Pierre Chauvin | Inserm - Academia.edu (original) (raw)
Papers by Pierre Chauvin
... des inégalités sociales et territoriales de santé ... Synthèse de l'atelier 4 : Poli... more ... des inégalités sociales et territoriales de santé ... Synthèse de l'atelier 4 : Politique des villes, pilotage local de santé, déterminants de santé Animateur : Valérie ... DGS Monique LAFON, chargée de mission SGAR Aquitaine Pierre LARCHER, chargé de mission santé, précarité et ...
Journal of Epidemiology & Community Health, 2011
In order to validate two new lots of Me rieux BCG vaccine (Me rieux seed derived from strain 10... more In order to validate two new lots of Me rieux BCG vaccine (Me rieux seed derived from strain 1072), a calibration study was performed to compare their safety and immunogenicity to a full dose of the WHO-reference BCG vaccine (Tokyo strain 172) as well as the WHO-reference vaccine given at 1/10 of its normal concentration, in an open, randomized, four-arm, multicenter study in Senegal. A total of 1041 healthy Senegalese children aged 8±10 years were screened for participation in this study, of whom 548 had a negative Mantoux test and complied with inclusion and exclusion criteria. These children were randomly allocated a single dose of one of the following vaccines: full-dose Me rieux BCG vaccine (lot E0650); full-dose Me rieux BCG vaccine (lot E0624); full-dose WHO-reference vaccine (Tokyo strain 172); or 1/10 dose WHO-reference vaccine. A follow-up examination, including a tuberculin test, was performed 10±12 weeks after BCG vaccination for 465 (85%) children: 236 Me rieux BCG vaccine (117 lot E0650; 119 lot E0624); 115 full-dose WHO; 114 1/10 dose WHO. The percentage of subjects with a positive tuberculin test after vaccination was signi®cantly lower ( p < 0.001) in the 1/10 dose group (81.5%) compared to the other three groups (>96%). The mean induration diameter was signi®cantly smaller in subjects who received the low-dose of WHO vaccine compared to the others, according to analyses considering all subjects vaccinated, as well as only those subjects with a positive tuberculin test after vaccination. More children in the low-dose group did not have a vaccination scar, and the mean diameter of scars was smaller in this group. The rate of tuberculin reactions, the classi®cation of reactions (Palmer and Edwards), and the characteristics of the vaccinal lesion were similar for the Me rieux BCG vaccines and the full-dose WHOreference vaccine. All vaccines were safe, as evidenced by the absence of adenitis or suppurative adenitis during the course of the study. Results from this trial show that the two lots of Me rieux BCG vaccine behave equally as well as the full-dose WHOreference BCG vaccine. The WHO-reference vaccine, given at 1/10 of its normal concentration was signi®cantly less immunogenic, according to all parameters evaluated. #
Public Health, 2005
Objectives. We investigated the effects of the density of specialists and of the area-level perce... more Objectives. We investigated the effects of the density of specialists and of the area-level percentage of highly educated individuals on the odds of consulting a specialist, and examined whether these variables could explain the observed urban/rural contrast in utilization of specialty care.
Journal of Epidemiology & Community Health, 2011
Study objective The aim of the study was to improve understanding of the relationships between co... more Study objective The aim of the study was to improve understanding of the relationships between contextual socioeconomic characteristics and coronary heart disease (CHD) incidence in France. Several authors have suggested that CHD risk factors (diabetes, hypertension, cholesterol, overweight, tobacco consumption) may partly mediate associations between socioeconomic environmental variables and CHD. Studies have assessed the overall mediating role of CHD risk factors, but have never investigated the specific mediating role of each risk factor, not allowing their specific contribution to the area socioeconomic positioneCHD association to be disentangled. Design After assessing geographical variations in CHD incidence and socioeconomic environmental effects on CHD using a multilevel Cox model, the extent to which this contextual effect was mediated by each of the CHD risk factors was assessed. Participants Data of the French GAZEL cohort (n¼19 808) were used. Main results After adjustment for several individual socioeconomic indicators, it was found, in men from highly urbanised environments, that CHD incidence increased with decreasing socioeconomic position of the residential environment. After individual-level adjustment, a higher risk of obesity, smoking and cholesterol was observed in the most deprived residential environments. When risk factors were introduced into the model, a modest decrease was observed in the magnitude of the association between the socioeconomic contextual variable and CHD. Risk factors that contributed most to the decrease of the association were smoking and cholesterol. Conclusions Classic risk factors, although some of them more than others, mediated a modest part of the association between area socioeconomic position and CHD.
American Journal of Medical Genetics, 2004
Recent investigations identified a large deletion of the GJB6 gene in trans to a mutation of GJB2... more Recent investigations identified a large deletion of the GJB6 gene in trans to a mutation of GJB2 in deaf patients. We looked for GJB2 mutations and GJB6 deletions in 255 French patients presenting with a phenotype compatible with DFNB1. 32% of the patients had biallelic GJB2 mutations and 6% were a heterozygous for a GJB2 mutation and a GJB6 deletion. Biallelic GJB2 mutations and combined GJB2/GJB6 anomalies were more frequent in profoundly deaf children. Based on these results, we are now assessing GJB6 deletion status in cases of prelingual hearing loss.
American Journal of Epidemiology, 2004
Cet ouvrage propose un état des lieux de la situation de différentes mégapoles du Nord et du Sud,... more Cet ouvrage propose un état des lieux de la situation de différentes mégapoles du Nord et du Sud, de l'Orient et de l'Occident, confrontées au « défi des nouvelles inégalités ». Les auteurs ont, en effet, voulu sensibiliser un lectorat le plus large possible à plusieurs notions ...
Revue d'Épidémiologie et de Santé Publique, 2008
![Research paper thumbnail of [Migration, health and access to care in Mayotte Island in 2007: lessons learned from a representative survey]](https://attachments.academia-assets.com/44410416/thumbnails/1.jpg)
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Vaccine, Jan 19, 2013
After withdrawal of multipuncture BCG device from the French market in January 2006, vaccination ... more After withdrawal of multipuncture BCG device from the French market in January 2006, vaccination coverage (VC) with the intradermal device has dropped and since remained sub-optimal in Ile-de-France, the only region of mainland France where BCG is recommended to all children. We conducted a cross-sectional study to identify socio-economic factors associated with BCG VC in children of Paris metropolitan area born after January 2006. Two-stage random sampling was used to include 425 children up to 5 years old from Paris and its suburbs. Information was collected through face-to-face interviews and vaccination status confirmed by a vaccination document. Poisson regression analyzed the association between VC and potential determinants. VC of children from families with the lowest incomes (first quartile of family income/consumption unit (CU) (<883 €) was close to 100% regardless of family origin. In families with higher incomes (≥ 883 €/CU), VC was significantly higher among children...
![Research paper thumbnail of [Low pneumococcal conjugated vaccine immunization coverage in low-income families: a study in Île-de-France]](https://attachments.academia-assets.com/44410452/thumbnails/1.jpg)
](Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2014
Socio-economic inequalities in access to vaccination are poorly documented in France. This study ... more Socio-economic inequalities in access to vaccination are poorly documented in France. This study analyzed socio-economic inequalities in pneumococcal conjugate vaccine (PCV7) immunization coverage, the cost of which is about 180 € for three doses. We conducted a cross-sectional survey including children aged 0-5 years living in Paris and its immediate suburbs, selected by a stratified two-stage random sampling design. Data were collected in a face-to-face interview. Vaccination coverage, confirmed by a document, was measured for the first dose and the full primary vaccination series. Poisson regression was used to analyze the association between PCV7 vaccination coverage and several socio-economic and demographic factors. Vaccination coverage for the first dose was 93.7% and 76.7% for the full primary vaccination series. The first-dose vaccination coverage in children from lower income families (first quartile of income) was lower than that of children from higher income families (8...
PEDIATRICS, 2007
http://pediatrics.aappublications.org/content/120/4/e984.full.html located on the World Wide Web at:
Introduction/Objectives. Socio-economic inequalities in access to vaccination are poorly document... more Introduction/Objectives. Socio-economic inequalities in access to vaccination are poorly documented in France. This study analyzed socio-economic inequalities in pneumococcal conjugate vaccine (PCV7) immunization coverage, the cost of which is about 180 s for three doses. Methods. We conducted a cross-sectional survey including children aged 0-5 years living in Paris and its immediate suburbs, selected by a stratified two-stage random sampling design. Data were collected in a face-to-face interview. Vaccination coverage, confirmed by a document, was measured for the first dose and the full primary vaccination series. Poisson regression was used to analyze the association between PCV7 vaccination coverage and several socio-economic and demographic factors. Results. Vaccination coverage for the first dose was 93.7% and 76.7% for the full primary vaccination series. The first-dose vaccination coverage in children from lower income families (first quartile of income) was lower than that of children from higher income families (83.2% versus 97.3%, P = 0.033). A similar result was also observed for the full primary vaccination series, although this result was not statistically significant (65.5% versus 87.6%, P = 0.09). Full Résumé § Ce travail (mêmes auteurs) a été présenté au Congrès de l'Association des épidémiologistes de langue française, les 17-19 octobre 2013 à Bordeaux. § § Ce travail a été financé par l'
... des inégalités sociales et territoriales de santé ... Synthèse de l'atelier 4 : Poli... more ... des inégalités sociales et territoriales de santé ... Synthèse de l'atelier 4 : Politique des villes, pilotage local de santé, déterminants de santé Animateur : Valérie ... DGS Monique LAFON, chargée de mission SGAR Aquitaine Pierre LARCHER, chargé de mission santé, précarité et ...
Journal of Epidemiology & Community Health, 2011
In order to validate two new lots of Me rieux BCG vaccine (Me rieux seed derived from strain 10... more In order to validate two new lots of Me rieux BCG vaccine (Me rieux seed derived from strain 1072), a calibration study was performed to compare their safety and immunogenicity to a full dose of the WHO-reference BCG vaccine (Tokyo strain 172) as well as the WHO-reference vaccine given at 1/10 of its normal concentration, in an open, randomized, four-arm, multicenter study in Senegal. A total of 1041 healthy Senegalese children aged 8±10 years were screened for participation in this study, of whom 548 had a negative Mantoux test and complied with inclusion and exclusion criteria. These children were randomly allocated a single dose of one of the following vaccines: full-dose Me rieux BCG vaccine (lot E0650); full-dose Me rieux BCG vaccine (lot E0624); full-dose WHO-reference vaccine (Tokyo strain 172); or 1/10 dose WHO-reference vaccine. A follow-up examination, including a tuberculin test, was performed 10±12 weeks after BCG vaccination for 465 (85%) children: 236 Me rieux BCG vaccine (117 lot E0650; 119 lot E0624); 115 full-dose WHO; 114 1/10 dose WHO. The percentage of subjects with a positive tuberculin test after vaccination was signi®cantly lower ( p < 0.001) in the 1/10 dose group (81.5%) compared to the other three groups (>96%). The mean induration diameter was signi®cantly smaller in subjects who received the low-dose of WHO vaccine compared to the others, according to analyses considering all subjects vaccinated, as well as only those subjects with a positive tuberculin test after vaccination. More children in the low-dose group did not have a vaccination scar, and the mean diameter of scars was smaller in this group. The rate of tuberculin reactions, the classi®cation of reactions (Palmer and Edwards), and the characteristics of the vaccinal lesion were similar for the Me rieux BCG vaccines and the full-dose WHOreference vaccine. All vaccines were safe, as evidenced by the absence of adenitis or suppurative adenitis during the course of the study. Results from this trial show that the two lots of Me rieux BCG vaccine behave equally as well as the full-dose WHOreference BCG vaccine. The WHO-reference vaccine, given at 1/10 of its normal concentration was signi®cantly less immunogenic, according to all parameters evaluated. #
Public Health, 2005
Objectives. We investigated the effects of the density of specialists and of the area-level perce... more Objectives. We investigated the effects of the density of specialists and of the area-level percentage of highly educated individuals on the odds of consulting a specialist, and examined whether these variables could explain the observed urban/rural contrast in utilization of specialty care.
Journal of Epidemiology & Community Health, 2011
Study objective The aim of the study was to improve understanding of the relationships between co... more Study objective The aim of the study was to improve understanding of the relationships between contextual socioeconomic characteristics and coronary heart disease (CHD) incidence in France. Several authors have suggested that CHD risk factors (diabetes, hypertension, cholesterol, overweight, tobacco consumption) may partly mediate associations between socioeconomic environmental variables and CHD. Studies have assessed the overall mediating role of CHD risk factors, but have never investigated the specific mediating role of each risk factor, not allowing their specific contribution to the area socioeconomic positioneCHD association to be disentangled. Design After assessing geographical variations in CHD incidence and socioeconomic environmental effects on CHD using a multilevel Cox model, the extent to which this contextual effect was mediated by each of the CHD risk factors was assessed. Participants Data of the French GAZEL cohort (n¼19 808) were used. Main results After adjustment for several individual socioeconomic indicators, it was found, in men from highly urbanised environments, that CHD incidence increased with decreasing socioeconomic position of the residential environment. After individual-level adjustment, a higher risk of obesity, smoking and cholesterol was observed in the most deprived residential environments. When risk factors were introduced into the model, a modest decrease was observed in the magnitude of the association between the socioeconomic contextual variable and CHD. Risk factors that contributed most to the decrease of the association were smoking and cholesterol. Conclusions Classic risk factors, although some of them more than others, mediated a modest part of the association between area socioeconomic position and CHD.
American Journal of Medical Genetics, 2004
Recent investigations identified a large deletion of the GJB6 gene in trans to a mutation of GJB2... more Recent investigations identified a large deletion of the GJB6 gene in trans to a mutation of GJB2 in deaf patients. We looked for GJB2 mutations and GJB6 deletions in 255 French patients presenting with a phenotype compatible with DFNB1. 32% of the patients had biallelic GJB2 mutations and 6% were a heterozygous for a GJB2 mutation and a GJB6 deletion. Biallelic GJB2 mutations and combined GJB2/GJB6 anomalies were more frequent in profoundly deaf children. Based on these results, we are now assessing GJB6 deletion status in cases of prelingual hearing loss.
American Journal of Epidemiology, 2004
Cet ouvrage propose un état des lieux de la situation de différentes mégapoles du Nord et du Sud,... more Cet ouvrage propose un état des lieux de la situation de différentes mégapoles du Nord et du Sud, de l'Orient et de l'Occident, confrontées au « défi des nouvelles inégalités ». Les auteurs ont, en effet, voulu sensibiliser un lectorat le plus large possible à plusieurs notions ...
Revue d'Épidémiologie et de Santé Publique, 2008
Vaccine, Jan 19, 2013
After withdrawal of multipuncture BCG device from the French market in January 2006, vaccination ... more After withdrawal of multipuncture BCG device from the French market in January 2006, vaccination coverage (VC) with the intradermal device has dropped and since remained sub-optimal in Ile-de-France, the only region of mainland France where BCG is recommended to all children. We conducted a cross-sectional study to identify socio-economic factors associated with BCG VC in children of Paris metropolitan area born after January 2006. Two-stage random sampling was used to include 425 children up to 5 years old from Paris and its suburbs. Information was collected through face-to-face interviews and vaccination status confirmed by a vaccination document. Poisson regression analyzed the association between VC and potential determinants. VC of children from families with the lowest incomes (first quartile of family income/consumption unit (CU) (<883 €) was close to 100% regardless of family origin. In families with higher incomes (≥ 883 €/CU), VC was significantly higher among children...
Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie, 2014
Socio-economic inequalities in access to vaccination are poorly documented in France. This study ... more Socio-economic inequalities in access to vaccination are poorly documented in France. This study analyzed socio-economic inequalities in pneumococcal conjugate vaccine (PCV7) immunization coverage, the cost of which is about 180 € for three doses. We conducted a cross-sectional survey including children aged 0-5 years living in Paris and its immediate suburbs, selected by a stratified two-stage random sampling design. Data were collected in a face-to-face interview. Vaccination coverage, confirmed by a document, was measured for the first dose and the full primary vaccination series. Poisson regression was used to analyze the association between PCV7 vaccination coverage and several socio-economic and demographic factors. Vaccination coverage for the first dose was 93.7% and 76.7% for the full primary vaccination series. The first-dose vaccination coverage in children from lower income families (first quartile of income) was lower than that of children from higher income families (8...
PEDIATRICS, 2007
http://pediatrics.aappublications.org/content/120/4/e984.full.html located on the World Wide Web at:
Introduction/Objectives. Socio-economic inequalities in access to vaccination are poorly document... more Introduction/Objectives. Socio-economic inequalities in access to vaccination are poorly documented in France. This study analyzed socio-economic inequalities in pneumococcal conjugate vaccine (PCV7) immunization coverage, the cost of which is about 180 s for three doses. Methods. We conducted a cross-sectional survey including children aged 0-5 years living in Paris and its immediate suburbs, selected by a stratified two-stage random sampling design. Data were collected in a face-to-face interview. Vaccination coverage, confirmed by a document, was measured for the first dose and the full primary vaccination series. Poisson regression was used to analyze the association between PCV7 vaccination coverage and several socio-economic and demographic factors. Results. Vaccination coverage for the first dose was 93.7% and 76.7% for the full primary vaccination series. The first-dose vaccination coverage in children from lower income families (first quartile of income) was lower than that of children from higher income families (83.2% versus 97.3%, P = 0.033). A similar result was also observed for the full primary vaccination series, although this result was not statistically significant (65.5% versus 87.6%, P = 0.09). Full Résumé § Ce travail (mêmes auteurs) a été présenté au Congrès de l'Association des épidémiologistes de langue française, les 17-19 octobre 2013 à Bordeaux. § § Ce travail a été financé par l'