The Epidemiologic Transition in French Guiana: Secular Trends and Setbacks, and Comparisons with Continental France and South American Countries

Author:

Nacher Mathieu123ORCID,Basurko Célia12,Douine Maylis12ORCID,Lambert Yann12,Hcini Najeh24ORCID,Elenga Narcisse25,Le Turnier Paul26,Epelboin Loïc26,Djossou Félix26,Couppié Pierre27,de Toffol Bertrand28,Drak Alsibai Kinan12,Sabbah Nadia29ORCID,Adenis Antoine123ORCID

Affiliation:

1. Centre Hospitalier de Cayenne, CIC INSERM 1424, 97300 Cayenne, French Guiana

2. Amazonian Infrastructures for Population Health, 97300 Cayenne, French Guiana

3. Département Formation Recherche, Université de Guyane, Campus de Troubiran, 97300 Cayenne, French Guiana

4. Centre Hospitalier de l’Ouest Guyanais, 97320 Saint Laurent du Maroni, French Guiana

5. Centre Hospitalier de Cayenne, Pédiatrie, 97300 Cayenne, French Guiana

6. Centre Hospitalier de Cayenne, Service des Maladies Infectieuses et Tropicales, 97300 Cayenne, French Guiana

7. Centre Hospitalier de Cayenne, Service de Dermatologie, 97300 Cayenne, French Guiana

8. Centre Hospitalier de Cayenne, Service de Neurologie, 97300 Cayenne, French Guiana

9. Centre Hospitalier de Cayenne, Service d’Endocrinologie Diabétologie, 97300 Cayenne, French Guiana

Abstract

There are great variations between population subgroups, notably in poorer countries, leading to substantial inconsistencies with those predicted by the classical epidemiologic transition theory. In this context, using public data, we aimed to determine how the singular case of French Guiana fit and transitioned in the epidemiologic transition framework. The data show a gradual decline in infant mortality to values above 8 per 1000 live births. Premature mortality rates were greater but declined more rapidly in French Guiana than in mainland France until 2017 when they reascended in a context of political turmoil followed by the COVID-19 pandemic and strong reluctance to get vaccinated. Although infections were a more frequent cause of death in French Guiana, there is a marked decline and circulatory and metabolic causes are major causes of premature death. Fertility rates remain high (>3 live births per woman), and the age structure of the population is still pyramid-shaped. The singularities of French Guiana (rich country, universal health system, widespread poverty) explain why its transition does not fit neatly within the usual stages of transition. Beyond gradual improvements in secular trends, the data also suggest that political turmoil and fake news may have detrimentally affected mortality in French Guiana and reversed improving trends.

Publisher

MDPI AG

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,General Immunology and Microbiology

Reference28 articles.

1. The Epidemiologic Transition: Changing Patterns of Mortality and Population Dynamics;McKeown;Am. J. Lifestyle Med.,2009

2. The Development and Experience of Epidemiological Transition Theory over Four Decades: A Systematic Review;Santosa;Glob. Health Action,2014

3. Zéphirin, R. (2020). Political Demography and Urban Governance in French Guyana: Implications for Latin America and the Caribbean, Springer.

4. Renouncing Care in French Guiana: The National Health Barometer Survey;Cropet;BMC Health Serv. Res.,2019

5. (2022, November 15). Our World in Data. Available online: https://ourworldindata.org.

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