of domestic animals. The pathogenicity and economic importance is discussed. The parasitic fauna is rather poor in spite of favourable environmental conditions for the evolution of parasites; therefore veterinary services must increase their surveillance to avoid any introduction of new parasite.

Animals↗
PubMedDate not supplied

[Dengue outbreak by virus type 4 in French Polynesia. I. General epidemiology - clinical specific aspects (author's transl)].

Authors describe an extensive outbreak of dengue 4 virus which is observed for the first time out of its Asian original focus. The whole archipelagos of French Polynesia have been contaminated in a space of four months. Usual form of the disease is typical with lightness of the symptoms. This outbreak has been implicated in the death of a child by shock; and two cases of reversible encephalitis have been certainly caused by this virus. The neurotropism is the main characteristic of dengue virus type 4.

Adult↗
PubMedDate not supplied

[Dengue outbreak by virus type 4 in French Polynesia. II. Preliminary biological observations on epidemiology and physiopathology of the disease (author's transl)].

Authors report some accurate epidemiologic and physiopathologic data about dengue 4. Thanks to virus intrathoracic inoculation in Toxorhynchites amboinensis (Doleshall, 1857), 202 viral strains have been isolated from 633 sera samples. The incidence of the disease has decreased very early after immunization of the whole population and resulted in an eradication of dengue type 1 virus which was endemic in French Polynesia since 1976. Only one type of dengue virus seems to be tolerated in French Polynesian ecosystem in the same time. There is no crossing protection with dengue 1. Clinically, the picture has been the same in both new and previously infected by dengue 1 patients. Duration of viremia during the secondary dengue fever is not shorter than in the primary one. The hemagglutination inhibiting antibodies do not protect patients, but do not result in immune-complexes pathology.

Antibodies, Viral↗
PubMed1993

[Hemorrhagic dengue with shock in children in French Polynesia].

The dengue fever is an intertropical arbovirus, well known in French Polynesia where the first cases of dengue haemorrhagic fever appeared at the end of 1989. The authors report their experience in the paediatrics ward of the Centre Hospitalier Territorial (CHT) of Papeete, where, from 1990 to 1992, 310 cases of dengue fever have been registered with 79 cases of dengue shock syndrome (25.5%) and 12 deaths (4%). Then, following an epidemiologic summary and a description of how the clinical picture evolves in children, they insist on the fact that the pathophysiology of dengue fever is unknown, and there is no predictive factor; even if, in this study, the young age seems to be factor of severity. Therefore, an epidemiologic survey, and a very close monitoring of each case are necessary, in order to start an aggressive symptomatic treatment as soon as possible. The antivector's fight is still the only prevention against this arbovirosis.

Child↗
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↗
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↗
PubMed1993

Periodicity of Wuchereria bancrofti var. pacifica filariasis in French Polynesia.

In 1992, a study on microfilaremia periodicity was carried out on 12 Wuchereria bancrofti carriers in the Marquesas islands. Blood samples were collected simultaneously every 4 hours during a 48 hour period by finger-prick and venipuncture for determination of microfilaremia by both blood film and membrane filtration technique methods, and for determination of antigenemia. The membrane filtration results showed no significant nycthemeral variations between the microfilaria densities at hours 16:00, 20:00, 24:00, 04:00, 08:00 and 12:00. Conversely, the blood film method showed a significant difference between the microfilaria densities: the microfilaremia was higher during the day (12:00-20:00 hours) than during the night (24:00-08:00 hours). As for antigenemia, using Og 4 C3 monoclonal antibody, there was no significant fluctuation during 48 hours. These results confirm that W. bancrofti var. pacifica is subperiodic and diurnal in French Polynesia. In particular, they substantiate the validity of examining venous blood by the membrane filtration technique as the judgment criterion of choice in therapeutic trials and of examining capillary blood during peak hours by the blood film method for evaluating the endemic level in a population.

Adult↗
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↗
PubMed1996

Parasites of coral reef fish recruits, Epinephelus merra (Serranidae), in French Polynesia.

Honeycomb grouper recruits Epinephelus merra (Serranidae) from 2 recruitment events on Moorea Island, French Polynesia, were examined for internal parasites. Trypanorhynch blastocysts (Eucestoda: Trypanorhyncha) and encysted phyllobothriid metacestodes (Eucestoda: Phyllobothriidae) were found in recruits from both events. Fish from the second event were examined later as juveniles and were found to harbor apparently melanized parasites. Neither parasite was found in adults. Evidence suggests these patterns are not due to differential mortality among recruits but to the elimination of parasites by host immune responses. The data also suggest that pelagic fish larvae may represent a dispersal mechanism for parasites if transfer occurs before the death of the parasite.

Animals↗