Gisèle et Béatrice (French Edition)

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The incidence of P vivax and P ovale was relatively stable over the years eFigure 1 in the Supplement.

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A shift in age distribution between and was observed with an increase in the number of cases occurring in the 45 to 60 years and older than 60 years classes eFigure 3 in the Supplement. Six hundred fifty infants year represented 1. Overall, the sex ratio male to female was 1. The ratio significantly increased with age, ranging from 1. Overall, the number of malaria cases among African and European individuals was 39 Between and , there was a significant increase in the proportion of malaria cases in African individuals [ The distribution of age by sex was known for 42 individuals.

During the study period, there were significant trends in aging for both African and European individuals.


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The sex ratio was significantly higher in European individuals than African individuals 2. Concerning the purpose of travel, full information, including that on tourism and business, was not available before In contrast, European individuals were mostly tourists [ Moreover, of of imported malaria cases European individuals are often male and either business travelers or tourists [ Time between return and onset of symptoms and time between onset of symptoms and diagnosis were associated with species. The time between onset of symptoms and diagnosis did not change significantly for P falciparum over time eFigure 4 in the Supplement.

This increase was not associated with an elevation in mortality, which remained stable at approximately 0. Our findings show changes in the population structure of people with imported malaria in metropolitan France, which may explain the persistence of a higher level of malaria incidence, particularly of severe cases. The most striking changes were the increase in the proportion of malaria cases among African individuals from These changes were supported by the fact that modalities of our surveillance system remained unchanged and the network of participating hospitals was stable over the study period.

Our study shows that malaria cases peaked at in and then declined until to , followed by stability at approximately cases per year until Figure 2. A global decrease in the imported malaria incidence was observed in many industrialized countries, such as Denmark, Switzerland, the Netherlands, Italy, Germany, and the United Kingdom. The balance between these different mechanisms may explain the complexity of the temporal patterns observed in several countries with imported malaria.

The travel conditions of these 2 groups differ in age, sex, and length of stay. European individuals are often male business travelers or tourists These findings may have implications for the use of chemoprophylaxis to prevent malaria. Therefore, in the absence of financial support to purchase malaria chemoprophylaxis, it would be difficult to obtain drugs for those traveling with their families for longer stays, such as African VFRs.

The aging of patients with malaria from to also represents a change that deserves explanation. Studies by the French National Institute of Statistics and Economic Studies reported a 5-year increase in the median age over the study period, which only partly explains our finding. Overall, the difference in median age between African and European individuals in our study was mainly due to the significant differences in the age structure of the 2 populations, with more children in the African individuals category.

Compared with other industrialized countries, the overall median age of 33 IQR, years observed in our study was close to that found in the United Kingdom 35 [IQR, ] years , Spain The significant increase in severe malaria incidence in our findings was also reported in other countries in Europe, as well as in Canada and the United States. This elevation could be related to the increase in age of trave l ers, as observed in the United Kingdom and United States.

The improvement of medical care in intensive care units in the past 20 years and the use of parenteral artesunate as the first-line treatment for severe malaria since May may have contributed to the stability of the mortality. To our knowledge, our database is the largest regarding imported malaria in industrialized countries; however, the study may have limitations.

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First, missing data on purpose of travel and country of residence led to the exclusion of malaria cases. Therefore, a sensitivity analysis showed that the magnitude of differences when comparing results with or without excluded cases were not clinically relevant eTable 2 in the Supplement. Third, because we are analyzing only confirmed malaria cases, our results cannot be extrapolated to all travelers to malaria endemic areas eg, proportion of malaria among patients alleging prophylaxis intake. Because age appears to be associated with an increase in the severity and mortality of malaria, especially in older male European travelers, attention measures to prevent and quickly detect imported malaria in travelers should be strengthened.

Moreover, the substantial increase in the proportion of African VFRs underscores the importance for public authorities to implement effective solutions and for travel operators and family practitioners to renew efforts to engage this group in the use of malaria preventive means, such as prevention messages, personal antivector protection and chemoprophylaxis. National Center for Biotechnology Information , U. Published online Apr 5. Papa A. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Sep 20; Accepted Feb Copyright Kendjo E et al.

Key Points Question Could changes in the population experiencing imported malaria in France over the past 2 decades explain the persistence of the high number of malaria cases despite national preventive measures? Meaning Although prophylactic measures appeared to be efficient among European individuals traveling for tourism or business purposes, progress is needed to ensure better protection for African individuals visiting friends or relatives. Abstract Importance Despite annually adapted recommendations to prevent malaria in travelers to endemic areas, France is still the industrialized country reporting the highest number of imported cases of malaria.

Objective To study epidemiologic trends of imported cases of malaria in travelers in geographic territories of France on the European continent metropolitan France from through to potentially explain the persistence of high imported malaria incidence despite national preventive measures. Main Outcomes and Measures Evolution of the main epidemiologic characteristics of patients with imported malaria.

Conclusions and Relevance Beyond the apparent stability of the number of imported malaria cases in France, significant changes appear to have occurred among the population who developed malaria infection following travel in endemic areas. Methods Participants Only patients with malaria diagnosed in metropolitan France from civilian travelers were included to avoid biases related to military, people living in endemic areas, or autochthonous malaria with a specific epidemiology. Case Definition All suspected cases were confirmed by microscopy or polymerase chain reaction either at the network hospitals or by the CNR du Paludisme reference laboratories.

Diagnosis and Case Managements Malaria diagnosis was confirmed by physician and biologist experts involved in everyday diagnostic procedures, including species identification, parasitemia count, and treatment monitoring. Estimation of the Total Number of Malaria Cases The total incidence of Plasmodium malaria infection was derived using 4 complete national surveys performed in , , , and eMethods in the Supplement.

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Open in a separate window. Figure 1. Imported Malaria Trend As reported in Figure 2 , from through , the number of confirmed malaria cases peaked at in and then declined to in Figure 2. Figure 3. Ethnicity Overall, the number of malaria cases among African and European individuals was 39 She enjoys being with family and friends, reading, theaters and art, outdoor sports and yoga.

Floriane Anglio Preschool French Teacher. Caroline Bertier Elementary French Teacher. Caroline is originally from the Southeast of France. She enjoys helping students find their independence, believe in their abilities and develop their eagerness to learn. Benedicte Cambon Kindergarten French Teacher. She worked as an occupational therapist in a special needs school motor and sensory disabilities, dysphasia. After an amazing year studying drawing and painting in Paris, Sue Campbell is excited to return as a sixth and seventh grade English teacher and eighth grade Visual Art teacher.

Sue has been an independent school English teacher for twenty-seven years and held many position at the EB Middle School. She has taught English for all grades as well as Visual Art. Andrea Cavallo Preschool English Teacher. She is accredited to teach Preschool-8th grade but is especially passionate about early childhood education and literacy. She has two children that attend EB. Andrea loves spending time with her family, doing yoga, and baking.

Ender Choo is originally from Malaysia. He was educated in a school system where Mandarin Chinese is the medium of instruction. Besides English and Chinese, he also speaks Malay and Cantonese. He completed his graduate program at Cal State East Bay and taught Chinese classes at several private schools before joining EB in He is currently teaching Mandarin Chinese and coding class. He also teaches badminton and leads a group of students doing fish tank maintenance at school during club time. He has two children: his daughter, Lisette, who graduated from EB in , and his son, Ian who is in seventh grade.

Ender enjoys music is currently leading singing worship in a church on a regular basis. He studied biology and education in Tours and Orleans. Then he moved to the beautiful city of Nantes on the west coast to get his teaching diploma in Then he taught on the West Coast for 8 years from preschool to 5th grade. In , he visited a friend in the Bay Area for couple of months and got hooked to the place!

The next year, he was hired at EB to teach in Preschool. Patrick Coulon Kindergarten Teacher's Assistant. After completing her B. A, she spent over three years in the Peace Corps living in Burkina Faso, West Africa, working as an English teacher and community liaison in the Girls Education and Empowerment program. She has taught multiple elementary grades in independent and bilingual schools. Emilie is also an EB alumna. Clemence Demoncheaux Kindergarten French Teacher.

Fatimatou Fall Preschool Teacher's Assistant. Virginie Falquerho Preschool French Teacher. Virginie is originally from Nantes, in the west part of France. She studied French Literature, then obtained credentials in linguistics and french as a foreign language. She has taught French in Slovakia and Vietnam for several months.

In , she came for a year as an au pair in San Carlos. She joined EB in as a Kindergarten Assistant and is now a preschool teacher. Her son Hisham is an elementary school student at EB. When she is not teaching, Virginie enjoys baking vegan cakes, dancing and singing in a community choir. Aurelia Filato is originally from Marseilles, Provence in south of France. She holds a degree in history from the University of Aix-en-Provence and taught history and geography for 13 years in middle school in Paris. She moved to Berkeley to start a new adventure in and started to teach at EB as a History-Geography teacher 4th to 8th grade.

Aurelia is passionate about French culture, sustainable development, history and art. During her free time, she loves to travel, visit museums, listen to live music and dance. Florian Franceschini Preschool French Teacher. He graduated with a Bachelor of Science in Physical Education and holds teaching credentials since He spent his first five teaching years in France, working mostly in pre-K to grade 2. His last four years have been spent in Dubai, United Arab Emirates, in an International Baccalaureate bilingual school.

He believes the most important goal in teaching is to ensure each student enjoys learning and that they can apply their learning to the world around them. He promotes the use of inquiry and reflection to allow students to think outside the box and express their own personality. Nichele Harris Preschool English teacher. Nichele Harris, originally from Southern California, has a background in print and television production. Her work in children's programming fueled her passion for connecting with young people.

That passion has led her to pursue her teaching credential. Nichele is excited to bring her talents with arts, crafts and movement to EB's youngest students. Gabrielle Hedlund is from Oakland, CA. She holds a B. Santa Cruz.


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Gabrielle worked as a technology journalist for nearly a decade before moving to the business side of technology, building sites in the early days of the Internet. Later, she transitioned to teaching, earning her credential at CSU Hayward. Gabrielle and her husband, Marc, have two children at the Lower School. Hana Khabbaz Preschool Teacher's Assistant.

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Anne Kuhry Music teacher. Anne Kuhry is a native from France and holds a bachelor's degree in Music Education from the University of Strasbourg.

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She obtained her teaching credentials in France and has taught music in French elementary and middle school for 17 years. Anne is a songwriter and has traveled to the US many times. She looks forward to sharing her passion for music with EB students. Over the past 6 years Emmanuel has been a chaperon for the trip in France with the 5th graders. Emmanuel knows the students well and the students know him well too!

Fanny Labadie Kindergarten French Teacher. Thibaut Laffite Elementary French Teacher. He has been teaching for several years in France at different levels from kindergarten to grade 5. He recently moved to the San Francisco Bay Area and is passionate about outdoor activities like biking, hiking, traveling, literature and cinema. Aka Breezy Baracuda.

What a coincidence! My family calls me Vero for short, too, for Veronique. Elenore — Rory for short. Isabelle Bella Bernadette Bernie. We had a kick-ass French au pair named Valerie. She is in the French military — she can set up a hospital in less than a day — spent time in Afghanistan.

Val for short. Comment Policy This blog was always a quiet place, but lately we have had some fights, so we reserve the right to delete your comment if we find it creates a potential for a flame war. Short form is Vivi. Also maybe Ondine or Odette. Perhaps something like Amelie, shortened to Amie? Or Chloe, nickname Chlo! Melissande is a beautiful name, I think. I have a friend named Capucine. Some call her Capu for short.

Not particularly French but always loved Mirabella. Or Angelique for a French origin. The Hugh snippet is on this blog now.