BACKGROUND: French Polynesia includes several ethnic groups; thus, it is well suited for evaluation of racial incidence of extrahepatic biliary atresia (BA). On the other hand, its geographic localization, far from specialized centers, does not facilitate early referral, indispensable for effective surgery. POPULATION AND METHODS: The files of 17 infants with BA, born in French Polynesia between 1 December 1981 and 1 December 1991, were retrospectively studied. During this period, there were 53,111 live births. RESULTS: The incidence of BA was 1/3,124. There were eight boys and nine girls; all belonged to the Maohi ethnic group (67% of the total population). They were admitted at the mean age of 71 +/- 33 days (range: 15-120 days); 15 of them were transferred to France at a mean age of 80 +/- 38 days (range: 35-150 days) and were operated on at 99 +/- 43 days (range: 48-195 days). The Kasai procedure was effective in four patients, with a follow-up ranging from 7 to 10 years. Among the 11 other patients, two underwent liver transplantation, four are waiting for transplantation and four have died. CONCLUSIONS: The influence of race on the incidence of BA has not been statistically established here even though this incidence appears high in French Polynesia and similar to Chinese babies in Hawaii. Local geographic conditions explain late admission in pediatric Units whereas possibilities for early surgery are improving.

Biliary Atresia↗

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

[Retrospective study of 45 cases of congenital syphilis in French Guiana from 1980 to 1990].

From 1980 through 1990, 45 cases of congenital syphilis, i.e., 15.5/10,000 births, were reported in French Guyana. Epidemiological and clinical characteristics of these cases were analyzed retrospectively. Most mothers were immigrants (32%) or members of the traditional Maroni community (60%). Congenital infections were often severe (symptomatic in 85% of cases and fatal in 33%). Treatment should be especially aggressive in patients infected with the human immunodeficiency virus.

Causality↗

PubMed1993