Disseminated histoplasmosis is a common differential diagnosis of tuberculosis in disease-endemic areas. We aimed to find a predictive score to orient clinicians towards disseminated histoplasmosis or tuberculosis when facing a non-specific infectious syndrome in patients with advanced HIV disease. We reanalyzed data from a retrospective study in Cayenne Hospital between January 1997–December 2008 comparing disseminated histoplasmosis and tuberculosis: 100 confirmed disseminated histoplasmosis cases and 88 confirmed tuberculosis cases were included. A simple logit regression model was constructed to predict whether a case was tuberculosis or disseminated histoplasmosis. From this model, a score may be obtained, where the natural logarithm of the probability of disseminated histoplasmosis/tuberculosis = +3.917962 × WHO performance score (1 if >2, 0 if ≤2) −1.624642 × Pulmonary presentation (1 yes, 0 no) +2.245819 × Adenopathies > 2 cm (1 yes, 0 no) −0.015898 × CD4 count − 0.001851 × ASAT − 0.000871 × Neutrophil count − 0.000018 × Platelet count + 6.053793. The area under the curve was 98.55%. The sensitivity of the model to distinguish between disseminated histoplasmosis and tuberculosis was 95% (95% CI = 88.7–98.3%), and the specificity was 93% (95% CI = 85.7.3–97.4%). In conclusion, we here present a clinical-biological predictive score, using simple variables available on admission, that seemed to perform very well to discriminate disseminated histoplasmosis from tuberculosis in French Guiana in well characterized patients.

In the complex context of French Guiana, different vulnerabilities and different risk factors between genders may lead to complex differences in health outcomes, mortality, and life expectancy. Our aim was, thus, to compare male and female mortality and life expectancy, to compare it between French Guiana and mainland France, and to look at temporal trends and the main specific causes of death in order to identify actionable singularities. National databases were used to obtain life expectancy at birth, at 20, 40, and 60 years, and mortality statistics. Standardized death rates and causes of death for French Guiana and mainland France were obtained through the CEPIDC, which analyzes information from death certificates. When comparing with mainland France, life expectancy at birth was significantly shorter both in males and females (mean = −2.9 years); life expectancy at 20 years, which allows to remove the effect of the greater child mortality in French Guiana, was also shorter in French Guiana for males (mean = −1.8 years) and females (mean = −2 years). The differences between mainland France and French Guiana regarding life expectancy at 40 and 60 years (mean = −1.5 and −1.3 years) was mainly found among females, males in French Guiana life expectancy at 40 and 60 years was closer to that in mainland France (mean = −0.8 and −0.6 years). Although they have a greater life expectancy at birth than men, women in French Guiana are substantially more affected by overweight/obesity and type 2 diabetes. The observed patterns of life expectancy at different ages presumably reflect the burden of external causes and AIDS in males and perhaps metabolic diseases in women.

La drépanocytose est l'une des maladies génétiques les plus fréquentes en France. En Guyane, le dépistage néonatal a été mis en place en 1992, en même temps que les autres programmes de dépistage des maladies infantiles. L'objectif de cette étude est de décrire l'organisation et les résultats du dépistage de la drépanocytose en Guyane entre 1992 et 2021. Nous avons utilisé plusieurs sources de données : les données issues du Programme de médicalisation des systèmes d'information (PMSI), recueillies depuis 2005, les rapports d'activité du Programme national de dépistage néonatal et les données des campagnes de dépistage organisées par l'association Drépaguyane entre 2010 et 2021 sur 1 300 sujets. Les échantillons de sang des nouveau-nés sont collectés par prélèvement capillaire ou veineux et absorption sur papier buvard (Guthrie) en même temps que ceux des autres dépistages néonatals. Les papiers séchés sont envoyés au laboratoire interrégional de Lille pour être analysés. À Saint-Laurent-du-Maroni, afin de réduire la proportion de perdus de vue, un double dépistage est réalisé et le résultat est rendu avant la sortie de maternité. Les données recueillies anonymement ont été analysées à l'aide du logiciel STATA. Parmi les 175 593 naissances entre 1992 et 2021, le dépistage a permis de détecter 823 syndromes drépanocytaires majeurs et 17 950 hétérozygotes. Les syndromes drépanocytaires majeurs comprennent 493 de formes homozygotes SS (60 %), 302 SC (37 %) et 28 S-Bêta-thalassémie (3 %). L'incidence des syndromes drépanocytaires majeurs dans la population des nouveau-nés est de 1/213, IC 95 % [1/236-1/204] et celle des hétérozygotes de 1/10, IC 95 % [1/12-1/8]. La majorité de ces enfants (52 %) était originaire de l'Ouest guyanais. Le délai entre le dépistage et les résultats des tests était de 7 jours. Seuls les résultats pathologiques (homozygote, hétérozygote) sont communiqués aux parents et/ou au médecin traitant par courrier. Ces données confirment la tendance à l'augmentation du nombre d'enfants dépistés pour syndromes drépanocytaires majeurs en Guyane. Les données issues des campagnes de dépistage organisées par l'association Drépaguyane ont permis de décrire la répartition des différentes fractions d'hémoglobines anormales et de confirmer que l'HbS est plus fréquente dans l'ouest de la Guyane. La Guyane est le territoire français où l'incidence des syndromes drépanocytaires majeurs est la plus élevée, et cette incidence continue d'augmenter au fil du temps. Ces données seront utilisées pour guider les politiques de santé publique dans la poursuite de l'amélioration des soins et de la prévention primaire.

Although treatment is recommended for all people living with HIV, not all individuals in the French Guiana cohort were receiving antiretroviral therapy (AR

The drivers of the HIV epidemic, the viruses, the opportunistic infections, the attitudes and the resources allocated to the fight against HIV/AIDS, vary substantially across countries. French Guiana, at the crossroads between Amazonian South America and the Caribbean, constitutes a singular context with poor populations and rich country health funding, which has allowed researchers to gather lots of information on the particulars of our epidemic. We aimed to focus on the little known story of forty years of HIV research in French Guiana and emphasize how local research intertwined with public health action has yielded continuous progress, despite the difficult social conditions of the affected population. We searched Web of Science and associated local experts who worked through much of the epidemic in selecting the most meaningful products of local research for clinical and public health outcomes in French Guiana. Research tools and facilities included, from 1991 onwards, the HIV hospital cohort and the HIV-histoplasmosis cohort. Ad hoc studies funded by the ANRS or the European Regional Development fund shed light on vulnerable groups. The cumulative impact of prospective routine collection and focused efforts has yielded a breadth of knowledge, allowing for informed decisions and the adaptation of prevention, testing and care in French Guiana. After this overview, we emphasize that the close integration of research and public health was crucial in adapting interventions to the singular context of French Guiana.