Research for Angiostrongylus Cantonensis and Costaricensis in French West Indies and French Guiana

Summary

Hospitals in the French West Indies (Fort-de-France (Martinique); Basse-Terre and Pointe-à-Pitre (Guadeloupe); and French Guiana (Cayenne, Saint-Laurent du Maroni)) have noted the emergence of eosinophilic meningitis cases in recent years. This finding is part os eosinophilic meningitis cases emergence and meningoencephalitis caused by the parasite Angiostrongylus cantonensis on the American continent and in the Greater Antilles.

In 2013, the investigation of an eosinophilic meningitis case by the Basse-Terre hospital team with a positive specific PCR in the CSF (CDC, Atlanta, USA) showed the first case of neuromeningeal angiostrongylosis in Guadeloupe. A similar case was diagnosed by serology at Pointe-à-Pitre University Hospital a few years earlier without having been published, and another serious case diagnosed also at Pointe-à-Pitre University Hospital Center in January 2017. The team at the Martinique University Hospital Center also reported several cases of eosinophilic meningitis with positive serologies for A. cantonensis carried out in laboratories outside Martinique (Laboratory of Parasitology, Gonesse, France; Thailand; and Tropical Institute and Public Health, Switzerland) in recent years.

The emergence of this parasitosis is related to the introduction of the intermediate host Achatina fulica on the American continent and the geographical evolution of the angiostrongylosis cases is intrinsically linked to that of the Achatins. To date, only two studies report the environmental presence of Angiostrongylus cantonensis in the Lesser Antilles. One proved the presence in rats (23.4%) on the island of Grenada, and the other in Guadeloupe, showing that 32.4% of Achatina fulica collected carried the parasite by specific PCR. In Martinique, where the number of cases is increasing, and in French Guiana, where there is an increase in the number of cases in neighboring countries, especially Brazil, no study has been conducted on this parasite.

In parallel with this finding, several serious digestive tables associated with strong hypereosinophilia were reported in Martinique and Guadeloupe in the 90s but also in recent years, the last case in December 2016. Etiological diagnoses were established by the discovery of Angiostrongylus costaricensis parasite in ileal pathological specimens. However, these cases could never be investigated by serology or specific PCR due to lack of diagnostic tools available in the French West Indies and Guiana region, and more broadly in metropolitan France.

Conditions

• Angiostrongylosis
• Hypereosinophilia

Interventions

BIOLOGICAL

Parasitic serologies

Suspected angiostrongylosis - Angiostrongylus cantonensis: * An aliquot of CSF and an aliquot of serum will be sent to the laboratory of tropical medicine in Switzerland for research of specific antibodies. * A CSF aliquot will be sent to the CDC for PCR. Suspected angiostrongylosis- Angiostrongylus costaricensis: \- An aliquot of serum will be sent to the laboratory of tropical medicine in Switzerland for research of specific antibodies.

PROCEDURE

Biopsy

Suspected angiostrongylosis - Angiostrongylus costaricensis: \- A piece of biopsy or intestinal resection will be sent to the pathology laboratory for parasitic elements suggestive of Angiostrongylus costaricensis infection

Sponsors & Collaborators

• University Hospital Center of Pointe-à-Pitre/Abymes (Guadeloupe)

  collaborator UNKNOWN

• Hospital Center of Basse-Terre (Guadeloupe)

  collaborator UNKNOWN

• Hospital Center of Cayenne (French Guiana)

  collaborator UNKNOWN

• Hospital Center of Saint-Laurent du Maroni (French Guiana)

  collaborator UNKNOWN

• University Hospital Center of Martinique

  lead OTHER

Principal Investigators

• Nicole DESBOIS, MD · CHU of Martinique

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-04-03

Primary Completion

2021-04-03

Completion

2021-08-01

Countries

• France