1
|
Nacher M, Basurko C, Osei L, Thomas N, Louis A, Leneuve M, Dotou D, Tosi A, Lambert V, Monjardé E, Muhigirwa GB, Elenga N, Hcini N. Timing of infant mortality in French Guiana: The persistence of high post neonatal mortality. JOURNAL OF EPIDEMIOLOGY AND POPULATION HEALTH 2024; 72:202535. [PMID: 38851108 DOI: 10.1016/j.jeph.2024.202535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Infant mortality in French Guiana, a French overseas territory, is 2.7 times greater than in mainland France. Given the importance of better understanding infant mortality we aimed to describe the early & late neonatal, and postneonatal mortality in French Guiana between 2007 and 2022. METHODS We used data from the Institut National de la Statistique et des Etudes Economiques to describe trends and performed survival analysis. RESULTS Overall, there were 1 073 deaths before one year of age, of which 297 (27.7 %) occurred on the first day of life. The overall proportion of early neonatal deaths was 47.1 %, late neonatal deaths was 17.3 %, and post-neonatal deaths was 35.6 %. The overall incidences were 4.6 per 1,000 for early neonatal mortality, 1.4 per 1,000 for late neonatal mortality, and 3.1 per 1,000 for post neonatal mortality. The incidence for infant mortality for French Guiana residents was thus 9.1 per 1,000. CONCLUSIONS We show that post neonatal deaths in French Guiana are proportionally greater than in mainland France and they do not seem to decline, as they did in France. The relative proportions of post-neonatal mortality can thus help to identify important areas for action to correct excess infant mortality. Although poor pregnancy follow-up remains a problem we show that follow-up of infants is also a pressing problem that warrants increased efforts.
Collapse
Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Universite de Guyane, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana, France.
| | - Celia Basurko
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Lindsay Osei
- Pediatrics department, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Protection Maternelle et Infantile, 97300 Cayenne, French Guiana, France
| | - Nadia Thomas
- Departement des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Alphonse Louis
- Service de Gynécologie Obstétrique, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Malika Leneuve
- Service de Gynécologie Obstétrique, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Dominique Dotou
- Service de Gynécologie Obstétrique, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Alice Tosi
- Registre des Handicaps de l'Enfant et observatoire de la périnatalité, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Veronique Lambert
- Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
| | | | | | - Narcisse Elenga
- Pediatrics department, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France
| | - Najeh Hcini
- Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
| |
Collapse
|
2
|
Lucron H, Brard M, d’Orazio J, Long L, Lambert V, Zedong-Assountsa S, Le Harivel de Gonneville A, Ahounkeng P, Tuttle S, Stamatelatou M, Grierson R, Inamo J, Cuttone F, Elenga N, Bonnet D, Banydeen R. Infant congenital heart disease prevalence and mortality in French Guiana: a population-based study. LANCET REGIONAL HEALTH. AMERICAS 2024; 29:100649. [PMID: 38124997 PMCID: PMC10733111 DOI: 10.1016/j.lana.2023.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
Background Few studies have assessed the prevalence and mortality of simple or complex congenital heart diseases (CHD) in newborns. In Latin America and Caribbean (LAC), CHD epidemiology seems highly variable, with few population-based assessments and different methodologies between studies. To date, the situation in French Guiana, a French overseas territory located in South America between Brazil and Suriname, has never been described. Methods We analysed CHD prevalence, characteristics and related infant mortality in French Guiana, with a population-based registry analysis of all fetal and live birth CHD cases in infants under 1 year (January 2012-December 2016). Findings Overall, 33,796 births (32,975 live births) were registered, with 231 CHD (56 fetuses), including 215 live births. Most frequent CHD categories were anomalies of the ventricular outflow tract and extra-pericardial trunks, and ventricular septal defects. 18.6% (43/231) chromosomal or genetic anomalies, and 6.5% (15/231) terminations of pregnancy were observed. Total CHD prevalence was 68.4 [95% CI: 67.9-68.8] per 10,000, while live birth prevalence was 65.2 [95% CI: 64.7-65.7] per 10,000. Total infant mortality was 9.4/10,000 live births [95% CI 9.1-9.7], with highest rates for functionally univentricular hearts (FUH). Interpretation A distinct profile for CHD is highlighted in French Guiana with elevated mortality linked to FUH. A potential determinant of the recognized excess mortality risk might be the presence of chromosomal or genetic anomalies in about a fifth of all CHD. This helps us to better understand CHD burden in this part of South America and provides future keys towards reducing CHD-related infant mortality. Funding The authors received no financial support for the present research, authorship, and/or publication of this article.
Collapse
Affiliation(s)
- Hugues Lucron
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| | - Mélanie Brard
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| | - Julie d’Orazio
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
- Neonatal and Pediatric Department, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France
| | - Laurence Long
- Neonatal and Pediatric Department, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France
| | - Véronique Lambert
- Fetal Unit. Department of Obstetrics, Hospital Center Franck Joly, Saint-Laurent du Maroni, French Guiana, France
| | - Serge Zedong-Assountsa
- Neonatal and Pediatric Department, Hospital Center Franck Joly, Saint-Laurent du Maroni, French Guiana, France
| | - Alix Le Harivel de Gonneville
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| | - Patrick Ahounkeng
- Fetal Unit. Department of Obstetrics, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France
| | - Saskia Tuttle
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| | - Marianna Stamatelatou
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| | - Rory Grierson
- Neonatal and Pediatric Department, Hospital Center Franck Joly, Saint-Laurent du Maroni, French Guiana, France
| | - Jocelyn Inamo
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
- Cardiac Pathology, Environmental Toxicity and Envenomations (PC2E) Team, UR5_3, Université des Antilles (University of the French West Indies), 97200, Fort de France, France
| | - Fabio Cuttone
- Antilles-Guyane M3C Pediatric Cardiology Center, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| | - Narcisse Elenga
- Neonatal and Pediatric Department, Hospital Center Andrée Rosemon, Cayenne, French Guiana, France
| | - Damien Bonnet
- M3C-Necker, Pediatric Cardiology Department, Necker Sick Children Hospital, AP-HP, Paris Cité University, Paris, France
| | - Rishika Banydeen
- Cardiac Pathology, Environmental Toxicity and Envenomations (PC2E) Team, UR5_3, Université des Antilles (University of the French West Indies), 97200, Fort de France, France
- Clinical Research Unit, Critical Care and Emergency Medicine Department, CHU Martinique (University Hospital of Martinique), 97200, Fort de France, France
| |
Collapse
|
3
|
Nacher M, Basurko C, Muhigirwa GB, Lambert V, Osei L, Njuieyon F, Louis A, Dotou D, Thomas N, Bernard S, Leneuve M, Elenga N, Hcini N. Infant mortality in French Guiana between 2001 and 2017 : Trends and comparisons with mainland France. Rev Epidemiol Sante Publique 2023; 71:102175. [PMID: 37918040 DOI: 10.1016/j.respe.2023.102175] [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: 08/28/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND French Guiana is a French overseas territory which combines a well-funded universal health system and a population where half are under the poverty line. In this context, we aimed to measure and describe the causes of infant mortality and, because French Guiana is a French territory, to compare them with mainland France. METHODS National death certificate data between 2001 and 2017 was used. RESULTS Overall, 6.9 % of deaths before 65 years concerned infants <1 year (in mainland France 2.6%). The infant mortality rate over the 2001-2017 period was 2.6 times that of mainland France (1159.5 vs 446.2 per 100,000 infants <1 year) with excess incidence in perinatal causes, malformations and chromosomal anomalies, accidents, infectious causes, and in poorly defined conditions. Over time, there seemed to be a reduction of infant mortality for all the main causes, except for congenital malformations and chromosomal anomalies, which, on the contrary, seemed to increase. The data sources did not allow to study the weight of social factors or place of residence. CONCLUSIONS All causes of infant mortality seemed to decline over time except malformations and chromosomal anomalies, which increased. Although exposure to heavy metals, infectious diseases are potential explanations we cannot pinpoint the cause of this increase with the available data. The present results suggest infant mortality and malformations should benefit from more detailed data sources in order to better assess and alleviate the burden of infant mortality in French Guiana.
Collapse
Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Université de Guyane, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France.
| | - Célia Basurko
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Université de Guyane, 97300 Cayenne, French Guiana, France
| | - Gabriel Bafunyembaka Muhigirwa
- Amazonian Infrastructures for Population Health, French Guiana, France; Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
| | - Véronique Lambert
- Amazonian Infrastructures for Population Health, French Guiana, France; Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
| | - Lindsay Osei
- Protection Maternelle et Infantile, 97300 Cayenne, French Guiana, France
| | - Falucar Njuieyon
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France
| | - Alphonse Louis
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France
| | - Dominique Dotou
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France
| | - Nadia Thomas
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France
| | | | - Malika Leneuve
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France
| | - Narcisse Elenga
- CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana, France; Université de Guyane, 97300 Cayenne, French Guiana, France; Amazonian Infrastructures for Population Health, French Guiana, France
| | - Najeh Hcini
- Amazonian Infrastructures for Population Health, French Guiana, France; Western French Guiana Hospital, Saint Laurent du Maroni, 97320, French Guiana, France
| |
Collapse
|
4
|
Nacher M, Basurko C, Douine M, Lambert Y, Hcini N, Elenga N, Le Turnier P, Epelboin L, Djossou F, Couppié P, de Toffol B, Drak Alsibai K, Sabbah N, Adenis A. The Epidemiologic Transition in French Guiana: Secular Trends and Setbacks, and Comparisons with Continental France and South American Countries. Trop Med Infect Dis 2023; 8:tropicalmed8040219. [PMID: 37104345 PMCID: PMC10143289 DOI: 10.3390/tropicalmed8040219] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 04/28/2023] Open
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.
Collapse
Affiliation(s)
- Mathieu Nacher
- Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Département Formation Recherche, Université de Guyane, Campus de Troubiran, 97300 Cayenne, French Guiana
| | - Célia Basurko
- Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
| | - Maylis Douine
- Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
| | - Yann Lambert
- Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
| | - Najeh Hcini
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de l'Ouest Guyanais, 97320 Saint Laurent du Maroni, French Guiana
| | - Narcisse Elenga
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Pédiatrie, 97300 Cayenne, French Guiana
| | - Paul Le Turnier
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Service des Maladies Infectieuses et Tropicales, 97300 Cayenne, French Guiana
| | - Loïc Epelboin
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Service des Maladies Infectieuses et Tropicales, 97300 Cayenne, French Guiana
| | - Félix Djossou
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Service des Maladies Infectieuses et Tropicales, 97300 Cayenne, French Guiana
| | - Pierre Couppié
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Service de Dermatologie, 97300 Cayenne, French Guiana
| | - Bertrand de Toffol
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Service de Neurologie, 97300 Cayenne, French Guiana
| | - Kinan Drak Alsibai
- Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
| | - Nadia Sabbah
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Centre Hospitalier de Cayenne, Service d'Endocrinologie Diabétologie, 97300 Cayenne, French Guiana
| | - Antoine Adenis
- Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana
- Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana
- Département Formation Recherche, Université de Guyane, Campus de Troubiran, 97300 Cayenne, French Guiana
| |
Collapse
|
5
|
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]
|
6
|
Leménager P, Franck YK, Corlin F, Bouscaren N, Nacher M, Adenis A. Aetiological and morphological spectrum of cardiomyopathies in French Guiana: a retrospective study. Open Heart 2020; 7:openhrt-2019-001206. [PMID: 32404486 PMCID: PMC7228657 DOI: 10.1136/openhrt-2019-001206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/18/2020] [Accepted: 04/13/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Cardiomyopathies are a heterogeneous heart diseases group in terms of morphology and aetiology. Hypothesising a tropical specificity and given an absence of data in French Guiana, the primary objective of our study was to describe morphologies and aetiologies of cardiomyopathies observed at Cayenne General Hospital. Methods A cross-sectional study was conducted in Cayenne Hospital from 1 January 2009 to 1 June 2014 in the hospital database. Only patients with the definition of the European Society of Cardiology (ESC) were included, based on the first transthoracic ultrasonography found during the study period. Medical files were consulted. Results With 182 patients included, the prevalence of cardiomyopathies among heart diseases was estimated at 4.3% (95% CI 3.7% to 4.9%). Twelve patients had a familial or genetic aetiology (6.6%) and 170 a non-familial or non-genetic aetiology (93.4%). The morphological spectrum was: dilated for 114 patients (62.6%), hypertrophic for 27 (14.8%), unclassified for 1 (0.5%) and non-classifiable for 13 (7.1%). This group was constituted of patients with a systolic and/or diastolic functional impairment without morphological abnormality. The aetiological spectrum found 184 aetiologies including: 70.9% undetermined, 8.7% infectious (with 6.5% chagasic and 0.5% related with human immunodeficiency virus) and 6.0% with toxins. Conclusions Cardiomyopthies are a common and severe clinical problem. The frequency of infectious aetiologies and dilated impairment are arguments for cardiomyopathies with tropical particularities. However, the preponderance of undetermined aetiologies justifies the development of further research programmes.
Collapse
Affiliation(s)
- Paul Leménager
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| | - Yves-Kenol Franck
- Service de Cardiologie, Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| | - Florine Corlin
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| | - Nicolas Bouscaren
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon, Cayenne, French Guiana
| |
Collapse
|