Centre d'Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana.
TBIP, Université de la Guyane, Cayenne, French Guiana.
PLoS Negl Trop Dis. 2022 Aug 15;16(8):e0010326. doi: 10.1371/journal.pntd.0010326. eCollection 2022 Aug.
Most emerging pathogens are zoonoses and have a wildlife origin. Anthropization and disruption of ecosystems favor the crossing of inter-species barriers. We hypothesize that the marginalized population of undocumented goldminers in the Amazon is at risk of acquiring zoonoses.
A multicentric cross-sectional study included consenting gold-mining adult workers in 2019. A clinical examination recorded dermatological signs of leishmaniosis and past history of yellow fever vaccination. Biological tests were performed for yellow fever, Q fever and leptospirosis serologies. Additional blood samples from a previous study in 2015 were also tested for leptospirosis.
In 2019, 380 individuals were included in the study, along with 407 samples from the 2015 biological collection. The seroprevalence of leptospirosis was 31.0% [95%CI = 26.4-35.5] in 2015 and 28.1% [23.5-32.7] in 2019. The seroprevalence of Q fever was 2.9% [1.2-4.6]. The majority of participants reported being vaccinated against yellow fever (93.6%) and 97.9% had seroneutralizing antibodies. The prevalence of suspected active mucocutaneous leishmaniasis was 2.4% [0.8-3.9].
These unique data shed new light on the transmission cycles of zoonoses still poorly understood in the region. They support the existence of a wild cycle of leptospirosis but not of Q fever. Leishmaniasis prevalence was high because of life conditions and tree felling. High yellow fever vaccine coverage was reassuring in this endemic area. In the era of global health, special attention must be paid to these vulnerable populations in direct contact with the tropical ecosystem and away from the health care system.
大多数新发病原体是动物源性传染病,具有野生动物起源。人类活动的增加和生态系统的破坏有利于跨越物种间的障碍。我们假设亚马逊地区无证件的金矿工人这一边缘化人群面临获得动物源性传染病的风险。
一项多中心横断面研究纳入了 2019 年同意参加的成年采金工人。临床检查记录了皮肤利什曼病的皮肤征象和过去黄热病疫苗接种史。进行了黄热病、Q 热和钩端螺旋体病血清学检测。还对之前 2015 年的生物样本进行了钩端螺旋体病检测。
2019 年,研究纳入了 380 人,同时还纳入了 2015 年生物采集的 407 个样本。2015 年和 2019 年钩端螺旋体病的血清流行率分别为 31.0%(95%CI=26.4-35.5)和 28.1%(23.5-32.7)。Q 热的血清流行率为 2.9%(1.2-4.6)。大多数参与者报告接种过黄热病疫苗(93.6%),且 97.9%的人具有血清中和抗体。疑似活动性黏膜皮肤利什曼病的患病率为 2.4%(0.8-3.9)。
这些独特的数据为该地区仍知之甚少的动物源性传染病传播周期提供了新的认识。它们支持存在野生型钩端螺旋体病循环,但不支持 Q 热。由于生活条件和砍伐树木,利什曼病的患病率很高。在黄热病流行地区,高疫苗覆盖率令人安心。在全球健康时代,必须特别关注这些直接接触热带生态系统且远离卫生保健系统的弱势群体。