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Menseau V, Charbonnier J, Franchi A, Ouar S, Hamiche K, Pujo J, Kallel H, Nacher M, Fremery A. An Observational Study of Sexual Assaults in French Guiana During 2019-2020. Open Access Emerg Med 2024; 16:183-190. [PMID: 39050492 PMCID: PMC11268625 DOI: 10.2147/oaem.s451891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/17/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction Sexual violence is a major public health issue, including in French Guiana. The feeling of insecurity is significant in this part of France. Sexual violence is an important reason for consultation in forensic and emergency medicine. The challenge is to provide care within the first 72 hours, particularly in medicolegal terms and for infectious disease management. The objectives of our study were, firstly, to establish the epidemiology of sexual assaults at Cayenne General Hospital (CGH), and secondly, to evaluate the management of these victims. Materials and Methods From January 1st, 2019 to December 31st, 2020, we conducted a single-center retrospective descriptive study including patients who were consulted for sexual assaults in the Forensic medicine and the Emergency departments of CGH. Results Over this period, 400 sexual assault victims were consulted. Most of them, were women (87%) with a median age of 13 years-old [8; 17.5]. The aggressor was mostly male (99%) frequently known by the victim (87%) and from her family (39%). Suspected assaults represented 19% of consultations. The most frequent assault on women was penile-vaginal penetration (82%) and penile-anal penetration (77%) on men. The delay of consultation was superior to 72 hours in 60% of the cases. A psychological follow-up was recommended for 62% of these victims. Conclusion This work allowed to identify a young and female population at risk, most often assaulted by a male known to her. Most of the patients consulted more than 72 hours after the assault. Our study highlights the need for prevention actions in French Guiana focusing on this population at risk.
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Affiliation(s)
- Victoire Menseau
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | | | - Angélique Franchi
- Forensic Medicine Department, Cayenne General Hospital, French Guiana, France
| | - Sihem Ouar
- Forensic Medicine Department, Cayenne General Hospital, French Guiana, France
| | - Karim Hamiche
- Forensic Medicine Department, Cayenne General Hospital, French Guiana, France
| | - Jean Pujo
- Emergency Department, Cayenne General Hospital, French Guiana, France
- Faculty of Medicine, French Guiana University, French Guiana, France
| | - Hatem Kallel
- Faculty of Medicine, French Guiana University, French Guiana, France
- Intensive Care Unit, Cayenne General Hospital, French Guiana, France
| | - Mathieu Nacher
- Faculty of Medicine, French Guiana University, French Guiana, France
- CIC INSERM1424, Cayenne General Hospital, French Guiana, France
| | - Alexis Fremery
- Emergency Department, Cayenne General Hospital, French Guiana, France
- Faculty of Medicine, French Guiana University, French Guiana, France
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Hcini N, Lambert V, Carod JF, Mathieu M, Carles G, Picone O, Sibiude J, Pomar L, Nacher M. Emerging and re-emerging infectious diseases in pregnant women in an amazonian region: a large retrospective study from French Guiana. Eur J Clin Microbiol Infect Dis 2024; 43:1081-1090. [PMID: 38573394 DOI: 10.1007/s10096-024-04813-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Over the past decade, the Amazon basin has faced numerous infectious epidemics. Our comprehension of the actual extent of these infections during pregnancy remains limited. This study aimed to clarify the clinical and epidemiological features of emerging and re-emerging infectious diseases during pregnancy in western French Guiana and along the Maroni River over the previous nine years. METHODS This retrospective cohort study enrolled pregnant women living in west French Guiana territory and giving birth in the only local referral center after 22 weeks of gestation between 2013 and 2021. Data on symptomatic or asymptomatic biologically confirmed emerging or re-emerging diseases during pregnancy was collected. RESULTS Six epidemic waves were experienced during the study period, including 498 confirmed Zika virus infections (2016), 363 SARS-CoV-2 infections (2020-2021), 87 chikungunya virus infections (2014), 76 syphilis infections (2013-2021), and 60 dengue virus infections (2013-2021) at different gestational ages. Furthermore, 1.1% (n = 287) and 1.4% (n = 350) of pregnant women in west French Guiana were living with HIV and HTLV, respectively. During the study period, at least 5.5% (n = 1,371) faced an emerging or re-emerging infection during pregnancy. CONCLUSION These results highlight the diversity, abundance, and dynamism of emerging and re-emerging infectious agents faced by pregnant women in the Amazon basin. Considering the maternal and neonatal adverse outcomes associated with these infections, increased efforts are required to enhance diagnosis, reporting, and treatment of these conditions.
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Affiliation(s)
- Najeh Hcini
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana.
- DFR Santé Université Guyane, CIC Inserm 1424, Cayenne, France.
| | - Véronique Lambert
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Jean-François Carod
- Department of Biology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Meredith Mathieu
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Gabriel Carles
- Department of Obstetrics and Gynecology, West French Guiana Hospital Center, Saint-Laurent-du-Maroni, French Guiana
| | - Olivier Picone
- Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Université de Paris, Inserm IAME-U1137, Colombes Cedex, Paris, France
- Université de Paris, Colombes Cedex, Paris, France
- Inserm IAME-U1137, Paris, France
- Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), Vélizy, France
- FHU Prema, Paris, France
| | - Jeanne Sibiude
- Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Université de Paris, Inserm IAME-U1137, Colombes Cedex, Paris, France
- Université de Paris, Colombes Cedex, Paris, France
- Inserm IAME-U1137, Paris, France
- Groupe de Recherche sur les Infections pendant la Grossesse (GRIG), Vélizy, France
- FHU Prema, Paris, France
| | - Leo Pomar
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, 1011, Lausanne, Switzerland
- Ultrasound and Fetal medicine, Department Woman-mother-child, Lausanne University Hospital and Lausanne University, 1011, Lausanne, Switzerland
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Fremery A, Beguinot E, Franchi A, Douchet M, Tertre V, Hamiche K, Adenis A, Pujo JM, Kallel H. Epidemiologic analysis and mortality outcome of firearm injuries in French Guiana (2016-2019). Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02499-7. [PMID: 38512419 DOI: 10.1007/s00068-024-02499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND French Guiana (FG) is a French territory located in South America with the highest rate of armed assaults. FG presents a poorly developed road system and a young and precarious population that makes the geographical and socio-demographic characteristics specific. No data concerning the firearm injury management are available in this country. Studying thesis trauma could permit to improve the management of victims. The objective of this study is to investigate the epidemiology of firearm injuries in FG, to define characteristics of the victims, and to assess factors associated with death. These identified factors could enable target primary prevention and intensification of medical management. METHODS From January 2016 to December 2019, we conducted a retrospective study at the Cayenne General Hospital (CGH), including all patients admitted for firearm injuries in the emergency department, the medical emergency and resuscitation service, and the forensic service. A bivariate analysis was performed to assess relevant clinical data that were entered into a logistic regression model to assess factors associated with death. RESULTS A total of 871 files were analyzed concerning 340 patients included after cross-checking. Victims were mainly males (90%) and young (30 ± 11 years old). The injury occurred mainly at night (60%), in a context of assaults (83%) and with long-barreled guns (82%). Among the 290 patients managed at the CGH, 60% were hospitalized including 12% that were in the intensive care unit, 41% that required surgical treatment, and 7% that died in hospital. The overall average length of stay was 10 ± 18 days. Overall mortality (n = 71, 21%) is statistically associated with male gender (p = 0.007) and suicide context (p < 0.001). In multivariate analysis, the sites of wounds (head and neck, thorax; p < 0.001) as well as induced organ injuries (neurological, respiratory, and vascular; p < 0.005) were independent factors associated to mortality. CONCLUSIONS This work underlines the high incidence of ballistic trauma in FG. This mainly involves a young and male population linked to the use of long arms and assaults. Despite the geographical difficulties of the territory and the technical platform deficits (no neurosurgery, no cardiothoracic surgery, no interventional radiology), the mortality is comparable to other studies, but remains more than twice as high as in mainland France. Finally, despite a change in legislation restricting access to firearms, our results show that gunshot firearm injuries remain a major public health concern requiring greater political actions.
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Affiliation(s)
- Alexis Fremery
- Emergency Department, Cayenne General Hospital, French Guiana, France.
- French Guiana University, French Guiana, France.
| | - Elliott Beguinot
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | - Angélique Franchi
- Forensic Medical Unit, Cayenne General Hospital, French Guiana, France
| | - Mathilde Douchet
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | - Victor Tertre
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | - Karim Hamiche
- Forensic Medical Unit, Cayenne General Hospital, French Guiana, France
| | - Antoine Adenis
- French Guiana University, French Guiana, France
- CIC INSERM1424, Cayenne General Hospital, French Guiana, France
| | - Jean Marc Pujo
- Emergency Department, Cayenne General Hospital, French Guiana, France
- French Guiana University, French Guiana, France
| | - Hatem Kallel
- French Guiana University, French Guiana, France
- Intensive Care Unit, Cayenne General Hospital, French Guiana, France
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Nacher M, Basurko C, Douine M, Lambert Y, Rousseau C, Michaud C, Garlantezec R, Adenis A, Gomes MM, Alsibai KD, Sabbah N, Lambert V, Epelboin L, Sukul RG, Terlutter F, Janvier C, Hcini N. Contrasted life trajectories: reconstituting the main population exposomes in French Guiana. Front Public Health 2024; 11:1247310. [PMID: 38274531 PMCID: PMC10808558 DOI: 10.3389/fpubh.2023.1247310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/21/2023] [Indexed: 01/27/2024] Open
Abstract
In French Guiana, life expectancy is between 2 and 3 years below that of France, reflecting differences in mortality rates that are largely sensitive to primary healthcare and thus preventable. However, because poverty affects half of the population in French Guiana, global measurements of life expectancy presumably conflate at least two distinct situations: persons who have similar life expectancies as in mainland France and persons living in precariousness who have far greater mortality rates than their wealthier counterparts. We thus aimed to synthesize what is known about statistical regularities regarding exposures and sketch typical French Guiana exposomes in relation to health outcomes. We conducted a narrative review on common exposures in French Guiana and made comparisons between French Guiana and mainland France, between rich and poor in French Guiana, and between urban and rural areas within French Guiana. The most striking fact this panorama shows is that being a fetus or a young child in French Guiana is fraught with multiple threats. In French Guiana, poverty and poor pregnancy follow-up; renouncing healthcare; wide variety of infectious diseases; very high prevalence of food insecurity; psychosocial stress; micronutrient deficiencies; obesity and metabolic problems; and frequent exposure to lead and mercury in rural areas constitute a stunningly challenging exposome for a new human being to develop into. A substantial part of the population's health is hence affected by poverty and its sources of nutrition.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Célia Basurko
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Maylis Douine
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Yann Lambert
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | - Cyril Rousseau
- Centres délocalisés de Prévention et de Soins, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Celine Michaud
- Centres délocalisés de Prévention et de Soins, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Ronan Garlantezec
- Épidémiologie et science de l’exposition en santé-environnement (Elixir), Institut de Recherche en Santé Environnement et Travail (IRSET), Rennes, France
- Santé publique et épidémiologie, CHU de Rennes, Rennes, France
| | - Antoine Adenis
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
| | | | - Kinan Drak Alsibai
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Nadia Sabbah
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Service d’endocrinologie diabétologie, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Véronique Lambert
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Western French Guiana Hospital, Saint Laurent du Maroni, French Guiana
| | - Loïc Epelboin
- CIC INSERM, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Université de Guyane, Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Service des Maladies Infectieuses et Tropicales, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | | | - Fredrik Terlutter
- Western French Guiana Hospital, Saint Laurent du Maroni, French Guiana
| | - Caroline Janvier
- Service de Psychiatrie, Centre hospitalier de Cayenne, Cayenne, French Guiana
| | - Najeh Hcini
- Amazonian Infrastructures for Population Health, Cayenne, French Guiana
- Western French Guiana Hospital, Saint Laurent du Maroni, French Guiana
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Nacher M, Epelboin L, Bonifay T, Djossou F, Blaizot R, Couppié P, Adenis A, Lucarelli A, Lambert Y, Schaub R, Douine M. Migration in French Guiana: Implications in health and infectious diseases. Travel Med Infect Dis 2024; 57:102677. [PMID: 38049022 DOI: 10.1016/j.tmaid.2023.102677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/06/2023]
Abstract
In French Guiana, more than a third of the population, and nearly half of the adults, are of foreign origin. This immigration is explained by the French standard of living, which is attractive to nationals of surrounding countries. Infectious diseases remain in the top 10 causes of premature death, often in the most precarious populations. In this context we aimed to synthesize the state of the knowledge regarding immigration and infectious diseases in French Guiana and the general implications that follow this diagnosis. For HIV, although the majority of patients are of foreign origin, estimates of the presumed date of infection based on CD4 erosion modelling and from molecular analyses suggest that the majority of transmissions in foreign-born individuals occur in French Guiana and that the Guiana shield has been a crossroad between Latin America and the Caribbean. Among key populations bridging these regions illegal gold miners are very mobile and have the greatest proportion B Caribbean HIV viruses. Gold miners have been a key vulnerable population for falciparum malaria and other tropical diseases such as leishmaniasis, leprosy, or leptospirosis. The complex history of migrations in French Guiana and on the Guiana Shield is also reflected in the fingerprinting of mycobacterium tuberculosis and the high incidence of tuberculosis in French Guiana, notably in immigrants, reflects the incidences in the countries of origin of patients. The high burden of infectious diseases in immigrants in French Guiana is first and foremost a reflection of the precarious living conditions within French Guiana and suggests that community-based proactive interventions are crucial to reduce transmission, morbidity, and mortality from infectious diseases.
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Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana.
| | - Loïc Epelboin
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Infectious Diseases, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Timothée Bonifay
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Félix Djossou
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Infectious Diseases, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Romain Blaizot
- Department of Dermatology, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Pierre Couppié
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Department of Dermatology, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Aude Lucarelli
- Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana; Coordination Regionale de lutte contre le VIH, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana
| | - Yann Lambert
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Roxane Schaub
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
| | - Maylis Douine
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300, Cayenne, French Guiana; Université de Guyane, Cayenne, 97300, Cayenne, French Guiana; Amazonian Infrastructures for Population Health & Tropical Medicine, Cayenne, French Guiana
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Osei L, Basurko C, Nacher M, Vignier N, Elenga N. About the need to address pediatric health inequalities in French Guiana : a scoping review. Arch Pediatr 2022; 29:340-346. [DOI: 10.1016/j.arcped.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/26/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
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Massicard M, Drak Alsibai K, Nacher M, Sabbah N. Nutritional and Socioeconomic Determinants of Overweight and Obesity in the French Amazon: The Health Barometer Study. Front Endocrinol (Lausanne) 2022; 13:849718. [PMID: 35498399 PMCID: PMC9040446 DOI: 10.3389/fendo.2022.849718] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES French Guiana is a multicultural overseas territory where obesity is a major public health problem. This study aimed to highlight the nutritional and socioeconomic determinants of overweight and obesity in different populations in French Guiana. METHODS A two-stage random sample of 1390 individuals aged 15 to 75 years was surveyed by telephone, and the participants were initially screened for diabetes. Logistic regression was fitted on the sample to adjust for potential confounding factors. RESULTS Overweight and obesity were found in 54.7% of the respondents, a higher proportion than in mainland France. There was a significant body image discrepancy in our population, with a higher risk of obesity among single women, often immigrants from the non-French Caribbean and South America, unemployed or low education. CONCLUSIONS The main factors associated with obesity were being a precariousness immigrant; there was often a mismatch between body image and overweight/obesity, which is a major obstacle to the improvement of dietary behaviors and lifestyle. This information provides operational clues as to where to act and the necessary adaptations to attempt to modify behaviors in a culturally-adapted manner.
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Affiliation(s)
- Mickael Massicard
- Department of Endocrinology and Metabolic Diseases, Centre Hospitalier André Rosemon, Cayenne, French Guiana
| | - Kinan Drak Alsibai
- Department of Pathology, Cayenne Hospital Center Andrée Rosemon, Cayenne, French Guiana
- Center of Biological Resources (CRB Amazonie), Cayenne Hospital Center Andrée Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- Clinical Investigation Center, Centre Hospitalier André Rosemon, University Antilles French Guiana (CIC INSERM 1424), Cayenne, French Guiana
| | - Nadia Sabbah
- Department of Endocrinology and Metabolic Diseases, Centre Hospitalier André Rosemon, Cayenne, French Guiana
- Clinical Investigation Center, Centre Hospitalier André Rosemon, University Antilles French Guiana (CIC INSERM 1424), Cayenne, French Guiana
- *Correspondence: Nadia Sabbah,
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Kallel H, Resiere D, Houcke S, Hommel D, Pujo JM, Martino F, Carles M, Mehdaoui H. Critical care medicine in the French Territories in the Americas: Current situation and prospects. Rev Panam Salud Publica 2021; 45:e46. [PMID: 33936184 PMCID: PMC8080944 DOI: 10.26633/rpsp.2021.46] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/03/2020] [Indexed: 11/24/2022] Open
Abstract
Hospitals in the French Territories in the Americas (FTA) work according to international and French standards. This paper aims to describe different aspects of critical care in the FTA. For this, we reviewed official information about population size and intensive care unit (ICU) bed capacity in the FTA and literature on FTA ICU specificities. Persons living in or visiting the FTA are exposed to specific risks, mainly severe road traffic injuries, envenoming, stab or ballistic wounds, and emergent tropical infectious diseases. These diseases may require specific knowledge and critical care management. However, there are not enough ICU beds in the FTA. Indeed, there are 7.2 ICU beds/100 000 population in Guadeloupe, 7.2 in Martinique, and 4.5 in French Guiana. In addition, seriously ill patients in remote areas regularly have to be transferred, most often by helicopter, resulting in a delay in admission to intensive care. The COVID-19 crisis has shown that the health care system in the FTA is unready to face such an epidemic and that intensive care bed capacity must be increased. In conclusion, the critical care sector in the FTA requires upgrading of infrastructure, human resources, and equipment as well as enhancement of multidisciplinary care. Also needed are promotion of training, research, and regional and international medical and scientific cooperation.
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Affiliation(s)
- Hatem Kallel
- Cayenne General Hospital Cayenne French Guiana Cayenne General Hospital, Cayenne, French Guiana
| | - Dabor Resiere
- Martinique University Hospital Fort-de-France Martinique Martinique University Hospital, Fort-de-France, Martinique
| | - Stéphanie Houcke
- Cayenne General Hospital Cayenne French Guiana Cayenne General Hospital, Cayenne, French Guiana
| | - Didier Hommel
- Cayenne General Hospital Cayenne French Guiana Cayenne General Hospital, Cayenne, French Guiana
| | - Jean Marc Pujo
- Cayenne General Hospital Cayenne French Guiana Cayenne General Hospital, Cayenne, French Guiana
| | - Frederic Martino
- Guadeloupe University Hospital Pointe-à-Pitre Guadeloupe Guadeloupe University Hospital, Pointe-à-Pitre, Guadeloupe
| | - Michel Carles
- Guadeloupe University Hospital Pointe-à-Pitre Guadeloupe Guadeloupe University Hospital, Pointe-à-Pitre, Guadeloupe
| | - Hossein Mehdaoui
- Martinique University Hospital Fort-de-France Martinique Martinique University Hospital, Fort-de-France, Martinique
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