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MALARIA RISK FACTORS IN AMERINDIAN CHILDREN IN FRENCH GUIANA

Malaria is a major public health problem in French Guiana. This study was conducted in children <1–5 years of age in Camopi, an Amerindian village in eastern French Guiana. Medical, environmental, and behavioral predictive factors of malaria were studied using the Kaplan-Meier method and Cox modeling. Variables included were clearing vegetation around the home (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = 0.43–0.88 for 50–75% cleared and HR = 0.5, 95% CI = 0.31–0.81 for > 75% cleared) relative to homes surrounded by vegetation; distance of a home from a river (HR = 0.56, 95% CI = 0.37–0.85 for distances between 20 and 40 meters, HR = 0.72, 95% CI = 0.47–1.09 for distances between 40 and 80 meters, HR = 0.52, 95% CI = 0.28–0.94 for distances between 80 and 120 meters, and HR = 0.5, 95% CI = 0.30–0.86 for distances > 120 meters) relative to distances < 20 meters; the number of occupants in the home (HR = 1.54, 95% CI = 0.98–2.44 for 7 occupants, HR = 1.9, 95% CI = 1.29–2.81 for 8–11 occupants, and HR = 2.03, 95% CI = 1.27–3.23 for > 11 occupants); clothing (HR = 0.64, 95% CI = 0.46–0.90 for children wearing western-style clothes relative to those wearing the traditional kalimbe), and ethnicity (Wayampi children had a lower hazard of malaria relative to Emerillon children: HR = 0.55, 95% CI = 0.40–0.80). The environment near the home was strongly associated with malaria. This suggests that simple pragmatic protection measures would be useful in Camopi.

Received June 22, 2006. Accepted for publication October 31, 2006.

Acknowledgments: We the staff of the Health Center of Camopi, particularly Alain Maniglier, Anne Viaud, and Christelle Monnerville, for their assistance.

^* Address correspondence to Sarah Hustache, Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana. E-mail: sarah.hustache{at}yahoo.fr

Authors’ addresses: Sarah Hustache and Bernard Carme, Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana, E-mail: sarah.hustache{at}yahoo.fr. Mathieu Nacher, Centre d’Information et de Soins de l’Immunodéficience Humaine, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana. Félix Djossou, Départements des Centres de Santé, Centre Hospitalier de Cayenne, BP 6006, 97300 Cayenne, French Guiana.