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Cohort of Patients Infected by an Arbovirus

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StatusRegrutovanje
Sponzori
University Hospital Center of Martinique
Saradnici
Institut National de la Santé Et de la Recherche Médicale, France
Clinique Antilles-Guyane

Ključne riječi

Sažetak

Arbovirus refers to a group of viruses transmitted by blood-feeding arthropods. There are hundred which have been shown to cause disease in humans. The incubation period is usually limited between 1 and 15 days. The most common clinical features of infection are 4: algo-eruptive, hemorrhagic fever, neurological or arthritic afflictions.
Dengue is a mosquito-born viral disease caused by 4 different serotypes of virus. Dengue fever (DF) is defined by the sudden onset of fever with non-specific constitutional symptoms, recovery occurring spontaneously after 3 to 7 days.
The infection can sometimes progress to dengue hemorrhagic fever (DHF) characterized by a transient increase in vascular permeability provoking a plasma leakage syndrome. DHF can be complicated by shock and internal hemorrhage. Other rarer but potentially life-threatening complications include encephalitis, hepatitis, rhabdomyolysis and myocarditis.
There is currently no way of predicting the outcome of DF or DHF and the WHO classification lacks sufficient sensitivity and specificity to recognize and guide the management of severe forms of dengue. The pathophysiology of these severe forms is also poorly known.
Since the early 2000s, the French West Indies and French Guiana have become hyperendemic for dengue with simultaneous circulation of the 4 serotypes, regular large outbreak and severe dengue including fatalities.
Chikungunya is a re-emerging alphavirus causing massive epidemics in Africa, in the Indian Ocean and Southeast Asia. The first autochthonous cases were described in French Antilles in Nov. 2013. The disease consists of an acute illness like dengue fever, characterized by abrupt onset of a high-grade fever, followed by constitutionals symptoms, poly-arthritis and skin involvement. Usually, the illness resolves within 4 to 6 weeks. However, severe clinical forms in early stage may appear and chronic forms such as incapacitating arthralgia which affect 40 to 60% of patients with confirmed chikungunya. In France, others arboviruses may cause severe emerging and re-emerging infectious diseases like Zika or West Nile. In non-immunized population they may cause outbreaks with specific severe clinical complications. French interministerial mission on emerging infectious diseases, coordinated by Professor A. Flahault, recommended such studies.

Opis

Principal objective To identify demographic, clinical, biological, virologic, immunologic and genetic factors associated with or predictive of severe complications of arbovirus infections (shock, internal bleeding, organ failure, death) in a cohort of children and adults with confirmed arbovirus infections, in France.

Secondary objective

To identify demographic, clinical, biological, virologic, immunologic and genetic factors predictive of altered quality of life after confirmed an acute arbovirus infection. Onset of specific complications:

- Hemorrhagic fever (dengue :WHO criteria..)

- Neurological disorders (West Nile virus infection, Zika virus infection, Japanese encephalitis…)

- Chronic chikungunya (persistent musculoskeletal symptoms for more than three months after symptoms onset)

Datumi

Posljednja provjera: 12/31/2018
Prvo podneseno: 02/22/2010
Predviđena prijava predata: 04/05/2010
Prvo objavljeno: 04/07/2010
Zadnje ažuriranje poslato: 07/21/2019
Posljednje ažuriranje objavljeno: 07/23/2019
Stvarni datum početka studija: 05/31/2010
Procijenjeni datum primarnog završetka: 06/30/2021
Predviđeni datum završetka studije: 06/30/2021

Stanje ili bolest

Fever
Dengue
Chikungunya
Zika Virus

Intervencija / liječenje

Other: biological sample collection

Other: quality of life questionnaire EuroQol®

Other: Health Assessment Questionnaire - MDHAQ and RAPID3

Faza

-

Kriteriji prihvatljivosti

Polovi podobni za studiranjeAll
Metoda uzorkovanjaNon-Probability Sample
Prihvaća zdrave volontereDa
Kriterijumi

INCLUSION CRITERIA :

1. Adult, child or newborn.

2. Consulting a participating hospital center (emergency room, full hospitalization, day hospitalization, or outpatient visit).

3. Arbovirosis suspected or confirmed biologically:

A suspected case of arbovirus infection is defined by:

- The combination of clinical and biological signs observed on the day of enrollment or during the previous 7 days: fever (reported by the patient or family, or documented) and two or more of the following signs: headache, rash, myalgia, arthralgia, abdominal pain, hemorrhage, thrombocytopenia, or

- Children under 6 years: the report (by family or documented) of a fever on the day of enrollment or within 7 previous days, possibly accompanied by a of pain greater than or equal to 4/10 on hetero assessment scale age age-appropriate

A case of arbovirus infection confirmed biologically is defined by:

- RT-PCR arbovirus positive in plasma or urine (Zika virus infection), or by detection of the NS1 antigen (dengue), or an appearance or an significant increase (multiplication of the title by four) of the G immunoglobulin directed against arbovirus in question on an early taken serum ( during the first week following the start of symptoms) and another taken at least 10 days later..

4. Symptom onset within the seven days before the enrollment visit or within 21 days for severe forms of the disease.Possibility of follow-up throughout study period.

5. Patient or holder of parental authority registered in the French medical social security national program

6. Acceptance to participate in the study and in follow-up; informed consent of the patient (adult and minor in age to express his desire) or a legal representative (for minors, and patients unable to sign the consent form).

EXCLUSION CRITERIA :

1. Newborn with a weight < 2.5 kg the days of enrollment

2. Suspected arbovirosis whose symptom onset date more than 7 days or 21 days for severe forms of the disease.Clinical diagnosis of another infection as arbovirosis

3. Confirmed Malaria Access

4. No follow-up possible after the first visit

5. Refusal to participate to the study

6. Patient or holder of parental authority not registered in the French medical social security national program

Ishod

Primarne mjere ishoda

1. Occurrence, during follow-up (for 12 weeks following symptom onset), of shock, internal bleeding, failure of one or several organs or systems (brain, heart, lung, liver, kidney, clotting system), or death. [12 weeks]

The primary endpoint is a composite endpoint defined as the occurrence, within 12 weeks of the onset of arbovirosis, of at least 1 of the following events: death or shock or internal bleeding, or failure to one or more organs or systems (brain, heart, lung, liver, kidney, hemostasis). Deaths not attributable directly or indirectly to the arbovirosis in question will not be taken into account.

Sekundarne mjere ishoda

1. Specific complications: Onset of hemorrhagic fever (dengue) Onset of encephalitis or neurological disorders (West Nile virus, Japanese encephalitis, Zika virus) Onset of chronic form (Chikungunya) [12 weeks]

The analysis will focus only on patients with biologically confirmed arbovirosis by one of the following exams: RT-PCR plasma (arbovirus), or urine (Zika virus), Research of the NS1 positive antigen (dengue), Significant appearance or increase of the G immunoglobulin directed against the arbovirus in question between an early serum (during the first week following the onset of symptoms) and another taken at least 10 days later

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