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Master Thesis

Leishmaniose Cutanée en Guyane : mise à jour épidémiologique et étude des facteurs de risque environnementaux

Abstract : Background: American cutaneous Leishmaniasis (ACL) is endemic in French Guiana. Its epidemiology is evolving, notably due to immigration, anthropization of natural areas and new detection methods. Our first objective was to update clinical and epidemiological data for this pathology. Our second objective was to look for ethnical, geographical and behavioural risk factors of ACL. Methods: This study was conducted in the Cayenne General Hospital and its 10 health centres for remote areas, from October 2017 to June 2018. Patients with suspicion of mucocutaneous leishmaniasis were included in case of positive smear. Culture with MALDI-TOF and PCR- RFLP were used for species identification. Results: One hundred and twenty-three patients met the inclusion criteria. Among them, 41% cases involved Brazilian gold miners, 58% were between 16 and 40 years old, 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% of them) or leisure activities (57%) and had a shorter time to diagnosis than workers of the hinterland. Among environmental risk factors, presence of a water spring (40%) and dogs around houses (40%) were frequently reported. Leishmania guyanensis represented 80% cases, followed by Leishmania braziliensis (6%), Leishmania naiffi (2%) and Leishmania amazonensis (1%). Conclusions: These results show how goldmining and trips to the primary forest represent high- risk situations for ACL in French Guiana. A larger study should investigate the importance of housing, dogs and water sources as risk factors.
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Master Thesis
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Rémi Loiseau. Leishmaniose Cutanée en Guyane : mise à jour épidémiologique et étude des facteurs de risque environnementaux. Médecine humaine et pathologie. 2019. ⟨dumas-02500107⟩

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