Isolation of Leishmania species from wild mammals in French Guiana.

Between 1981 and 1987, 486 wild mammals collected from 13 sites in French Guiana were examined for Leishmania. Eleven of 31 two-toed sloths, Choloepus didactylus, were infected, 4 of the isolates being identified as L. braziliensis guyanensis. This species was also found in 2 Didelphis marsupialis and 2 Proechimys sp. L. mexicana amazonensis was isolated from 3 Proechimys sp., 2 of which were P. cuvieri. The role of these mammals in the life cycles of the 2 anthropotropic species of Leishmania encountered in French Guiana is discussed.

Epidemiological aspects of human cutaneous leishmaniasis in French Guiana.

A follow-up study of 219 patients infected with parasitologically confirmed cutaneous leishmaniasis in French Guiana was made between 1981 and 1987. Cutaneous leishmaniasis appeared to be common in young male adults entering the forest for professional activities (84.2% of the cases). The lesions were generally of the classical ulcerative type. They were limited to the skin and preferentially located on the legs and forearms (20.7% and 19.8% respectively). Most of the cases (86.6%) represented primary infections, but 6.8% had a recurrent lesion at the site of an old, previously cured lesion.

[Malaria in Guiana. I. General status of the endemic]. / Le paludisme en Guyane. I. Situation générale de l'endémie.

Before 1949 malaria was highly prevalent in the whole territory of French Guiana. When malaria control based on house-spraying and drug prophylaxis was implemented in 1950 the disease sharply dropped below 20 cases per year. Since 1976 despite vector control malaria is rising again. In 1987, 3,269 cases have been notified giving an incidence of 37.6 per thousand for the whole country population; only four deaths were recorded. All the age groups were concerned but the transmission was restricted to some foci along the Oyapock river (prevalence rate 25%), along the Maroni river (prevalence 2.3%) and in a few places of the coastal area. The main cities remain malaria free. In vivo resistance to chloroquine was observed in 22% of the cases which could be cleared by amodiaquine or quinine.

[Malaria in Guiana. II. The characteristics of different foci and antimalarial control]. / Le paludisme en Guyane. II. Les caractéristiques des différents foyers et la lutte antipaludique.

In French Guiana, the distribution of malaria in foci inhabited by quite different ethnic groups calls for specific studies. Along the Oyapock on the Brasilian border and along the Litani on the Surinam border, incidence among American Indians and Creoles ranges from 300 and 900 per thousand; Plasmodium falciparum accounts for 65% and P. vivax for 35%. Along the middle and lower Maroni on the Surinam border, the Boni and Ndjukas Negroes move freely through the frontier and since the civil strife Surinamese used to attend health centres of Guiana. Therefore it is difficult to find the sources of contamination and the incidence among French citizens; P. falciparum is the only parasite recorded in this focus. In 1987 a small outbreak mainly due to P. vivax, occurred in a Lao refugees village in the hinterland. The coastal foci harbour large communities of Haitian and Brazilian migrants. The vector is Anopheles darlingi and up to now there is no evidence that other species could be involved. The rise of malaria despite of control measures involves several factors: the house spraying is no more accepted by a large percentage of house holders and the alternative larviciding has only a limited efficacy; the houses of American Indians have no walls to be sprayed; there is a continuous introduction of parasites by migrants. It has been said that vectors have change their behaviour toward exophily but such a statement has not yet been supported by evidence. All these factors should be taken in account to improve malaria control.