Les recompositions territoriales dans le Maroni : relation mobilité-environnement

Piantoni, Frédéric

doi:10.4000/remi.1630

Cited by 14 publications

(3 citation statements)

References 8 publications

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“…Although the river constitutes a border dividing different norms and laws, there is great mobility and dense connections between both sides of the river (Piantoni, 2002). Efforts to change cultural norms regarding stigmatization of PLWHIV must be coherent and take place on both sides.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictive factors of stigmatizing attitudes towards people living with HIV in the remote villages on the Maroni River in French Guiana

Melle¹,

Parriault²,

Basurko³

et al. 2014

AIDS Care

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The Maroni basin, an isolated region which lies between Suriname and French Guiana, has been affected by the HIV epidemic 10 years after coastal French Guiana. However, the rise in HIV prevalence was sharp with a prevalence exceeding 1% within 10 years. Stigma and discrimination towards people living with HIV (PLWHIV) or "suspected to have HIV" is rampant as reported by health professionals or non-governmental organisations. The objective of this article is to present the first quantitative data from the general population of this region on stigma towards people living with HIV. Data were collected in 2012 by a structured questionnaire among a random sample of 896 individuals residing in remote villages on the Maroni River. Proportion comparisons between the Maroni sample and the sample from the general population on the coastline in 2011 were conducted. Simple and multivariate logistic regression models were used to predict stigmatising attitudes. For all situations involving PLWHIV, the proportion of negative attitudes was significantly higher on the Maroni than in coastal French Guiana (p < 0.001). Findings indicate that the different levels of knowledge, erroneous beliefs and poor situation (not having electricity in one's home; not having French health insurance) were associated with stigmatising attitudes. The present data could help both sides coordinate interventions both at the individual level by improving knowledge and at the community level to change norms in order to reduce stigma and discrimination aiming for increased impact.

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictive factors of stigmatizing attitudes towards people living with HIV in the remote villages on the Maroni River in French Guiana

Melle¹,

Parriault²,

Basurko³

et al. 2014

AIDS Care

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“…The Maroni river is mainly inhabited by Maroons (descendants from runaway enslaved individuals) and Amerindians ( 14 ), who live, respectively, on the northern and southern part of the river ( Figure 1 ). The settlement of the different ethnic communities along the Maroni river follows historical events and natural boundaries formed by rapids that are difficult to cross, instead of administrative considerations ( 15 ). Except for Maripasoula and Saint-Laurent-du-Maroni which are multi-ethnic cities, the different communities live side by side in mainly mono-ethnic villages ( 14 , 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Involving hard-to-reach populations is pivotal for the tailoring and implementation of an epidemiological study in cross-border communities of French Guiana and Suriname

Schaub,

Ottevanger,

Harkisoen

et al. 2023

Front. Public Health

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BackgroundHard-to-reach, vulnerable and cross-border populations are often disproportionately affected by communicable diseases. Epidemiological data on viral hepatitis in French Guiana and Suriname are available for urban areas, but not for remote communities. The Maroni River, which separates FG and Suriname, is home to Tribal and Indigenous communities. Reaching these populations is challenging due to logistical constraints, cultural and language barriers, and mistrust of outsiders.ObjectivesWe aimed to conduct an epidemiological study of viral hepatitis [Maroni Hepatites Virales (MaHeVi)] in this remote and complex area. Here, we describe the operational hurdles and solutions required to achieve this.MethodsWe undertook a preliminary assessment of the area with local community leaders and health workers to gain approval of MaHeVi, acceptance of blood sampling, and suggestions for adapting the study to cultural and logistical constraints. Anthropological assessments were conducted through focus groups and interviews with key individuals to assess knowledge, beliefs and risk factors for VH.ResultsMaHeVi was well received by the local communities. The approval of the community leaders was crucial for the implementation and acceptance of the study. The main adaptations were hiring community health mediators to overcome cultural and language differences, using blotting paper instead of venipuncture for logistical and acceptability reasons, and adapting communication materials.ConclusionCareful preparation and tailoring of the communication materials and research protocol have enabled the successful implementation of the study. This process could be replicated in this area and transferred to other complex contexts combining borders, logistical hurdles and populations requiring cultural adaptations.

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“…When relatives and friends are scattered on both sides, the administrative dimension of the river is hence often virtual. This leads to what is called pendular migration, with people moving back and forth between sides ( 8 ). Given these continuous fluxes, it is key to act on both sides of the border and to coordinate the health professionals and Non-Government Organizations (NGOs) on both sides of the border.…”

Section: Introductionmentioning

confidence: 99%

Sexually transmitted infections on the border between Suriname and French Guiana: A scoping review

et al. 2022

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PurposeThe Maroni basin –delineating the border between Suriname and Frnch Guiana— presents sociocultural, geographical and economic circumstances that have been conducive to the circulation of sexually transmitted infections and to delays in diagnosis and care. Given the scarcity of published data, we aimed to describe different sexually transmitted infections along the Maroni and to gain a broader understanding of the epidemiologic situation.MethodsWe conducted a scoping review of the efforts to approach the problem of sexually transmitted infections in this complex border area. Temporal trends were plotted and crude numbers were divided by local population numbers.ResultsFor HIV, despite increasing testing efforts, most patients still present at the advanced HIV stage (median CD4 count at diagnosis is < 20 per mm3), and 25% of patients in Saint Laurent du Maroni were lost to follow-up within 6 years. However, progress on both sides has led to a decline in AIDS cases and mortality. Despite a rapid increase in the 1990’s along the Maroni, the current HIV prevalence seemed lower (0.52%) in the rural villages than in coastal urban centers (> 1%). High risk HPV infection prevalence among women reaches 23.3%. The incidence of gonorrhea was 4.2 per 1,000 population aged 15-59. For chlamydiasis it was 3.4 per 1,000 population aged 15-59. For syphilis, the incidence was 2.5 per 1,000 population aged 15-59. Gonorrhea, chlamydiasis, hepatitis B detection increased over time with greater testing efforts and new diagnostic tests. Since the COVID-19 epidemic, congenital syphilis has dramatically increased in Saint Laurent du Maroni reaching 808 per 100,000 live births.ConclusionSexually transmitted infections seemed more prevalent in Saint Laurent du Maroni –the sole urban center—than in the remote villages along the Maroni. The syndromic approach and the heterogeneity of diagnostic platforms presumably overlook most infections in the region. Therefore, a concerted approach and a shared diagnostic upgrade with molecular diagnosis and rapid diagnostic tests seem necessary to reduce the burden of sexually transmitted infections on both sides of the Maroni. Congenital syphilis resulting from COVID-19 disruption of health services requires urgent attention.

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Les recompositions territoriales dans le Maroni : relation mobilité-environnement

Cited by 14 publications

References 8 publications

Prevalence and predictive factors of stigmatizing attitudes towards people living with HIV in the remote villages on the Maroni River in French Guiana

Prevalence and predictive factors of stigmatizing attitudes towards people living with HIV in the remote villages on the Maroni River in French Guiana

Involving hard-to-reach populations is pivotal for the tailoring and implementation of an epidemiological study in cross-border communities of French Guiana and Suriname

Sexually transmitted infections on the border between Suriname and French Guiana: A scoping review

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