The singular epidemiology of HPV infection among French Guianese women with normal cytology.

BACKGROUND: In French Guiana, cervical cancer is the second most frequent cancer in females. The objective of the present study was to describe the prevalence of HPV infections in women with normal cervical cytology living in the remote villages of French Guiana. METHODS: Before the study, the study team communicated in the remote villages on the importance of screening. All women from the target population were offered to participate. They signed informed consent during inclusion and then had a concomitant HPV-test and cervical smear. Only women with normal cytology and a good quality smear were analyzed. The detection of HPV-DNA was performed using the GREINER-BIO-ONE kit. RESULTS: Overall, 27.2% of women with normal cervical cytology had a positive HPV-test. There was a U-shaped evolution of prevalence with women over 50 years having the highest HPV prevalence, followed by the 20 to 29 years group. The most prevalent HPV genotypes were HPV 53(3.52%), 68(3.33%), 52(2.59%), 31(2.22%) and 16 (1.85%). The proportion of HPV 16 among HPV-infected women was 6.8%. CONCLUSIONS: HPV prevalence in cytologically normal women was very high. The most prevalent genotypes were very different from what is usually described in the world, and notably in South America.

[Diagnoses in children seen in general practice in the region of Sousse (Tunisie)]. / La morbidité diagnostiquée chez les enfants en médecine générale dans la région de Sousse (Tunisie).

The objectives of this study were to identify the diseases diagnosed in children under the age of nineteen years old in primary health care centers, and to determine those that have required referral to a specialist for treatment. It is a descriptive study conducted in 92.5% of primary health care centers in the region, and the survey was conducted from two perspectives and levels of analysis. The first focused on a timescale of study, three weeks per season per district. The second focused on assessing medical records. The statistical unit used was the medical consultation. The coding of diagnosis and referrals was done according to the International Classification of Primary Car (ICPC2). The consultations of children under the age of 19 years old accounted for 6629, which is equal to 42.5% of the total number of consultations (including all ages and gender combined). Respiratory disease was by far pre-dominant with 62.5%, followed by digestive and skin disorders respectively in 10.4% and 9.1% of cases. Among the 6629 consultations, 270 of them (representing 4.1%) have needed a reference for specialist treatment or care. More referrals were made for males (57.4%) than females (42.6%) (p=0.015). In most of the cases referred (83%), they could be divided and categorized according to the ICPC2 chapters of classification; 21.9% for respiratory, 16.7% for digestive, 12.6% for both eye and skin, 10.4% for musculoskeletal, 4.8% for urology and 4.1% for ear. The interest of this study is not only epidemiological, but also it has interest as a pedagogical contribution to support and guide the choice of themes for medical training and to provide comparable types of data to be shared between regions and countries.