Alexandre Mendibil | Université Lyon (original) (raw)

Papers by Alexandre Mendibil

Malaria Journal, 2016

In December 2010, a Plasmodium vivax malaria outbreak occurred among French forces involved in a ... more In December 2010, a Plasmodium vivax malaria outbreak occurred among French forces involved in a mission to control illegal gold mining in French Guiana. The findings of epidemiological and entomological investigations conducted after this outbreak are presented here. Data related to malaria cases reported to the French armed forces epidemiological surveillance system were collected during the epidemic period from December 2010 to April 2011. A retrospective cohort study was conducted to identify presumed contamination sites. Anopheles mosquitoes were sampled at the identified sites using Mosquito Magnet and CDC light traps. Specimens were identified morphologically and confirmed using molecular methods (sequencing of ITS2 gene and/or barcoding). Anopheles infections with Plasmodium falciparum and P. vivax were tested by both enzyme-linked immunosorbent assay and real-time PCR. Seventy-two P. vivax malaria cases were reported (three were mixed P. falciparum/P. vivax infections), leading to a global attack rate of 26.5 % (72/272). Lack of compliance with vector control measures and doxycycline chemoprophylaxis was reported by patients. Two illegal gold mining sites located in remote areas in the primary forest were identified as places of contamination. In all, 595 Anopheles females were caught and 528 specimens were formally identified: 305 Anopheles darlingi, 145 Anopheles nuneztovari s.l., 63 Anopheles marajoara and 15 Anopheles triannulatus s.l. Three An. darlingi were infected by P. falciparum (infection rate: 1.1 %) and four An. marajoara by P. vivax (infection rate: 6.4 %). The main drivers of the outbreak were the lack of adherence by military personnel to malaria prevention measures and the high level of malaria transmission at illegal gold mining sites. Anopheles marajoara was clearly implicated in malaria transmission for the first time in French Guiana. The high infection rates observed confirm that illegal gold mining sites must be considered as high level malaria transmission areas in the territory. Illegal gold mining activities are challenging the control of malaria in French Guiana. Collaboration with neighbouring countries is necessary to take into account mobile populations such as gold miners. Malaria control strategies in the French armed forces must be adapted to P. vivax malaria and sylvatic Anopheles species.

Le bloc ilio-fascial est une technique d’analgésie de référence ayant montrée son intérêt et son ... more Le bloc ilio-fascial est une technique d’analgésie de référence ayant montrée son intérêt et son innocuité en urgence préhospitalière. Les indications du bloc ilio-fascial sont les fractures de la diaphyse fémorale mais aussi les lésions touchant les structures osseuses de la hanche. Les contre-indications sont nombreuses en traumatologie préhospitalière et doivent être scrupuleusement respectées. Le geste technique est réalisé après information du patient. Cette anesthésie locorégionale nécessite peu de matériel et consiste en l'injection d’un anesthésique local dans l'espace ilio-fascial où transitent les nerfs fémoral, cutané latéral de la cuisse et obturateur. Le mécanisme de cette analgésie est double : direct par bloc sensitif et indirect par relâchement musculaire. Comme pour toute anesthésie locorégionale les conditions de sécurité élémentaires sont requises avec à disposition immédiate les moyens nécessaires pour palier effets indésirables et complications immédiates (malaise, toxicité systémique, allergie). Nous présentons la technique du bloc ilio-fascial en urgence préhospitalière.

Malaria Journal, 2010

Background: Plasmodium ovale is responsible for 5% of imported malaria in French travellers. The ... more Background: Plasmodium ovale is responsible for 5% of imported malaria in French travellers. The clinical and biological features of six clustered cases of P. ovale malaria in an army unit of 62 French soldiers returning from the Ivory Coast are reported. Case report: All patients were symptomatic and developed symptoms on average 50 days after their return and 20 days after the end of chemoprophylaxis (doxycycline). Clinical features included fever (6/6), mostly tertian (4/6), aches (6/6), nausea (3/6), abdominal pain (2/6), diarrhoea (2/6), or cough (2/6). Thrombocytopaenia was lower than 100,000/mm 3 in half the cases only, and the haemoglobin count was normal for all patients. The diagnosis was made after at least three thick and thin blood smear searches. Parasitaemia was always lower than 0.5%. All rapid diagnostic tests were negative for HRP2 and pLDH antigens. Discussion: Plasmodium ovale malaria is currently a problem to diagnose in travellers, notably in French soldiers returning from the Ivory Coast. Early attempts at diagnosis are difficult due to the lack of specific clinical features, the rarity of biological changes and the poor sensitivity of diagnostic tools to detect low parasitaemia. Thus, the diagnosis is commonly delayed or missed. Physicians should be aware of this diagnostic challenge to avoid relapses and provide prompt and adequate treatment with chloroquine and radical cure with primaquine.

Les blocs des nerfs ulnaire, médian et radial sont des techniques de choix dans l’abord de la mai... more Les blocs des nerfs ulnaire, médian et radial sont des techniques de choix dans l’abord de la main traumatisée en urgence: fracture, luxation, plaie, douleur par exemple. L’anatomie fonctionnelle doit être connue et comprise. La réalisation de ces blocs permet dans la majorité des cas le traitement en urgence d’une main traumatisée, sans avoir recours nécessairement à la neurostimulation ou encore à l’échographie. Le principe est de déposer à proximité du nerf une quantité de xylocaïne suffisante permettant l’anesthésie de celui-ci par diffusion et en sécurité. En France et depuis 2002, la Société Française d’Anesthésie et de Réanimation (SFAR), le Service d’Aide Médicale Urgente (SAMU) ainsi que la Société Francophone de Médecine d’Urgence (SFMU) autorisent le médecin urgentiste à pratiquer les anesthésies locorégionales de la main : Pratique des anesthésies locales et locorégionales par des médecins non spécialisées en anesthésie-réanimation. Les recommandations actualisées de 2010 par ces mêmes sociétés savantes propose de diffuser plus largement les techniques d’ALR en médecine d’urgence. Le but de ce travail est de faire le point sur les blocs au poignet.

Malaria Journal, 2016

In December 2010, a Plasmodium vivax malaria outbreak occurred among French forces involved in a ... more In December 2010, a Plasmodium vivax malaria outbreak occurred among French forces involved in a mission to control illegal gold mining in French Guiana. The findings of epidemiological and entomological investigations conducted after this outbreak are presented here. Data related to malaria cases reported to the French armed forces epidemiological surveillance system were collected during the epidemic period from December 2010 to April 2011. A retrospective cohort study was conducted to identify presumed contamination sites. Anopheles mosquitoes were sampled at the identified sites using Mosquito Magnet and CDC light traps. Specimens were identified morphologically and confirmed using molecular methods (sequencing of ITS2 gene and/or barcoding). Anopheles infections with Plasmodium falciparum and P. vivax were tested by both enzyme-linked immunosorbent assay and real-time PCR. Seventy-two P. vivax malaria cases were reported (three were mixed P. falciparum/P. vivax infections), leading to a global attack rate of 26.5 % (72/272). Lack of compliance with vector control measures and doxycycline chemoprophylaxis was reported by patients. Two illegal gold mining sites located in remote areas in the primary forest were identified as places of contamination. In all, 595 Anopheles females were caught and 528 specimens were formally identified: 305 Anopheles darlingi, 145 Anopheles nuneztovari s.l., 63 Anopheles marajoara and 15 Anopheles triannulatus s.l. Three An. darlingi were infected by P. falciparum (infection rate: 1.1 %) and four An. marajoara by P. vivax (infection rate: 6.4 %). The main drivers of the outbreak were the lack of adherence by military personnel to malaria prevention measures and the high level of malaria transmission at illegal gold mining sites. Anopheles marajoara was clearly implicated in malaria transmission for the first time in French Guiana. The high infection rates observed confirm that illegal gold mining sites must be considered as high level malaria transmission areas in the territory. Illegal gold mining activities are challenging the control of malaria in French Guiana. Collaboration with neighbouring countries is necessary to take into account mobile populations such as gold miners. Malaria control strategies in the French armed forces must be adapted to P. vivax malaria and sylvatic Anopheles species.

Le bloc ilio-fascial est une technique d’analgésie de référence ayant montrée son intérêt et son ... more Le bloc ilio-fascial est une technique d’analgésie de référence ayant montrée son intérêt et son innocuité en urgence préhospitalière. Les indications du bloc ilio-fascial sont les fractures de la diaphyse fémorale mais aussi les lésions touchant les structures osseuses de la hanche. Les contre-indications sont nombreuses en traumatologie préhospitalière et doivent être scrupuleusement respectées. Le geste technique est réalisé après information du patient. Cette anesthésie locorégionale nécessite peu de matériel et consiste en l'injection d’un anesthésique local dans l'espace ilio-fascial où transitent les nerfs fémoral, cutané latéral de la cuisse et obturateur. Le mécanisme de cette analgésie est double : direct par bloc sensitif et indirect par relâchement musculaire. Comme pour toute anesthésie locorégionale les conditions de sécurité élémentaires sont requises avec à disposition immédiate les moyens nécessaires pour palier effets indésirables et complications immédiates (malaise, toxicité systémique, allergie). Nous présentons la technique du bloc ilio-fascial en urgence préhospitalière.

Malaria Journal, 2010

Background: Plasmodium ovale is responsible for 5% of imported malaria in French travellers. The ... more Background: Plasmodium ovale is responsible for 5% of imported malaria in French travellers. The clinical and biological features of six clustered cases of P. ovale malaria in an army unit of 62 French soldiers returning from the Ivory Coast are reported. Case report: All patients were symptomatic and developed symptoms on average 50 days after their return and 20 days after the end of chemoprophylaxis (doxycycline). Clinical features included fever (6/6), mostly tertian (4/6), aches (6/6), nausea (3/6), abdominal pain (2/6), diarrhoea (2/6), or cough (2/6). Thrombocytopaenia was lower than 100,000/mm 3 in half the cases only, and the haemoglobin count was normal for all patients. The diagnosis was made after at least three thick and thin blood smear searches. Parasitaemia was always lower than 0.5%. All rapid diagnostic tests were negative for HRP2 and pLDH antigens. Discussion: Plasmodium ovale malaria is currently a problem to diagnose in travellers, notably in French soldiers returning from the Ivory Coast. Early attempts at diagnosis are difficult due to the lack of specific clinical features, the rarity of biological changes and the poor sensitivity of diagnostic tools to detect low parasitaemia. Thus, the diagnosis is commonly delayed or missed. Physicians should be aware of this diagnostic challenge to avoid relapses and provide prompt and adequate treatment with chloroquine and radical cure with primaquine.

Les blocs des nerfs ulnaire, médian et radial sont des techniques de choix dans l’abord de la mai... more Les blocs des nerfs ulnaire, médian et radial sont des techniques de choix dans l’abord de la main traumatisée en urgence: fracture, luxation, plaie, douleur par exemple. L’anatomie fonctionnelle doit être connue et comprise. La réalisation de ces blocs permet dans la majorité des cas le traitement en urgence d’une main traumatisée, sans avoir recours nécessairement à la neurostimulation ou encore à l’échographie. Le principe est de déposer à proximité du nerf une quantité de xylocaïne suffisante permettant l’anesthésie de celui-ci par diffusion et en sécurité. En France et depuis 2002, la Société Française d’Anesthésie et de Réanimation (SFAR), le Service d’Aide Médicale Urgente (SAMU) ainsi que la Société Francophone de Médecine d’Urgence (SFMU) autorisent le médecin urgentiste à pratiquer les anesthésies locorégionales de la main : Pratique des anesthésies locales et locorégionales par des médecins non spécialisées en anesthésie-réanimation. Les recommandations actualisées de 2010 par ces mêmes sociétés savantes propose de diffuser plus largement les techniques d’ALR en médecine d’urgence. Le but de ce travail est de faire le point sur les blocs au poignet.