[The subcutaneous etonogestrel implant: a new contraceptive method in Mayotte?]. / L'etonogestrel en implant sous-cutané: un nou- veau moyen de contraception a Mayotte?

The isle of Mayotte is a part of the Comoros archipelago, its political status is that of a French Territory Despite a birth control programme helping to space out the births rather than restricting their number, the Mayotte population growth is soaring. Since the visit of the President in May 2001 the subcutaneous etonogestrel implant became available for the population of Mayotte. We then carried out a study to evaluate the response given by 50 post-partum women to this new contraceptive method. 38% of the women declared to be willing to use this contraceptive device while 52% instead didn't wish to try. Although not clearly expressed, the wish to have large families is still there and can be explained by religious and cultural factors. Considering the study results, this contraceptive method could certainly be useful in Mayotte. However a well-balanced education campaign, neither too negative nor too enthusiastic, should be necessary to avoid false expectations which in that case could induce widespread negative rumour towards the birth control method.

Efficacy of artemether-lumefantrine treatment in patients with acute uncomplicated Falciparum malaria in Mayotte, a French collectivity of the Comoros Archipelago.

Mayotte is a French island located in the Comoros archipelago in the Indian Ocean. Due to the high level of resistance to chloroquine and sulfadoxine-pyrimethamine in this area, new therapeutic strategies are required. The aim was to assess and to document the efficacy of artemether-lumefantrine (AL) combination in four oral dosages. The follow-up was carried out during 21 days to monitor the antimalarial drug efficacy in an open trial in April-May, 2002. Results were obtained from 51 patients, aged from three to 46 years (12% less than five years). No case of therapeutic failure was observed. At day 2 after treatment, all the patients were apyretic and none of them had parasitaemia until day 21. This first therapeutic trial of the AL combination in the Indian Ocean sub-region shows that this association is safe, effective and rapid. AL should be an alternative treatment of uncomplicated malaria attacks in Comoros Archipelago, and will be of help to manage imported chloroquine-resistant falciparum malaria strains in Madagascar.