Investigation of a possible malaria epidemic in an illegal gold mine in French Guiana: an original approach in the remote Amazonian forest
Investigation of a possible malaria epidemic in an illegal gold mine in French Guiana: an original approach in the remote Amazonian forest
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DOI：
10.1186/s12936-019-2721-2
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发表时间：
2019-03-22
期刊：
影响因子：
3
通讯作者：
De Laval, Franck
中科院分区：
文献类型：
--
作者：
Douine, Maylis;Sanna, Alice;De Laval, Franck
背景：2017年4月，苏里南卫生部向法属圭亚那地区卫生局（RHA）发出警报，称来自位于亚马逊森林的法属海外领地法属圭亚那一个名为索菲（Sophie）的非法金矿点的输入性疟疾病例有所增加。 方法：由于索菲的安全问题和地处偏远，RHA请求法国武装部队配合开展流行病学调查。直升机运送了一支医疗队和六名士兵，以确保任务的安全。 结果：在调查过程中，46 人中诊断出两例疟疾发作。其中 26 例来自索菲，那里 PCR 疟原虫流行率估计为 60% (15/26)。这一结果与之前的研究一致，即金矿工人中疟疾流行率很高。苏里南输入性病例的增加可能是由于在法国军队加强镇压非法采矿的背景下，金矿开采利润下降，获得非处方抗疟疾药物的机会减少，以及金矿开采者向苏里南移民的人数增加。结论：对可疑疟疾流行病的调查证实了疟疾在非法金矿开采者中的重要性。他们沿着圭亚那地盾的流动性和寻求健康的行为可能会在那些正在大力抗击这种疾病的人群中传播疟疾。在这一人群中抗击疟疾仍然比以往任何时候都更加重要。目前正在进行一项试点研究（Malakit 项目），以评估自我诊断和自我治疗套件的功效。
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.