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Master Thesis

Suivi pédiatrique des enfants des communes « de l'intérieur » de la Guyane : description de 9 ans de consultations

Abstract : Introduction: French Guiana has the particularity of having isolated villages, accessible only by air or pathway river. People there are mainly Native Indians or Maroon Blacks. In these villages, the supply of care is served by the Delocalized Centers of Prevention and Care (CDPS). Some specialists, including pediatricians, regularly go there for consultations. The main objective of our study was to provide an epidemiological description of childhood pathologies that required follow-up or at least one consultation by pediatricians in CDPS between 2011 and 2019. Material and method: We made descriptive, retrospective, multicenter epidemiological study of consultations by pediatricians in health centers in Guiana between January 1, 2011 and December 31, 2019. Results: A total of 1779 patients were analyzed. In 2011, at the beginning of pediatric missions, 91 patients had at least one consultation with a pediatrician while 319 patients were followed by a pediatrician in the CDPS in 2019. 62% of pediatric consultations are one-off consultations. 23 deaths were recorded between 2011 and 2019 which represent 1.4% of the followed children. 164 patients were lost to follow-up. The most frequently found pathologies are cardiological and infectious causes, developmental delays, prematurity and genetic pathologies, including sickle cell disease. Discussion: This study shows that the rate of children followed by pediatricians on assignment in the CDPS is high: due to INSEE data from 2017, we estimate that 7.1% of the population 0-14 years of Maripasoula is followed for a chronic pathology. Genetic or congenital pathologies are the 5th reason for specialist consultation in pediatrics in the CDPS. We have shown that there is a significantly higher risk of developing major sickle cell syndrome in Maroni than in Oyapock (p = 0.0001). This is completely related to the ethnic origin of the populations, mostly Maroon Blacks on the Maroni and Native Indian on the Oyapock, and to the knowledge of the genes of major sickle cell syndromes. Socio-medical care for patients with Down's syndrome appears to be significantly lower than that expected in France. Concerning the height-weight and language delays, they are significantly more numerous at Camopi with respectively p = 0.0001 and p = 0.008. Lead poisoning could be a factor explaining this difference. Congenital heart disease is also common in Guiana. We have shown with these data the importance of specialized consultations in isolated villages.
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https://dumas.ccsd.cnrs.fr/dumas-03344227
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Submitted on : Tuesday, September 14, 2021 - 5:30:31 PM
Last modification on : Tuesday, February 8, 2022 - 3:37:57 AM

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Laure Jouan. Suivi pédiatrique des enfants des communes « de l'intérieur » de la Guyane : description de 9 ans de consultations. Pédiatrie. 2020. ⟨dumas-03344227⟩

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