Équipe Mobile Santé Environnement, Croix-Rouge française, Cayenne, French Guiana.
Santé publique France, Cayenne, French Guiana.
Front Public Health. 2024 Jun 25;12:1364229. doi: 10.3389/fpubh.2024.1364229. eCollection 2024.
In 2022, four severe cases of Hantavirus pulmonary syndrome (HPS) were reported in patients from informal settlements around Cayenne, the main city in French Guiana. Regional Health Agency (RHA) was commissioned by the French Public Health Agency to estimate the seroprevalence of Hantavirus infections in the neighborhoods of confirmed cases of HPS. RHA then commissioned the French Red Cross (FRC) mobile public health team, providing support in environmental health issues to the population living in informal settlements by health mediators, to facilitate the investigation. The objective of this study was to describe the health mediators' activities set up to improve the efficiency of the investigation.
The health mediators' team was specifically trained by virologist and infectiologist specialized in HPS. They helped the investigating team and health workers at various steps of the investigation. These interventions are then described in the results section.
The investigation took place between Nov. 2022 and March 2023 in three neighborhoods. During the pre-investigation activities, the mediators raised awareness about HPS of 343 people, among whom 319 (93%) planned to participate in the investigation. Altogether, 274 people finally participated in the investigation, including, i.e., 30.8% of the estimated population living in the three concerned settlements. The global proportion of patients with positive IgG anti-Hantavirus was 5.1%. The health mediators team supported the following steps: preliminary meetings and training modules, identification of resource persons, field visits and awareness and information campaigns (pre-investigation); on field data collection in informal settlements (per-investigation) and communication of individual results, public feedback meeting (post-investigation).
DISCUSSION/CONCLUSION: The involvement of mediators was probably a factor in the success of the public health response to socially vulnerable people living in the investigated neighborhoods. The preliminary prevention activities helped to raise awareness of the health risk and to enroll participants. Health mediation and outreach activities seem relevant tools of epidemiological field investigations in diseases affecting inhabitants of informal settlements.
2022 年，在法属圭亚那首府卡宴附近的非正规住区报告了四起严重的汉坦病毒肺综合征（HPS）病例。区域卫生局（RHA）受法国公共卫生署委托，估计 HPS 确诊病例所在社区汉坦病毒感染的血清流行率。RHA 随后委托法国红十字会（FRC）流动公共卫生小组，通过卫生中介为居住在非正规住区的居民提供环境卫生问题支持，以促进调查。本研究的目的是描述为提高调查效率而设立的卫生中介的活动。
卫生中介小组由专门研究 HPS 的病毒学家和传染病专家进行了专门培训。他们在调查的各个阶段为调查小组和卫生工作者提供帮助。这些干预措施在结果部分进行了描述。
调查于 2022 年 11 月至 2023 年 3 月在三个街区进行。在调查前活动期间，调解人提高了 343 人的 HPS 意识，其中 319 人（93%）计划参与调查。共有 274 人最终参与了调查，包括居住在三个相关住区的估计人口的 30.8%。抗汉坦病毒 IgG 阳性患者的总比例为 5.1%。卫生中介小组支持了以下步骤：初步会议和培训模块、确定资源人员、实地访问以及宣传和信息运动（调查前）；在非正规住区进行现场数据收集（调查中）和个人结果的交流、公共反馈会议（调查后）。
讨论/结论：调解人的参与可能是对居住在调查街区的弱势人群进行公共卫生应对的成功因素之一。初步预防活动有助于提高健康风险意识并招募参与者。卫生调解和外展活动似乎是影响非正规住区居民疾病的流行病学现场调查的相关工具。
