BackgroundThe prevalence of asthma in children is a significant phenomenon in the Caribbean. Among the etiologic factors aggravating asthma in children, environmental pollution is one of the main causes. In Guadeloupe, pollution is primarily transported by Saharan dust including inhalable particles.MethodsThis study assesses, over one year (2011), the short-term effects of pollutants referred to as PM10 (PM10: particulate matter <10 µm) and PM2.5–10 (PM2.5–10: particulate matter >2.5 µm and <10 µm) contained in Saharan dust, on the visits of children aged between 5 and 15 years for asthma in the health emergency department of the main medical facility of the archipelago of Guadeloupe. A time-stratified case-crossover model was applied and the data were analysed by a conditional logistic regression for all of the children but also for sub-groups corresponding to different age classes and genders.ResultsThe visits for asthma concerned 836 children including 514 boys and 322 girls. The Saharan dust has affected 15% of the days of the study (337 days) and involved an increase in the average daily concentrations of PM10 (49.7 µg/m3 vs. 19.2 µg/m3) and PM 2.5–10 (36.2 µg/m3 vs. 10.3 µg/m3) compared to days without dust. The excess risk percentages (IR%) for visits related to asthma in children aged between 5 and 15 years on days with dust compared to days without dust were, for PM10, ((IR %: 9.1% (CI95%, 7.1%–11.1%) versus 1.1%(CI95%, −5.9%–4.6%)) and for PM2.5–10 (IR%: 4.5%(CI95%, 2.5%–6.5%) versus 1.6% (CI95%, −1.1%–3.4%). There was no statistical difference in the IR% for periods with Saharan dust among different age group of children and between boys and girls for PM10 and PM2.5–10.ConclusionThe PM10 and PM2.5–10 pollutants contained in the Saharan dust increased the risk of visiting the health emergency department for children with asthma in Guadeloupe during the study period.
This epidemiological study on sarcoidosis in Guadeloupe reveals a low incidence of the disease and a high degree of severity as evidenced by the average number of affected organs, the high frequency of extrathoracic organ involvement, the frequent use of corticosteroids, and a mortality rate of 5.3%.
Background
Kodamaea ohmeri
is a yeast is frequently mistaken for
Candida,
which belongs to the same family. This micro-organism has been reported to cause life-threatening infections in humans.
Case presentation
A 81-year-old woman developed a severe fungemic pulmonary infection due to
Kodamaea ohmeri
that was identified from bronchoalveolar fluid and blood cultures, which is unusual in immunocompetent patients. Because
K. ohmeri
was first wrongly identified as
Candida albicans
, the patient inadequately received caspofungin, which was clinically ineffective, especially as the strain was resistant to echinocandins. Clinical cure was obtained after treatment was switched to voriconazole.
Conclusions
An increasing number of serious infections due to
K. ohmeri
has been reported in the literature, but the correct identification of this micro-organism remains difficult.
The population of the French Departments of the Americas (FDA) is highly influenced by the intense migratory flows with mainland France and surrounding countries of the Caribbean and Latin America, some of which have high incidence rates of tuberculosis (Haiti: 230/100,000; Guyana: 111/100,000; and Suriname: 145/100,000) and drug resistance. Since the development of drug resistance to conventional antituberculous drugs has a major impact on the treatment success of tuberculosis, we therefore decided to review carefully Mycobacterium tuberculosis drug resistance and associated genotypic lineages in the FDA over a seventeen-year period (January 1995–December 2011). A total of 1239 cases were studied, including 153 drug-resistant and 26 multidrug-resistant- (MDR-) TB cases, representing 12.3% and 2.1% of the TB cases in our study setting. A significantly higher proportion of M. tuberculosis isolates among relapse cases showed drug resistance to isoniazid (22.5%, P = 0.002), rifampicin (20.0%, P < 0.001), or both (MDR-TB, 17.5%; P < 0.001). Determination of spoligotyping based phylogenetic clades showed that among the five major lineages observed—T family (30.1%); Latin-American and Mediterranean (LAM, 23.7%); Haarlem (H, 22.2%); East-African Indian (EAI, 7.2%); and X family (6.5%)—two lineages, X and LAM, were overrepresented in drug-resistant and MDR-TB cases, respectively. Finally, 19 predominant spoligotypes were identified for the 1239 isolates of M. tuberculosis in our study among which 4 were significantly associated with drug resistance corresponding to SIT20/LAM1, SIT64/LAM6, SIT45/H1, and SIT46/undefined lineage.
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