A Late Pleistocene coastal ecosystem in French Guiana was hyperdiverse relative to today.

Warmer temperatures and higher sea level than today characterized the Last Interglacial interval [Pleistocene, 128 to 116 thousand years ago (ka)]. This period is a remarkable deep-time analog for temperature and sea-level conditions as projected for 2100 AD, yet there has been no evidence of fossil assemblages in the equatorial Atlantic. Here, we report foraminifer, metazoan (mollusks, bony fish, bryozoans, decapods, and sharks among others), and plant communities of coastal tropical marine and mangrove affinities, dating precisely from a ca. 130 to 115 ka time interval near the Equator, at Kourou, in French Guiana. These communities include ca. 230 recent species, some being endangered today and/or first recorded as fossils. The hyperdiverse Kourou mollusk assemblage suggests stronger affinities between Guianese and Caribbean coastal waters by the Last Interglacial than today, questioning the structuring role of the Amazon Plume on tropical Western Atlantic communities at the time. Grassland-dominated pollen, phytoliths, and charcoals from younger deposits in the same sections attest to a marine retreat and dryer conditions during the onset of the last glacial (ca. 110 to 50 ka), with a savanna-dominated landscape and episodes of fire. Charcoals from the last millennia suggest human presence in a mosaic of modern-like continental habitats. Our results provide key information about the ecology and biogeography of pristine Pleistocene tropical coastal ecosystems, especially relevant regarding the-widely anthropogenic-ongoing global warming.

Health professionals and Amerindian patients: representations and practices in French Guiana / Professionnels de santé et patients amérindiens : représentations et pratiques en Guyane française

CONTEXT: In French Guiana, Amerindian populations find themselves in a health system whose therapeutic itinerary revolves around their traditional medicine and modern medicine provided by health professionals mostly from hexagonal France. The latter intervene in a “complexity of intercultural contact” which influences the caregiver-patient relationship and affects therapeutic adherence. METHOD: To better understand the practices and representations of the health system in an intercultural context, qualitative research was carried out in the field between 2018 and 2019 with seventeen health professionals working in health centers located in the municipalities of the Interior of French Guiana. Semi-structured individual interviews were conducted in order to explore the representations, the difficulties encountered, and the tools used by these caregivers in their daily practice. These interviews were crossed with participant observations and bibliographical research in the medical and anthropological fields. RESULTS: The caregiver-patient encounter was asymmetrical, unequal and was part of a power relationship. The caregivers remained marked by ethnocentric representations -inherent to each culture- far removed from those of the populations and this divergence impacted the practice. DISCUSSION: It would be advisable to shift the focus in order to « penetrate » the frame of reference of the Other and rebalance relationships. The exploration of popular knowledge and skills and the application of proven teaching methods would encourage therapeutic adherence. « Homethnic workers » and intercultural training could help promote community health.

Contexte: En Guyane française, les populations amérindiennes se retrouvent dans un système de santé dont l'itinéraire thérapeutique s'articule autour de leur médecine traditionnelle et d'une médecine moderne prodiguée par des professionnels de santé originaires, pour la plupart, de la France hexagonale. Ces derniers interviennent dans une « complexité de contact interculturel ¼ qui influence la relation soignant soigné et affecte l'adhésion thérapeutique. Méthode: Pour mieux comprendre les représentations et pratiques du système de santé en contexte interculturel, une recherche qualitative a été menée sur le terrain, en 2018 et 2019, auprès de dix-sept professionnels de santé exerçant dans les centres de santé situés dans les communes de l'Intérieur de la Guyane. Des entretiens individuels semi-structurés ont été menés afin d'explorer les représentations, les difficultés rencontrées et les outils mobilisés par ces soignants dans leur pratique courante. Ces entretiens ont été croisés avec des observations participantes et des recherches bibliographiques dans les champs médicaux et anthropologiques. Résultats: La rencontre soignant soigné était asymétrique, inégale et s'inscrivait dans un rapport de pouvoir. Les soignants restaient marqués de représentations ethnocentriques - inhérentes à chaque culture - éloignées de celles des populations amérindiennes, et cette divergence impactait la pratique. Discussion: Il conviendrait de se décentrer, pour « pénétrer ¼ dans le cadre de référence de l'Autre et rééquilibrer les rapports. L'exploration des savoirs et savoir-faire populaires et l'application de méthodes éprouvées d'enseignement encourageraient l'adhésion thérapeutique. Les « intervenants homethniques ¼ et une formation à l'interculturalité pourraient favoriser la promotion de la santé communautaire.

Vitamin D Deficiency in Patients with Diabetes in French Guiana: Epidemiology and Relation with Microvascular and Macrovascular Complications.

Vitamin D (VD) insufficiency is common among patients with diabetes in French Guiana. The study aimed to evaluate the prevalence of VD deficiency in the different type of diabetes encountered and to analyze the relationship between VD deficiency and diabetes complications. METHODS: An observational study was conducted between May 2019 and May 2020 in French Guiana, based on data from the CODIAM study (Diabetes Cohort in French Amazonia), describing the characteristics of patients with diabetes mellitus. Among 600 patients enrolled with diabetes, 361 had an available VD assay. RESULTS: The mean 25(OH)VD (hydroxycalciferol) level was 27.9 ng/mL. The level of VD was inversely proportional to the HbA1c (glycated hemoglobin) level. Patients with angina pectoris had a greater proportion of deficiencies VD < 20 ng/mL than those without angina. By contrast, patients with retinopathy had higher vitamin D concentrations than those without retinopathy. There was no association between vitamin D and arteriopathy, stroke, nephropathy and polyneuropathy. VD deficiency was more frequent in women, and in patients with a high school education. CONCLUSION: The prevalence of VD deficiency was high in patients with diabetes in French Guiana, emphasizing the importance of VD supplementation.

Hg concentrations and stable isotope variations in tropical fish species of a gold-mining-impacted watershed in French Guiana.

The aim of the study was to determine if gold-mining activities could impact the mercury (Hg) concentrations and isotopic signatures in freshwater fish consumed by riparian people in French Guiana. Total Hg, MeHg concentrations, and Hg stable isotopes ratios were analyzed in fish muscles from different species belonging to three feeding patterns (herbivorous, periphytophagous, and piscivorous). We compared tributaries impacted by gold-mining activities (Camopi, CR) with a pristine area upstream (Trois-Sauts, TS), along the Oyapock River. We measured δ15N and δ 13C to examine whether Hg patterns are due to differences in trophic level. Differences in δ 15N and δ 13C values between both studied sites were only observed for periphytophagous fish, due to difference of CN baselines, with enriched values at TS. Total Hg concentrations and Hg stable isotope signatures showed that Hg accumulated in fish from both areas has undergone different biogeochemical processes. Δ199Hg variation in fish (-0.5 to 0.2‰) was higher than the ecosystem baseline defined by a Δ199Hg of -0.66‰ in sediments, and suggested limited aqueous photochemical MeHg degradation. Photochemistry-corrected δ202Hg in fish was 0.7‰ higher than the baseline, consistent with biophysical and chemical isotope fractionation in the aquatic environment. While THg concentrations in periphytophagous fish were higher in the gold-mining area, disturbed by inputs of suspended particles, than in TS, the ensemble of Hg isotope shifts in fish is affected by the difference of biotic (methylation/demethylation) and abiotic (photochemistry) processes between both areas and did therefore not allow to resolve the contribution of gold-mining-related liquid Hg(0) in fish tissues. Mercury isotopes of MeHg in fish and lower trophic level organisms can be complementary to light stable isotope tracers.

Prevalence and risk factors for micronutrient deficiencies during pregnancy in Cayenne, French Guiana.

BACKGROUND: Involved in physical and brain development, immunity and metabolism, micronutrients have profound health effects. The nutritional status of pregnant women is a major determinant of foetal health. French Guiana has a rapid population growth. Social inequalities, cultural practices and gastrointestinal nematode infections in French Guiana could affect the prevalence of these deficiencies. The main objective of the present study was to estimate the prevalence of micronutrient deficiency among pregnant women in French Guiana. The secondary objective was to identify socio-demographic, dietary, obstetrical and neonatal risk factors associated with deficiencies. METHODS: Pregnant women over 22 weeks of pregnancy hospitalized for delivery at the Obstetrical Emergency Department of the Hospital Center in Cayenne from May 2018 to March 2019 were included. A socio-demographic and food questionnaire was administered. Medical data were collected from the medical records. Blood and urine samples were taken. The descriptive analysis used Student and chi-squared tests. RESULTS: A total of 341 women were included. The majority were born in Haiti (39%) and French Guiana (34%). At least one micronutrient deficiency was observed in 81% of women. Precarious women had a significantly greater risk of micronutrient deficiency during pregnancy compared to those with both normal and complementary health insurance. CONCLUSIONS: Micronutrient deficiencies in pregnant women in French Guiana are a public health problem, a fact that was previously overlooked in the context of rising obesity. With over half the women overweight or obese, and 81% with at least 1 micronutrient deficiency, balanced nutrition should be a major focus.

Geopolitics of bitterness: Deciphering the history and cultural biogeography of Quassia amara L.

ETHNOPHARMACOLOGICAL RELEVANCE: Quassia amara L. recently came into the spotlight in French Guiana, when it became the object of a biopiracy claim. Due to the numerous use records throughout the Guiana shield, at least since the 18th century, a thorough investigation of its origin seemed relevant and timely. In the light of the Convention on Biological Diversity (CBD) and the Nagoya protocol, questions about the origin of local knowledge are important to debate. AIM OF THE STUDY: Defining cultural biogeography as the dynamics through space and time of biocultural complexes, we used this theoretical framework to shed light on the complex biogeographical and cultural history of Q. amara. We explored in particular the possible transfer of medicinal knowledge on an Old World species to a botanically related New World one by enslaved Africans in Suriname. MATERIALS AND METHODS: Historical and contemporary literature research was performed by means of digitized manuscripts, archives and databases from the 17th to the 21st century. We retrieved data from digitized herbarium vouchers in herbaria of the Botanic Garden Meise (Belgium); Naturalis Biodiversity Center (the Netherlands); Missouri Botanical Garden, the Smithsonian National Museum of Natural History, the Field Museum (USA); Royal Botanic Gardens Kew (UK); the IRD Herbarium, French Guiana and the Museum National d'Histoire Naturelle (France). Vernacular names were retrieved from literature and herbarium specimens and compared to verify the origin of Quassia amara and its uses. RESULTS: Our exploration of digitized herbarium vouchers resulted in 1287 records, of which 661 were Q. amara and 636 were Q. africana. We observed that the destiny of this species, over at least 300 years, interweaves politics, economy, culture and medicine in a very complex way. Quassia amara's uses are difficult to attribute to specific cultural groups: the species is widely distributed in Central and South America, where it is popular among many ethnic groups. The species spread from Central to South America during the early 18th century due to political and economic reasons. This migration possibly resulted from simultaneous migration by religious orders (Jesuits) from Central America to northern South America and by Carib-speaking Amerindians (from northern South America to Suriname). Subsequently, through colonial trade networks, Q. amara spread to the rest of the world. The absence of African-derived local names in the Guiana shield suggests that Q. africana was not sufficiently familiar to enslaved Africans in the region that they preserved its names and transferred the associated medicinal knowledge to Q. amara. CONCLUSIONS: Cultural biogeography has proven an interesting concept to reconstruct the dynamics of biocultural interactions through space and time, while herbarium databases have shown to be useful to decipher evolution of local plant knowledge. Tracing the origin of a knowledge is nevertheless a complex adventure that deserves time and interdisciplinary studies.

Hidden Rice Diversity in the Guianas.

Traditional crop varieties are an important source of genetic diversity for crop adaptation and modern breeding. Landraces of Asian (Oryza sativa) and African (Oryza glaberrima) rice have been well studied on the continents where they were domesticated. However, their history of cultivation in northern South America is poorly understood. Here, we reveal the rice diversity that is maintained by Maroons, descendants of enslaved Africans who fled to the interior forests of the Guianas ca. 300 years ago. We interviewed subsistence farmers who practice shifting cultivation along the Maroni and Lawa rivers that form the natural border between French Guiana and Suriname, and used ethnobotanical and morphological methods to identify around 50 varieties, of which 15 were previously undocumented. The genetic origin of these varieties was explored using the Angiosperms353 universal probe set. Despite the large distances between sites and relative inaccessibility of the area, phenotypic and genetic diversity did not display any geographic structure, which is consistent with knowledge of seed exchange among members of the same ethnolinguistic group. Although improved US cultivars were introduced in Maroon villages in the 1940s, these have not displaced the traditional landraces, which are cherished for their taste and nutritious qualities and for their importance in Maroon spiritual life. The unique agricultural and ritual practices of Maroons confirm their role as custodians of rice diversity, a role that is currently under threat from external pressures and encroaching globalization. We expect that the rice diversity uncovered in this study represents only a fraction of the total diversity in the Guianas and may constitute a large untapped resource that holds promise for future rice improvement. Further efforts to inventory and preserve these landraces will help to protect a precious cultural heritage and local food security.

Decreased antibiotic susceptibility of Enterobacteriaceae causing community-acquired urinary tract infections in French Amazonia.

OBJECTIVES: Urinary tract infections (UTIs) have rarely been studied in the Amazon region. We aimed to describe the epidemiology of bacteria causing UTIs in French Guiana. PATIENTS AND METHODS: We performed a monocenter retrospective study of adults consulting at the emergency department of Cayenne Hospital in 2014 with a diagnosis of UTI. The bacterial species and resistance profile were described. RESULTS: Two-hundred-and-eighty-nine patients presenting with UTI were included: 82 (28.4%) presented with cystitis, 166 (57.4%) with pyelonephritis, and 41 (14.2%) with male UTI. E. coli was predominant (74.1%), and had decreased susceptibility to ampicillin, amoxicillin-clavulanic acid, fluoroquinolones, co-trimoxazole, and furans compared with data from metropolitan France. Extended-spectrum beta-lactamases (ESBL) was isolated in 3.1% of E. coli and 31.6% of K. pneumoniae. CONCLUSIONS: Antibiotic susceptibility in UTI is lower than reported in metropolitan France without evidence for an excessive consumption of antibiotics.

Wayanin and guaijaverin, two active metabolites found in a Psidium acutangulum Mart. ex DC (syn. P. persoonii McVaugh) (Myrtaceae) antimalarial decoction from the Wayana Amerindians.

ETHNOPHARMACOLOGICAL RELEVANCE: Psidium acutangulum Mart. ex DC is a small tree used by the Wayana Amerindians from the Upper-Maroni in French Guiana for the treatment of malaria. AIM OF THE STUDY: In a previous study, we highlighted the in vitro antiplasmodial, antioxidant and anti-inflammatory potential of the traditional decoction of P. acutangulum aerial parts. Our goal was then to investigate on the origin of the biological activity of the traditional remedy, and eventually characterize active constituents. MATERIALS AND METHODS: Liquid-liquid extractions were performed on the decoction, and the antiplasmodial activity evaluated against chloroquine-resistant FcB1 ([(3)H]-hypoxanthine bioassay) and 7G8 (pLDH bioassay) P. falciparum strains, and on a chloroquine sensitive NF54 ([(3)H]-hypoxanthine bioassay) P. falciparum strain. The ethyl acetate fraction (D) was active and underwent bioguided fractionation. All the isolated compounds were tested on P. falciparum FcB1 strain. In vitro anti-inflammatory activity (IL-1ß, IL-6, IL-8, TNFα) of the ethyl acetate fraction and of an anti-Plasmodium active compound, was concurrently assessed on LPS-stimulated human PBMC and NO secretion inhibition was measured on LPS stimulated RAW murine macrophages. Cytotoxicity of the fractions and pure compounds was measured on VERO cells, L6 mammalian cells, PBMCs, and RAW cells. RESULTS: Fractionation of the ethyl acetate soluble fraction (IC50 ranging from 3.4 to <1µg/mL depending on the parasite strain) led to the isolation of six pure compounds: catechin and five glycosylated quercetin derivatives. These compounds have never been isolated from this plant species. Two of these compounds (wayanin and guaijaverin) were found to be moderately active against P. falciparum FcB1 in vitro (IC50 5.5 and 6.9µM respectively). We proposed the name wayanin during public meetings organized in June 2015 in the Upper-Maroni villages, in homage to the medicinal knowledge of the Wayana population. At 50µg/mL, the ethyl acetate fraction (D) significantly inhibited IL-1ß secretion (-46%) and NO production (-21%), as previously observed for the decoction. The effects of D and guiajaverin (4) on the secretion of other cytokines or NO production were not significant. CONCLUSIONS: The confirmed antiplasmodial activity of the ethyl acetate soluble fraction of the decoction and of the isolated compounds support the previous results obtained on the P. acutangulum decoction. The antiplasmodial activity might be due to a mixture of moderately active non-toxic flavonoids. The anti-inflammatory activities were less marked for ethyl acetate fraction (D) than for the decoction.

Antiplasmodial and anti-inflammatory effects of an antimalarial remedy from the Wayana Amerindians, French Guiana: takamalaimë (Psidium acutangulum Mart. ex DC., Myrtaceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Field investigations highlighted the use of Psidium acutangulum Mart. ex DC (syn. P. persoonii McVaugh), a small tree used by the Wayana Amerindians in Twenke-Taluhwen and Antecume-Pata, French Guiana, for the treatment of malaria, and administered either orally in the form of a decoction or applied externally over the whole body. This use appears limited to the Wayana cultural group in French Guiana and has never been reported anywhere else. Our goal was to evaluate the antimalarial and anti-inflammatory activities of a P. acutangulum decoction to explain the good reputation of this remedy. MATERIALS AND METHODS: Interviews with the Wayana inhabitants of Twenke-Taluhwen and Antecume-Pata were conducted within the TRAMAZ project according to the TRAMIL methodology, which is based on a quantitative and qualitative analysis of medicinal plant uses. A decoction of dried aerial parts of P. acutangulum was prepared in consistency with the Wayana recipe. In vitro antiplasmodial assays were performed on chloroquine-resistant FcB1 ([(3)H]-hypoxanthine bioassay) and 7G8 (pLDH bioassay) P. falciparum strains and on chloroquine sensitive NF54 ([(3)H]-hypoxanthine bioassay) P. falciparum strain. In vitro anti-inflammatory activity (IL-1ß, IL-6, IL-8, TNFα) was evaluated on LPS-stimulated human PBMC and NO secretion inhibition was measured on LPS stimulated RAW murine macrophages. Cytotoxicity of the decoction was measured on L6 mammalian cells, PBMCs, and RAW cells. A preliminary evaluation of the in vivo antimalarial activity of the decoction, administered orally twice daily, was assessed by the classical four-day suppressive test against P. berghei NK65 in mice. RESULTS: The decoction displayed a good antiplasmodial activity in vitro against the three tested strains, regardless to the bioassay used, with IC50 values of 3.3µg/mL and 10.3µg/mL against P. falciparum FcB1 and NF54, respectively and 19.0µg/mL against P. falciparum 7G8. It also exhibited significant anti-inflammatory activity in vitro in a dose dependent manner. At a concentration of 50µg/mL, the decoction inhibited the secretion of the following pro-inflammatory cytokines: TNFα (-18%), IL-1ß (-58%), IL-6 (-32%), IL-8 (-21%). It also exhibited a mild NO secretion inhibition (-13%) at the same concentration. The decoction was non-cytotoxic against L6 cells (IC50>100µg/mL), RAW cells and PBMC. In vivo, 150µL of the decoction given orally twice a day (equivalent to 350mg/kg/day of dried extract) inhibited 39.7% average parasite growth, with more than 50% of inhibition in three mice over five. The absence of response for the two remaining mice, however, induced a strong standard deviation. CONCLUSIONS: This study highlighted the in vitro antiplasmodial activity of the decoction of P. acutangulum aerial parts, used by Wayana Amerindians from the Upper-Maroni in French Guiana in case of malaria. Its antioxidant and anti-inflammatory potential, which may help to explain its use against this disease, was demonstrated using models of artificially stimulated cells.

First report of a family outbreak of Chagas disease in French Guiana and posttreatment follow-up.

The outbreak of acute Chagas disease due to oral transmission of the parasite is a well-known phenomenon mainly occurring in the Amazon. Such an event is described here for the first time in French Guiana. Eight patients of the same family, presenting epidemiological and clinical histories compatible with recent Trypanosoma cruzi infection of Chagas disease due to the ingestion of palm Oenocarpus bacaba juice were, rather late after the putative date of infection, underwent four parasitological and two serological specific tests for confirmation of the diagnosis. Real-time PCR results were positive for all the patients; strains were isolated by hemoculture from four patients, PCR identification of TcI DTU was made for six patients, while parasites were not detected in any of the patients by direct microscopic examination. The results of two serologic tests were positive. All patients were treated with benznidazole, and two patients were additionally given nifurtimox. A 6-year follow-up was possible for six patients. Real-time PCR was negative for these patients after 1 year, while the antibody rates decreased slowly and serology results were negative only after several years (1-5 years). Our findings confirm the occurrence of an outbreak of Chagas infection in members of the same family, with the oral mode of infection being the most likely hypothesis to explain this group of cases. Our results show the successful treatment of patients infected by TcI and the usefulness of real-time PCR for the emergency diagnosis of recent Chagas disease cases and in posttreatment follow-up.

Adapting information for Maroons in French Guyana.

PIP: In 1990 in French Guiana, the nongovernmental organization, AIDES-Guyane interviewed Maroon refugees living in camps along the border with Suriname to obtain baseline data on HIV/AIDS. The Maroons consisted of at least the Aluka, Ndjuka, Paramaka, and Saramaka groups. In July 1991, it used findings of this preliminary research to implement an HIV/AIDS education project targeting adults and incorporating traditional healers. A project evaluation occurred in February 1992 consisting traditional healers. A project evaluation occurred in February 1992 consisting of interviews with 197 Maroons living in different areas of French Guiana. Almost 50% had attended at least 1 project session and considered the sessions to be very clear. They also appreciated that the sessions were in their own language. Even though many participants were aware that HIV is not transmitted via bodily contact, they still feared sharing food, clothing, and living space with HIV-positive persons. Nonetheless, they had significantly improved their attitudes toward people infected with HIV. Virtually all the maroons immediately referred to condoms as a means to protect against HIV/AIDS and officially praised condoms. In private, however, the Maroons claimed that condoms reduced pleasure. Some people claimed that condoms were difficult to obtain and embarrassing and difficult to use. Most men carried condoms, evidently because this was fashionable, but rarely used them. Some people doubted that condoms effectively prevented HIV transmission. Men tended to change their strategies of choosing sexual partners, but these strategies overlooked the fact that anyone may carry HIV (e.g., a village girl rather than a nonvillage girl). None of the women ever used condoms. Relationships between traditional healers and biomedical practitioners improved over time. Interviews with 8-10 year olds who listened to sessions through windows and crannies of walls showed that they understood and retained HIV/AIDS information well, sometimes better than did adults. The project aimed to include children in future sessions.^ieng