Cutaneous leishmaniasis in French Guiana: revising epidemiology with PCR-RFLP

Simon, Stéphane; Carme, Bernard; Basurko, Célia; Roger, Amaury; Adenis, Antoine; Ginouvès, Marine; Demar, Magalie; Couppié, Pierre

doi:10.1186/s41182-017-0045-x

Cited by 43 publications

(71 citation statements)

References 25 publications

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“…Infection with Tunga penetrans is a neglected tropical disease 15 and underlines the burden of poor living conditions in Amerindian communities of French Guiana. Cutaneous leishmaniasis was reported on nine occasions, an important incidence compared to the coastal region of French Guiana 16,17 …”

Section: Discussionmentioning

confidence: 99%

Spectrum of skin diseases in Amerindian villages of the Upper Oyapock, French Guiana

et al. 2020

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Background Due to their genetic characteristics, their isolation in rainforest areas, and their traditional way of life, Amerindian populations are likely to suffer from a specific spectrum of dermatoses. However, there are few available data on such skin disorders. Our aims were to describe all skin disorders in two Amerindian villages of French Guiana. Methods This retrospective study concerned all patients who consulted in the HealthCentres of Camopi and Trois-Sauts between July 1, 2017, and December 31, 2018. We included all patients classified with an ICD code linked to a skin disorder. All medical records were cross-checked by two dermatologists to correct misclassifications.Results A total of 639 patients formed the study population, for 866 different skin disorders. Non-sexually transmitted infections represented 57.6% of all skin disorders, followed by eczema (11.5%) and bites/envenomations (9.1%). Bacteria were responsible for 238 skin infections, followed by fungi (141 cases) and parasites (69 cases, including 43 scabies, nine cutaneous leishmaniasis, and two tungiasis). We reported a low prevalence of sexually transmitted infections (10 cases) and an absence of skin cancers. ConclusionsThis study revealed the absence of skin cancer in the Amerindian population of the Upper Oyapock and the important burden of infectious and animal-related diseases. Future studies should assess a possible underestimation of sexually transmitted diseases in this area. Public health policies should target neglected diseases such as cutaneous leishmaniasis, tungiasis, scabies, and envenomations. Atopic dermatitis was a significant and unexpected cause of consultations. Dermatological conditions in the Amerindian villages of French Guiana have never been described. About 12,000 Amerindians live in this territory, divided into six different ethnic groups. Many of them live in cities where ethnic diversity makes their study difficult, and the selection of patients according to ª

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Section: Discussionmentioning

confidence: 99%

Spectrum of skin diseases in Amerindian villages of the Upper Oyapock, French Guiana

et al. 2020

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“…In French Guiana, five species have been incriminated, the two most frequent being Leishmania ( Vianna ) guyanensis and Leishmania ( Vianna ) braziliensis. However, a possible shift toward a greater prevalence of Leishmania braziliensis has been reported in previous studies and needs to be followed up . New species such as Leishmania lainsoni and Leishmania naiffi have been sporadically reported, but the clinical data of these patients were not thoroughly studied.…”

Section: Introductionmentioning

confidence: 90%

“…Information files with epidemiological and clinical data were filled in by nurses or physicians for each suspected case of ACL. Patients were included when one of the following tests was positive: smear, culture from skin biopsy, PCR‐RFLP from skin biopsy . Species isolation was made by MALDI‐TOF from positive cultures or by PCR‐RFLP from skin biopsy.…”

Section: Methodsmentioning

confidence: 99%

“…PCR‐RFLP was performed using the technique first described by Simon et al in 2009, using a 615‐bp fragment of the RNA polymerase II gene. Since then, this technique has become the reference method for species identification in French Guiana . Mass spectrometry was performed on positive parasite cultures as previously reported …”

Section: Methodsmentioning

confidence: 99%

“…Epidemiological data are frequently updated with new techniques of species identification. Simon et al produced the last study on this subject in 2017, establishing the utility of polymerase chain reaction‐restriction fragment length polymorphism (PCR‐RFLP), and describing a possible increase of L. braziliensis after Brazilian immigration. Since then, the introduction of Matrix‐Assisted Laser Desorption/Ionization (MALDI‐TOF) in French Guiana offers another tool for species identification.…”

Section: Introductionmentioning

confidence: 99%

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American cutaneous leishmaniasis in French Guiana: an epidemiological update and study of environmental risk factors

et al. 2019

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BackgroundAmerican cutaneous leishmaniasis (ACL) is endemic in French Guiana. Its epidemiology is evolving, notably because of immigration, anthropization of natural areas, and new microbiological methods. Our first objective was to update epidemiological data. Our second objective was to look for risk factors of ACL.MethodsThis multicentric study was conducted from October 2017 to June 2018 in French Guiana. Patients with suspicion of mucocutaneous leishmaniasis were included in case of positive smear, culture, or PCR‐RFLP on skin biopsy. ResultsOne hundred and twenty‐three patients met the inclusion criteria. Among those patients, 59.3% were Brazilian, mostly gold miners. Most of them (58%) were between 16 and 40 years old, and 69% were male. A large proportion of patients lived in traditional wooden houses (51%). Patients living in coastal towns were usually infected during trips to the primary forest (60%) and had a shorter time to diagnosis than workers of the hinterland. Among environmental risk factors, the presence of a water spring (40%) and dogs around houses (40%) were frequently reported. Leishmania guyanensis represented 80% of cases, followed by Leishmania braziliensis (6%), Leishmania naiffi (2%), and Leishmania amazonensis (1%).ConclusionsGold mining and trips to the primary forest represent high‐risk situations for ACL in French Guiana, where the population of infected patients is dominated by Brazilian immigrants. Possible environmental risk factors such as the presence of dogs, water sources, and traditional wooden houses require further investigation.

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Use of miltefosine in the treatment of cutaneous leishmaniasis in French Guiana

Oliveira,

Arrivé,

Andro

et al. 2024

JEADV Clinical Practice

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BackgroundNearly half of the cutaneous leishmaniasis (CL) cases in French Guiana occur in remote rainforest areas. The treatment of pentamidine‐resistant strains currently requires hospitalisation for intravenous amphotericin, involving significant indirect costs. Miltefosine is currently the only oral drug available but is only used in French Guiana as a third‐ or fourth‐line treatment under a temporary use authorisation.ObjectivesThe primary objective of this study was to evaluate the effectiveness of miltefosine in French Guiana. Secondary objectives were to evaluate its safety and acceptability, and patient satisfaction.MethodsThe study was carried out at the Cayenne Hospital and remote health centres in French Guiana. All patients with proven CL and treated with miltefosine between 1 January 2017 and 1 April 2022 were included. Cure was defined as complete re‐epithelisation with no new lesions at 90 days. Adherence (all doses taken) and side effects were routinely evaluated at the end of treatment. Patients were retrospectively called back to evaluate the impact of CL on their life quality before treatment and their satisfaction with miltefosine.ResultsFifteen patients were included. The main species was Leishmania guyanensis (n = 9; 60%), followed by L. braziliensis (n = 4; 26.7%). Eight patients (53.3%) were cured. Eleven patients (73.3%) presented adverse effects (mainly digestive), with seven of these (46.7%) requiring therapeutic adaptations. Eight patients demonstrated complete adherence; of these, six (75%) were cured, including six cases of L. guyanensis, one case of L. braziliensis and one Leishmania spp. Most patients (88.9%) were satisfied with the treatment and said they preferred oral administration to the parenteral route.ConclusionsMiltefosine is a valuable treatment option for CL in French Guiana. The side effects can diminish patient adherence, but its oral administration is associated with high patient satisfaction. A regular marketing authorisation would facilitate its prescription and allow for the creation of larger cohorts.

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Cutaneous leishmaniasis in French Guiana: revising epidemiology with PCR-RFLP

Cited by 43 publications

References 25 publications

Spectrum of skin diseases in Amerindian villages of the Upper Oyapock, French Guiana

Spectrum of skin diseases in Amerindian villages of the Upper Oyapock, French Guiana

American cutaneous leishmaniasis in French Guiana: an epidemiological update and study of environmental risk factors

Use of miltefosine in the treatment of cutaneous leishmaniasis in French Guiana

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