Hunger in French Guiana's Vulnerable Urban Neighborhoods: A Neglected Consequence of COVID-19.

BACKGROUND: In French Guiana, restrictions to control the spread of SARS-CoV-2 were put in place between March 2020 and March 2022. In vulnerable urban neighborhoods, during this period, requests for food assistance increased and fear of hunger overtook fear of being affected by COVID-19. OBJECTIVE: The objective of this survey was to describe food security during the COVID-19 pandemic in French Guiana and to study the relationship between the socioeconomic conditions of the study households and household hunger. METHODS: A multicenter survey was therefore conducted in mobile clinics and fixed structures providing care to at-risk urban populations. In a face-to-face interview, a community health worker asked participants questions about the sociodemographic and economic profile of the household, and about household food security (food consumption score, coping strategies in the face of food shortages, and household hunger index). Two hundred seventy-seven households were recruited in February 2021. RESULTS: According to the household hunger scale, 42.6% of households experienced moderate hunger and 23.8% of households experienced severe hunger in the month preceding the survey. Lack of residence permit, lack of social support, water insecurity, small housing, and lack of access to an urban garden were determinants related to the risk of household hunger. CONCLUSIONS: Food insecurity has affected a large majority of the households in this survey, and the immediate consequences for children's health were already apparent. These results draw attention to a neglected health problem in a socioeconomically vulnerable population during the COVID-19 pandemic.

E6/E7 Sequence Diversity of High-Risk Human Papillomaviruses in Two Geographically Isolated Populations of French Guiana.

Amerindian and Maroon populations of French Guiana have been living in isolation for generations and sexual networks remained mostly endogamous. The present study aimed to describe the phylogeny of E6 and E7 sequences of the most common high-risk HPV genotypes in these regions, to ascertain the diversity of intra-type variants and describe evolutionary relationships. There were 106 women with at least one of HPV16, 18, 31, 52, 58, and 68 genotypes. The most clear-cut phylogenetic pattern was obtained for HPV18 and HPV58 for which the major branches were crisply divided between Amerindian villages on the Oyapock and Maroon villages on the Maroni. Such clustering was less clear for HPV31 and 52. For HPV16, there was also some evidence of clustering on the Oyapock with type A European viruses and on the Maroni with type B and C African viruses among Maroon women. HPV68 showed the largest sequence heterogeneity of the six genotypes at both nucleotide and amino acid levels and was restricted to Maroon women. The present results show that there were significant geographically based differences of E6 and E7 oncogenes. These differences were compatible with different ancestral virus populations and local virus evolution in a context of prolonged population isolation.

Predictors of abnormal cytology among HPV-infected women in remote territories of French Guiana.

BACKGROUND: Cervical cancer prevention using cervical cytology is insufficiently sensitive, a significant proportion of HPV-infected women having normal cytology. The objective of the present study was to try to identify factors associated with abnormal cytology in HPV-infected women living in remote areas of French Guiana. METHODS: A study was conducted in women aged 20-65 years having HPV infections confirmed by HPV DNA detection using the GREINER-BIO-ONE kit. In addition to HPV testing, cytology was performed and classified as normal or abnormal. Demographic and life history variables, and infecting genotypes were compared between the normal and abnormal cytology groups. RESULTS: None of the demographic and life history variables were associated with cytology results. HPV genotype 53 was significantly associated with absence of cytological abnormalities whereas HPV 52, 58, 16 and perhaps 33 and 66 were independently associated with a greater risk of cytological abnormalities. When grouping HPV genotypes in different species, only species 9 (HPV 16, 31, 33, 35, 52, 58, 67) was significantly associated with abnormal cytology AOR = 5.1 (95% CI = 2.3-11.2), P < 0.001. CONCLUSIONS: It was not possible to predict which HPV-infected women will have cytological abnormalities or notfrom anamnesis. In this study HPV 53 seemed more benign than other HPV genotypes. On the contrary, species n°9, containing 5 of the genotypes contained in the nonavalent HPV vaccine, was significantly associated with more cytological abnormalities. HPV testing and vaccination with the nonavalent vaccine should be implemented in these remote parts of French Guiana.

The singular epidemiology of HPV infection among French Guianese women with normal cytology.

BACKGROUND: In French Guiana, cervical cancer is the second most frequent cancer in females. The objective of the present study was to describe the prevalence of HPV infections in women with normal cervical cytology living in the remote villages of French Guiana. METHODS: Before the study, the study team communicated in the remote villages on the importance of screening. All women from the target population were offered to participate. They signed informed consent during inclusion and then had a concomitant HPV-test and cervical smear. Only women with normal cytology and a good quality smear were analyzed. The detection of HPV-DNA was performed using the GREINER-BIO-ONE kit. RESULTS: Overall, 27.2% of women with normal cervical cytology had a positive HPV-test. There was a U-shaped evolution of prevalence with women over 50 years having the highest HPV prevalence, followed by the 20 to 29 years group. The most prevalent HPV genotypes were HPV 53(3.52%), 68(3.33%), 52(2.59%), 31(2.22%) and 16 (1.85%). The proportion of HPV 16 among HPV-infected women was 6.8%. CONCLUSIONS: HPV prevalence in cytologically normal women was very high. The most prevalent genotypes were very different from what is usually described in the world, and notably in South America.