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International audience; Context Ensure healthy lives and promote well-being for all at all ages Target: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases • Malaria: 216 million cases and 445 thousand deaths worldwide in 2016 (WHO, 2017) • Between 2000 and 2015, 58% and 37% decreases of the mortality and incidence rates, respectively • Socio-demographical and environmental contexts that vulnerabilize local populations • High mobility of pathogen-carrying populations • Patient follow-up difficulties (situations of illegality, auto-medication, ...) • Different strategies and means of surveillance, prevention and control of diseases between countries • Lack of international cooperation: Few regular exchange of comparable data and information between countries ⇒ Heterogeneous data types and formats, nomenclatures and concepts How to ensure cross-border epidemiological data interoperability on an ongoing basis? FTP server Computation and display application (R/Shiny) Harmonized DB Rebuilt DB Rebuilt DB Automated processing chain Integration and harmonization Indicator computation and visualization CHAR/CDPS Cayenne, FG Objectives and challenges • Integrate and harmonize automatically and regularly malaria cross-border epidemiological data • Disseminate indicators and data in an interpretable way for specialists, health actors and population In fine, this should conduct to • Provide a unified vision of the epidemiological cross-border situations • Participate to define concerted, targeted and effective control actions for disease elimination Cross-border malaria considered as a "Major obstacle for malaria elimination" [Wangdi et al., 2015] Paris France Study Region Ethical considerations • Exploitation and dissemination of anonymized data • Temporal and spatial aggregation of the data for public user profile • Authorization of the Commission Nationale de l'Informatique et des Libertés (CNIL) for personal data automatic processing and data transmission to a foreign country (ongoing request No. 2135463) • Multi-platform Extract Transform Load (ETL) tools (TALEND®) Harmonization rules based on expert knowledge in epidemiology and parasitology • Web services for data online publication • Web application (R-Shiny) for online data visualization CDPS ... Funding LMI Sentinela GAPAM Sentinela GCE18-Investment ID OPP1171795 Wangdi K. et al. Cross-border malaria: A major obstacle for malaria elimination. Adv. Parasitol. 2015, 89, 79-107 Barcellos C. et al. An observatory to gather and disseminate information on the health-related effects of environmental and climate change. Pan American Journal of Public Health. 2016. 40(3): 167-73 Roux E. et al. Un "site sentinelle" à la frontière franco-brésilienne pour comprendre et suivre les relations entre climat et santé. In Proceedings of the ENVIBRAS (Environnement et géomatique-approches comparées France Brésil) conference. Rennes; 2014:1-8

International audience; In September 2014, an increase in the number of Cryptosporidium spp. gastrointestinal tract infections was reported over a 6-month period among children living in a remote area along the Maroni River in French Guiana. Children presented gastroenteritis symptoms with Cryptosporidium-positive stools. Questionnaires were administered and stool examinations were controlled 3 months after the onset of symptoms. Data collection included demographics, food consumption, river behavior, symptoms, and outcome. Stool specimens were tested using microscopy and polymerase chain reaction. Samples from the water systems were examined for turbidity and culture for bacteria. Data from the reference laboratory were analyzed to calculate the median cryptosporidiosis incidence among immunocompetent patients from 2008 to 2015. Data on gastroenteritis cases reported by the Delocalized Center for Prevention and Care in the area were also collected. We report a cluster of 14 cases. All cases were children, aged between 4.5 and 38 months. Seven reported moderate to severe dehydration and required hospitalization. Speciation and microbiological typing revealed the cluster strain was Cryptosporidium hominis subtype IbA10G2 but C. hominis IbA9G2 and IbA15G1 strains were also identified. The median incidence in French Guiana was 5.8 cases per year before the outbreak. The first cases of the cluster appeared in the dry season. We describe the clinical features, epidemiology, and state of current investigations for the largest documented outbreak of cryptosporidiosis in French Guiana.

International audience; French Guiana, a French overseas department in South America, has been classified epidemic for HIV. The dynamics of the spread of the AIDS epidemic ranges according to the characteristics of each geographical region in different population groups. Isolated area in French Guiana have a vast diversity of population including maroon population, amerindians and migrants in particulary from Brazil, Surinam and Guyana. Isolated area in French Guiana is defined by all rural areas compared to urban area: Cayenne, Kourou and Saint Laurent du Maroni (Map 1). The aim of this study was to evaluate spacial and temporal trend of the AIDS epidemic among type of population on isolated area of French Guiana.

National audience; Bien que la prise en charge de personnes vivant avec le VIH (PVVIH) s’améliore globalement en Guyane, les disparités entre les régions et les différentes populations-clés sont importantes. Cet article a pour objectif de décrire les caractéristiques épidémiologiques, spatiales et cliniques des PVVIH suivies en zones isolées en les comparant avec celles suivies sur le littoral, dans les centres hospitaliers, en Guyane Française.Les données présentées reposent sur les données de suivi clinique réalisé au cours des missions délocalisées d’infectiologie au sein des Centres Délocalisés de Prévention et de Soins (CDPS) de Guyane. Ces données ont été analysées en relation avec les données INSEE issue du dernier recensement des communes de Guyane en 2012 et comparées aux données de suivi des PVVIH dans les différents centres hospitaliers de Guyane issues du logiciel Nadis®.L’évolution du taux annuel de découvertes de séropositivité VIH montre une arrivée plus tardive en zones isolées que sur le littoral de cette infection. L’épidémie apparait ces dernières années comme particulièrement active notamment chez les patients d’origine Brésilienne. L’âge médian des PVVIH en CDPS est de 43,8 ans, le sex ratio homme/femme est de 0,98. Prés de 37% des PVVIH sont dépistées au stade tardif (< 200 CD4/mm3). Le pourcentage de succès virologiques après 6 mois de traitement est de 80% par rapport à 88% sur le littoral.L’histoplasmose est la première cause d’infection opportuniste retrouvée. Les infections tropicales et notamment le paludisme (16%) sont fréquentes. La répartition spatiale des patients suivis montre une absence de PPVIH identifiées en amont des villes de Maripasoula et Saint Georges de l’Oyapock. Ces caractéristiques géographiques régionales rappellent l’importance de prendre en charge les PVVIH en zones isolées, particulièrement aux frontières, qui constituent des zones de passage, de repli, de prise de risques mais aussi de carence en offre de dépistage et de soins.Ainsi, en zones isolées en Guyane Française, les efforts doivent être poursuivis afin d’enrayer et de contrôler la diffusion de l’épidémie de VIH sur ces zones devenues stratégiques en terme de santé publique.