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FRENCH GUIANA, FRANCE Figure 1 FRENCH GUIANA, FRANCE Figure 1. Malaria by Annual Parasite Index (API) at commune level (ADM2), French Guiana 2014 French Guiana is an overseas territory of France and is one of the only few malaria endemic areas under the French government (Figure 1). In 2014, French Guiana reported 448 confirmed cases of malaria and no recorded deaths (Figure 2). These figures are the lowest the territory has reported in decades. Overall, morbidity has decreased by 87.9% since 2000, achieving the WHA 58.2 target for MDG 6C. API Figure 2. Number of cases and deaths due to per 1,000Suriname people No cases malaria in French Guiana, 2000-2014 French Guiana ≤ 0.1 0.11 - 1 5,000 10 1.01 - 5 5.01 - 10 4,000 8 10.01 - 50 s e s 6 >50 a 3,000 s h f c t o ea 2,000 4 D ® 0 25 50 100 umber N Kilometers Longitude/Latitude Datum WGS84 Brazil 1,000 2 Source: PAHO/CHA/VT 0 0 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 site of Eau Claire located in the Maripasoula commune 200 200 200 200 200 200 200 200 200 200 201 201 201 201 201 found a 50% prevalence rate of malaria among miners, of which 40% of cases were asymptomatic (32). Malaria P. fa■lciparum & Mixed Con■firmed Cases ■ Deaths P. falciparum & mixed Confirmed cases Deaths transmission is reported not to occur in the coastal area though many cases are diagnosed there. Although The Guiana Shield is one of the richest mineral deposits information about malaria cases by locale of infection is in the world and is the site of legal and illegal gold mining. not available for all cases, information from the French Commune Department The area extends Aintoge g roupparts of French Guiana, Suriname, military posted in the interior of the country indicates Cayenne Cayenne 118 69 Guyana, Venezuela,104 Colombia, and Brazil. Many people that transmission along the Maroni and Oyapock rivers Maripasoula Saint Laurent du Maroni 66 290 migrate to77 the rainforest in50 +order to participate in mining (Figure 3), which form the borders with Suriname and Saint Georges* Cayenne 264 182 which is6 6an occupation linked to having a higher risk of Brazil, respectively, is lesser compared to the central Kourou Cayenne 58 54 malaria35 (31). A 2013 study conducted in the illegal mining interior part of the country. Saint-Laurent** Saint Laurent du Maroni 6 0 31 Figu15-49re 3 year. sCommunes with the highest malaria case by place Regina Cayenne 124 38 18 Figure 3.o Cf odmiamgnuonseis wini tFhr ethnech h Giguhieasnta m, 2a0la1r2ia- 2c0a1s4e by place Camopi Cayenne 66 46 Figure15 3. Communes withof the dia highestgnosis malariain Fre ncasesch G byuia placena, 2 of0 1diagnosis2-2014 in French Guiana, 2012-2014 Roura Cayenne 18 6 C9ommune De5-14par yeartmsent Remire-Montjoly Cayenne 26 15 C7aoymenmnuene CDaeypeanrntme ent 118 69 104 118 69 104 Papaichton Saint Laurent du Maroni 6 26 MC3ayriepnanseoula SCaiynet nLnaeurent du Maroni 66 290 77 SMaairnipt aGseoourlgaes* CSaiynet nLnaeurent du Maroni 66 264 182 290 6767 0 100 200 300 0 100 200 300 0 50 100 Under 5 Decrease Increase Saint Georges* Cayenne 264 182 66 2012 2013 Kourou2014 Cayenne 58 54 35 Insufficient data/No change Kourou Cayenne 6 58 0 54 3315 Data was unaSavianiltab-Llea fuorr 2014ent*.* Saint Laurent du Maroni 0 50 100 150 200 250 *Saint GeorgeRSaeisgn (deitn-aL l'Oyauaporenck)t** CSaiynet nLnaeurent du Maroni 6 124 0 38 1381 **Saint-Laurent (du Maroni) Confirmed cases CRaemginoapi Cayenne 66 124 3486 158 RCoaumroapi Cayenne 18 66 6 46 915 Roura Cayenne 18 6 9 67 Remire-Montjoly Cayenne 26 15 7 PRaepmaiirceh-Mtoonntjoly SCaiynet nLnaeurent du Maroni 626 1256 37 Papaichton Saint Laurent du Maroni 6 26 3 Decrease Increase 0 100 200 300 0 100 200 300 0 100 200 300 Decrease Increase 0 100 200 300 0 100 200 300 0 100 200 300 Insufficient data/No change 2012 2013 2014 Insufficient data/No change 2012 2013 2014 Data was unavailable for 2014. D*Sataain wt aGse uonrgaevsa i(ladbel el'O foyra 2p0o1ck4). *Sa*i*nSt aGineto-Lrgaeusre (ndte ( dl'Ou yMaaproocnki) **Saint-Laurent (du Maroni) - 65 - 5,000 10 4,000 8 s e s 6 a 3,000 s h f c t o ea 2,000 4 D umber N 1,000 2 0 0 9 0 5 6 8 1 2 3 4 7 3 4 0 1 2 200 200 200 200 200 201 201 200 200 200 200 200 201 201 201 P. falciparum & Mixed Confirmed Cases Deaths Figure 4. Malaria cases by age in French Guiana, out with RDTs used by community health workers who 2014 do not pose a threat to illegal miners. Interventions have been successful and as a result Suriname has been able Commune Department Age group to provide access to diagnosis and treatment to many Cayenne Cayenne 118 69 104 illegal miners. Under French law, only certified health Maripasoula Saint Laurent du Maroni 66 290 77 50+ professionals are allowed to perform RDTs and prescribe Saint Georges* Cayenne 264 182 66 treatment, which means interventions like these are not Kourou Cayenne 58 54 35 possible (34). Saint-Laurent** Saint Laurent du Maroni 6 0 31 15-49 years Medication is usually obtained across borders where 124 38 18 Regina Cayenne it is then partially consumed and the rest is sold back Camopi Cayenne 66 46 15 in the mining sites in exchange for gold. Monotherapy Roura Cayenne 18 6 9 5-14 years of artemisinin derivatives is available from illegal Remire-Montjoly Cayenne 26 15 7 pharmacies in mining areas throughout most of the Papaichton Saint Laurent du Maroni 6 26 3 Guiana Shield. Self-medication is common in mining sites, especially illegal ones, and often incomplete; this 0 100 200 300 0 100 200 300 0 50 100 Under 5 Decrease Increase could possibly lead to development of parasite resistance 2012 2013 2014 to artemisinin. Other populations at risk are those that Insufficient data/No change Data was unavailable for 2014. live along the rivers and in forest areas. 0 50 100 150 200 250 *Saint Georges (de l'Oyapock) **Saint-Laurent (du Maroni) Confirmed cases 67 Efforts to reduce malaria incidence in Suriname have Figure 5. Blood slides examined and SPR in benefitted French Guiana particularly during the French Guiana, 2000-2014 “Looking for gold, finding malaria” project funded by the Global Fund. There has been a decrease in cases along the border with Suriname because of this project. However, 50,000 15% French Guiana must still reinforce these interventions 40,000 12% R) P d S ( within its borders. Plans to coordinate efforts among e n e i 530,000 915%% t a countries in the Guiana Shield are forthcoming. m a x e 40,000 12% e l 20,000 6% R) P sitivity R op d o S The principal malaria vector isAn. darlingi. However, e ( e P P n e i e 30,000 9% t d a the previously mentioned study in Eau Claire found m 10,000 3% a Sli x e An. nuneztovari and An. ininii to be naturally infected e l 20,0000 06% sitivity R op 0 1 2 3 4 5 6 7 8 9 0 1 2 3 4 with Plasmodium species in the mining area with the o e 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 P P 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 e 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 former present in high numbers (32). Another study 10,000 3% d found Anopheles (Anopheles) intermedius Peryassu, Blood Slides Examined SPR(%) Sli 0 0% 1 4 5 6 7 8 An. (Nyssorhynchus) nuneztovari Gabaldon, and An. 0 2 3 9 0 1 3 4 2 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 (Nys.) oswaldoi Peryassu to be naturally infected with 2 2 2 2 Plasmodium species in the country (33). In 2014, FigureBlood 6.Slid eNumbers Examined of malariaSPR(%) cases and those 33% of cases were caused by P. falciparum and mixed treated with first-line treatment in French Guiana, infections. In French Guiana, Pf/PAN RDTs are used 2000-20145,000 First-line treatments especially in the interiors which results in P. vivax mono- Confirmed Cases 4,000 le infections and mixed infections diagnosed as “other op pe 3,000 positive RDTs” when RDTs are the only used method of f o 5,000 First-line treatments r malaria diagnosis. Information regarding malaria cases be 2,000 Confirmed Cases m 4,000 u le by sex is not reported. Those between the ages of 15-49 N op 1,000 pe 3,000 are the most affected by malaria (Figure 4). f o r 0 be 0 2 1 3 6 9 4 7 5 8 4 0 2,000 1 2 3 1 0 0 0 1 0 0 0 0 0 0 1 1 1 0 m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Priority Groups u 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 N 1,000 Miners in remote areas have difficulty accessing *First-line treatment data is unavailable for 2000-2014.
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