Author: "Maylis Douine" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

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1. Novel Chronic Anaplasmosis in Splenectomized Patient, Amazon Rainforest

Author: Olivier Duron, Rachid Koual, Lise Musset, Marie Buysse, Yann Lambert, Benoît Jaulhac, Denis Blanchet, Kinan Drak Alsibai, Yassamine Lazrek, Loïc Epelboin, Pierre Deshuillers, Céline Michaud, and Maylis Douine
Subjects: anaplasmosis, Amazon rainforest, bacteria, vector-borne infections, zoonoses, French Guiana, Medicine, Infectious and parasitic diseases, RC109-216
Abstract: We report a case of unusual human anaplasmosis in the Amazon rainforest of French Guiana. Molecular typing demonstrated that the pathogen is a novel Anaplasma species, distinct to all known species, and more genetically related to recently described Anaplasma spp. causing infections in rainforest wild fauna of Brazil.
Published: 2022
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2. COVID-19 and Vaccination: Knowledge, Attitudes and Practices of People Working on Illegal Gold Mining Sites in French Guiana

Author: Pierre Durand, Célia Basurko, Stephen Vreden, Mathieu Nacher, and Maylis Douine
Subjects: COVID-19, French Guiana, Brazil, Suriname, Amazonian Forest, illegal gold mining, Medicine
Abstract: Introduction: French Guiana is a French territory bordering Brazil and Suriname where the COVID-19 pandemic has severely strained the French Guianese health system. The people working on illegal gold mining sites in French Guiana, also known as garimpeiros, are mainly of Brazilian origin. Their health conditions are precarious, they live under the radar of the surveillance system and therefore, assessment of their health is quite challenging.. The objective of this study was to describe their knowledge, attitudes and practices regarding COVID-19 and vaccination against this infection. Methods: We conducted an international multicenter cross-sectional survey between 1 March 2022 and 30 April 2022 in French Guiana and Suriname, using a structured questionnaire. Results: Eighty persons were included, 95.0% of whom were Brazilian. Most had good general knowledge of COVID-19. Antibiotic prophylaxis had been practiced by 10.0% of participants. Forty-three people thought they had been infected with COVID-19 (53.8%). Self-medication was frequent, often with antibiotics (32.6%, mostlychloroquine, ivermectin or azithromycin) and most had not consulted a physician for symptoms of COVID-19. A majority (62.5%) had received at least one dose of vaccine. Those who were ever tested for COVID-19 were the most likely to be vaccinated (PR = 1.98, p = 0.009). Conclusions: Garimpeiros have a good level of knowledge about COVID-19 but the high consumption of antibiotics raises concerns about the selection of resistant bacteria. The vaccination rate was higher than that of the Guianese population. The most vaccinated individuals were those who had already taken a COVID test suggesting that these individuals had more exposure to the disease, were more health conscious, or had easier access to health centers.
Published: 2023
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3. What can lead to late diagnosis of HIV in an illegal gold mining environment? A qualitative study at the French Guiana’s border with Brazil

Author: Luis Sagaon-Teyssier, Bruno Spire, Charlotte Floersheim, Sandrine Musso, August Eubanks, Maylis Douine, Marie Claire Parriault, Gabriel Girard, and Emilie Mosnier
Subjects: Medicine
Abstract: Objective The present study aimed to understand what factors can lead to late HIV diagnosis of illegal gold miners at French Guiana’s border with Brazil.Design An exploratory qualitative study with in-depth interviews and observations was conducted between November 2019 and February 2020.Setting The study was conducted in the main medical healthcare service and two non-governmental organisation premises in the Oyapock border region, which is a supply area for illegal gold mining sites.Participants Fifteen people living with HIV diagnosed with CD4 count
Published: 2022
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4. The Epidemiologic Transition in French Guiana: Secular Trends and Setbacks, and Comparisons with Continental France and South American Countries

Author: Mathieu Nacher, Célia Basurko, Maylis Douine, Yann Lambert, Najeh Hcini, Narcisse Elenga, Paul Le Turnier, Loïc Epelboin, Félix Djossou, Pierre Couppié, Bertrand de Toffol, Kinan Drak Alsibai, Nadia Sabbah, and Antoine Adenis
Subjects: epidemiologic transition, infectious diseases, non communicable diseases, tropical, life expectancy, premature mortality, Medicine
Abstract: There are great variations between population subgroups, notably in poorer countries, leading to substantial inconsistencies with those predicted by the classical epidemiologic transition theory. In this context, using public data, we aimed to determine how the singular case of French Guiana fit and transitioned in the epidemiologic transition framework. The data show a gradual decline in infant mortality to values above 8 per 1000 live births. Premature mortality rates were greater but declined more rapidly in French Guiana than in mainland France until 2017 when they reascended in a context of political turmoil followed by the COVID-19 pandemic and strong reluctance to get vaccinated. Although infections were a more frequent cause of death in French Guiana, there is a marked decline and circulatory and metabolic causes are major causes of premature death. Fertility rates remain high (>3 live births per woman), and the age structure of the population is still pyramid-shaped. The singularities of French Guiana (rich country, universal health system, widespread poverty) explain why its transition does not fit neatly within the usual stages of transition. Beyond gradual improvements in secular trends, the data also suggest that political turmoil and fake news may have detrimentally affected mortality in French Guiana and reversed improving trends.
Published: 2023
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5. Sexual and addictive risk behaviors and sexually transmitted infections in illegal gold miners in French Guiana: A multicenter observational study.

Author: Louise Mutricy-Hureau, Amandine Pisoni, Martha Suarez-Mutis, Amanda Figueira da Silva, Yann Lambert, Pauline Mespoulhe, Audrey Godin, Marie-Claire Parriault, Astrid Van Melle, Emilie Mosnier, Mélanie Gaillet, Céline Michaud, Roxane Schaub, Muriel Galindo, Antoine Adenis, Mathieu Nacher, Stephen Vreden, Edouard Tuaillon, and Maylis Douine
Subjects: Medicine, Science
Abstract: ObjectivesCommon representations of the world of gold mining-especially illegal-are usually negative: the activity conjures up images of drug trafficking, human exploitation, the sex trade, environmental destruction, and infectious diseases, in particular sexually transmitted infections (STIs). The aim of the present article is to describe the levels of risk behaviors such as transactional sex, multiple sexual partners, and the frequency of condom use, addictive substance consumption, and the prevalence of STIs among the population of illegal gold miners in French Guiana (FG), a French overseas entity in Amazonia, in order to guide potential interventions.MethodsAn observational multicenter cross-sectional study was carried out from October to December 2019 along the two borders of FG with Suriname and Brazil at rest sites used by the miners.ResultsAmong the 499 participants, transactional sex was very prevalent, declared by 33.5% of men and 8.4% of women. Condoms were more frequently used for transactional sex than with a non-commercial partner (93.4% versus 42.1%). More women were tested for HIV than men (91.1% versus 55.2%). Excessive alcohol consumption (57.3%%) and tobacco use (41.2%) were very frequent, but cocaine or crack consumption was low (1.2%), which refuted our initial assumption. Consumers of alcohol had more sexual partners and reported condom use more frequently. Prevalence of HIV, HCV, HBV, and syphilis was respectively 0.5% (95% CI: 0.1-2.1), 2.1% (95% CI: 0.7-3.6), 1.6% (95% CI: 0.3-2.8), and 12.4% (95% CI: 9.0-15.7), which was higher than in the local population, especially for syphilis.ConclusionThis study documents for the first time the risk behaviors of gold miners in FG. Although the level of condom use was high, the prevalence of STIs combined with the high rate of transactional sex should encourage an increase in prevention and screening, in particular through rapid tests, given the mobility of the population concerned.
Published: 2022
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6. Levers and Barriers to Vaccinate against COVID-19 in the Multicultural Context of French Guiana: A Qualitative Cross-Sectional Survey among Health Care Workers

Author: Maylis Douine, Sibylle Granier, Kepha Brureau, Jacques Breton, Céline Michaud, Mélanie Gaillet, Camille Agostini, Mathilde Ballet, Mathieu Nacher, Audrey Valdes, Philippe Abboud, Antoine Adenis, Félix Djossou, Loïc Epelboin, and Nicolas Vignier
Subjects: COVID-19, vaccination, French Guiana, willingness, barriers, multiculturalism, Medicine
Abstract: In French Guiana, a French overseas territory in South America facing a fourth wave of COVID-19, vaccination coverage is very low, both in the population and among health care workers (HCWs). Vaccine hesitancy concerned 35.7% of the latter in early 2021. The objective of this complementary study is to understand barriers and levers and to adapt messages to increase vaccination coverage among HCWs. We conducted a regional cross-sectional survey of HCWs with a questionnaire containing open-ended questions exploring factors associated with vaccine hesitancy and the needs to adapt the vaccination campaign in French Guiana. The discourses were analyzed using a qualitative approach based on grounded theory, with open coding of data by themes and construction of abstract categories. The analysis of the 357 responses collected from January to March 2021 reveals several trends. The ethical aspect of the HCWs’ role emphasizes the importance of getting vaccinated themselves (to protect patients, to set an example...) and of vaccinating as many people as possible, including the most geographically or socially distant, such as undocumented migrants. However, some HCWs remain suspicious of the vaccine with concerns over the efficacy and side effects, of health institutions, and of the pharmaceutical industry. The role of fake news circulating on social networks has been widely discussed. Efforts to explain and convince HCWs must be continued in French Guiana using the identified levers to improve the acceptability of vaccination.
Published: 2021
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7. Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin

Author: Nicolas Vignier, Kepha Brureau, Sybille Granier, Jacques Breton, Céline Michaud, Mélanie Gaillet, Camille Agostini, Mathilde Ballet, Mathieu Nacher, Audrey Valdes, Philippe Abboud, Antoine Adenis, Félix Djossou, Loïc Epelboin, and Maylis Douine
Subjects: COVID-19 vaccines, health personnel, vaccine hesitancy, willingness to get vaccinated, French Guiana, South America, Medicine
Abstract: Background: In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (Gamma) variant of concern (VOC), mRNA vaccines have been made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimed to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods: A cross-sectional survey was conducted from January 22 to March 26, 2021 among a sample of HCWs in French Guiana. They were asked about their willingness to get vaccinated against COVID-19 and vaccine hesitancy, vaccine uptake and vaccines attitudes. Factors associated with willingness to get vaccinated have been analyzed with ordinal logistic regression, using Stata software. Results: A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. HCWs were more willing to get vaccine if they were older, were worried about COVID-19 and were confident in the management of epidemic. Conversely, participants were less likely to have been vaccinated or willing to if they were nurses or of another non-medical profession, born in French Guiana, feared adverse effects, or if they did not trust pharmaceutical companies and management of the epidemic by authorities. Conclusion: Negative attitudes towards vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with Gamma VOC. General vaccine hesitancy and concerns about future side effects in particular represent important barriers. Low confidence in government and science are significant in COVID-19 vaccine refusal among non-medical staffs. Public health messaging with information on vaccine safety should be tailored to address these concerns. The specific challenges of HCWs from French Guiana must be taken into account.
Published: 2021
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8. Implementation of a novel malaria management strategy based on self-testing and self-treatment in remote areas in the Amazon (Malakit): confronting a-priori assumptions with reality

Author: José Hermenegildo Gomes, Antoine Adenis, Martha Cecilia Suárez-Mutis, Alice Sanna, Muriel Galindo, Jane Bordalo Miller, Stephen Vreden, Laure Garancher, Mathieu Nacher, Hedley Cairo, Yann Lambert, Cassio Peterka, Louise Mutricy, Helene Hiwat, Maylis Douine, Malbec, Odile, Centre d'Investigation Clinique Antilles Guyane [Cayenne, Guyane française], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], The Ink Link Association [Paris], DPAC-Fronteira [Oiapoque, Brazil], Ministry of Health [Brasília, Brazil], Ministry of Health [Paramaribo, Suriname], Biome Tropical et Immuno-Pathophysiologie = Tropical Biome and ImmunoPhysiopathology [Lille] (TBIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Instituto Oswaldo Cruz / Oswaldo Cruz Institute [Rio de Janeiro] (IOC), Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Foundation for the Advancement of Scientific Research in Suriname [Paramaribo] (SWOS), and Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ)
Subjects: Motivation, Self-treatment, Computer science, Amazon rainforest, [SDV]Life Sciences [q-bio], Implementation outcomes, Public Health, Environmental and Occupational Health, Miners, medicine.disease, Process evaluation, Mining population, Malaria, [SDV] Life Sciences [q-bio], Border malaria, Management strategy, Self-Testing, Risk analysis (engineering), Remote health, medicine, A priori and a posteriori, Humans, Gold
Abstract: Background A novel strategy to combat malaria was tested using a methodology adapted to a complex setting in the Amazon region and a hard-to-reach, mobile community. The intervention strategy tested was the distribution, after training, of malaria self-management kits to gold miners who cross the Surinamese and Brazilian borders with French Guiana to work illegally in the remote mining sites in the forest of this French overseas entity. Main text This article aims at presenting all process and implementation outcomes following the Conceptual Framework of Implementation Fidelity i.e. adherence, including content and exposure, and moderators, comprising participant responsiveness, quality of delivery, facilitation strategies, and context. The information sources are the post-intervention survey, data collected longitudinally during the intervention, a qualitative study, data collected during an outreach mission to a remote gold mining site, supervisory visit reports, in-depth feedback from the project implementers, and videos self-recorded by facilitators based on opened ended questions. As expected, being part of or close to the study community was an essential condition to enable deliverers, referred to as “facilitators”, to overcome the usual wariness of this gold mining population. Overall, the content of the intervention was in line with what was planned. With an estimated one third of the population reached, exposure was satisfactory considering the challenging context, but improvable by increasing ad hoc off-site distribution according to needs. Participant responsiveness was the main strength of the intervention, but could be enhanced by reducing the duration of the process to get a kit, which could be disincentive in some places. Regarding the quality of delivery, the main issue was the excess of information provided to participants rather than a lack of information, but this was corrected over time. The expected decrease in malaria incidence became a source of reduced interest in the kit. Expanding the scope of facilitators’ responsibilities could be a suitable response. Better articulation with existing malaria management services is recommended to ensure sustainability. Conclusions These findings supplement the evaluation outcomes for assessing the relevance of the strategy and provide useful information to perpetuate and transfer it in comparable contexts. Trial registration ClinicalTrials.gov. NCT03695770. 10/02/2018 “Retrospectively registered”.
Published: 2022

9. Malaria in Gold Miners in the Guianas and the Amazon: Current Knowledge and Challenges

Author: Gilberto Gilmar Moresco, Stephen Vreden, Juan F. Sanchez, Paola Marchesini, Yann Lambert, Liana Reis Blume, Martha Cecilia Suárez-Mutis, Horace Cox, Vincent Pommier de Santi, Helene Hiwat, Alice Sanna, Leopoldo Villegas, Maylis Douine, Lise Musset, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Laboratoire de Parasitologie [Cayenne, Guyane française], National Malaria Programme [Suriname]], Ministry of Health [Paramaribo, Suriname], Ministry of Health, Brazilia, Brazil, Ministry of Public Health [Georgetown, Guyana], U.S. Naval Medical Research Unit No. 6 (NAMRU-6), Global Development One, Silver Spring, USA, Asociacion Civil Impacto Social, Bolivar, Venezuela, Centre d'épidémiologie et de santé publique des armées [Marseille] (CESPA), Service de Santé des Armées, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Health Regional Agency [Cayenne], Foundation for the Advancement of Scientific Research in Suriname [Paramaribo] (SWOS), Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Centre Collaborateur OMS pour la surveillance de la résistance aux antipaludiques [Cayenne, Guyane française] (CCOMS), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Ministry of Health [Brasília, Brazil], Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), and Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ)
Subjects: Gold mining, Latin Americans, 030231 tropical medicine, Context (language use), 03 medical and health sciences, 0302 clinical medicine, Malaria transmission, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Deforestation, parasitic diseases, medicine, Immunology and Allergy, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, Significant risk, Socioeconomics, Amazon rainforest, business.industry, 1. No poverty, medicine.disease, 3. Good health, Infectious Diseases, Geography, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Malaria
Abstract: Purpose of Review Following Paraguay and Argentina, several countries from the Amazon region aim to eliminate malaria. To achieve this, all key affected and vulnerable populations by malaria, including people working on gold mining sites, must be considered. What is the situation of malaria in these particular settings and what are the challenges? This literature review aims to compile knowledge to answer these questions. Recent Findings The contexts in which gold miners operate are very heterogeneous: size and localization of mines, links with crime, administrative status of the mines and of the miners, mobility of the workers or national regulations. The number of malaria cases has been correlated with deforestation (Brazil, Colombia), gold production (Colombia), gold prices (Guyana), or location of the mining region (Peru, Colombia, Venezuela, Guyana). The burden of malaria in gold mines differs between territories: significant in Guyana, French Guiana, or Venezuela; lower in Brazil. Although Plasmodiumvivax causes 75% of malaria cases in the Americas, P. falciparum is predominant in several gold mining regions, especially in the Guiana Shield. Because of the remoteness from health facilities, self-medication with under-the-counter antimalarials is frequent. This constitutes a significant risk for the emergence of new P. falciparum parasites resistant to antimalarial drugs. Summary Because of the workers’ mobility, addressing malaria transmission in gold mines is essential, not only for miners, but also to prevent the (re-)emergence of malaria. Strategies among these populations should be tailored to the context because of the heterogeneity of situations in different territories. The transnational environment favoring malaria transmission also requires transborder and regional cooperation, where innovative solutions should be considered and evaluated.
Published: 2020

10. When local phytotherapies meet biomedicine. Cross-sectional study of knowledge and intercultural practices against malaria in Eastern French Guiana

Author: Mélanie Gaillet, Marc-Alexandre Tareau, Loïc Epelboin, Claire Cropet, Paul Brousse, Céline Michaud, F. Djossou, Maylis Douine, Emilie Mosnier, P. Travers, Lise Musset, B. Philogene, Damien Davy, Yassamine Lazrek, Guillaume Odonne, Laboratoire Ecologie, Evolution, Interactions des Systèmes amazoniens (LEEISA), Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Université de Guyane (UG)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Parasitologie [Cayenne, Guyane française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], DAAC - NGO [Saint Georges de l’Oyapock], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Biome Tropical et Immuno-Pathophysiologie = Tropical Biome and ImmunoPhysiopathology [Lille] (TBIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Guyane (UG), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), This study was funded by: European Funds for Regional Development (Synergie: n°GY0012082), the Regional Agency for Health of French Guiana, Cayenne Hospital, the French Ministry for Research and Santé Publique France through the Institut Pasteur de la Guyane. It was also supported by 'Investissement d’Avenir' grants managed by the Agence Nationale de la Recherche (Labex DRIIHM/IRDHEI: ANR-11-LABX-0010 and Labex CEBA: ANR-10-LABX-25-01)., ANR-11-LABX-0010,DRIIHM / IRDHEI,Dispositif de recherche interdisciplinaire sur les Interactions Hommes-Milieux(2011), ANR-10-LABX-0025,CEBA,CEnter of the study of Biodiversity in Amazonia(2010), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Service des maladies infectieuses, Hopital Andree Rosemond, Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Réseau International des Instituts Pasteur (RIIP), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Centre Collaborateur OMS pour la surveillance de la résistance aux antipaludiques [Cayenne, Guyane française] (CCOMS), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG), Musset, Lise, Dispositif de recherche interdisciplinaire sur les Interactions Hommes-Milieux - - DRIIHM / IRDHEI2011 - ANR-11-LABX-0010 - LABX - VALID, Laboratoires d'excellence - CEnter of the study of Biodiversity in Amazonia - - CEBA2010 - ANR-10-LABX-0025 - LABX - VALID, Laboratoire Ecologie, Evolution, Interactions des Systèmes amazoniens [LEEISA], Centre National de Référence du Paludisme [Cayenne, Guyane française] [CNR - laboratoire associé], Centre d'Investigation Clinique Antilles-Guyane [CIC - Antilles Guyane], Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 [CIIL], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD], Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER), and Observatoire Hommes Milieux (OHM) Oyapock-Labex DRIIHM ANR-11-LABX-0010
Subjects: Male, Health Knowledge, Attitudes, Practice, Cross-sectional study, Ethnic group, Medical pluralism, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, [SHS]Humanities and Social Sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Discovery, ComputingMilieux_MISCELLANEOUS, 0303 health sciences, education.field_of_study, Rapid diagnostic test, Amazon rainforest, 3. Good health, French Guiana, Geography, 030220 oncology & carcinogenesis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, Knowledge attitudes and practices, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Adult, medicine.medical_specialty, Fever, Integrated community survey, Population, 03 medical and health sciences, Antimalarials, Young Adult, Medicinal plants, Amazonia, Environmental health, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], parasitic diseases, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, education, Traditional phytotherapies, Biomedicine, 030304 developmental biology, Pharmacology, Plants, Medicinal, business.industry, Public health, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, [SHS.ANTHRO-SE]Humanities and Social Sciences/Social Anthropology and ethnology, medicine.disease, Malaria, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, OHM Oyapock, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, medicinal plants, traditional phytotherapies, integrated community survey, medical pluralism, knowledge attitudes and practices, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Medicine, Traditional, business, Phytotherapy
Abstract: International audience; Ethnopharmacological relevance: In French Guiana, traditional phytotherapies are an important part of self-healthcare, however, a precise understanding of the interactions between local phytotherapies and biomedicine is lacking. Malaria is still endemic in the transition area between French Guiana and Brazil, and practices of self-treatment, although difficult to detect, have possible consequences on the outcome of public health policies.Aim of the study: The objectives of this research were 1) to document occurences of co-medication (interactions between biomedicine and local phytotherapies) against malaria around Saint-Georges de l’Oyapock (SGO), 2) to quantify and to qualify plant uses against malaria, 3) and to discuss potential effects of such co-medications, in order to improve synergy between community efforts and public health programs in SGO particularly, and in Amazonia more broadly.Materials and methods: This cross-sectional study was conducted in 2017 in SGO. Inhabitants of any age and nationality were interviewed using a questionnaire (122 questions) about their knowledge and habits regarding malaria, and their use of plants to prevent and treat it. They were invited to show their potential responses on a poster illustrating the most common antimalarial plants used in the area. In order to correlate plant uses and malaria epidemiology, all participants subsequently received a medical examination, and malaria detection was performed by Rapid Diagnostic Test (RDT) and Polymerase Chain Reaction (PCR).Results: A total of 1566 inhabitants were included in the study. Forty-six percent of them declared that they had been infected by malaria at least once, and this rate increased with age. Every person who reported that they had had malaria also indicated that they had taken antimalarial drugs (at least for the last episode), and self-medication against malaria with pharmaceuticals was reported in 142 cases. A total of 550 plant users was recorded (35.1% of the interviewed population). Among them 95.5% associated pharmaceuticals to plants. All plants reported to treat malaria were shared by every cultural group around SGO, but three plants were primarily used by the Palikur: Cymbopogon citratus, Citrus aurantifolia and Siparuna guianensis. Two plants stand out among those used by Creoles: Eryngium foetidum and Quassia amara, although the latter is used by all groups and is by far the most cited plant by every cultural group. Cultivated species accounts for 91.3% of the use reports, while wild taxa account for only 18.4%.Conclusions: This study showed that residents of SGO in French Guiana are relying on both traditional phytotherapies and pharmaceutical drugs to treat malaria. This medical pluralism is to be understood as a form of pragmatism: people are collecting or cultivating plants for medicinal purposes, which is probably more congruent with their respective cultures and highlights the wish for a certain independence of the care process. A better consideration of these practices is thus necessary to improve public health response to malaria.
Published: 2021

11. Levers and Barriers to Vaccinate against COVID-19 in the Multicultural Context of French Guiana: A Qualitative Cross-Sectional Survey among Health Care Workers

Author: Nicolas Vignier, Mélanie Gaillet, Antoine Adenis, Mathieu Nacher, Audrey Valdes, Philippe Abboud, Kepha Brureau, Loïc Epelboin, Jacques Breton, Sibylle Granier, Félix Djossou, Camille Agostini, Mathilde Ballet, Céline Michaud, Maylis Douine, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Biome Tropical et Immuno-Pathophysiologie = Tropical Biome and ImmunoPhysiopathology [Lille] (TBIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG), Université de Montpellier (UM), Université des Antilles (UA), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Agence Régionale de la Santé [Cayenne, Guyane française] (ARS), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Université Sorbonne Paris Nord, This study received logistical support from the Centre Hospitalier de Cayenne (Centre d’investigation Clinique Antilles Guyane, CIC Inserm 1424)., CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, and Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Guyane (UG)
Subjects: medicine.medical_specialty, Cross-sectional study, media_common.quotation_subject, barriers, Immunology, Population, education, Context (language use), multiculturalism, Article, Grounded theory, information, 03 medical and health sciences, 0302 clinical medicine, Political science, Drug Discovery, Health care, medicine, Pharmacology (medical), 030212 general & internal medicine, 030304 developmental biology, media_common, Pharmacology, 0303 health sciences, education.field_of_study, business.industry, COVID-19, vaccination, 3. Good health, French Guiana, Vaccination, Infectious Diseases, Multiculturalism, Family medicine, Medicine, willingness, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, qualitative research, Qualitative research
Abstract: International audience; In French Guiana, a French overseas territory in South America facing a fourth wave of COVID-19, vaccination coverage is very low, both in the population and among health care workers (HCWs). Vaccine hesitancy concerned 35.7% of the latter in early 2021. The objective of this complementary study is to understand barriers and levers and to adapt messages to increase vaccination coverage among HCWs. We conducted a regional cross-sectional survey of HCWs with a questionnaire containing open-ended questions exploring factors associated with vaccine hesitancy and the needs to adapt the vaccination campaign in French Guiana. The discourses were analyzed using a qualitative approach based on grounded theory, with open coding of data by themes and construction of abstract categories. The analysis of the 357 responses collected from January to March 2021 reveals several trends. The ethical aspect of the HCWs’ role emphasizes the importance of getting vaccinated themselves (to protect patients, to set an example...) and of vaccinating as many people as possible, including the most geographically or socially distant, such as undocumented migrants. However, some HCWs remain suspicious of the vaccine with concerns over the efficacy and side effects, of health institutions, and of the pharmaceutical industry. The role of fake news circulating on social networks has been widely discussed. Efforts to explain and convince HCWs must be continued in French Guiana using the identified levers to improve the acceptability of vaccination.
Published: 2021

12. Review of: 'Malaria Care-Seeking and Treatment Ideation among Gold Miners in Guyana'

Author: Maylis Douine
Subjects: medicine.medical_specialty, Care seeking, business.industry, Medicine, Ideation, business, Psychiatry, medicine.disease, Malaria
Published: 2021

13. Contribution of Research in the West Indies and Northeast Amazonia to Knowledge of the 2014–2015 Chikungunya Epidemic in the Americas

Author: Margarete do Socorro Mendonça Gomes, Raymond Cézaire, C Clavel, Dominique Rousset, Yanouk Epelboin, Sylvie Abel, Félix Djossou, Hélène Hilderal, Timothée Bonifay, Moustapha Dramé, Lidvine Godaert, Narcisse Elenga, Maylis Douine, André Cabié, Bruno Hoen, Fatiha Najioullah, Laurence Fagour, Loïc Epelboin, Marcus V. G. Lacerda, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre hospitalier [Valenciennes, Nord], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Louis Constant Fleming, CHU de la Martinique [Fort de France], Laboratório Central de Saúde Pública do Amapa, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], CHU Pointe-à-Pitre/Abymes [Guadeloupe], and BONIZEC, Sandrine
Subjects: medicine.medical_specialty, Aedes albopictus, viruses, West Indies, [SDV]Life Sciences [q-bio], 030231 tropical medicine, America, Disease, medicine.disease_cause, Arbovirus, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, medicine, Immunology and Allergy, 030212 general & internal medicine, Chikungunya, Socioeconomics, Amazonian Diseases in isolate populations (M Nacher, Section Editor), biology, Outbreak, virus diseases, biology.organism_classification, medicine.disease, [SDV] Life Sciences [q-bio], Infectious Diseases, Geography, Guiana Shield, Vector (epidemiology), Encephalitis
Abstract: Purpose of Review Although the chikungunya virus was discovered more than 60 years ago, it has only really been studied since the outbreak in La Reunion in 2005–2006. Ten years later, between 2014 and 2015, the chikungunya virus spread throughout the Americas, affecting millions of people. The objective of this review is to describe the contributions of research on chikungunya virus infection gained from epidemic in the West Indies and the Guiana Shield. Recent Findings Prevalence data were similar to those found in the Indian Ocean or Asia during epidemics. Clinically, there is now a better understanding of the typical, atypical, and severe forms. Several studies have insisted on the presence of neurological forms of chikungunya infection, such as encephalitis or Guillain–Barré syndrome. Cases of septic shock due to chikungunya virus as well as thrombotic thrombocytopenic purpura were described for the first time. Given the magnitude of the epidemic and the large number of people affected, this has led to a better description and new classifications of chikungunya virus infections in specific populations such as pregnant women, the elderly, and children. Several studies also described the behavior of populations faced with an emerging disease. Summary Current epidemiological data from tropical regions highlights the risk of spreading emerging diseases at higher latitudes, especially concerning arboviruses, since the vector Aedes albopictus is already established in many parts of northern countries. A better understanding of the disease and its epidemic dynamics will foster better management, the crucial importance of which was demonstrated during the COVID-19 epidemic.
Published: 2021

14. Attitudes towards the COVID-19 Vaccine and Willingness to Get Vaccinated among Healthcare Workers in French Guiana: The Influence of Geographical Origin

Author: Kepha Brureau, Nicolas Vignier, Félix Djossou, Philippe Abboud, Céline Michaud, Antoine Adenis, Jacques Breton, Mathieu Nacher, Audrey Valdes, Mélanie Gaillet, Loïc Epelboin, Maylis Douine, Camille Agostini, Mathilde Ballet, Sybille Granier, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), UFR Santé, Médecine et Biologie Humaine (UFR SMBH), Université Sorbonne Paris Nord, Université des Antilles (UA), Université de Montpellier (UM), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], and Université de Guyane (UG)
Subjects: 0301 basic medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), [SDV]Life Sciences [q-bio], Immunology, COVID-19 vaccines, Context (language use), health personnel, Article, 03 medical and health sciences, 0302 clinical medicine, Drug Discovery, Health care, Pandemic, medicine, Pharmacology (medical), 030212 general & internal medicine, Pharmacology, Government, business.industry, Public health, South America, 3. Good health, French Guiana, 030104 developmental biology, Infectious Diseases, Family medicine, Vaccine refusal, Medicine, vaccine hesitancy, Ordered logit, willingness to get vaccinated, business
Abstract: Background: In the context of the global COVID-19 pandemic and the expansion of the more transmissible 20J/501Y.V3 (Gamma) variant of concern (VOC), mRNA vaccines have been made available in French Guiana, an overseas French territory in South America, from mid-January 2021. This study aimed to estimate the willingness to be vaccinated and the socio-demographic and motivational correlates among Health Care Workers (HCWs) in French Guiana. Methods: A cross-sectional survey was conducted from January 22 to March 26, 2021 among a sample of HCWs in French Guiana. They were asked about their willingness to get vaccinated against COVID-19 and vaccine hesitancy, vaccine uptake and vaccines attitudes. Factors associated with willingness to get vaccinated have been analyzed with ordinal logistic regression, using Stata software. Results: A total of 579 HCWs were interviewed, including 220 physicians and 200 nurses most often working in hospital (54%) or in the liberal sector (22%). Overall, 65.6% of respondents reported that they were willing or had already been vaccinated against COVID-19, while 24.3% of respondents reported that they did not want to get vaccinated against COVID-19 and 11.2% were unsure. HCWs were more willing to get vaccine if they were older, were worried about COVID-19 and were confident in the management of epidemic. Conversely, participants were less likely to have been vaccinated or willing to if they were nurses or of another non-medical profession, born in French Guiana, feared adverse effects, or if they did not trust pharmaceutical companies and management of the epidemic by authorities. Conclusion: Negative attitudes towards vaccines are a major public health concern among HCWs in French Guiana when considering the current active epidemic with Gamma VOC. General vaccine hesitancy and concerns about future side effects in particular represent important barriers. Low confidence in government and science are significant in COVID-19 vaccine refusal among non-medical staffs. Public health messaging with information on vaccine safety should be tailored to address these concerns. The specific challenges of HCWs from French Guiana must be taken into account.
Published: 2021
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15. Maliqua: A study within Malakit, a project on malaria and gold miners in French Guiana

Author: Muriel Galindo, Maylis Douine, Parent A, and Yann Lambert
Subjects: Intervention (law), Politics, Gold mining, Geography, business.industry, parasitic diseases, medicine, Social inequality, medicine.disease, Socioeconomics, business, Free distribution, Malaria
Abstract: Malaria is endemic in French Guiana, especially within the gold mining community working illegally. Gold miners travel to remote camps in the forest to carry out their activities, exposing themselves to the presumed contamination area. This paper presents the results of a qualitative case study of the Malakit project, a free distribution of self-diagnosis and self-treatment kits, along with appropriate training/information from health facilitators, at resting sites in Brazil and Suriname on the borders with French Guiana. This study documents how Malakit is part of the care trajectory of gold miners. The data was collected using three methods: 1) on-site observation; 2) semi-structured individual interviews (n=26); 3) semi-structured group interviews (n=2). The results inform us that Malakit responds to the need for treatment and facilitates access to care. Gold miners say they trust the facilitators and receive accurate explanations. The majority of participants find the kit easy to use and to carry and explanations given were sufficient, although some people needed to be reminded how to use it once in the forest. Results remind us that malaria among illegal gold miners in French Guiana is a question of social inequalities in health, where the interaction of the health, social, economic and political contexts of Brazil and French Guiana influence exposure to numerous risk factors. Thus, malaria intervention practices such as Malakit cannot be carried out without considering the complexity generated by social inequalities in health.
Published: 2021

16. The Epidemiology of COVID 19 in the Amazon and the Guianas: Similarities, Differences, and International Comparisons

Author: Mathieu Nacher, Cyril Rousseau, Tiphanie Succo, Audrey Andrieu, Mélanie Gaillet, Céline Michaud, Véronique Servas, Maylis Douine, Roxane Schaub, Antoine Adenis, Magalie Demar, Philippe Abboud, Loïc Epelboin, and Félix Djossou
Subjects: medicine.medical_specialty, Internationality, Amazonian, Context (language use), Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Cause of Death, parasitic diseases, Case fatality rate, Epidemiology, medicine, Humans, 030212 general & internal medicine, Epidemics, Amazon, Socioeconomic status, Original Research, 030304 developmental biology, 0303 health sciences, SARS-CoV-2, Amazon rainforest, lcsh:Public aspects of medicine, Mortality rate, International comparisons, Public Health, Environmental and Occupational Health, COVID-19, lcsh:RA1-1270, mortality, testing, French Guiana, Europe, Geography, North America, Guiana shield, epidemiology, Public Health, COVID 19, Brazil, vulnerable populations, Demography
Abstract: Background: The COVID 19 epidemic submerged many health systems in the Amazon. The objective of the present study was to focus on the epidemic curves of the COVID 19 epidemic in different centers, and to look at testing and mortality data.Methods: Publicly available datasets were used. The log10 of the daily cumulated number of cases starting from the day the territory reached 100 cumulated cases was plotted to compare the magnitude, shape and slope of the different curves. The maximum daily testing efforts were plotted for each territory in relation to the maximum daily number of diagnoses. The case fatality rate was computed by dividing the number of COVID 19 deaths by the number of confirmed cases.Results: In the Amazonian regions in general the speed of growth was generally lower than in Europe or the USA, or Southern Brazil. Whereas, countries like South Korea or New Zealand “broke” the curve relatively rapidly the log linear trajectory seemed much longer with signs of a decline in growth rate as of early July 2020. After a very slow start, French Guiana had the lowest slope when compared to other Amazonian territories with significant epidemics. The Amazonian states of Roraima, Amazonas, Parà, and Amapà had among the highest number of cases and deaths per million inhabitants in the world. French Guiana had significantly fewer deaths relative to its number of confirmed cases than other Amazonian territories. French Guiana had a late epidemic surge with intense testing scale-up often exceeding 4,000 persons tested daily per million inhabitants. Brazil was an outlier with low daily testing levels in relation to the number of daily diagnoses.Conclusions: There were marked heterogeneities mortality rates suggesting that socioeconomic, political factors, and perhaps ethnic vulnerability led to striking outcome differences in this Amazonian context.
Published: 2021

17. Self-Diagnosis and Self-Treatment of Malaria in Hard-to-Reach and Mobile Populations of the Amazon: Results of Malakit, a Multicentric Intervention Research Project. Towards a Paradigm Shift?

Author: Jane Bordalo Miller, Helene Hiwat, Stephen Vreden, Muriel Galindo, Paola Marchesini, Martha Cecilia Suárez-Mutis, Alice Sanna, Mathieu Nacher, Yann Lambert, Magalie Demar, Maylis Douine, Hedley Cairo, Antoine Adenis, Lise Musset, Cassio Peterka, Louise Mutricy, and Yassamine Lazrek
Subjects: medicine.medical_specialty, business.industry, Conflict of interest, Declaration, Certification, medicine.disease, Family medicine, Intervention (counseling), General Data Protection Regulation, Health care, medicine, media_common.cataloged_instance, European union, business, Malaria, media_common
Abstract: Background: Illegal gold miners are currently a key reservoir for malaria in French Guiana (FG), with a risk of emergence of resistance linked to improper use of artemisinin-based combination therapy (ACT). The remoteness of the mines and regulatory issues hinder their access to health care. Methods: An intervention researched project (Malakit) implemented in FG borders with Brazil and Suriname aimed at determining the effectiveness of distributed kits for self-diagnosis and self-treatment to illegal gold miners, after training, at strategic border staging areas. Evaluation relied on questionnaires at inclusion and follow-up visits, and pre/post intervention surveys. The primary outcome was the proportion of persons reporting a use of certified ACT after a positive malaria diagnosis. The secondary outcomes assessed antimalarial adherence, kit use and impact on malaria epidemiology. Findings: The proportion of patients reporting a use of certified ACT after a positive diagnosis increased after the intervention (OR 1.8, 95%CI [1.1-3.0]). From April 2018 to March 2020, 3,733 persons participated in the intervention. The kit was used correctly by 71.7% [65.8-77.7] of the 223 persons reporting having used a malakit during the follow-up visits. The intervention could have accelerated the decline in malaria incidence in the region by 42.9%. InterpretationThis innovative international project showed that people with low education can correctly self-manage their malaria symptoms. This strategy could be integrated in the malaria control programs of the countries involved and considered in other regions with residual malaria in remote areas. Funding: This project was funded by the European Union, the Global Fund, PAHO, Brazil MoH, Cayenne Hospital and FG Health Regional Agency. Declaration of Interest: Any authors declare to have no conflict of interest. Ethical Approval: Each participant gave a written consent after clear and appropriate information. Ethics approvals were obtained from countries where the project was implemented (Table 1). The project was the subject of a Normal CNIL Declaration on 24 May 2018 (Declaration Number 2188949 v 0) for data analysis according to the General Data Protection Regulation (European Union Regulation 2016/679).
Published: 2021

18. Setting-up a cross-border action-research project to control malaria in remote areas of the Amazon: describing the birth and milestones of a complex international project (Malakit)

Author: Muriel Galindo, Mathieu Nacher, Helene Hiwat, Jane Bordalo Miller, Yann Lambert, Martha Cecilia Suárez-Mutis, Hélène Hilderal, Stephen Vreden, Hedley Cairo, Laure Garancher, Cassio Peterka, José Hermenegildo Gomes, Louise Mutricy, Alice Sanna, and Maylis Douine
Subjects: Adult, Male, medicine.medical_specialty, Malaria control, International Cooperation, 030231 tropical medicine, Population, Control (management), RC955-962, Context (language use), Infectious and parasitic diseases, RC109-216, Mining population, Mobile migrants, 03 medical and health sciences, Border malaria, 0302 clinical medicine, Complex intervention, Arctic medicine. Tropical medicine, Health care, medicine, Malaria, Vivax, Humans, 030212 general & internal medicine, Action research, Malaria, Falciparum, education, education.field_of_study, Suriname, business.industry, Public health, Methodology, Neglected population, Public relations, Middle Aged, medicine.disease, French Guiana, Intervention (law), Infectious Diseases, Action-research, Communicable Disease Control, Implementation science, Parasitology, Female, Business, Health Services Research, Malaria, Brazil
Abstract: Background In French Guiana, gold miners working illegally represents a major reservoir of malaria. This mobile population, mainly of Brazilian descent, enters the French Guianese forest from neighbouring countries, Suriname and Brazil. A complex and innovative intervention was piloted as a cooperation with the three involved countries involved to control malaria in this specific population. The principle was that health workers called “facilitators” provide the participants with a self-diagnosis and self-treatment kit along with adequate training and material to rapidly manage an episode of malaria symptoms on their own, when they find themselves isolated from health care services. Methods This paper describes the design, development, content of the intervention and players’ organization of this multi-country project, the opportunities and constraints encountered, and the lessons learnt at this stage. Results The choice not to implement the usual “Test and Treat” approach within the community is mainly driven by regulatory reasons. The content of medical messages tends to balance the tension between thoroughness, accuracy and efficacy. The wide range of tools developed through a participatory approach was intended to cope with the challenges of the literacy level of the target population. Despite the difficulties encountered due to language, regulation differences and distance between partners, cooperation was fruitful, due to the complementary of stakeholders, their involvement at all important stages and regular face-to-face meetings. Discussion and conclusion This experience shows the feasibility of an ambitious project of action-research in a border malaria context, involving several countries and with a mobile and undocumented population. It reveals some factors of success which may be transferable in analogous settings.
Published: 2020

19. Simultaneous dengue and COVID-19 epidemics: Difficult days ahead?

Author: Stanley Carroll, Audrey Valdes, Maylis Douine, Mélanie Gaillet, Mathieu Nacher, Dominique Rousset, Cyril Rousseau, Nathalie Passard, Chedli Mahdaoui, Félix Djossou, Magalie Demar, Claude Flamand, Loïc Epelboin, Gabriel Carles, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université de Guyane (UG), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité d'Epidémiologie [Cayenne, Guyane française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française] (CNR - laboratoire associé), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Réseau de médecins sentinelles, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], The authors received no specific funding for this work., Flamand, Claude, and CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG)
Subjects: RNA viruses, Viral Diseases, MESH: Coronavirus Infections, Epidemiology, [SDV]Life Sciences [q-bio], RC955-962, [MATH] Mathematics [math], MESH: Dengue, MESH: Hospitalization, Pathology and Laboratory Medicine, Social Distancing, Geographical locations, Dengue fever, Dengue Fever, Dengue, 0302 clinical medicine, Medical Conditions, Arctic medicine. Tropical medicine, Medicine and Health Sciences, 030212 general & internal medicine, [MATH]Mathematics [math], ComputingMilieux_MISCELLANEOUS, Coinfection, [SDV] Life Sciences [q-bio], [STAT]Statistics [stat], Viewpoints, Hospitalization, Infectious Diseases, Medical Microbiology, Viral Pathogens, Viruses, MESH: Betacoronavirus, Public aspects of medicine, RA1-1270, Pathogens, Coronavirus Infections, Brazil, Neglected Tropical Diseases, 2019-20 coronavirus outbreak, MESH: Pandemics, Coronavirus disease 2019 (COVID-19), Infectious Disease Control, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030231 tropical medicine, Physical Distancing, Pneumonia, Viral, Microbiology, Diagnosis, Differential, 03 medical and health sciences, Betacoronavirus, MESH: Diagnosis, Differential, Diagnostic Medicine, medicine, Humans, Microbial Pathogens, Pandemics, MESH: Humans, Biology and life sciences, Flaviviruses, business.industry, SARS-CoV-2, Public Health, Environmental and Occupational Health, Organisms, COVID-19, Covid 19, Dengue Virus, South America, medicine.disease, Tropical Diseases, [STAT] Statistics [stat], MESH: Coinfection, MESH: Pneumonia, Viral, Co-Infections, Medical Risk Factors, MESH: Social Distance, People and places, business, Co infection
Abstract: International audience
Published: 2020

20. Resurgence risk for malaria, and the characterization of a recent outbreak in an Amazonian border area between French Guiana and Brazil

Author: Emmanuel Roux, Yanouk Epelboin, Isabelle Dusfour, Guillaume Lacour, Félix Djossou, Mathieu Nacher, Maylis Douine, Lise Musset, Magalie Demar, Amandine Guidez, Damien Davy, Vanessa Ardillon, Margarete do Socorro Mendonça Gomes, Johana Restrepo, Alice Sanna, Emilie Mosnier, Raphael de Freitas Saldanha, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Altopictus [Biarritz], Institute of Scientific and Technological Communication and Information in Health / Instituto de Comunicação e Informação Científica e Tecnológica em Saúde [Rio de Janeiro] (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Superintendência de Vigilância em Saúde do Amapá (SVS-AP), Health Regional Agency [Cayenne], Collectivité Territoriale de Guyane (CTG), Laboratoire Ecologie, Evolution, Interactions des Systèmes amazoniens (LEEISA), Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER), Laboratoire Hospitalo-Universitaire de Parasitologie et Mycologie [Cayenne, Guyane Française], Université de Guyane (UG), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cellule interrégionale d'épidémiologie Antilles-Guyane [CIRE], Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), UMR 228 Espace-Dev, Espace pour le développement, Université de Guyane (UG)-Université des Antilles (UA)-Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM), LMI Sentinela [Rio de Janeiro], Institut de Recherche pour le Développement (IRD)-Universidade de Brasilia [Brasília] (UnB)-Fundação Oswaldo Cruz (FIOCRUZ), Vectopôle Amazonien Emile Abonnenc [Cayenne, Guyane française], Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Université de Guyane (UG)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Laboratoire de Parasitologie [Cayenne, Guyane française], Centre Collaborateur OMS pour la surveillance de la résistance aux antipaludiques [Cayenne, Guyane française] (CCOMS), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM)-Université de Guyane (UG)-Université des Antilles (UA), Institut de Recherche pour le Développement (IRD)-Universidade de Brasilia [Brasília] (UnB)-Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), Universidade de Brasilia [Brasília] (UnB), Agence Régionale de la Santé [Cayenne, Guyane française] (ARS), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe]-CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Guyane (UG)-Université des Antilles (UA)-Université de Montpellier (UM), OHM Oyapock, ANR-11-LABX-0010,DRIIHM / IRDHEI,Dispositif de recherche interdisciplinaire sur les Interactions Hommes-Milieux(2011), Roux, Emmanuel, and Aix Marseille Université (AMU)
Subjects: Male, [SDV]Life Sciences [q-bio], [SHS.GEO] Humanities and Social Sciences/Geography, Plasmodium vivax, Attack rate, Distribution (economics), [SHS]Humanities and Social Sciences, Disease Outbreaks, 0302 clinical medicine, [STAT.AP] Statistics [stat]/Applications [stat.AP], Residence Characteristics, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Anopheles darlingi, 030212 general & internal medicine, Socioeconomics, [STAT.AP]Statistics [stat]/Applications [stat.AP], biology, Amazon rainforest, Incidence, Transnational, [SHS.GEO]Humanities and Social Sciences/Geography, 3. Good health, French Guiana, Indigenous south Americans, Infectious Diseases, Geography, Female, Seasons, Brazil, Research Article, medicine.medical_specialty, Adolescent, 030231 tropical medicine, Outbreak investigation, Mosquito Vectors, Indigenous, lcsh:Infectious and parasitic diseases, Young Adult, 03 medical and health sciences, Spatio-Temporal Analysis, Amazonia, Anopheles, parasitic diseases, Malaria, Vivax, medicine, Animals, Humans, lcsh:RC109-216, business.industry, Outbreak, biology.organism_classification, medicine.disease, Malaria, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Tropical medicine, OHM Oyapock, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: BackgroundIn 2017, inhabitants along the border between French Guiana and Brazil were affected by a malaria outbreak primarily due toPlasmodium vivax(Pv). While malaria cases have steadily declined between 2005 and 2016 in this Amazonian region, a resurgence was observed in 2017.MethodsTwo investigations were performed according to different spatial scales and information details: (1) a local study on the French Guiana border, which enabled a thorough investigation of malaria cases treated at a local village health center and the entomological circumstances in the most affected neighborhood, and (2) a regional and cross-border study, which enabled exploration of the regional spatiotemporal epidemic dynamic. Number and location of malaria cases were estimated using French and Brazilian surveillance systems.ResultsOn the French Guianese side of the border in Saint-Georges de l’Oyapock, the attack rate was 5.5% (n = 4000), reaching 51.4% (n = 175) in one Indigenous neighborhood. Entomological findings suggest a peak ofAnopheles darlingidensity in August and September. Two femaleAn. darlingi(n = 1104, 0.18%) were found to bePv-positive during this peak. During the same period, aggregated data from passive surveillance conducted by Brazilian and French Guianese border health centers identified 1566 cases ofPvinfection. Temporal distribution during the 2007–2018 period displayed seasonal patterns with a peak in November 2017. Four clusters were identified among epidemic profiles of cross-border area localities. All localities of the first two clusters were Brazilian. The localization of the first cluster suggests an onset of the outbreak in an Indigenous reservation, subsequently expanding to French Indigenous neighborhoods and non-Native communities.ConclusionsThe current findings demonstrate a potential increase in malaria cases in an area with otherwise declining numbers. This is a transborder region where human mobility and remote populations challenge malaria control programs. This investigation illustrates the importance of international border surveillance and collaboration for malaria control, particularly in Indigenous villages and mobile populations.
Published: 2020

21. Resurgence risk for malaria, characterization of a recent outbreak in a Amazonian border area -French Guiana/Brazil

Author: Emmanuel Roux, Yanouk Epelboin, Vanessa Ardillon, Emilie Mosnier, Damien Davy, Magalie Demar, Raphael de Freitas Saldanha, Mathieu Nacher, Félix Djossou, Isabelle Dusfour, Johana Restrepo, Guillaume Lacour, Alice Sanna, Margarete do Socorro Mendonça Gomes, Lise Musset, Maylis Douine, and Amandine Guidez
Subjects: Geography, Amazonian, parasitic diseases, medicine, Outbreak, Socioeconomics, medicine.disease, Malaria
Abstract: Background In 2017, inhabitants along the border between French Guiana and Brazil were affected by a malaria outbreak primarily due to Plasmodium vivax ( Pv ). While malaria cases have steadily declined between 2005-2016 in this Amazonian region, a resurgence was observed in 2017. Methods Two investigations were performed according to two different spatial scales and type of information details. Firstly, a local study on the French Guiana border, which enabled a thorough investigation of the malaria cases treated at the local village health center and of the entomological situation in the most affected neighborhood and secondly a regional and cross-border study, which enabled exploration of the regional spatial-temporal epidemic dynamic. Number and location of malaria cases were estimated using French and Brazilian surveillance systems. Results On the French Guiana side of the border in Saint Georges de l’Oyapock, the attack rate was 5.5% (n=219/4000), reaching 51.4% (n=90/175) in one Amerindian neighborhood. Entomological findings suggest a peak of Anopheles darlingi density in August and September. Two female An. darlingi (n=2/1104, 0.18%) were found Pv -positive during this peak. During the same period, aggregated data from passive surveillance conducted by Brazilian and French Guianese border health centers identified 1,566 cases of Pv infection. Temporal distribution during the 2007-2018 period displayed seasonal patterns with a peak in November 2017. Four clusters were identified among the epidemic profiles of the localities of the cross-border area. All localities of the first two clusters were Brazilian. The localization of the first cluster suggests an onset of the outbreak in the Amerindian reservation, subsequently expanding to French Amerindian neighborhoods and to non-Native communities. Conclusions The current findings demonstrate a potential increase in malaria cases in an area with otherwise declining numbers. This is a transborder area where human mobility and remote populations challenge malaria control programs. This investigation illustrates the importance of international border surveillance and collaboration for malaria control, particularly in Amerindian villages and mobile populations.
Published: 2020

22. Prevalence of Plasmodium spp. in the Amazonian border context (French Guiana-Brazil) : associated factors and spatial distribution

Author: Lise Musset, Emilie Mosnier, Emmanuel Roux, Olivier Moriceau, Maylis Douine, Stéphane Pelleau, Mélanie Gaillet, Luana Mathieu, Magalie Demar, Céline Michaud, Claire Cropet, Mathieu Nacher, Félix Djossou, Yassamine Lazrek, Guillaume Odonne, Pôle des Centres Délocalisés de Prévention et de Soins [CH Andrée Rosemon, Guyane Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), UMR 228 Espace-Dev, Espace pour le développement, Université de Guyane (UG)-Université des Antilles (UA)-Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM), Institute of Scientific and Technological Communication and Information in Health / Instituto de Comunicação e Informação Científica e Tecnológica em Saúde [Rio de Janeiro] (ICICT), Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Institut Pasteur de la Guyane, Laboratoire Hospitalier et Universitaire Parasitologie Mycologie, Laboratoire Ecologie, Evolution, Interactions des Systèmes amazoniens (LEEISA), Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), This study was funded by European Funds for Regional Development, N° Synergie: GY0012082, the Regional Agency for Health of French Guiana, Cayenne Hospital, the French Ministry for Research and Sante Publique France through the Institut Pasteur de la Guyane., We are grateful to the study participants in STG, French Guiana, the NGO, DAAC, provided culturally adapted mediators, offering crucial support throughout this study, and Franck De Laval, Gaelle Walter, Bastien Bidaud, Loıc Epelboin, Alessia Melzani, and Mylene Cebe also contributed to data collection., Roux, Emmanuel, Institut de Recherche pour le Développement (IRD)-Université de Perpignan Via Domitia (UPVD)-Avignon Université (AU)-Université de La Réunion (UR)-Université de Montpellier (UM)-Université de Guyane (UG)-Université des Antilles (UA), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Université de Guyane (UG)-Centre National de la Recherche Scientifique (CNRS), Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), and Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé)
Subjects: Adult, Male, Multivariate analysis, Adolescent, 030231 tropical medicine, Plasmodium vivax, Plasmodium falciparum, Context (language use), Plasmodium, 03 medical and health sciences, Young Adult, 0302 clinical medicine, [STAT.AP] Statistics [stat]/Applications [stat.AP], [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, parasitic diseases, medicine, Malaria, Vivax, Humans, Malaria, Falciparum, Child, Rapid diagnostic test, [STAT.AP]Statistics [stat]/Applications [stat.AP], biology, Infant, Articles, medicine.disease, biology.organism_classification, 3. Good health, French Guiana, Infectious Diseases, Carriage, Geography, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Child, Preschool, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Malaria, Brazil, Demography
Abstract: International audience; To implement future malaria elimination strategies in French Guiana, a characterization of the infectious reservoir is recommended. A cross-sectional survey was conducted between October and December 2017 in the French Guianese municipality of St Georges de l'Oyapock, located along the Brazilian border. The prevalence of Plasmodium spp. was determined using a rapid diagnostic test (RDT) and a polymerase chain reaction (PCR). Demographic, house locations, medical history, and biological data were analyzed. Factors associated with Plasmodium spp. carriage were analyzed using logistic regression, and the carriage localization was investigated through spatial cluster analysis. Of the 1,501 samples analyzed with PCR, positive results totaled 90 and 10 for Plasmodium vivax and Plasmodium falciparum, respectively. The general PCR prevalence was 6.6% [5.3-7.9], among which 74% were asymptomatic. Only 13/1,549 were positive by RDT. In multivariate analysis, participants older than 15 years, living in a remote neighborhood, with a prior history of malaria, anemia, and thrombocytopenia were associated with an increased odds of Plasmodium spp. carriage. High-risk clusters of P. vivax carriage were detected in the most remote neighborhoods on the village outskirts and two small foci in the village center. We also detected a hot spot for both P. vivax and P. falciparum symptomatic carriers in the northwestern part of the village. The present study confirms a wide-scale presence of asymptomatic P. falciparum and P. vivax carriers in this area. Although they were more often located in remote areas, their geographic distribution was spatially heterogeneous and complex.
Published: 2020

23. Investigation of a possible malaria epidemic in an illegal gold mine in French Guiana: an original approach in the remote Amazonian forest

Author: Franck de Laval, Alice Sanna, Helene Hiwat, François Michel Le Tourneau, Didier Belleoud, Sébastien Briolant, Hervé Bogreau, Mathieu Nacher, Maylis Douine, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Health Regional Agency [Cayenne], National Malaria Programme [Suriname]], Ministry of Health [Paramaribo, Suriname], Institut de Recherche Biomédicale des Armées [Antenne Marseille] (IRBA), French Armed Forces medical health service [Cayenne], Interdisciplinary and Global Environmental Studies (iGLOBES), University of Arizona-Centre National de la Recherche Scientifique (CNRS), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), French National Centre for Malaria [Marseille] (CNR Paludisme), Regional Health Agency of French Guiana, COMBE, Isabelle, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Institut de Recherche Biomédicale des Armées (IRBA)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Université de Guyane (UG), Interdisciplinary and Global Environmental Studes (iGLOBES), Centre d'épidémiologie et de santé publique des armées (CESPA), and Service de Santé des Armées
Subjects: Male, Pilot Projects, [SHS]Humanities and Social Sciences, 0302 clinical medicine, Communicable Diseases, Imported, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 030212 general & internal medicine, Socioeconomics, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, education.field_of_study, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Amazon rainforest, Middle Aged, French Guiana, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Infectious Diseases, Geography, Population Surveillance, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Adult, medicine.medical_specialty, Gold mining, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, 030231 tropical medicine, Population, Context (language use), Miners, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Amazonia, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, parasitic diseases, medicine, Humans, lcsh:RC109-216, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Epidemics, education, Investigation, business.industry, Research, Public health, Outbreak, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Malaria, Guiana Shield, Tropical medicine, Parasitology, Gold, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Background: In April 2017, Suriname's Ministry of Health alerted French Guiana's Regional Health Agency (RHA) about an increase of imported malaria cases among people coming from an illegal gold mining site called Sophie, in French Guiana, a French overseas territory located in the Amazonian forest. Methods: Due to safety issues and the remoteness of Sophie, the RHA requested the collaboration of the French Armed Forces for the epidemiological investigation. A medical unit, and six soldiers to ensure the security of the mission , were transported by helicopter. Results: During the investigation, two malaria episodes were diagnosed among 46 persons. Twenty-six of them were from Sophie, where PCR-Plasmodium prevalence was estimated at 60% (15/26). This result was concordant with previous studies revealing high malaria endemicity in the gold miner population. The increase of imported cases in Suriname may have resulted from decreased access to under-the-counter anti-malarials and increased migration of gold miners to Suriname following a decline of the profitability of gold mining in a context of increased repression against illegal mining by the French army. Conclusion: This investigation of a suspicious malaria epidemic confirms the importance of malaria among illegal gold miners. Their mobility along the Guiana Shield and their health-seeking behaviour are likely to spread malaria in populations for which significant efforts are undertaken to fight against this disease. Fighting malaria in this population remains more relevant than ever. A pilot study (Malakit project) is currently in progress to evaluate the efficacy of kits for self-diagnosis and self-treatment.
Published: 2019

24. Self-diagnosis and self-treatment of malaria in hard-to-reach and mobile populations of the Amazon: results of Malakit, an international multicentric intervention research project

Author: Mathieu Nacher, Jane Bordalo Miller, Yassamine Lazrek, Maylis Douine, Muriel Galindo, Yann Lambert, Hedley Cairo, Louise Mutricy, Lise Musset, Stephen Vreden, Cassio Peterka, Alice Sanna, Helene Hiwat, Paola Marchesini, Antoine Adenis, M. Demar, Martha Cecilia Suárez-Mutis, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Biome Tropical et Immuno-Pathophysiologie = Tropical Biome and ImmunoPhysiopathology [Lille] (TBIP), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS)-Université de Guyane (UG), Agence Régionale de la Santé [Cayenne, Guyane française] (ARS), Ministry of Health [Brasília, Brazil], National Malaria Programme [Suriname]], Ministry of Health [Paramaribo, Suriname], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Parasitologie [Cayenne, Guyane française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Réseau International des Instituts Pasteur (RIIP), DPAC-Fronteira [Oiapoque, Brazil], Foundation for the Advancement of Scientific Research in Suriname [Paramaribo] (SWOS), Instituto Oswaldo Cruz / Oswaldo Cruz Institute [Rio de Janeiro] (IOC), Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), The CHC, as sponsor, directly managed most of the project funds. Half of the funding was by the European Regional Development Fund (FEDER) via the Interregional Amazon Cooperation Program (IACP) 2014-2020 (N° Presage 3949), supplemented with self-funding from the CHC, funds from the French Guiana Regional Health Agency and contributions in kind from the (Global Fund to Fight AIDs, Tuberculosis and Malaria) and the Ministry of Health of Brazil., Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Guyane (UG), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Fundação Oswaldo Cruz (FIOCRUZ), and Musset, Lise
Subjects: Self-treatment, Low education, 030231 tropical medicine, Library science, malaria control, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, self-diagnosis, 03 medical and health sciences, Amazon forest, 0302 clinical medicine, quasi-experimental design, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Political science, Internal Medicine, medicine, self-treatment, media_common.cataloged_instance, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, 030212 general & internal medicine, European union, media_common, Amazon rainforest, Health Policy, Public Health, Environmental and Occupational Health, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, interventional research, mobile population, medicine.disease, 3. Good health, Neutral position, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, vulnerable population, Intervention research, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Public aspects of medicine, RA1-1270, Americas, Malaria control, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Malaria
Abstract: BackgroundIllegal gold miners are currently key hosts for malaria in French Guiana (FG), with a risk of emergence of resistance linked to improper use of artemisinin-based combination therapy (ACT). The remoteness of the mines and regulatory issues hinder their access to health care.MethodsA quasi-experimental researched project (Malakit) implemented in FG borders with Brazil and Suriname aimed at determining the effectiveness of distributed kits for self-diagnosis and self-treatment to illegal gold miners, after training, at strategic border staging areas. Evaluation relied on questionnaires at inclusion and follow-up visits, and pre/post intervention surveys. The primary outcome was the proportion of persons reporting a use of certified ACT after a positive malaria diagnosis. The secondary outcomes assessed antimalarial adherence, kit use and impact on malaria epidemiology.FindingsThe proportion of patients reporting a use of certified ACT after a positive diagnosis increased after the intervention (OR 1.8, 95%CI [1.1-3.0]). From April 2018 to March 2020, 3,733 persons participated in the intervention. The kit was used correctly by 71.7% [65.8-77.7] of the 223 persons reporting having used a malakit during the follow-up visits. No serious adverse events related to the misuse of malakit have been reported. The intervention appears to have accelerated the decline in malaria incidence in the region by 42.9%.InterpretationThis innovative international project showed that people with low education can correctly self-manage their malaria symptoms. This strategy could be integrated in the malaria control programs of the countries involved and considered in other regions with residual malaria in remote areas., ContexteLes chercheurs d'or illégaux sont actuellement un réservoir clé du paludisme en Guyane, avec un risque d'émergence de résistance lié à une mauvaise utilisation des combinaisons thérapeutiques à base d'artémisinine (ACT). L'isolement de ces sites miniers clandestins et des contraintes règlementaires entravent leur accès aux soins.MéthodesUn projet de recherche opérationnelle quasi-expérimental (Malakit) a été mis en œuvre aux frontières de la Guyane avec le Brésil et le Suriname. Il visait à déterminer l'efficacité de la distribution de kits d'autodiagnostic et d'autotraitement à des orpailleurs illégaux, après une formation adaptée, dans des zones stratégiques transfrontalières. L'évaluation s'est appuyée sur des questionnaires lors des visites d'inclusion et de suivi, et sur des enquêtes pré/post intervention. L'indicateur principal était la proportion de personnes déclarant avoir utilisé une ACT certifiée après un diagnostic positif de paludisme. Les indicateurs secondaires reposaient sur l'adhérence aux traitements antipaludiques, l'utilisation des kits et l'impact sur l'épidémiologie du paludisme.RésultatsLa proportion de patients déclarant une utilisation d'ACT certifiée après un diagnostic positif a augmenté après l'intervention (OR 1,8, 95%CI [1,1-3,0]). D'avril 2018 à mars 2020, 3 733 personnes ont participé à l'intervention. Le kit a été utilisé correctement par 71,7% [65,8-77,7] des 223 personnes revues en visites de suivi ayant déclaré avoir utilisé un malakit. Aucun événement indésirable grave lié à une mauvaise utilisation du malakit n'a été signalé. L'intervention semble avoir accéléré la diminution de l'incidence du paludisme dans la région de 42,9%.InterprétationCe projet international innovant a montré que les personnes ayant un faible niveau d'éducation peuvent se prendre en charge par eux-mêmes pour des symptômes de paludisme. Cette stratégie pourrait être intégrée dans les programmes de lutte contre le paludisme des pays impliqués et envisagée dans d'autres régions où du paludisme résiduel persiste dans des zones isolées.
Published: 2021

25. The singular epidemiology of HPV infection among French Guianese women with normal cytology

Author: Vincent Lacoste, Jean Luc Deshayes, Fatiha Najioullah, Hatem Ben Amor, Paul Brousse, Maylis Douine, Vincent Molinie, Raymond Césaire, Odile Kilié, Nadia Thomas, Valentin Dufit, Gabriel Carles, Remy Pignoux, Dominique Catherine, Antoine Adenis, Claire Grenier, Mathieu Nacher, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Laboratoire de Virologie [Fort-de-France, Martinique], CHU de la Martinique [Fort de France], Service d'anatomopathologie [Fort de France, Martinique], CHU Fort de France, Service de Gynecologie Obstétrique [Cayenne], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Association de Dépistage Organisé des Cancers de Guyane (AGDOC), Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais, Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), The Study was funded by the European Regional Development Fund (FEDER) Presage number 30814., We wish to thank all study participants and the staff from the health centers of French Guiana., Lacoste, Vincent, Centre d'investigation clinique Antilles-Guyane ( CIC - Antilles Guyane ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU de la Martinique-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Virologie-Immunologie [Fort de France, Martinique], Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Association guyanaise de dépistage organisé des cancers ( AGDOC ), Service de gynécologie-obstétrique [Saint Laurent du Maroni, Guyane Française], Réseau International des Instituts Pasteur ( RIIP ), and Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine ( COREVIH Guyane )
Subjects: MESH: Cervix Uteri/cytology, MESH: Uterine Cervical Neoplasms/pathology, [SDV]Life Sciences [q-bio], MESH: Uterine Cervical Neoplasms/epidemiology, Uterine Cervical Neoplasms, Cervix Uteri, 0302 clinical medicine, Informed consent, Surveys and Questionnaires, Epidemiology, Prevalence, MESH: DNA, Viral/genetics, Medicine, 030212 general & internal medicine, Papillomaviridae, MESH: Aged, MESH: Papillomavirus Infections/epidemiology, Cervical cancer, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Obstetrics, lcsh:Public aspects of medicine, HPV infection, virus diseases, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Uterine Cervical Neoplasms/diagnosis, Middle Aged, female genital diseases and pregnancy complications, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], MESH: Papillomaviridae/genetics, Women's Health Services, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Papillomaviridae/isolation & purification, MESH: Young Adult, 030220 oncology & carcinogenesis, Female, Normal cytology, Research Article, Papanicolaou Test, Adult, medicine.medical_specialty, Human papillomavirus, MESH: French Guiana/epidemiology, Genotype, MESH: Papillomavirus Infections/prevention & control, MESH: Women's Health Services, MESH: Papanicolaou Test, Young Adult, 03 medical and health sciences, MESH: Cross-Sectional Studies, Humans, MESH: Papillomaviridae/classification, MESH: Surveys and Questionnaires, MESH: Uterine Cervical Neoplasms/prevention & control, [SDV.MP] Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Prevalence, MESH: Papillomavirus Infections/pathology, Aged, Gynecology, MESH: Humans, business.industry, Public health, Papillomavirus Infections, Public Health, Environmental and Occupational Health, Cancer, MESH: Adult, lcsh:RA1-1270, medicine.disease, MESH: Papillomavirus Infections/diagnosis, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Concomitant, DNA, Viral, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biostatistics, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND:In French Guiana, cervical cancer is the second most frequent cancer in females. The objective of the present study was to describe the prevalence of HPV infections in women with normal cervical cytology living in the remote villages of French Guiana.METHODS:Before the study, the study team communicated in the remote villages on the importance of screening. All women from the target population were offered to participate. They signed informed consent during inclusion and then had a concomitant HPV-test and cervical smear. Only women with normal cytology and a good quality smear were analyzed. The detection of HPV-DNA was performed using the GREINER-BIO-ONE kit.RESULTS:Overall, 27.2% of women with normal cervical cytology had a positive HPV-test. There was a U-shaped evolution of prevalence with women over 50 years having the highest HPV prevalence, followed by the 20 to 29 years group. The most prevalent HPV genotypes were HPV 53(3.52%), 68(3.33%), 52(2.59%), 31(2.22%) and 16 (1.85%). The proportion of HPV 16 among HPV-infected women was 6.8%.CONCLUSIONS:HPV prevalence in cytologically normal women was very high. The most prevalent genotypes were very different from what is usually described in the world, and notably in South America.
Published: 2017

26. High prevalence of hepatitis B and syphilis in illegal gold miners in French Guiana

Author: Antoine Adenis, Amandine Pisoni, H. Jardin, Mathieu Nacher, Emilie Mosnier, S. Vreden, Edouard Tuaillon, Roxane Schaub, L. Hureau-Mutricy, Maylis Douine, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), and roussel, pascale
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Male, medicine.medical_specialty, Hepatitis B virus, [SDV]Life Sciences [q-bio], 030106 microbiology, Population, Context (language use), Miners, Vulnerable Populations, law.invention, 03 medical and health sciences, 0302 clinical medicine, Condom, Informed consent, law, Environmental health, medicine, Prevalence, Humans, Serologic Tests, 030212 general & internal medicine, Syphilis, Treponema pallidum, education, education.field_of_study, business.industry, Public health, Undocumented Immigrants, General Medicine, Hepatitis B, medicine.disease, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], Infectious Diseases, Female, Gold, Viral hepatitis, business
Abstract: International audience; Viral hepatitis and syphilis remain important public health issues because of chronic forms and clinical complications. The omission of hard-to-reach and disadvantaged populations from public health and medical research is one of the current barriers to achieve the WHO target of reducing the burden of viral hepatitis and syphilis by 2030 [ 1 ]. Illegal gold miners in French Guiana, a French overseas territory in South America, are a perfect example of this type of population: they comprise about 10 000 people from Brazil living in a remote mining camp in the rainforest. We have previously shown that gold miners are a vulnerable population, notably with a human immunodeficiency virus (HIV) prevalence of 1.4% (95% CI 0.29–2.56) in a context where prostitution is frequent and condom access is difficult [ 2 ]. This study, nested in the Orpal study conducted in 2015 (NCT02903706) [ 3 ], aimed to estimate the prevalence of hepatitis B (HBV), D (HDV) and C (HCV) viruses, and syphilis in the specific population of illegal gold miners in French Guiana. The data collection method was previously reported [ 3 ]. Subjects provided informed consent. This ancillary study was approved by the Cayenne General Hospital Ethics committee.
Published: 2019

27. Mycobacterium ulcerans Infection in French Guiana; Current State of Knowledge

Author: Rodolphe E. Gozlan, Camilla Jensen Velvin, Maylis Douine, Pierre Couppié, Romain Blaizot, Mathieu Nacher, and Marine Combe
Subjects: Buruli ulcer, Lineage (genetic), biology, Mycobacterium ulcerans, medicine, Virulence, Zoology, medicine.disease, biology.organism_classification
Abstract: M. ulcerans infections (Buruli ulcer; BU) have been reported in French Guiana since the 1960s [1]. It is striking to see that French Guiana concentrates most of the cases of BU in America with only a few cases reported in Suriname, Peru, Mexico and Bolivia in the past [2, 3]. Either BU is underdiagnosed and underreported in most of the continent; or the specific environmental conditions in French Guiana represent a unique niche for the disease to appear; or a sublineage of M. ulcerans has established in French Guiana that has a higher virulence than other members of the ancestral lineage found in the Americas.
Published: 2019

28. Morbidité pédiatrique d’un village amérindien en Guyane française (2009–2016)

Author: C. Potentier, F. Henaff, Paul Brousse, Mathieu Nacher, Emilie Mosnier, Elise Martin, B. Guarmit, Maylis Douine, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Malbec, Odile
Subjects: [SDV]Life Sciences [q-bio], 030231 tropical medicine, Teko, Poison control, Context (language use), Suicide prevention, Pediatrics, Occupational safety and health, Pathology and Forensic Medicine, 03 medical and health sciences, Native American population, 0302 clinical medicine, Camopi, Injury prevention, medicine, 030212 general & internal medicine, Medical prescription, business.industry, Yellow fever, Wayampi, medicine.disease, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], Geographical isolation, Population study, Morbidity, business, Demography
Abstract: International audience; The situation of the Amerindian village of Camopi in French Guiana is particular because of its geographical isolation and its socio-cultural environment. Does this unique context affect the morbidity of the children? This study describes the morbidity of children aged 0-5 years in Camopi. The study population included all the children living in Camopi, born between 01/01/2009 and 31/12/2013. Sociodemographic and medical data were collected from Child Health Record until 05/01/2016, with a maximum of five years. 149 children were included and received 5916 consultations during the period of study. ENT and upper respiratory diseases were the most frequent diseases that were followed by digestive disorders. Lower respiratory conditions were the leading cause of hospitalization. Tropical diseases were rare. Antibiotics were delivered in 32.5% of the consultations. The vaccination coverage exceeded 95% for BCG, DTP, HBVand yellow fever, remove than that of MMR which was little lower (89.9%) and only 4 children were vaccinated against pneumococcus. Despite the Amazonian context, the morbidity of Camopi's children mainly includes classic disorders. Traumas seem uncommon but can be violent. Facilitating access to rapid diagnostic tests, setting up protocols, and training staff could reduce the prescription of antibiotics.
Published: 2018

29. Épidémie de virus Zika en Amérique latine : quels enjeux pour la Guyane française en avril 2016 ?

Author: Nicolas Villemant, Loïc Epelboin, Dominique Rousset, Mathieu Nacher, Emilie Mosnier, Gabriel Carles, Maylis Douine, and F. Djossou
Subjects: medicine.medical_specialty, Microcephaly, Latin Americans, biology, Amazon rainforest, Public health, 030231 tropical medicine, Outbreak, biology.organism_classification, medicine.disease, Arbovirus, 3. Good health, Pathology and Forensic Medicine, Zika virus, 03 medical and health sciences, 0302 clinical medicine, Geography, Epidemiology, medicine, 030212 general & internal medicine, Socioeconomics
Abstract: Started in 2015 in Brazil, an outbreak linked to a little known arbovirus, Zika virus spread throughout Latin America. This virus, considered until recently as responsible of only mild symptoms, made mention of previously unsuspected complications, with severe neurological manifestations in adults and malformations of the central nervous system, including microcephaly, in newborns of mother infected during the pregnancy. While the continent is more accustomed to the succession of arbovirus epidemics, suspected complications and the many unknowns keys of the latter arriving raise many public health issues. French Guiana, a French territory located in the north-east of the continent, combines both European level of resources and climate and issues specific to the Amazon region and Latin America. We discuss here the issues for 2016 Zika virus epidemic in our region, many of them are generalizable to neighboring countries.
Published: 2016

30. Dépistage du cancer du col de l'utérus en Guyane : taux de couverture du dépistage entre 2006 et 2011

Author: Maylis Douine, Christian Lelarge, Tristan Roue, Nadia Thomas, Mathieu Nacher, Antoine Adenis, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Registre des Cancers de Guyane, Laboratoire d’anatomopathologie - Abbeville, Laboratoire d’anatomopathologie, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Association Guyanaise Dépistage Organisé des Cancers [Cayenne] (A.G.D.O.C), and The present study was funded by the Health Regional Agency of French Guiana.
Subjects: Overseas department, MESH: Mass Screening/statistics & numerical data, MESH: Uterine Cervical Neoplasms/pathology, MESH: Mass Screening/organization & administration, MESH: Uterine Cervical Neoplasms/epidemiology, Uterine Cervical Neoplasms, 0302 clinical medicine, Epidemiology, Mass Screening, MESH: Incidence, Early Detection of Cancer, Cervical cancer, MESH: Middle Aged, 030219 obstetrics & reproductive medicine, Incidence, Incidence (epidemiology), Mortality rate, Age Factors, MESH: Uterine Cervical Neoplasms/diagnosis, Middle Aged, French Guiana, 3. Good health, 030220 oncology & carcinogenesis, Pap-smear, Screening, Female, Papanicolaou Test, Adult, medicine.medical_specialty, MESH: French Guiana/epidemiology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Pathology and Forensic Medicine, 03 medical and health sciences, parasitic diseases, medicine, Humans, Neoplasm Invasiveness, MESH: Uterine Cervical Neoplasms/prevention & control, Mass screening, Retrospective Studies, MESH: Age Factors, Gynecology, MESH: Humans, MESH: Early Detection of Cancer*/statistics & numerical data, business.industry, MESH: Adult, MESH: Retrospective Studies, Retrospective cohort study, MESH: Neoplasm Invasiveness, medicine.disease, Metropolitan France, MESH: Papanicolaou Test/statistics & numerical data, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography
Abstract: International audience; In French Guiana, the age-standardized incidence rate of cervical cancer is four times higher than in France and the mortality rate 5.5 times higher. A survival study revealed that stage at diagnosis was the main factor influencing the prognosis, showing that early detection is crucial to increase cervical cancer survival. The present study aimed at evaluating the cervical cancer screening rate between 2006 and 2011 by age and for 3-years period in French Guiana. All pap smears realised in French Guiana were analysed in two laboratories allowing exhaustive review of screening data. The screening rate was estimated at about 54% from 2006 to 2011, with a statistical difference between coastal and rural area (56.3% versus 18.7%).Although the methodological difference did not allow comparisons with mainland France, these results could be used to evaluate the impact of organised cervical cancer screening by the French Guiana Association for Organized Screening of Cancers implemented in French Guiana since 2012.; En Guyane, l’incidence du cancer du col de l’utérus est quatre fois plus élevée qu’en métropole, et la létalité 5,5 fois plus élevée. Dans ce vaste département recouvert à plus de 90 % de forêt amazonienne, les difficultés d’accès aux soins, l’âge précoce au premier rapport et le manque de dépistage sont de possibles facteurs explicatifs. Une première étude a montré que le diagnostic tardif était le principal facteur impactant la survie. Un diagnostic précoce - par frottis cervico-vaginal tous les 3 ans de 25 à 64 ans selon les recommandations nationales - est donc crucial pour améliorer la survie. L’objectif de cette étude est d’évaluer le taux de couverture de dépistage par frottis en Guyane entre 2006 et 2011 ainsi que l’activité de réalisation de frottis et le taux de cancers dépistés. Tous les frottis cervico-vagin aux réalisés en Guyane sont analysés dans seulement deux laboratoires d’anatomie pathologique, ce qui permet une analyse exhaustive des données de dépistage de ce département. La date de naissance, la date de réalisation du frottis, l’adresse de la patiente ou celle du prescripteur (selon les laboratoires) ainsi que la date de réalisation du précédent frottis ont été recueillis. Le taux de couverture de dépistage a été évalué à 54 % entre 2006 et 2011, avec une différence significative entre le littoral et l’intérieur de la Guyane (56,3 % versus 18,7 %). L’activité de réalisation de frottis était de 23,5 à 25,8 frottis pour 100 femmes-année. Le taux de diagnostic de cancer était de 191,8/100 000 femmes année, soit un cancer cervical diagnostiqué pour 521 personnes dépistées. Bien que le taux de couverture de dépistage en Guyane ne semble pas très différent de la métropole, nous ne pouvons réaliser de comparaison statistique du fait de la différence de méthodologie utilisée. Le taux de diagnostic de cancer était de 6 à 12 fois plus élevé qu’en métropole, confirmant l’importance du dépistage par frottis en Guyane. Des efforts de dépistage doivent être réalisés notamment dans l’intérieur de la Guyane, où le taux de dépistage est plus faible. Cet état des lieux du dépistage entre 2006 et 2011 pourra permettre d’évaluer l’impact de la campagne organisée de dépistage du cancer du col mise en place en 2012 par l’Association guyanaise du dépistage organisé des cancers (AGDOC).
Published: 2015

31. High mortality due to snakebites in French Guiana: Time has come to re-evaluate medical management protocols

Author: R. Mutricy, Frédérique Perotti, Véronique Lambert, Mathieu Nacher, Christian Marty, Jean-Philippe Chippaux, Xavier Heckmann, Maylis Douine, Anne Jolivet, David Boels, Sébastien Larréché, Loïc Epelboin, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service d’Accueil des Urgences/SAMU/SMUR [Cayenne, Guyane Fraçaise], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Croix-rouge française [Cayenne, Guyane Fraçaise], Département de Santé Publique [Saint-Laurent-du-Maroni, Guyane Française], Service de gynécologie et d’obstétrique [Saint Laurent du Maroni, Guyanne Française], Pharmacy, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, France, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Centre Antipoison et Toxicovigilance du Grand Ouest (Angers) (CAPTV Angers), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Hôpital d'Instruction des Armées Begin, Service de Santé des Armées, Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et l’Enfance [Cotonou, Bénin] (CERPAGE), Université d’Abomey-Calavi = University of Abomey Calavi (UAC), Mère et enfant en milieu tropical : pathogènes, système de santé et transition épidémiologique (MERIT - UMR_D 216), Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5), PRES Sorbonne Paris Cité, Université Paris Descartes - Faculté de Pharmacie de Paris (UPD5 Pharmacie), Université Paris Descartes - Paris 5 (UPD5), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne, Guyane] (COREVIH), Unité des Maladies Infectieuses et Tropicales (UMIT), Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centres antipoison et de toxicovigilance (CAPTV Angers), Centre d’Etude et de Recherche sur le Paludisme Associé à la Grossesse et l’Enfance (CERPAGE), University of Abomey Calavi (UAC), Université des Antilles et de la Guyane - UFR des sciences médicales (UAG UFR SM), Université des Antilles et de la Guyane (UAG), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Service d'Oto-Rhino-Laryngologie [CH Briançon], Centre Hospitalier des Escartons de Briançon (CH Briançon), Université de Guyane (UG), and Latour, Marie
Subjects: 0301 basic medicine, [SDV]Life Sciences [q-bio], Snake Bites, Toxicology, Pathology and Laboratory Medicine, Geographical locations, 0302 clinical medicine, Medicine and Health Sciences, Medicine, Toxins, Snakebite, ComputingMilieux_MISCELLANEOUS, Mortality rate, lcsh:Public aspects of medicine, High mortality, Eukaryota, Snakes, Squamates, 3. Good health, French Guiana, [SDV] Life Sciences [q-bio], Viewpoints, Infectious Diseases, Research Design, Vertebrates, Brazil, Neglected Tropical Diseases, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Death Rates, Clinical Research Design, 030231 tropical medicine, Toxic Agents, Colombia, Research and Analysis Methods, 03 medical and health sciences, Population Metrics, Environmental health, Animals, Humans, Adverse effect, Population Biology, business.industry, Venoms, Public Health, Environmental and Occupational Health, Organisms, Biology and Life Sciences, Reptiles, lcsh:RA1-1270, South America, Tropical Diseases, Health Care, 030104 developmental biology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Amniotes, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Adverse Events, People and places, Health Statistics, Morbidity, business
Abstract: International audience; no abstract
Published: 2018

32. Pregnancy Outcomes after ZIKV Infection in French Territories in the Americas

Author: Yoann Madec, Cécile Herrmann-Storck, Arnaud Fontanet, Bruno Hoen, Caroline Callier, Raymond Césaire, Dominique Rousset, Alice Monthieux, Cédric Laouénan, Manon Boullard, Anna L. Funk, Maylis Douine, S. Stegmann-Planchard, Benoit Tressières, Bruno Schaub, Fatiha Najioullah, Jean-Luc Voluménie, Eustase Janky, André Cabié, Gabriel Carles, Kinda Schepers, Samson Yassinguezo, Sylvie Cassadou, Vanessa Ardillon, Philippe Kadhel, Mathieu Nacher, Catherine Ryan, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université des Antilles et de la Guyane (UAG), Maison de la Femme de la Mère et de l'Enfant [CHU de la Martinique] (MFME [Fort de France]), CHU de la Martinique [Fort de France], Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology, Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université des Antilles et de la Guyane - UFR des sciences médicales (UAG UFR SM), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre Hospitalier Louis Constant Fleming, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Center for Global Health Research and Education - Centre pour la Recherche et la Formation en Santé Mondiale (CGH), Institut Pasteur [Paris] (IP)-Réseau International des Instituts Pasteur (RIIP), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Supported by the French Ministry of Health (Soutien Exceptionnel à la Recherche et à l’Innovation), by a grant (ANR-10-LABX-62-IBEID) from Laboratoire d’Excellence Integrative Biology of Emerging Infectious Diseases project, by the ZIKAlliance consortium (the European Union’s Horizon 2020 Research and Innovation Program), and by INSERM. This study is part of the ZIKAlliance consortium project., We thank the women who participated in this study, all the physicians, midwives, clinical research assistants, health officers, and epidemiologists who helped conduct this study in each of the French territories in the Americas: Myriam Atine, Lyderic Aubert, Marie Barrau, Kebe Beavogui, Christelle Celeste, Joelle Colat-Peyron, Elvire Couchy, Véronique Davidas, Lucetta Delver, Jacqueline Dubois, Stanie Gaete, Dorothée Harrois, Marie-Laure Lalanne-Mistrih, Mathilde Melin, Marie-France Mirane, Francelise Nadessein, Marie-Josée Pelczar, Véronique Plantier, Céline Rocquet, Magdalena Saint-Marc, Patrick Saint-Martin, Valérie Soter, Ingrid Soubdhan, Jennifer Taillefond, Lambo Velonasy, and Véronique Walter (Guadeloupe), Nicole Ambroisine, Gilda Belrose, Alain Blateau, Patricia Blondel, Isabelle Calmont, Valérie Decatrelle, Michèle Gueneret, Eugénie Jolivet, Isabelle Komla-Soukha, Corinne Plavonil, Marie-andrée Pyram, and Jean-Luc Voluménie (Martinique), Antoine Adenis, Audrey Andrieu, Luisiane Carvalho, Sandy Dabrowski, Céline Delorme, Maryvonne Dueymes, Aniza Fahrasmane, Arthur Felix, Hélène Hilderal, Anne Jolivet, Justine Krajewsky, Véronique Lambert, Thomas Lemaitre, Myriam Livain, Jérémie Pasquier, Marion Petit-Sinturel, Céline Pomar, Léo Pomar, and Stéphanie Rogier (French Guiana), and David Baud (University of Lausanne, Switzerland) and Rebecca Grant (Institut Pasteur de Paris, France) for their critical review of an earlier version of the manuscript., ANR-10-LABX-0062,IBEID,Integrative Biology of Emerging Infectious Diseases(2010), Jonchère, Laurent, Integrative Biology of Emerging Infectious Diseases - - IBEID2010 - ANR-10-LABX-0062 - LABX - VALID, Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Université des Antilles (UA)-CHU de la Martinique [Fort de France], and Réseau International des Instituts Pasteur (RIIP)-Institut Pasteur [Paris]
Subjects: 0301 basic medicine, Microcephaly, [SDV]Life Sciences [q-bio], Chromosome Disorders, MESH: Amniotic Fluid, Zika virus, Cohort Studies, 0302 clinical medicine, MESH: Pregnancy, Pregnancy, MESH: Martinique, ZikV Infection, Medicine, 030212 general & internal medicine, Pregnancy Complications, Infectious, Prospective cohort study, Guadeloupe, MESH: Cohort Studies, MESH: Chromosome Disorders, MESH: Middle Aged, biology, Zika Virus Infection, Obstetrics, MESH: Infant, Newborn, Pregnancy Outcome, Gestational age, MESH: Congenital Abnormalities, General Medicine, Middle Aged, French Guiana, 3. Good health, [SDV] Life Sciences [q-bio], Fetal Diseases, MESH: Fetal Diseases, MESH: Young Adult, Cohort, Female, Pregnancy Trimesters, Adult, medicine.medical_specialty, Adolescent, MESH: Zika Virus, Article, MESH: Microcephaly, Congenital Abnormalities, Young Adult, 03 medical and health sciences, MESH: Zika Virus Infection, MESH: French Guiana, Humans, MESH: Guadeloupe, Martinique, MESH: Pregnancy Complications, Infectious, Pregnancy outcomes, MESH: Adolescent, Fetus, MESH: Humans, business.industry, Infant, Newborn, MESH: Adult, Zika Virus, Amniotic Fluid, medicine.disease, biology.organism_classification, MESH: Pregnancy Outcome, Confidence interval, 030104 developmental biology, business, MESH: Female, MESH: Pregnancy Trimesters
Abstract: International audience; BACKGROUND:The risk of congenital neurologic defects related to Zika virus (ZIKV) infection has ranged from 6 to 42% in various reports. The aim of this study was to estimate this risk among pregnant women with symptomatic ZIKV infection in French territories in the Americas.METHODS:From March 2016 through November 2016, we enrolled in this prospective cohort study pregnant women with symptomatic ZIKV infection that was confirmed by polymerase-chain-reaction (PCR) assay. The analysis included all data collected up to April 27, 2017, the date of the last delivery in the cohort.RESULTS:Among the 555 fetuses and infants in the 546 pregnancies included in the analysis, 28 (5.0%) were not carried to term or were stillborn, and 527 were born alive. Neurologic and ocular defects possibly associated with ZIKV infection were seen in 39 fetuses and infants (7.0%; 95% confidence interval, 5.0 to 9.5); of these, 10 were not carried to term because of termination of pregnancy for medical reasons, 1 was stillborn, and 28 were live-born. Microcephaly (defined as head circumference more than 2 SD below the mean for sex and gestational age) was detected in 32 fetuses and infants (5.8%), of whom 9 (1.6%) had severe microcephaly (more than 3 SD below the mean). Neurologic and ocular defects were more common when ZIKV infection occurred during the first trimester (24 of 189 fetuses and infants [12.7%]) than when it occurred during the second trimester (9 of 252 [3.6%]) or third trimester (6 of 114 [5.3%]) (P=0.001).CONCLUSIONS:Among pregnant women with symptomatic, PCR-confirmed ZIKV infection, birth defects possibly associated with ZIKV infection were present in 7% of fetuses and infants. Defects occurred more frequently in fetuses and infants whose mothers had been infected early in pregnancy. Longer-term follow-up of infants is required to assess any manifestations not detected at birth. (Funded by the French Ministry of Health and others; ClinicalTrials.gov number, NCT02916732 .).
Published: 2018

33. Predictors of abnormal cytology among HPV-infected women in remote territories of French Guiana

Author: Jerome Ponty, Raymond Césaire, Nadia Thomas, Vincent Molinie, Claire Grenier, Valentin Dufit, Maylis Douine, Laure Bianco, Mathieu Nacher, Paul Brousse, Antoine Adenis, Dominique Catherine, Gabriel Carles, Fatiha Najioullah, Odile Kilié, Jean Luc Deshayes, Vincent Lacoste, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Service d'anatomopathologie [Fort de France, Martinique], CHU Fort de France, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Association Guyanaise Dépistage Organisé des Cancers [Cayenne] (A.G.D.O.C), Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), The present study was funded by the European Regional Development Funds (FEDER) N° Presage 30,814., and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
Subjects: Rural Population, [SDV]Life Sciences [q-bio], Uterine Cervical Neoplasms, MESH: Genotype, 0302 clinical medicine, MESH: Rural Population, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Cytology, Genotype, Medicine, 030212 general & internal medicine, Life history, Papillomaviridae, Anamnesis, MESH: Aged, MESH: Middle Aged, lcsh:Public aspects of medicine, Obstetrics and Gynecology, virus diseases, General Medicine, MESH: Papillomavirus Vaccines, Middle Aged, Abnormal cytology, female genital diseases and pregnancy complications, MESH: Predictive Value of Tests, 3. Good health, French Guiana, Vaccination, MESH: Young Adult, 030220 oncology & carcinogenesis, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, MESH: Papillomavirus Infections/complications, MESH: DNA, Viral/analysis, Research Article, Adult, medicine.medical_specialty, Cytodiagnosis, Reproductive medicine, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Papillomavirus Infections/prevention & control, lcsh:Gynecology and obstetrics, MESH: Papillomaviridae/isolation & purification, MESH: Cytodiagnosis/statistics & numerical data, 03 medical and health sciences, Young Adult, Predictive Value of Tests, Internal medicine, MESH: French Guiana, Humans, Papillomavirus Vaccines, MESH: Papillomaviridae/genetics, Normal cytology, lcsh:RG1-991, Aged, MESH: Uterine Cervical Neoplasms/virology, MESH: Humans, business.industry, Papillomavirus Infections, MESH: Papillomavirus Infections/virology, lcsh:RA1-1270, MESH: Adult, Reproductive Medicine, DNA, Viral, MESH: Uterine Cervical Neoplasms/prevention & control, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; BACKGROUND: Cervical cancer prevention using cervical cytology is insufficiently sensitive, a significant proportion of HPV-infected women having normal cytology. The objective of the present study was to try to identify factors associated with abnormal cytology in HPV-infected women living in remote areas of French Guiana.METHODS: A study was conducted in women aged 20-65 years having HPV infections confirmed by HPV DNA detection using the GREINER-BIO-ONE kit. In addition to HPV testing, cytology was performed and classified as normal or abnormal. Demographic and life history variables, and infecting genotypes were compared between the normal and abnormal cytology groups.RESULTS: None of the demographic and life history variables were associated with cytology results. HPV genotype 53 was significantly associated with absence of cytological abnormalities whereas HPV 52, 58, 16 and perhaps 33 and 66 were independently associated with a greater risk of cytological abnormalities. When grouping HPV genotypes in different species, only species 9 (HPV 16, 31, 33, 35, 52, 58, 67) was significantly associated with abnormal cytology AOR = 5.1 (95% CI = 2.3-11.2), P
Published: 2018

34. Illegal gold miners in French Guiana: a neglected population with poor health

Author: Charlotte Charpentier, Anne-Laure Aucouturier, Emilie Mosnier, Florine Corlin, Mathieu Nacher, Quentin Le Hingrat, Louise Hureau, Florence Niemetsky, Yassamine Lazrek, Lise Musset, Antoine Adenis, Magalie Demar, Maylis Douine, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Département des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), This study was funded by European Funds for Regional Development (Feder), N° Presage 32,078. The Funding body had no role in the study and in the publication process., CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424
Subjects: medicine.medical_specialty, Gold mining, 030231 tropical medicine, Population, Global health, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Epidemiology, Transborder, Medicine, 030212 general & internal medicine, education, Health policy, education.field_of_study, Communicable disease, business.industry, Public health, lcsh:Public aspects of medicine, 1. No poverty, Public Health, Environmental and Occupational Health, HIV, Neglected population, lcsh:RA1-1270, 3. Good health, French Guiana, Malaria, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Hypertension, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Biostatistics, business, Research Article
Abstract: International audience; BACKGROUND:In French Guiana, a French overseas territory in South America, 6 to 10 thousands undocumented persons work illegally in gold mining sites in the Amazonian forest. Precarious life conditions lead to poor health but few data exist on the health status of illegal gold miners in French Guiana. The objective of this article was to describe the sociodemographic and health status of this vulnerable population.METHOD:A prospective cross-sectional survey was conducted in 2015 on gold mine supply sites at the border between French Guiana and Suriname. Health status was assessed through medical examination, past medical history, haemoglobin concentration, and HIV and malaria testing. A questionnaire was used to collect data about the migration itinerary and life conditions on mining sites.RESULTS:Among the 421 adults included in the study, 93.8% (395/421) were Brazilian, mainly from Maranhão (55.7%, 220/395), the poorest Brazilian state. The sex ratio was 2.4. Overall, 48% of persons never went to school or beyond the primary level. The median time spent in gold mining was quite long (10 years), with a high turn-over. One third of the surveyed population (37.1%, 156/421) had high blood pressure, and only two had a medical follow-up. Most persons had experienced malaria (89.3%, 376/421). They declared frequent arboviroses and digestive disorders. Active leishmaniasis was observed in 8.3% of gold miners. Among women, 28.5% were anemic. Concerning HIV, 36.6% (154/421) of persons, mainly men, never got tested before and 6 were tested positive, which represented an HIV prevalence of 1.43% (95%CI =0.29-2.5).CONCLUSION:These findings support the hypothesis that mining in remote areas is linked to several specific illnesses. Theoretically, gold miners would be presumed to start their economical migration to French Guiana as a healthy group. However, their strenuous working and living conditions there lead to poor health caused by infectious and non infectious diseases. This description of their health status is precious for health policy planners in French Guiana given the importance of controlling communicable disease, and the severity and range of specific illnesses acquired by this neglected population.TRIAL REGISTRATION:Clinical trial registration PRS N° NCT02903706 . Retrospectively registered 09/13/2016.
Published: 2017

35. Mycobacterium ulcerans infection (Buruli ulcer) in French Guiana, South America, 1969–2013: an epidemiological study

Author: Sylvain Labbé, Dominique Sainte-Marie, Roger Pradinaud, Rodolphe E. Gozlan, Mathieu Nacher, Jean-François Guégan, Maylis Douine, J. Dufour, Pierre Couppié, Yann Reynaud, Christine Chevillon, Alain Berlioz-Arthaud, Marine Combe, Eric Elguero, Camilla Jensen Velvin, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Biologie des Organismes et Ecosystèmes Aquatiques (BOREA), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Muséum national d'Histoire naturelle (MNHN)-Institut de Recherche pour le Développement (IRD)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université des Antilles (UA), Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine [Cayenne] (COREVIH), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut Pasteur de la Guadeloupe, Réseau International des Instituts Pasteur (RIIP), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Evolution of host-microbe communities (MIVEGEC-EVCO), Processus Écologiques et Évolutifs au sein des Communautés (PEEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Institut Pasteur de la Guyane, Service de Dermatologie [Cayenne, Guyanne Française], Centre Hospitalier Andre Rosemon, This work was funded by an 'Investissement d’Avenir' grant managed by Agence Nationale de la Recherche (Centre d’Étude de la Biodiversité Amazonienne, reference ANR-10-LABX-2501)., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Génétique et évolution des maladies infectieuses (GEMI), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Génétique et évolution des maladies infectieuses (GEMI)
Subjects: Male, Buruli ulcer, Health (social science), Medicine (miscellaneous), MESH: Mycobacterium ulcerans, MESH: Buruli Ulcer/epidemiology, 0302 clinical medicine, MESH: Aged, 80 and over, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, Epidemiology, 030212 general & internal medicine, MESH: Incidence, Child, Buruli Ulcer, lcsh:Environmental sciences, lcsh:GE1-350, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, biology, Transmission (medicine), Incidence, Health Policy, Incidence (epidemiology), MESH: Infant, Newborn, Middle Aged, MESH: Infant, French Guiana, 3. Good health, MESH: Young Adult, Child, Preschool, Mycobacterium ulcerans, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Leprosy, Adult, medicine.medical_specialty, Tuberculosis, Adolescent, MESH: French Guiana/epidemiology, 030231 tropical medicine, Bone Infection, Young Adult, 03 medical and health sciences, medicine, Humans, Aged, MESH: Adolescent, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, MESH: Adult, medicine.disease, biology.organism_classification, Dermatology, MESH: Male, Surgery, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: Summary Background Mycobacterium ulcerans infection is the third most common mycobacterial disease in the world after tuberculosis and leprosy. To date, transmission pathways from its environmental reservoir to humans are still unknown. In South America, French Guiana has the highest reported number of M ulcerans infections across the continent. This empirical study aimed to characterise the epidemiology of M ulcerans infection in French Guiana between 1969 and 2013. Methods Data were collected prospectively mainly by two dermatologists at Cayenne Hospital's dermatology department between Jan 1, 1969, and Dec 31, 2013, for age, date of diagnosis, sex, residence, location of the lesion, type of lesion, associated symptoms, and diagnostic method (smear, culture, PCR, or histology) for all confirmed and suspected cases of M ulcerans . We obtained population data from censuses. We calculated mean M ulcerans infection incidences, presented as the number of cases per 100 000 person-years. Findings 245 patients with M ulcerans infections were reported at Cayenne Hospital's dermatology department during the study period. M ulcerans infection incidence decreased over time, from 6·07 infections per 100 000 person-years (95% CI 4·46–7·67) in 1969–83 to 4·77 infections per 100 000 person-years (3·75–5·79) in 1984–98 and to 3·49 infections per 100 000 person-years (2·83–4·16) in 1999–2013. The proportion of children with infections also declined with time, from 42 (76%) of 55 patients in 1969–83 to 26 (31%) of 84 in 1984–98 and to 22 (21%) of 106 in 1999–2013. Most cases occurred in coastal areas surrounded by marshy savannah (incidence of 21·08 per 100 000 person-years in Sinnamary and 21·18 per 100 000 person-years in Mana). Lesions mainly affected limbs (lower limbs 161 [66%] patients; upper limbs 60 [24%] patients). We diagnosed no bone infections. Interpretation The decrease of M ulcerans infection incidence and the proportion of children with infections over a 45 year period in this ultra-peripheral French territory might have been mostly driven by improving living conditions, prophylactic recommendations, and access to health care. Funding Agence Nationale de la Recherche.
Published: 2017

36. High prevalence of HPV infection in the remote villages of French Guiana: an epidemiological study

Author: Florine Corlin, Vincent Lacoste, Mathieu Nacher, Vincent Molinie, Raymond Césaire, Valentin Dufit, Antoine Adenis, Maylis Douine, Gabriel Carles, Fatiha Najioullah, Gulen Ayhan, Paul Brousse, Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, European Regional Development Fund - FEDER presage n°30814 - INCOMING, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Service d'anatomopathologie [Fort de France, Martinique], CHU Fort de France, Département des Centres Délocalisés de Prévention et de Soins [Cayenne, Guyane Française], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de gynécologie-obstétrique [Saint Laurent du Maroni, Guyane Française], Centre Hospitalier de l'Ouest Guyanais, Laboratoire des Interactions Virus-Hôtes [Cayenne, Guyane Française], Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), This project was supported by an European Union Grant (PO FEDER 2007-2013, No. Présage: 30814, Guyane Française., We thank the health professionals of the Centres Délocalisés de Prévention et de Soins and the Protection Maternelle et Infantile., European Project: FEDER presage n°30814, and CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG)
Subjects: Genotyping Techniques, Epidemiology, Prevalence, MESH: Genotype, 0302 clinical medicine, 5. Gender equality, MESH: Papillomavirus Infections/virology, MESH: DNA, Viral/genetics, 030212 general & internal medicine, MESH: Cytological Techniques, Papillomaviridae, Cervical cancer, MESH: Aged, MESH: Papillomavirus Infections/epidemiology, education.field_of_study, MESH: Middle Aged, MESH: Epidemiologic Studies, Incidence (epidemiology), HPV infection, Middle Aged, Original Papers, 3. Good health, French Guiana, Vaccination, MESH: Papillomaviridae/genetics, Infectious Diseases, MESH: Papillomaviridae/isolation & purification, MESH: Young Adult, 030220 oncology & carcinogenesis, Female, MESH: DNA, Viral/analysis, Adult, medicine.medical_specialty, HPV, MESH: Vaginal Smears, MESH: French Guiana/epidemiology, Genotype, Population, Cytological Techniques, 03 medical and health sciences, Young Adult, MESH: Genotyping Techniques, medicine, Humans, MESH: Papillomaviridae/classification, education, MESH: Prevalence, Aged, Gynecology, Vaginal Smears, MESH: Humans, business.industry, Public health, Papillomavirus Infections, MESH: Adult, medicine.disease, Epidemiologic Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, DNA, Viral, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography
Abstract: SUMMARYCervical cancer is the second most frequent cancer in women in French Guiana. Studies have shown that populations living in the remote areas of the interior have early sexual debut and that multiple sexual partnerships are common. The objective of the present study was thus to determine the prevalence of human papillomavirus (HPV) infection in these areas. A study was conducted in women aged 20–65 years with previous sexual activity. Women were included on a voluntary basis after using local media and leaders to inform them of the visit of the team. HPV infection was defined by the detection of HPV DNA using the Greiner Bio-One kit. In addition to HPV testing cytology was performed. The overall age-standardized prevalence rate was 35%. There was a U-shaped evolution of HPV prevalence by age with women aged >50 years at highest risk for HPV, followed by the 20–29 years group. Twenty-seven percent of women with a positive HPV test had normal cytology. Given the high incidence of cervical cancer in French Guiana and the high prevalence of HPV infections the present results re-emphasize the need for screening for cervical cancer in these remote areas. Vaccination against HPV, preferably with a nonavalent vaccine, also seems an important prevention measure. However, in this region where a large portion of the population has no health insurance, this still represents a challenge.
Published: 2017

37. Predictors of complications of snake envenomation in Cayenne, French Guiana, 2007-2015

Author: Maylis Douine, Mathieu Nacher, Gérald Egmann, R. Mutricy, Stéphanie Houcke, Loïc Epelboin, Antoine Adenis, Christian Marty, Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Service d’Accueil des Urgences/SAMU/SMUR [Cayenne, Guyane Fraçaise], Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Croix-rouge française [Cayenne, Guyane Fraçaise], Unité de Soins Intensifs [Cayenne, Guyane Française], Unité des Maladies Infectieuses et Tropicales (UMIT), and Funding was provided by Ministère des Affaires Sociales et de la Santé (Grant No. Bourse année recherche 2015/2016).
Subjects: medicine.medical_specialty, Cayenne, Pain medicine, 030231 tropical medicine, Snake Bites, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Anesthesiology, medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, computer.programming_language, Snake envenomation, business.industry, Anatomy, medicine.disease, Snake bites, French Guiana, 3. Good health, Emergency medicine, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, business, computer
Abstract: International audience
Published: 2017

38. Poverty and arbovirus outbreaks: when chikungunya virus hits more precarious populations than dengue virus in French Guiana

Author: Maylis Douine, Félix Djossou, Mathieu Nacher, Loïc Epelboin, Timothée Bonifay, Clémence Bonnefoy, Benoit Hurpeau, Latour, Marie, Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université de Guyane (UG), Département Etudes Diffusion [Cayenne], Institut National de la Statistique et Etudes Economiques de Guyanne (INSEE Guyane ), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Service de médecine interne et maladies tropicales, and CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André
Subjects: chikungunya, poverty, viruses, [SDV]Life Sciences [q-bio], 030231 tropical medicine, Population, Dengue virus, medicine.disease_cause, Arbovirus, Dengue fever, Zika virus, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, parasitic diseases, Major Article, Medicine, 030212 general & internal medicine, Chikungunya, education, ComputingMilieux_MISCELLANEOUS, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, business.industry, 1. No poverty, Outbreak, virus diseases, Odds ratio, biochemical phenomena, metabolism, and nutrition, medicine.disease, biology.organism_classification, Virology, dengue, 3. Good health, French Guiana, precarity, [SDV] Life Sciences [q-bio], Infectious Diseases, Oncology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background Since 2013, 3 successive arbovirus outbreaks, dengue (DENV), chikungunya (CHIKV), and Zika virus, have occurred in French Guiana (FG). The primary objective of this study was to describe the socioeconomic indicators of the first patients infected with CHIKV during the outbreak of 2014. The secondary objective was to compare those patients with patient infected by DENV and with the local population. Methods A monocentric, retrospective, case-control study was conducted in Cayenne hospital in FG comparing a group of patients infected with CHIKV in 2014 with a group infected with DENV in 2013. Children aged less than 15 years and pregnant women were excluded. Results A total of 168 CHIKV patients were compared with 168 DENV patients. Factors associated with CHIKV were living in poor neighborhoods (82% vs 44%; odds ratio [OR], 5.81; 95% confidence interval [CI], 3.35–10.2), having a precarious status (54% vs 33%; OR, 2.37; 95% CI, 1.49–3.78), and being born abroad (70% vs 35%; OR, 4.35; 95% CI, 2.69–7.06). Conclusions The present results suggest that early in the epidemic, the populations most at risk for CHIKV infection were the most socially vulnerable populations in the poorest neighborhoods, whereas DENV appeared to have affected a richer population and richer areas.
Published: 2017

39. Predictors of antimalarial self-medication in illegal gold miners in French Guiana: a pathway towards artemisinin resistance

Author: Mathieu Nacher, Félix Djossou, Louise Hureau, Maylis Douine, Yassamine Lazrek, Stéphane Pelleau, R Chanlin, Magalie Demar, Lise Musset, Florine Corlin, S. Vreden, Helene Hiwat, Béatrice Volney, D. Blanchet, Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Laboratoires d'excellence - CEnter of the study of Biodiversity in Amazonia - - CEBA2010 - ANR-10-LABX-0025 - LABX - VALID, European Funds for Regional Development (Feder), N° Presage 32078 - OrPal - 32078 - INCOMING, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Malaria Program, Paramaribo, Suriname, Ministry of Health [Mozambique], Foundation for the Advancement of Scientific Research in Suriname [Paramaribo] (SWOS), Unité des Maladies Infectieuses et Tropicale, Centre Hospitalier de Cayenne, Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH Guyane), This study was funded by European Funds for Regional Development (Feder), N° Presage 32078, benefited from funding from Santé Publique France (French Ministry of Health) and was supported by an 'Investissement d'Avenir' grant managed by Agence Nationale de la Recherche (CEBA, ref. ANR-10-LABX-25-01)., ANR-10-LABX-0025,CEBA,CEnter of the study of Biodiversity in Amazonia(2010), European Project: 32078,OrPal, and Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé)
Subjects: Male, Cross-sectional study, Psychological intervention, Drug Resistance, Drug resistance, Self Medication, 0302 clinical medicine, Surveys and Questionnaires, Medicine, Mass Screening, Pharmacology (medical), 030212 general & internal medicine, Artemisinin, Malaria, Falciparum, Suriname, Traditional medicine, biology, Middle Aged, Artemisinins, 3. Good health, French Guiana, Infectious Diseases, Criminal Behavior, Female, medicine.drug, Self-medication, Microbiology (medical), Adult, Adolescent, 030231 tropical medicine, Plasmodium falciparum, Miners, 03 medical and health sciences, Antimalarials, Young Adult, Environmental health, parasitic diseases, Humans, Mass screening, Pharmacology, business.industry, biology.organism_classification, medicine.disease, Treatment Adherence and Compliance, Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Gold, business, Malaria
Abstract: International audience; Background:Malaria is endemic in French Guiana (FG), South America. Despite the decrease in cases in the local population, illegal gold miners are very affected by malaria (22.3% of them carried Plasmodium spp.). Self-medication seems to be very common, but its modalities and associated factors have not been studied. The aim of this study was to evaluate parasite susceptibility to drugs and to document behaviours that could contribute to resistance selection in illegal gold miners.Methods:This multicentric cross-sectional study was conducted in resting sites along the FG-Surinamese border. Participating gold miners working in FG completed a questionnaire and provided a blood sample.Results:From January to June 2015, 421 illegal gold miners were included. Most were Brazilian (93.8%) and 70.5% were male. During the most recent malaria attack, 45.5% reported having been tested for malaria and 52.4% self-medicated, mainly with artemisinin derivatives (90%). Being in FG during the last malaria attack was the main factor associated with self-medication (adjusted OR = 22.1). This suggests that access to malaria diagnosis in FG is particularly difficult for Brazilian illegal gold miners. Treatment adherence was better for persons who reported being tested. None of the 32 samples with Plasmodium falciparum presented any mutation on the pfK13 gene, but one isolate showed a resistance profile to artemisinin derivatives in vitro.Conclusions:The risk factors for the selection of resistance are well known and this study showed that they are present in FG with persons who self-medicated with poor adherence. Interventions should be implemented among this specific population to avoid the emergence of artemisinin resistance.
Published: 2017

40. L’infection à Mycobacterium ulcerans (ulcère de Buruli) en Guyane ; transition d’un profil épidémiologique africain vers un profil australien

Author: Eric Elguero, Rodolphe E. Gozlan, J. Dufour, Alain Berlioz-Arthaud, Mathieu Nacher, Dominique Sainte-Marie, Roger Pradinaud, M. Combe, Pierre Couppié, Maylis Douine, S. Labbé, C. Chevillon, C. Velvin, J.-F. Guégan, and Yann Reynaud
Subjects: Gynecology, medicine.medical_specialty, Geography, medicine, Dermatology
Abstract: Introduction L’infection a Mycobacterium ulcerans (IMU) est la troisieme maladie mycobacterienne la plus repandue apres la tuberculose et la lepre. A ce jour, les voies de transmission de son reservoir environnemental aux humains sont encore inconnues. En Amerique du sud, la Guyane francaise a le plus grand nombre d’IMU sur le continent. Cette etude visait a caracteriser l’epidemiologie de l’IMU en Guyane francaise entre 1969 et 2013. Materiel et methodes Les donnees ont ete recueillies prospectivement par les medecins du seul service de dermatologie de Guyane a l’hopital de Cayenne entre 1969 et 2013. Elles portaient sur l’âge, la date du diagnostic, le sexe, la residence, la localisation de la lesion, le type de lesion, les symptomes associes et les elements diagnostiques (frottis, culture, PCR, histopathologie) pour tous les cas d’IMU. Nous avons calcule les incidences moyennes d’IMU, presentees comme le nombre de cas pour 100 000 personnes–annees, a partir des donnees demographiques de la population generale provenant des recensements (INSEE). Resultats Au total, 245 patients atteints d’IMU ont ete diagnostiques au Service de dermatologie de l’hopital de Cayenne au cours de la periode d’etude. L’incidence de l’IMU en nombre de cas pour 100 000 personnes–annees a diminue au fil du temps passant de 6,07 en 1969–1983 a 4,77 en 1984–1998 et a 3,49 en 1999–2013, cette baisse etant statistiquement significative (β–0,14 ; p = 0,02). La proportion d’enfants atteints a egalement diminue significativement avec le temps, passant de 76 % en 1969–1983 a 31 % en 1984–1998 et a 21 % en 1999–2013 (p = 0,01). La plupart des cas se sont produits dans les zones cotieres entourees de savanes marecageuses (incidence de 21,8 pour 100 000 personnes–annees a Sinnamary et de 21,8 ans pour 100 000 personnes–annees a Mana). Les lesions ont principalement affecte les membres (membres inferieurs : 66 % ; membres superieurs : 24 %). Nous n’avons diagnostique aucune infection osseuse. Discussion Cette etude, la plus longue serie mondiale sur l’IMU, met en evidence une modification de l’epidemiologie de cette infection en Guyane ces 45 dernieres annees : d’une part, une baisse d’incidence globale, d’autre part, une augmentation de la moyenne d’âge des patients avec passage d’une epidemiologie de type africain (surtout des enfants) a une epidemiologie de type australien (surtout des adultes). L’amelioration des conditions de vie et de l’acces aux soins sont les probables principaux facteurs explicatifs de cette evolution.
Published: 2017

41. Prevalence of Plasmodium spp. in illegal gold miners in French Guiana in 2015: a hidden but critical malaria reservoir

Author: Helene Hiwat, Frédérique Perotti, Antoine Adenis, Félix Djossou, Mathieu Nacher, Stephen Vreden, Magalie Demar, Florine Corlin, Paul Brousse, Maylis Douine, Stéphane Pelleau, Jérémie Pasquier, Louise Mutricy, Lise Musset, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR - laboratoire associé), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Stem cell and microenvironment laboratory, Weill Cornell Medicine [Qatar], Department Genetic Medicine, Corneil University-Weill Medical College of Cornell University [New York], Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Direction Interarmées du Service de Santé en Guyane, Département des Centres Délocalisés de Prévention et de Soins, Pharmacy, Centre Hospitalier de l’Ouest Guyanais, Saint Laurent du Maroni, France, Centre Hospitalier de l'Ouest Guyanais Franck Joly (Saint-Laurent-du-Maroni), Medical Mission, Academisch Ziekenhuis, Paramaribo Hospital, Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), funded by European Funds for Regional Development (Feder), N° Presage 32078 and the Institut Veille Sanitaire (French Ministry of Health), European Project: 32078,OrPal, CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Service d'Immunologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de Référence du Paludisme [Cayenne, Guyane française] (CNR), ADENIS, ANTOINE, and European Funds for Regional Development (Feder), N° Presage 32078 - OrPal - 32078 - INCOMING
Subjects: Male, Plasmodium, Cross-sectional study, artemisinin resistance, Polymerase Chain Reaction, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Health care, Prevalence, 030212 general & internal medicine, Immunoassay, Microscopy, Rapid diagnostic test, education.field_of_study, Malaria reservoir, Ecology, Transmission (medicine), Illegal gold mining, Middle Aged, French Guiana, 3. Good health, Infectious Diseases, Geography, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, Adult, medicine.medical_specialty, 030231 tropical medicine, Population, Miners, 03 medical and health sciences, Environmental health, parasitic diseases, medicine, Humans, education, Diagnostic Tests, Routine, business.industry, Research, Public health, medicine.disease, Malaria, Cross-Sectional Studies, Guiana Shield, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Asymptomatic Diseases, Tropical medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Parasitology, Gold, business
Abstract: International audience; BackgroundMalaria is endemic in French Guiana, an overseas territory of France on the Guiana Shield. Since 2005, notified malaria cases are decreasing. However, new data show that malaria affects many Brazilian gold miners working illegally in French Guiana, the majority of whom are not counted in official data. In addition, one major concern is the usual practice of improper self-treatment in this mining population, raising fear of the development of antimalarial resistance. This prospective study, conducted in 2015, aimed to estimate the prevalence of Plasmodium spp. in illegal gold miners working in French Guiana. MethodsThe recruitment of gold miners was carried out in resting sites along the French Guiana-Suriname border, where they go for supplies, medical care or leisure. After recording agreement, three malaria diagnostic methods were performed: rapid diagnostic test, microscopy and PCR,ResultsAmong 421 persons recruited in the study, malaria prevalence, detected by nested-PCR, was 22.3% (CI=[18.3-26.3], n=94/421) of which 84% were asymptomatic. ConclusionThis significant malaria reservoir in a mobile and illegal population with difficult access to a health care system raises the threat of artemisinin resistance and puts the population of the Guiana Shield at risk of new transmission foci while countries of the region aim at malaria elimination. Even though French legislation may hamper dealing with this population, France must face the reality of malaria in illegal gold miners in order to meet its commitment to malaria elimination.
Published: 2016

42. Predictive factors of the survival of women with invasive breast cancer in French Guiana: the burden of health inequalities

Author: Sophie Belliardo, Maylis Douine, Tristan Roue, Sylvain Labbé, Mathieu Nacher, Juliette Plenet, Registre des Cancers de Guyane, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), The present study was funded by the Health Regional Agency of French Guiana., The authors thank Professor J.P. Droz for a critical reading of the manuscript., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and ADENIS, ANTOINE
Subjects: Cancer Research, Pediatrics, Survival, Immigration, Health Services Accessibility, MESH: Healthcare Disparities/statistics & numerical data, 0302 clinical medicine, Breast cancer, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, Medicine, 030212 general & internal medicine, Early Detection of Cancer, MESH: Breast Neoplasms/pathology, media_common, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Relative survival, Carcinoma, Ductal, Breast, Age Factors, MESH: Neoplasm Staging, Place of birth, Middle Aged, Prognosis, MESH: Emigrants and Immigrants, 3. Good health, French Guiana, Survival Rate, Oncology, MESH: Breast Neoplasms/mortality, 030220 oncology & carcinogenesis, MESH: Survival Analysis, Female, Immigrant, Adult, medicine.medical_specialty, MESH: Socioeconomic Factors, MESH: Early Detection of Cancer/statistics & numerical data, MESH: French Guiana/epidemiology, MESH: Survival Rate, media_common.quotation_subject, Emigrants and Immigrants, Breast Neoplasms, MESH: Carcinoma, Ductal, Breast/mortality, MESH: Prognosis, 03 medical and health sciences, South America Word count : 2278, MESH: Health Services Accessibility, parasitic diseases, Humans, Healthcare Disparities, Survival rate, Survival analysis, Aged, Neoplasm Staging, MESH: Age Factors, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Survival Analysis, MESH: Carcinoma, Ductal, Breast/pathology, Cancer registry, Metropolitan France, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography
Abstract: International audience; This study aimed to compare the relative survival of patients with invasive breast cancer between women from French Guiana (a French territory in South America) and metropolitan France. No study hadever compared survival of breast cancer on the basis of immigrant status in France. Our study underlined that access to care for migrants is challenging whichwgenerates health inequalities. Background The prognosis of breast cancer in French Guiana is worse than in France with 23 deaths per 100 incident cases against 17 per 100 in metropolitan France. This study aimed to compare relative survival of patients with invasive breast cancer (IBC) between women from French Guiana and metropolitan France and to determine risk factors influencing breast cancer survival in French Guiana.Materials and methods Data were collected from the Cancer registry of French Guiana. We comparedthe relative survival of women with IBC between French Guiana and metropolitan France. We used Cox's proportional hazard regression to evaluate the effect of prognostic factors on cancer-specific mortality in French Guiana. Results We included all 269 cases of IBC in women diagnosed in French Guiana between 2003 and 2009. The overall 5-year relative survival rate of patients with IBC was 79% in French Guiana and 86% in metropolitan France. The place of birth (foreign country versus French territory), the tumor stage at the time of diagnosis, the mode of diagnosis (symptoms versus screening), the presence of hormone receptors in the tumor and the histologic type were the variables associated with survival differences. None of the other study variables were significantly associated with prognosis. Conclusion Access to care for migrants is challenging,which leads to health inequalities. Early detection through prevention programs is crucial to increaseIBC survival notably for foreign-born patients.
Published: 2016

43. Représentations et récits de la maladie chez des patients infectés par le virus de l’immunodéficience humaine originaires d’Afrique de l’Ouest et vivants en France

Author: Marie Rose Moro, Maylis Douine, Olivier Taïeb, Olivier Bouchaud, and Thierry Baubet
Subjects: medicine.medical_specialty, business.industry, Interpretation (philosophy), Illness experience, Loneliness, General Medicine, medicine.disease, computer.software_genre, Causality, Therapeutic relationship, Acquired immunodeficiency syndrome (AIDS), medicine, medicine.symptom, Psychiatry, Medical anthropology, business, computer, Interpreter
Abstract: Summary Objective Migrants, especially from West African countries, are highly affected by HIV in France but their representations of the illness have not been much studied. The aim of this study is to explore their representations of HIV infection through their explanatory models and etiologic theories. Method Nine interviews of patients living with HIV from West African countries and migrants in France have been carried out with the Mac Gill Illness Narrative Interview, an interview schedule to elicit meanings and modes of reasoning related to illness experience. The illness narratives have then been analyzed through a method from medical anthropology. Findings According to this study, aids remains a shameful illness, related to immoral behaviors such as unfaithfulness, intercourses with prostitutes or a high number of partners. Causality of illness is often related to the migration story. Stigmatization of people living with HIV is prevailing in the personal experience of the illness, which leads to underestimate oneself, to stop making plans for the future and brings social loneliness because of the secret around this illness. Conclusion Like any illness, diagnosis of HIV infection involves questions: “Why me? Why now?” requiring an interpretation to recreate coherence in patients’ lives. For medicals, caring about illnesses representations of the patients helps therapeutic relationship. Complementary surveys lead by a multidisciplinary team and an interpreter at different times could improve understandings of global representations of illness and their evolution.
Published: 2012

44. Prevalence and predictive factors for renouncing medical care in poor populations of Cayenne, French Guiana

Author: Marie Claire Parriault, Mathieu Nacher, Larissa Valmy, Maylis Douine, Thomas Pavlovsky, Astrid Van Melle, Antoine Adenis, Barbara Gontier, Célia Basurko, Claire Grenier, ADENIS, ANTOINE, Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Croix rouge française, Health Regional Agency (ARS), Laboratoire de Mathématiques Informatique et Applications (LAMIA), Université des Antilles (UA), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Centre Hospitalier Andrée Rosemon, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), UNICANCER-Université Lille Nord de France (COMUE), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
Subjects: Adult, Male, Health Knowledge, Attitudes, Practice, Renouncement, medicine.medical_specialty, media_common.quotation_subject, Immigration, Population, Emigrants and Immigrants, Logistic regression, Vulnerable Populations, Health informatics, Health administration, Treatment Refusal, 03 medical and health sciences, 0302 clinical medicine, Nursing, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Poverty Areas, Health care, medicine, Humans, Social inequality, 030212 general & internal medicine, Healthcare Disparities, education, ComputingMilieux_MISCELLANEOUS, Tree analysis, media_common, Physician-Patient Relations, education.field_of_study, business.industry, Health Policy, Public health, Nursing research, Refusal to Treat, French Guiana, 3. Good health, Poor populations, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Epidemiologic Methods, business, Research Article, Demography
Abstract: International audience; Background: Access to health care is a global public problem. In French Guiana, there exists social inequalities which are specially marked amongst immigrants who make up a third of the population. Health care inequalities are prevalent. The objective of this study was to determine factors associated with why health care amongst the poor population of Cayenne was renounced.Study design The study was cross sectional. It focused on knowledge, attitudes, practices and beliefs of the population living in poor neighborhoods of the Cayenne area. Methods: Populations coming at the Red Cross mobile screening unit in poor urban areas of Cayenne were surveyed from July 2013 to June 2014. Structured questionnaires consisted of 93 questions. Written informed consent was requested at the beginning of the questionnaire. The predictors for renouncing medical care were determined using logistic regression models and tree analysis. Results: Twenty percent of persons had renounced care. Logistic regression showed that renouncement of health care was negatively associated with having no regular physician Adjusted Odds Ratio (AOR)=0.43 (95%CI=0.24-0.79) and positively associated with being embarrassed to ask certain questions AOR=6.81 (95%CI=3.98-11.65) and having been previously refused health care by a doctor AOR=3.08 (95%CI=1.43-6.65) . Tree analysis also showed that three of these variables were linked to renouncement, with feeling shy to ask certain questions as the first branching.Conclusion: Although most people felt it was easy to see a doctor, one in five had renounced health care. The variables identified by the models suggest vulnerable persons generally had previous negative encounters with the health system and felt unwanted or non eligible for healthcare. Health care mediation and welcoming staff may be simple solutions to the above problems which were underscored in our observations.
Published: 2015

45. Cerebral injuries associated with Zika virus in utero exposure in children without birth defects in French Guiana

Author: Anne Favre, Maylis Douine, Olivier Flechelles, Antoine Defo, Narcisse Elenga, Mathieu Nacher, Edouard Hallet, Arthur Felix, Rémi Kom-Tchameni, and Jean-Marc Rosenthal
Subjects: Adult, Male, Microcephaly, Pediatrics, medicine.medical_specialty, neurological disorders, Risk Assessment, Ultrasonography, Prenatal, Zika virus, 03 medical and health sciences, Child Development, 0302 clinical medicine, Pregnancy, medicine, Humans, Clinical Case Report, 030212 general & internal medicine, Pregnancy Complications, Infectious, 030505 public health, biology, Cesarean Section, Zika Virus Infection, business.industry, Metabolic disorder, Infant, Newborn, Infant, General Medicine, biology.organism_classification, Pathogenicity, medicine.disease, Magnetic Resonance Imaging, French Guiana, birth defects, In utero, Brain Injuries, Prenatal Exposure Delayed Effects, Female, Abnormality, Differential diagnosis, 0305 other medical science, business, Research Article, Follow-Up Studies
Abstract: Rationale: A major epidemic of Zika virus (ZIKV) infection occurred in French Guiana and West Indies. French national epidemiological surveillance estimated that 1650 pregnant women contracted the ZIKV during epidemic period from January 2016 to October 2016 in French Guiana. Patient concerns: ZIKV infection during pregnancy is a cause of microcephaly and birth defects. Diagnoses: In this report, we describe 2 children with proven in utero ZIKV exposure. Their mothers were both symptomatic and ZIKV infection occurred early in pregnancy. Ultrasonography monitoring in utero did not show any abnormality for both patient. They were born at full-term, healthy, without any birth defects and no sign of congenital ZIKV infection. Interventions: ZIKV was neither found on placenta fragments nor children blood and urine at birth. Their neurodevelopment outcomes in early-life fitted the expectations. As recommended in national guidelines, we performed cerebral MRIs at 2 months old, showing severe brain abnormalities, especially of white matter areas. After a large screening, we did not find any differential diagnosis for their brain lesions. Outcomes: We concluded it was due to their in utero ZIKV exposure. Lessons: In this report, pathogenicity of ZIKV may involve mother's immunological response or metabolic disorder during the infection.
Published: 2017

46. Survival of patients with invasive cervical cancer in French Guiana, 2003-2008

Author: Antoine Adenis, Mathieu Nacher, Angela Fior, Nadia Thomas, Tristan Roue, Maylis Douine, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Registre des Cancers de Guyane, Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Association Guyanaise Dépistage Organisé des Cancers [Cayenne] (A.G.D.O.C), Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Health Regional Agency of French Guiana, Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and ADENIS, ANTOINE
Subjects: Oncology, Adult, Pediatrics, medicine.medical_specialty, Invasive cervical cancer, Survival, Uterine Cervical Neoplasms, Adenocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Fre nch Guiana, Early Detection of Cancer, ComputingMilieux_MISCELLANEOUS, Aged, Neoplasm Staging, Cervical cancer, Aged, 80 and over, Proportional hazards model, business.industry, Obstetrics and Gynecology, General Medicine, Middle Aged, medicine.disease, 3. Good health, French Guiana, Survival Rate, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Cox model, Carcinoma, Squamous Cell, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience
Published: 2014

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