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PubMed1992

Leprosy in French Polynesia. Epidemiological trends between 1946 and 1987.

The analysis of computerized data (OMSLEP system) on patients from French Polynesia followed since 1940 has shown a decrease in the mean annual detection rates for leprosy, all forms combined, from 24.73 per 100,000 inhabitants in 1946 to 8.1 per 100,000 in 1987 (y = -0.49 x + 45.83; p < 0.05). In fact, the decrease was significant (y = -1.18 x + 83.54; p < 0.05) during the first half of the study period (1946-66), but not during the second half (1967-87). Similarly, a significant decrease in all of the specific mean annual detection rates (according to the form of leprosy and to the sex and age of patients), in the proportion of multibacillary patients among the total of newly detected cases, and in the proportion of all patients with disabilities at the onset of leprosy was observed only during the first half of the study period (1946-66). Nevertheless, when comparing age-specific cumulative detection rates, calculated by 10-year age groups over the period 1946-66, to those of the period 1967-87, an ageing of the leprosy population was noted. Finally, the decrease of mean annual detection rates was greater in the smaller populations of remote islands than in the population of Tahiti, the main island, where 70% of the total population were living during the study period. This decline was shown to correspond to an effective improvement of the leprosy situation which could be attributed, among other factors (such as economic development and systematic BCG vaccination), to the implementation of a control programme for leprosy in 1950. The introduction in 1982 of multidrug therapy for all patients suffering active leprosy has raised the hope of a subsequent decline of leprosy in French Polynesia in the near future.

Adolescent↗

PubMedDate not supplied

[Thyroid epitheliomas in French Polynesia].

The authors reviewed 34 cases of thyroid epithelioma registered in French Polynesia from 1985 to 1990. Annual incidence classifies French Polynesia as a region with low endemicity. The patients were 31 females and 3 males. In 18 cases, carcinoma was discovered within a multiheteronodular goitre (MHNG) and in 16 cases within an isolated nodule. In each of these sub-groups, 4 micropapilliform cancers discovered at the occasion of a histopathological test. The mean age of the patients carrying a noduliferous cancer is 36.5 years and the one of multiheteronodular goitre is 50. No particular risk factor was discovered. Mean age of the disease is 2.8 years as far as noduliferous cancers are concerned, and 8.5 years for multiheteronodular goitre. The anatomical and echographic characters are discussed. What demanded a surgery intervention is reviewed. Mortality during intervention is zero. Morbidity recorded 17% of unilateral recurrent paralysis and 50% of transitory parathyroid insufficiency. Extemporaneous anatomopathological test was contributing in 25% of the cases; definitive test revealed 25 (74%) papilliform cancers (of which 8 micropapilliforms) and 9 vesicular cancers (26%). No canceration anaplasia was discovered. Evolutive stage is precised: 7 local invasions (isthm and/or capsule), 4 bifocal localizations, 8 cancers with adenoid metastasis, 4 with osseous and/or pulmonary metastasis. The way to select a therapy is reported and discussed. Cost evaluation is suggested in order to discuss the possibility to acquire for the Territory an equipment for isotopic exams.

Adult↗

PubMed1991

[The usefulness of systematic follow-up of tuberculosis for the diagnosis of relapse in French Polynesia between 1971 and 1984].

Standard chemotherapy for one year was proposed for the treatment of tuberculous patients in French Polynesia between 1971 and 1978, and for nine months with the addition of pyrazinamide from 1979 to 1984. After treatment, the patients were followed up systematically for a period of 5 years. The aim of this study was to evaluate the value of the follow up measures to detect relapses. Of 1,065 patients treated between 1971 and 1984 at the centre for the control of tuberculosis 35 (3%) presented with a relapse, of whom 30 were confirmed either by bacteriological examination or histological examination. The level of relapse seen was not linked to age, sex, nor type of treatment received (one year or nine months). However, the level of relapse in non compliant patients to the initial treatment (7%) was significantly greater than those observed in patients who were totally compliant (2%) (p less than 0.0001). Of the 35 relapses 9 (26%) were discovered during routine follow up visits, of whom 8 were detected during the first year. The median delay separating apparent recovery from relapse was 8 months. 28 patients (80%) presented with symptoms suggestive of a relapse. Over 5 years 5773 consultations were carried out, which meant 642 consultations to detect one relapse. The authors suggest that in French Polynesia a systematic follow up limited to one year after apparent cure should be adequate.

Adult↗

PubMed1986

[Bancroftian filariasis in French Polynesia. Epidemiologic status and perspectives after a 35-year preventive campaign].

The authors assess of three decades of struggle against Bancroftian filariasis in French Polynesia. Wuchereria bancrofti var. pacifica, aperiodic filaria, and Aedes polynesiensis, mosquito with high parasitologic output, set up a cycle very well adapted to the Polynesian environment; after numerous tests, the chemoprophylaxis with diethylcarbamazine (3 mg/kg/half-year) of all the exposed population has been decided, in association with methods of vector-control (use of predatory crustaceans). However, the achievement of this strategy is impeded by economical contingencies and the endemic comes up again particularly in areas close to eradication. Entomological clues show a high transmission over the greater part of French Polynesia.

Adolescent↗

PubMed1985

Field trials of preventive regimens in Thailand and French Polynesia.

Field demonstration trials of preventive agents or methods are needed so that the effectiveness and acceptability of such methods can be evaluated when used as part of the prevailing system and life style in a particular community. Agents so tested should have already been shown in a clinical trial to have a positive effect. Field demonstration trials differ from clinical trials in having no traditional control group; the study is not 'blind'; there is no special supervision and there is no special selection of participants. Results of two field demonstration trials, one in a population in Thailand with moderate but increasing caries severity and the other in French Polynesia, where caries severity is very high, are reported. The trials compared the effectiveness of various chewing gum formulations with the effectiveness of a fortnightly supervised sodium fluoride rinse. One gum formulation contained fluoride and was sweetened with sucrose or xylitol and sorbitol, the other was fluoride free and was sweetened with xylitol and sorbitol. The important information from these field trials is that a fluoride-containing chewing gum sweetened with xylitol/sorbitol appears to be effective in controlling caries experience even in communities apparently experiencing an increase of the disease; and that the apparent effectiveness was achieved in a field situation subject to all the problems of a programme not under a rigid clinical trial type of control. The fluoride-containing chewing gum-sucrose regime, in both the trials, and the non-fluoride chewing gum-xylitol/sorbitol regime in the French Polynesia trial failed to exhibit any notable preventive effect.

Adolescent↗

PubMedDate not supplied

[Hepatic amebiasis in French Polynesia. 16 cases in 2 years].

Asymptomatic amebiasis in known for long ago in French Polynesia; the presence of Entamoeba histolytica cyst carriers have been shown by several parasitological investigations. But, until now, no hepatic amebiasis case has been reported in this geographical area. An homogeneous series of 16 cases of hepatic amebiasis is reported here. The diagnosis was made by hepatic ultrasonography and confirmed by immunology (Indirect immunofluorescent tests gave always a positive reaction for a dilution of 1/512 or more). Clinical, biological and radiological signs are well known in tropical pathology. Therapy was always conducted with metronidazol by the authors. From the epidemiological point of view, 14 out of 16 cases come from Tuamotu Archipelago. This epidemiological fact appears important enough to carry out systematically hepatic ultrasonography and amebic++ serology for every patient evacuated from this Archipelago to Tahiti. Hence it must be kept in mind the possibility of hepatic amebiasis not only in people living in French Polynesia but also, for the ones coming from over there but living in France.

Adolescent↗

PubMedDate not supplied

[Polynesia, myth and depression (author's transl)].

The author emphasizes the frequency of depressive conditions in French Polynesia, prevailing in Europeans but affecting also the natives. This frequency, looking paradoxal, incites him to analyse the "Southern Seas Myth", which a possible causal factor. Following the XVIIIth century discovery, the Myth grew and is still flourishing. Polynesia is viewed as the "lost paradise" at last recovered, its inhabitants as the "good savages" according to the Rousseau pattern, and their social and politic system as a new figure of the "Golden Age". Victims of this deception are: -- the European whose credulity emphasizes the Myth and who will face a deceiving reality. Conscious of its error, suffering of a narcissistic wound, he will fall into depression more especially as he is affected by a predisposing neurotic status; -- the native who is seen, according to wrong patterns, as a piece of the scene, indispensable to feed the Myth. The specificity of its past and present being, socio-cultural status and of its prospects is not understood. He suffers of a socio-cultural desintegration under the stress caused by the western civilisation shock. In the end he falls into anaclitism.

Cultural Characteristics↗

PubMed1995

Genetic differentiation of Aedes aegypti, the vector of dengue virus in French Polynesia.

In recent years the incidence of dengue fever epidemics has increased and transmission has tended to be established over a geographically expanding area, including French Polynesia. An increase in air transportation contributes to the diffusion of the dengue virus from Southeast Asia, a region considered to be a hyperendemic dengue zone, to the Pacific region. Presently, little is known about the role of the vector (Aedes aegypti) in the diffusion of the dengue fever virus. A study on the genetic structure of vector populations was conducted using allozyme polymorphism. This study showed a low level of genetic exchange between mosquito populations on different islands. It is concluded that the occurrence of dengue hemorrhagic fever in French Polynesia during the last few years was likely due to the dispersal of the dengue virus via viremic people rather than via infected vectors.

Aedes↗

PubMed1995

Evaluation of entomopathogenic bacteria against Aedes polynesiensis, the vector of lymphatic filariasis in French Polynesia.

Thirteen strains among 3 species of entomopathogenic bacteria were tested against 3 medically important mosquito species in French Polynesia. Two strains of Bacillus thuringiensis were highly toxic to Aedes polynesiensis, Aedes aegypti, and Culex quinquefasciatus. Six of 7 strains of Bacillus sphaericus tested were highly toxic to Cx. quinquefasciatus but not to the Aedes spp. Clostridium bifermentans serovar. malaysia was more toxic to Ae. polynesiensis than to the other 2 species. Entomopathogenic bacteria merit field testing for larval mosquito control in French Polynesia.

Aedes↗

PubMed1998

Camallanus carangis Olsen, 1954 (Nematoda: Camallanidae) reported from French Polynesia and Hawai'i with a redescription of the species.

The marine fish parasite Camallanus carangis Olsen, 1954 (Nematoda: Camallanidae) is redescribed from the honeycomb grouper Epinephelus merra (Serranidae) in the Tuamotu Islands of French Polynesia and the glasseye Heteropriacanthus cruentatus (Priacanthidae) in Hawai'i, both coral reef fishes. Camallanus carangis is reported for the first time from French Polynesia and Hawai'i. Camallanus marinus Schmidt and Kuntz, 1969 is designated a synonym of C. carangis and Camallanus paracarangis Velasquez, 1980 is regarded as a species inquirenda. Additionally, the genus Oncophora may need to be redefined to accommodate Camallanus aotea Slankis and Korotaeva, 1974, which bears more resemblance to Oncophora than Camallanus.

Animals↗

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↗

PubMed1992

Histology of the reproductive tract of hybrids between gonochoristic males and parthenogenetic females of Lepidodactylus lugubris in French Polynesia (Reptilia, Gekkonidae).

Parthenogenetic populations of the gecko Lepidodactylus lugubris are widespread throughout Polynesia. They often occur parapatrically, and occasionally syntopically, with the increasingly rare bisexual populations. In these instances, a small number of hybrid individuals occur and include both "female" and "male" external phenotypes, both with greatly reduced gonads. Histological examination demonstrates that these hybrids possess small ovotestes. The differentiation of the cortical tissue is identical in both "male" and "female" hybrids, but the medullary tissue is more developed in "males." The remainder of the genital tract in "females" resembles that of fertile females in the parthenogenetic and bisexual populations. By contrast, the "male" hybrids are markedly intersexual. In one of the two specimens autopsied, the hemipenes are more or less the same size as those of bisexual males, and the sexual segment of the kidney is hypertrophied and serous. In the other hybrid "male," the hemipenes have a structure similar to that seen in females, and the sexual segment of the kidney is poorly differentiated. In both hybrid "males," the ductus deferens is extremely narrow and further reduced in its middle portion; oviducts are present and resemble those of normal or hybrid females. Thus, embryonic-like gonads are associated with complete and normal female reproductive ducts in hybrid "females." Hybrid "males" also have embryonic-like gonads and feminized genital ducts but associated with secondary sexual characters that match those of sexually active or quiescent normal males.

Animals↗

PubMed1991

Dengue surveillance in French Polynesia: an attempt to use the excess number of laboratory requests for confirmation of dengue diagnosis as an indicator of dengue activity.

The excess number of weekly laboratory requests for confirmation of dengue diagnosis over the expected number of requests forecasted by the modified Serfling method is proposed for the surveillance of dengue in French Polynesia, in addition to conventional methods. Retrospective analysis of the seasonal curves of dengue activity related to the number of laboratory requests is described for the years 1982-1987 where dengue type 4 was the only active flavivirus at the time when the forecast was initiated. By using past epidemic data, the probability of failing to recognize an increase in excess of requests as possibly epidemic was of 13.2% and 5.8%, respectively, when the criterion for epidemic increase was set respectively at 2 and 3 successive weeks during which the epidemic threshold is exceeded. A weekly surveillance was set up prospectively for 1988 using these criteria.

Clinical Laboratory Techniques↗

PubMedDate not supplied

Prevalence of hepatitis B virus infection in the Austral archipelago, French Polynesia: identification of transmission patterns for the formulation of immunization strategies.

A sero-epidemiological survey of hepatitis B virus (HBV) infection in a randomly selected sample of 957 persons from the population of the Austral Island group in French Polynesia was conducted as a first step before developing an immunization programme strategy. Prevalence rates of HBsAg ranged from 3.09% to 27% in the different islands of the group with a weighted mean of 10.48%, while the prevalence rate for at least one marker ranged from 46.91% to 81.03% with a weighted mean of 64.12%. In the 0-11 months and 1-4 years age groups, 2.08% and 10.57%, respectively, of the children were HBsAg carriers. These findings, when compared to the mean population carrier rate of 10.48%, suggest that HBV transmission occurred mostly after the first year of life. The highest prevalence rate for HBeAg positivity was in the 5-19 years age group (more than 40% of the HBsAg carriers were HBeAg positive), suggesting that contagiousness was greatest in childhood and adolescence. HBsAg was found in 11.45% of women of child-bearing age and HBeAg in 19.09% of women positive for HBsAg. It is concluded that immunization of newborns and infants, using vaccine alone, should be the most effective strategy for reducing HBV infection in the Austral Islands archipelago.

Age Factors↗

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↗

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↗

PubMedDate not supplied

Control of bancroftian filariasis in an endemic area of Polynesia by ivermectin 400 micrograms/kg.

Community treatment with ivermectin was implemented in Opoa, French Polynesia from April 1991 to October 1993. All consenting inhabitants aged 3 years or more were treated with twice-yearly single doses of ivermectin, pregnant women excepted. A dosage of 100 microgram/kg was used for the 3 first treatments and then abandoned because it did not reduce the prevalence of microfilariae (mf) carriers. With a dosage of 400 micrograms/kg dosage, this prevalence decreased dramatically from 21% to 7%, and the mf level in carriers dropped to only 0.5% of its initial value after 3 treatments. The 400 micrograms/kg dosage was well tolerated and compliance was excellent. The twice-yearly single dose strategy with ivermectin at 400 micrograms/kg is safe and highly effective for filariasis control in an endemic area.

Animals↗

PubMedDate not supplied

Plasma levels of tumour necrosis factor alpha and transforming growth factor beta-1 in children with dengue 2 virus infection in French Polynesia.

The pathogenesis of dengue haemorrhagic fever (DHF) is not well understood. In the absence of predictive clinical or biological criteria, the management of DHF patients remains difficult. The role played by cytokines in the occurrence of DHF has been suggested by several authors. In this study, we determined the plasma levels of tumour necrosis factor alpha (TNF alpha) and transforming growth factor beta-1 (TGF beta-1) in 52 children with laboratory-confirmed dengue virus infection admitted to hospital during the recent dengue 2 outbreak in French Polynesia. Thirty-three children were classified as having dengue fever (DF) and 19 as DHF. The plasma of both DF and DHF patients contained similar levels of TNF alpha. By contrast, plasma obtained from children with DHF had significantly higher levels of TGF beta-1 than plasma from children with DF, especially from days 1 to 3 after the onset of fever.

Adolescent↗