Research for Angiostrongylus Cantonensis and Costaricensis in French West Indies and French Guiana

NCT03378882 | Unknown

• 1 other identifier: 17/E/05
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Hospitals in the French West Indies (Fort-de-France (Martinique); Basse-Terre and Pointe-à-Pitre (Guadeloupe); and French Guiana (Cayenne, Saint-Laurent du Maroni)) have noted the emergence of eosinophilic meningitis cases in recent years. This finding is part os eosinophilic meningitis cases emergence and meningoencephalitis caused by the parasite Angiostrongylus cantonensis on the American continent and in the Greater Antilles. In 2013, the investigation of an eosinophilic meningitis case by the Basse-Terre hospital team with a positive specific PCR in the CSF (CDC, Atlanta, USA) showed the first case of neuromeningeal angiostrongylosis in Guadeloupe. A similar case was diagnosed by serology at Pointe-à-Pitre University Hospital a few years earlier without having been published, and another serious case diagnosed also at Pointe-à-Pitre University Hospital Center in January 2017. The team at the Martinique University Hospital Center also reported several cases of eosinophilic meningitis with positive serologies for A. cantonensis carried out in laboratories outside Martinique (Laboratory of Parasitology, Gonesse, France; Thailand; and Tropical Institute and Public Health, Switzerland) in recent years. The emergence of this parasitosis is related to the introduction of the intermediate host Achatina fulica on the American continent and the geographical evolution of the angiostrongylosis cases is intrinsically linked to that of the Achatins. To date, only two studies report the environmental presence of Angiostrongylus cantonensis in the Lesser Antilles. One proved the presence in rats (23.4%) on the island of Grenada, and the other in Guadeloupe, showing that 32.4% of Achatina fulica collected carried the parasite by specific PCR. In Martinique, where the number of cases is increasing, and in French Guiana, where there is an increase in the number of cases in neighboring countries, especially Brazil, no study has been conducted on this parasite. In parallel with this finding, several serious digestive tables associated with strong hypereosinophilia were reported in Martinique and Guadeloupe in the 90s but also in recent years, the last case in December 2016. Etiological diagnoses were established by the discovery of Angiostrongylus costaricensis parasite in ileal pathological specimens. However, these cases could never be investigated by serology or specific PCR due to lack of diagnostic tools available in the French West Indies and Guiana region, and more broadly in metropolitan France.

Conditions

Angiostrongylosis; Hypereosinophilia

Keywords

Angiostrongylosis; Hypereosinophilia; Eosinophilic meningitis; Meningoencephalitis; Achatina fulica; Angiostrongylus cantonensis; Angiostrongylus costaricensis

Outcome Measures

Primary Outcomes (2)

• Number of participants with angiostrongylosis A. cantonensis

  The crude incidence will be calculated: Reported number of cases of angiostrongylosis A. cantonensis diagnosed during the study inclusion period (3 years) on the total population (population census data). The number of human cases of angiostrongylosis A. cantonensis diagnosed since the emergence of the parasite in the West Indies and Guiana will be calculated. The standardized incidence (on age and sex) of this infection will be calculated.

  36 months

• Number of participants with angiostrongylosis A. costaricensis

  The crude incidence will be calculated: Reported number of cases of angiostrongylosis A. costaricensis diagnosed during the study inclusion period (3 years) on the total population (population census data). The number of human cases of angiostrongylosis A. costaricensis diagnosed since the emergence of the parasite in the West Indies and Guiana will be calculated. The standardized incidence (on age and sex) of this infection will be calculated.

  36 months

Interventions

Parasitic serologies BIOLOGICAL

Suspected angiostrongylosis - Angiostrongylus cantonensis: * An aliquot of CSF and an aliquot of serum will be sent to the laboratory of tropical medicine in Switzerland for research of specific antibodies. * A CSF aliquot will be sent to the CDC for PCR. Suspected angiostrongylosis- Angiostrongylus costaricensis: \- An aliquot of serum will be sent to the laboratory of tropical medicine in Switzerland for research of specific antibodies.

Biopsy PROCEDURE

Suspected angiostrongylosis - Angiostrongylus costaricensis: \- A piece of biopsy or intestinal resection will be sent to the pathology laboratory for parasitic elements suggestive of Angiostrongylus costaricensis infection

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All hospitalized patients, whatever their age, sex, weight, presenting hypereosinophilia. Suspicious cases may come from different hospital services (pediatrics, infectiology, resuscitation, neurology, emergencies, ...).

You may qualify if:

• Hypereosinophilia associated with a meningeal table (= suspicion of neuromeningeal angiostrongylosis), or,
• Hypereosinophilia associated with a severe gastrointestinal table(= suspicion of intestinal angiostrongylosis)

You may not qualify if:

• Refusal of the patient to be included in the study
• Angiostrongylosis of importation (contracted outside the French West Indies - French Guiana region)
• Absence of hypereosinophilia
• Hypereosinophilia in the context of an other parasitosis
• Non-parasitic hypereosinophilia

Sponsors & Collaborators

• University Hospital Center of Martinique: lead
• University Hospital Center of Pointe-à-Pitre/Abymes (Guadeloupe): collaborator
• Hospital Center of Basse-Terre (Guadeloupe): collaborator
• Hospital Center of Cayenne (French Guiana): collaborator
• Hospital Center of Saint-Laurent du Maroni (French Guiana): collaborator

Study Sites (1)

CHU of Martinique

Fort-de-France, 97261, France

RECRUITING

MeSH Terms

Conditions

Strongylida Infections; Eosinophilia; Meningoencephalitis; Angiostrongyliasis

Interventions

Biopsy

Condition Hierarchy (Ancestors)

Secernentea Infections; Nematode Infections; Helminthiasis; Parasitic Diseases; Infections; Leukocyte Disorders; Hematologic Diseases; Hemic and Lymphatic Diseases; Central Nervous System Viral Diseases; Central Nervous System Infections; Encephalitis; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neuroinflammatory Diseases; Meningitis

Intervention Hierarchy (Ancestors)

Cytodiagnosis; Cytological Techniques; Clinical Laboratory Techniques; Diagnostic Techniques and Procedures; Diagnosis; Specimen Handling; Diagnostic Techniques, Surgical; Surgical Procedures, Operative; Investigative Techniques

Study Officials

• Nicole DESBOIS, MD

  CHU of Martinique

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Nicole DESBOIS, MD

CONTACT

0596559665; nicole.desbois-nogard@chu-martinique.fr

Céline DARD, MD

CONTACT

cdard@chu-grenoble.fr

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 7, 2017
• First Posted: December 20, 2017
• Study Start: April 3, 2018
• Primary Completion: April 3, 2021
• Study Completion: August 1, 2021
• Last Updated: December 11, 2020

Record last verified: 2020-12

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)