Leprosy in French Guiana, 2015 to 2021: Dynamics of a Persistent Public Health Problem

Authors

  • Aurore Petiot Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana
  • Kinan Drak Alsibai Histopathology and Cytology Department, Cayenne Hospital Centre, Cayenne, French Guiana
  • Carmelita Dossou Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana
  • Pierre Couppie Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana
  • Romain Blaizot Dermatology Department, Cayenne Hospital Centre, Cayenne, French Guiana

DOI:

https://doi.org/10.2340/actadv.v103.6246

Keywords:

French Guiana, Leprosy, Epidemiology, Reversal Reaction, Infliximab

Abstract

A resurgence of leprosy as a public health problem in French Guiana was reported over the period 2007 to 2014, particularly among Brazilians gold miners. Prolonged multidrug therapy and reversal reactions represent a therapeutic challenge. The objective of this study was to assess the evolution of leprosy in this European overseas territory. All patients with leprosy confirmed in histopathology between 1 January 2015 and 31 December 2021 were included. A total of 86 patients were included, including 64 new cases and 22 previously diagnosed cases. Sixty patients (70%) were male, 6 cases were paediatric. Brazilian gold miners represented 44.1% of reported occupations (15/34). Maroons represented the second community (13 patients, 15%). Multibacillary and paucibacillary forms were found in 53 (71%) and 22 (29%) patients, respectively. The annual prevalence never exceeded the threshold of 1/10,000. The mean incidence and prevalence were significantly lower than during the period 2007 to 2014 (p < 0.0001). Reversal reactions were found in 29 patients and almost always required a long course of steroids. Infliximab allowed a reduction in the length of treatment with steroids in 2/2 cases. In conclusion, the prevalence of leprosy has decreased significantly in French Guiana, but remains driven by the population of illegal gold miners. Anti-tumour necrosis factor (anti-TNF) drugs represent a promising option in the management of reversal reactions.

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Published

2023-05-05

How to Cite

Petiot, A., Drak Alsibai, K., Dossou, C., Couppie, P., & Blaizot, R. (2023). Leprosy in French Guiana, 2015 to 2021: Dynamics of a Persistent Public Health Problem. Acta Dermato-Venereologica, 103, adv6246. https://doi.org/10.2340/actadv.v103.6246

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