| Autor: |
Velut G; Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France., de Laval F; Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France.; Aix-Marseille Université, INSERM, Institut de Recherche pour le Développement, Economic and Social Sciences, Health Systems, and Medical Informatics, Marseille, France., Berry M; Centre Médical Interarmées de Cayenne, Cayenne, French Guiana., Dufour Gaume F; Centre Médical Interarmées de Kourou, Kourou, French Guiana., André N; Direction Interarmées du Service de Santé des Forces Armées en Guyane, Cayenne, French Guiana., Epelboin L; Service des Maladies Infectieuses et Tropicales, et Centre d'investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana., Lavergne A; Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana., Enfissi A; Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana., Djossou F; Service des Maladies Infectieuses et Tropicales, et Centre d'investigation Clinique (CIC INSERM 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana., Rousset D; Laboratoire de Virologie, Institut Pasteur de la Guyane, Cayenne Cedex, French Guiana., Briolant S; Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique-Hôpitaux de Marseille, Service de Santé des Armées, Vecteurs - Infections Tropicales et Méditerranéennes, Marseille, France.; Institut Hospitalo-Universitaire - Méditerranée Infection, Marseille, France.; Unité de Parasitologie Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France. |
| Abstrakt: |
In tropical countries, acute febrile illnesses represent a complex clinical problem for general practitioners. We describe the prevalence of different etiologies of acute febrile illnesses occurring among French service members and their families, excluding children, in general practice in French Guiana. From June 2017 to March 2020, patients with a fever ≥37.8°C with a duration of less than 15 days who sought medical care at the army medical centers in Cayenne and Kourou were prospectively enrolled. Based on clinical presentation, blood, urine, nasopharyngeal, and stool samples were collected for diagnostic testing for viruses, bacteria, and parasites (by direct examination, microscopic examination of blood smears, culture, serology, or polymerase chain reaction), and standardized biological tests were systematically performed. Among 175 patients retained for analysis, fever with nonspecific symptoms was predominant (46.9%), with 10 Plasmodium vivax malaria cases, 8 dengue infections, and 6 cases of Q fever. The second most frequent cause of acute febrile illness was upper respiratory tract infections (32.0%) due to influenza virus (n = 18) or human rhinovirus (n = 10). Among the causes of acute febrile illness in French Guiana, clinicians should first consider arboviruses and malaria, as well as Q fever in cases of elevated C-reactive protein with nonspecific symptoms and influenza in cases of signs and symptoms associated with upper respiratory tract infections. Despite an expanded microbiological search, the etiology of 51.4% of acute febrile illnesses remain unknown. Further investigations will be necessary to identify the etiology of acute febrile illnesses, including new pathogens, in French Guiana. |
