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Etude des déterminants du paludisme chez les militaires français déployés en Guyane dans le cadre de la lutte contre l’orpaillage illégal

Abstract : Since 2002, French armed forces are involved in operations against illegal gold mining in French Guiana. Despite a properly dimensioned prevention program against malaria conducted, a drastic increase of malaria incidence has been observed among military personnel. The first part of this thesis aimed to describe the determinants of malaria in French Guiana forest, including human, vector and parasite features. We have established the link between malaria among military personnel and illegal gold mining sites. A study conducted among gold miners’ population has shown hyperendemic malaria foci in the rain forest, mainly due to P. falciparum, and highlighted a real risk for emergence of artemisinin resistance. Entomologic investigations supported that Anopheles darlingi is the main vector for malaria in rain forest. In addition, we have demonstrated the existence of daytime biting activity by An. darlingi in the forest, which might play a key role in malaria epidemic outbreaks among military personnel. Other sylvatic vectors were identified, as An. nuneztovari and An. triannulatus, but especially An. ininii and An. marajoara. The second part of the thesis, focused on a prospective cohort study conducted among French military population, highlighted real malaria exposure using serological tools. Serological evidences of Plasmodium infection (SEI) were more frequent for P. falciparum than P. vivax, in agreement with our findings in illegal gold miners’ population. SEI incidence rates were high, around 40 per 100 person-years for P. falciparum and P. vivax. Only complete compliance to malaria chemoprophylaxis using daily 100 mg doxycycline protected against malaria infection.
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  • HAL Id : tel-01831945, version 1

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Vincent Pommier de Santi. Etude des déterminants du paludisme chez les militaires français déployés en Guyane dans le cadre de la lutte contre l’orpaillage illégal. Médecine humaine et pathologie. Université de Guyane, 2017. Français. ⟨NNT : 2017YANE0008⟩. ⟨tel-01831945⟩

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