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Background To understand how local ecological knowledge changes and adapts, here in the case of the recent introduction of plant species, we report the knowledge and perceptions of the Ndjuka (Maroon) of French Guiana concerning two tree species, Acacia mangium and niaouli ( Melaleuca quinquenervia ), which are categorized as “invasive alien plants” in the savannas of their territory. Methods To this end, semi-structured interviews were conducted between April and July 2022, using a pre-designed questionnaire, plant samples and photographs. The uses, local ecological knowledge, and representations of these species were surveyed among populations of Maroon origin in western French Guiana. All responses to closed questions collected during the field survey were compiled into an Excel spreadsheet in order to perform quantitative analyses, including the calculation of use reports (URs). Results It appears that the local populations have integrated these two plant species, which are named, used and even traded, into their knowledge systems. On the other hand, neither foreignness nor invasiveness seem to be relevant concepts in the perspective of the informants. The usefulness of these plants is the determining factor of their integration into the Ndjuka medicinal flora, thus resulting in the adaptation of their local ecological knowledge. Conclusion In addition to highlighting the need for the integration of the discourse of local stakeholders into the management of \"invasive alien species,” this study also allows us to observe the forms of adaptation that are set in motion by the arrival of a new species, particularly within populations that are themselves the result of recent migrations. Our results furthermore indicate that such adaptations of local ecological knowledge can occur very quickly.

French Guiana, an overseas territory located in the Guiana Shield in South America, faces unique social and demographic challenges, particularly in relation to migration. Haitians represent 1 of the 3 largest foreign communities in the region and face specific barriers to health care access and prevention. They are also a population exposed to HIV infection. This Parcours d'Haïti study aims to update knowledge on the health of the Haitian population residing in French Guiana. From a quantitative standpoint, the primary objective of this study was to assess the frequency of sexual behaviors that expose Haitian individuals to HIV risk after arriving in French Guiana and explore the association of this risk with their living conditions. This study adopts a transdisciplinary approach to understand the broader determinants of health and the processes underlying HIV transmission. This mixed methods study involves a quantitative epidemiological and biographical analysis of Haitian individuals aged 18 to 60 years who have lived in French Guiana for more than 3 months. The biographical component uses a detailed grid that tracks key life events since birth. The qualitative component includes 3 substudies based on semistructured interviews and focus groups with Haitian people and health care professionals. These aim to deepen understanding of health care access, use of traditional and biomedical care, and mental health among Haitians. A phylogenetic component describes the distribution of clades of the Pol gene in the viruses of people living with HIV. The study materials were cocreated with local stakeholders. Recruitment of this partially hidden population used an innovative method involving all local actors and targeting key locations frequented by the Haitian community. Data collection and recruitment were carried out by Haitian Creole-speaking peer investigators (community health mediators). Over 20 months between 2021 and 2023, the Parcours d'Haïti study was implemented in French Guiana. Anticipated results suggest that the main reasons for migration include insecurity and fleeing violence. Upon arrival, Haitian people likely experience significant economic hardship and social isolation. Mental health deterioration is expected, with high rates of posttraumatic stress disorder. People living with HIV are expected to face heightened vulnerability compared to HIV-negative individuals even though they already struggle with precarious living conditions. The qualitative findings regarding health care use indicate that Haitian people encounter numerous barriers to accessing health care, such as administrative complexity, language, and financial and mobility issues. The anthropological results are expected to emphasize the magical-religious origins of HIV and the use of plants and traditional medicine for its treatment. Phylogenetic results are anticipated to show a high prevalence of Caribbean B HIV subtypes. The Parcours d'Haïti study aims to provide valuable insights into the health determinants and HIV-related risks in the Haitian population in French Guiana. These findings should help refine health care policies and practices to better meet the specific needs of this population. Trial Registration: ClinicalTrials.gov NCT05174234; https://clinicaltrials.gov/study/NCT05174234. DERR1-10.2196/63586.

Overview of infectious and non-infectious diseases in French Guiana in 2022Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue.Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana.Panorama des pathologies infectieuses et non infectieuses de Guyane en 2022Source de nombreux mythes, la Guyane représente un territoire exceptionnel par la richesse de sa biodiversité et par la variété des communautés qui la composent. Seul territoire européen en Amazonie, entouré du géant brésilien et du méconnu Suriname, on y lance des fusées Ariane 6 depuis Kourou tandis que 50 % de la population vit en dessous du seuil de pauvreté. Cette situation paradoxale est source de problématiques de santé spécifiques à ce territoire, qu’il s’agisse de maladies infectieuses à germes méconnus, d’intoxications, ou de pathologies chroniques.Certaines maladies infectieuses telles que la fièvre Q, la toxoplasmose, la cryptococcose ou l’infection à VIH sont communes aux pays tempérés, mais présentent en Guyane des spécificités entraînant une prise en charge et un raisonnement médical parfois différents. Parallèlement à ces pathologies, de nombreuses maladies tropicales sont par ailleurs présentes sur un mode endémique et / ou épidémique telles que le paludisme, la leishmaniose, la maladie de Chagas, l’histoplasmose ou la dengue.De plus, la dermatologie amazonienne est extrêmement variée, allant de pathologies rares, mais graves (ulcère de Buruli, lèpre), à d’autres fréquentes et bénignes telles que les poux d’agouti (acariens de la famille des Trombiculidae) ou la papillonite. Les envenimations par la faune sauvage ne sont pas rares, et méritent une prise en charge appropriée au taxon incriminé. Les pathologies obstétricale, cardiovasculaire et métabolique cosmopolites prennent parfois en Guyane une dimension particulière à prendre en compte dans la prise en charge des patients. Enfin, différents types d’intoxication sont à connaître par les praticiens, notamment aux métaux lourds.Les ressources de niveau européen offrent des possibilités diagnostiques et thérapeutiques inexistantes dans les pays et régions des environs, permettant ainsi la prise en charge de maladies peu connues ailleurs.Du fait de ces mêmes ressources de niveau européen, la recherche en Guyane occupe une place clé au sein de la région amazonienne, malgré une population moins nombreuse que dans les pays alentour. Ainsi, certaines pathologies telles que l’histoplasmose du patient immunodéprimé, la toxoplasmose amazonienne ou la fièvre Q ne sont pratiquement pas décrites dans les pays voisins, probablement du fait d’un sous-diagnostic lié à des ressources plus limitées. La Guyane joue ainsi un rôle moteur dans l’étude de ces pathologies.L’objectif de ce panorama est d’orienter les soignants venant ou exerçant en Guyane dans leur pratique quotidienne, mais également les praticiens prenant en charge des personnes au retour de Guyane.

La journée scientifique « Covid et société en Guyane et aux Antilles », qui s’est déroulée le 25 mars 2022 à Cayenne et en distanciel, est le fruit de la collaboration entre scientifiques et chercheurs issus de divers horizons académiques, et souhaitant donner un éclairage nouveau aux conséquences majeures de l’épidémie de Covid-19 dans les territoires français d’Amérique. Ainsi, soignants et chercheurs issus de l’ethnobotanique, de l’anthropologie, de l’épidémiologie, de la santé publique et de l’infectiologie ont réuni pour une journée scientifique exceptionnelle à Cayenne des intervenants en provenance de Guyane, Martinique, Guadeloupe et de l’Hexagone, avec une approche multidisciplinaire de l’épidémie de Covid-19 dans nos territoires. La session d’ouverture a été consacrée à l’épidémiologie, avec la présentation des données par Mme Luisiane Carvalho et le Dr Cyril Rousseau, épidémiologistes de Santé publique France Antenne Guyane sur l’épidémie de Covid-19 en Guyane, suivie d’une présentation de l’état des lieux du Covid-19 au CHU de Martinique par le Pr André Cabié, chef du service de Maladies infectieuses du dit hôpital, puis la présentation de l’étude sur la transmission du Covid-19 dans la population guyanaise par M. Claude Flamand, de l’équipe d’épidémiologie de l’Institut Pasteur de la Guyane, et enfin un exposé sur la mortalité hospitalière du Covid-19 en Guadeloupe par le Dr Bruno Jarrige, le directeur médical de crise de ce territoire. La seconde session était consacrée à l’ethnomédecine, avec une présentation de M. Marc-Alexandre Tareau, post-doctorant au laboratoire LEEISA du CNRS et de l’Université de Guyane, sur l’adaptation des médecines et des phytothérapies créoles guyanaises et haïtiennes face à l’émergence du Covid-19, suivie d’une présentation d’un travail mené à l’Institut Pasteur de la Guyane par la masteurante Mme Glwadys Forsans sur l’utilisation de la pharmacopée locale et l’hésitation vaccinale en Guyane et enfin une présentation par le Dr Emmanuel Nossin, pharmacien en Martinique, au sujet des plantes médicinales de la pharmacopée antillaise pouvant être associées à la lutte contre le Covid-19. La session suivante a été consacrée aux déterminants sociaux de l’hésitation vaccinale avec en introduction une présentation du Dr Amandine Gagneux-Brunon, infectiologue au CHU de Saint-Étienne, sur l’évolution de la perception de la vaccination suivie d’une présentation du Pr Loïc Epelboin, infectiologue au Centre hospitalier de Cayenne rappelant les enjeux politiques et sociétaux de l’épidémie de Covid-19 et l’arrivée du vaccin en Guyane, suivie d’une présentation de Mme le Pr Stéphanie Mulot, sociologue à l’Université Toulouse-Jean-Jaurès sur la politisation du rapport au Covid-19 et son vaccin en Guadeloupe, puis la présentation d’une étude sur l’hésitation vaccinale des soignants de Guyane par le Dr Nicolas Vignier, chercheur en épidémiologie au Centre d’investigation clinique du CH de Cayenne et enfin l’étude sur la caractérisation et le suivi des hésitations vaccinales dans la population guyanaise par M. Claude Flamand. Enfin la session qui a clôturé cette journée était consacrée à l’impact des périodes de confinement sur les modes de vie avec une première présentation par Mme Priscilla Thébaux, doctorante en anthropologie au LEEISA, de son travail sur l’accès à l’eau potable en temps de crise sanitaire en Guyane, suivie de la présentation de Mme Margot Schneider, masteurante au LEEISA et à l’Université Paris Cité, sur les conséquences de la syndémie sur la vie des habitants de Saint-Georges-de-l’Oyapock à la frontière franco-brésilienne, pour terminer avec la présentation de Mme Frédérique Groene, psychologue et chercheuse à l’Université de Guyane sur les indices psycho-sociétaux de l’épidémie de Covid-19 en Guyane. La journée a été conclue par les invitées d’honneur, Mme le Pr Stéphanie Mulot, sociologue à l’Université Toulouse-Jean-Jaurès et Mme le Pr France Roblot-Cazenave, présidente de la Société de pathologies infectieuses de langue française (SPILF), qui ont vanté l’originalité du concept du mélange des points de vue scientifiques à la croisée de la médecine, de l’épidémiologie et des sciences sociales sur la question du Covid-19, ainsi que la qualité et la variété des présentations. Une réflexion a été initiée sur la possibilité de reproduire et pérenniser ce concept original en proposant de nouvelles journées pour les années suivantes autour d’autres thématiques transdisciplinaires : VIH, maladies du péril fécal, maladies à transmission vectorielle, qui sait ?

To understand how local ecological knowledge changes and adapts, here in the case of the recent introduction of plant species, we report the knowledge and perceptions of the Ndjuka (Maroon) of French Guiana concerning two tree species, Acacia mangium and niaouli (Melaleuca quinquenervia), which are categorized as \"invasive alien plants\" in the savannas of their territory. To this end, semi-structured interviews were conducted between April and July 2022, using a pre-designed questionnaire, plant samples and photographs. The uses, local ecological knowledge, and representations of these species were surveyed among populations of Maroon origin in western French Guiana. All responses to closed questions collected during the field survey were compiled into an Excel spreadsheet in order to perform quantitative analyses, including the calculation of use reports (URs). It appears that the local populations have integrated these two plant species, which are named, used and even traded, into their knowledge systems. On the other hand, neither foreignness nor invasiveness seem to be relevant concepts in the perspective of the informants. The usefulness of these plants is the determining factor of their integration into the Ndjuka medicinal flora, thus resulting in the adaptation of their local ecological knowledge. In addition to highlighting the need for the integration of the discourse of local stakeholders into the management of \"invasive alien species,\" this study also allows us to observe the forms of adaptation that are set in motion by the arrival of a new species, particularly within populations that are themselves the result of recent migrations. Our results furthermore indicate that such adaptations of local ecological knowledge can occur very quickly.

Background French Guiana is characterized by a very multicultural population, made up of formerly settled groups (Amerindians, Maroons, Creoles) and more recent migrants (mostly from Latin America and the Caribbean). It is the ideal place to try to understand the influence of intercultural exchanges on the composition of medicinal floras and the evolution of phytotherapies under the effect of cross-culturalism. Methods A combination of qualitative and quantitative methods was used. Semi-directive interviews were conducted in 12 localities of French Guiana’s coast between January 2016 and June 2017, and the responses to all closed questions collected during the survey were computerized in an Excel spreadsheet to facilitate quantitative processing. Herbarium vouchers were collected and deposited at the Cayenne Herbarium to determine Linnaean names of medicinal species mentioned by the interviewees. A list of indicator species for each cultural group considered was adapted from community ecology to this ethnobiological context, according to the Dufrêne-Legendre model, via the “labdsv” package and the “indval” function, after performing a redundancy analysis (RDA). Results A total of 205 people, belonging to 15 distinct cultural groups, were interviewed using semi-structured questionnaires. A total of 356 species (for 106 botanical families) were cited. We observed that pantropical and edible species hold a special place in these pharmacopeias. If compared to previous inventories, 31 recently introduced species can be counted. Furthermore, this study shows that the majority of the plants used are not specific to a particular group but shared by many communities. However, despite this obvious cross-culturalism of medicinal plants between the different cultural communities of French Guiana, divergent trends nevertheless appear through the importance of 29 indicator/cultural keystone species in 10 cultural groups. Finally, we have emphasized that the transmission of herbal medicine’s knowledge in French Guiana is mainly feminine and intra-cultural. Conclusion French Guianese medicinal flora is undoubtedly related to the multiple cultures that settled this territory through the last centuries. Cultural pharmacopeias are more hybrid than sometimes expected, but cultural keystone species nevertheless arise from a common background, allowing to understand, and define, the relationships between cultural groups.

Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana.

Overview of infectious and non-infectious diseases in French Guiana in 2022 Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies. Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals. European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere. Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases. The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana. Panorama des pathologies infectieuses et non infectieuses de Guyane en 2022 Source de nombreux mythes, la Guyane représente un territoire exceptionnel par la richesse de sa biodiversité et par la variété des communautés qui la composent. Seul territoire européen en Amazonie, entouré du géant brésilien et du méconnu Suriname, on y lance des fusées Ariane 6 depuis Kourou tandis que 50 % de la population vit en dessous du seuil de pauvreté. Cette situation paradoxale est source de problématiques de santé spécifiques à ce territoire, qu’il s’agisse de maladies infectieuses à germes méconnus, d’intoxications, ou de pathologies chroniques. Certaines maladies infectieuses telles que la fièvre Q, la toxoplasmose, la cryptococcose ou l’infection à VIH sont communes aux pays tempérés, mais présentent en Guyane des spécificités entraînant une prise en charge et un raisonnement médical parfois différents. Parallèlement à ces pathologies, de nombreuses maladies tropicales sont par ailleurs présentes sur un mode endémique et / ou épidémique telles que le paludisme, la leishmaniose, la maladie de Chagas, l’histoplasmose ou la dengue. De plus, la dermatologie amazonienne est extrêmement variée, allant de pathologies rares, mais graves (ulcère de Buruli, lèpre), à d’autres fréquentes et bénignes telles que les poux d’agouti (acariens de la famille des Trombiculidae) ou la papillonite. Les envenimations par la faune sauvage ne sont pas rares, et méritent une prise en charge appropriée au taxon incriminé. Les pathologies obstétricale, cardiovasculaire et métabolique cosmopolites prennent parfois en Guyane une dimension particulière à prendre en compte dans la prise en charge des patients. Enfin, différents types d’intoxication sont à connaître par les praticiens, notamment aux métaux lourds. Les ressources de niveau européen offrent des possibilités diagnostiques et thérapeutiques inexistantes dans les pays et régions des environs, permettant ainsi la prise en charge de maladies peu connues ailleurs. Du fait de ces mêmes ressources de niveau européen, la recherche en Guyane occupe une place clé au sein de la région amazonienne, malgré une population moins nombreuse que dans les pays alentour. Ainsi, certaines pathologies telles que l’histoplasmose du patient immunodéprimé, la toxoplasmose amazonienne ou la fièvre Q ne sont pratiquement pas décrites dans les pays voisins, probablement du fait d’un sous-diagnostic lié à des ressources plus limitées. La Guyane joue ainsi un rôle moteur dans l’étude de ces pathologies. L’objectif de ce panorama est d’orienter les soignants venant ou exerçant en Guyane dans leur pratique quotidienne, mais également les praticiens prenant en charge des personnes au retour de Guyane. Overview of infectious and non-infectious diseases in French Guiana in 2022 Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies. Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals. European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere. Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases. The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana. Panorama des pathologies infectieuses et non infectieuses de Guyane en 2022 Source de nombreux mythes, la Guyane représente un territoire exceptionnel par la richesse de sa biodiversité et par la variété des communautés qui la composent. Seul territoire européen en Amazonie, entouré du géant brésilien et du méconnu Suriname, on y lance des fusées Ariane 6 depuis Kourou tandis que 50 % de la population vit en dessous du seuil de pauvreté. Cette situation paradoxale est source de problématiques de santé spécifiques à ce territoire, qu’il s’agisse de maladies infectieuses à germes méconnus, d’intoxications, ou de pathologies chroniques. Certaines maladies infectieuses telles que la fièvre Q, la toxoplasmose, la cryptococcose ou l’infection à VIH sont communes aux pays tempérés, mais présentent en Guyane des spécificités entraînant une prise en charge et un raisonnement médical parfois différents. Parallèlement à ces pathologies, de nombreuses maladies tropicales sont par ailleurs présentes sur un mode endémique et / ou épidémique telles que le paludisme, la leishmaniose, la maladie de Chagas, l’histoplasmose ou la dengue. De plus, la dermatologie amazonienne est extrêmement variée, allant de pathologies rares, mais graves (ulcère de Buruli, lèpre), à d’autres fréquentes et bénignes telles que les poux d’agouti (acariens de la famille des Trombiculidae) ou la papillonite. Les envenimations par la faune sauvage ne sont pas rares, et méritent une prise en charge appropriée au taxon incriminé. Les pathologies obstétricale, cardiovasculaire et métabolique cosmopolites prennent parfois en Guyane une dimension particulière à prendre en compte dans la prise en charge des patients. Enfin, différents types d’intoxication sont à connaître par les praticiens, notamment aux métaux lourds. Les ressources de niveau européen offrent des possibilités diagnostiques et thérapeutiques inexistantes dans les pays et régions des environs, permettant ainsi la prise en charge de maladies peu connues ailleurs. Du fait de ces mêmes ressources de niveau européen, la recherche en Guyane occupe une place clé au sein de la région amazonienne, malgré une population moins nombreuse que dans l