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SETTING-UP A CROSS-BORDER ACTION-RESEARCH PROJECT TO CONTROL MALARIA IN REMOTE AREAS OF THE AMAZON: DESCRIBING THE BIRTH AND MILESTONES OF A COMPLEX INTERNATIONAL PROJECT (MALAKIT)
Pesquisa de ação
Ciência da implementação
Malária fronteiriça
Controle da malária
População mineira
População negligenciada
Migrantes móveis
Action-research
Implementation science
Border malaria
Malaria control
Mining population
Neglected population
Mobile migrants
Autor
Afiliación
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
The Ink Link. Paris, France.
DPAC Fronteira. Oiapoque, Brasil.
DPAC Fronteira. Oiapoque, Brasil.
Agence Régionale de Santé de la Guyane. Cayenne, French Guiana.
Ministério da Saúde. Programa Nacional de Controle da Malária. Brasília, DF, Brasil.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
National Malaria Control Pro‑gramme, Ministry of Health of Suriname. Paramaribo, Suriname.
National Malaria Control Pro‑gramme, Ministry of Health of Suriname. Paramaribo, Suriname.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Doenças Parasitárias. Rio de Janeiro, RJ, Brasil.
Foundation for the Advancement of Scientifc Research in Suriname. Paramaribo, Suriname.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
The Ink Link. Paris, France.
DPAC Fronteira. Oiapoque, Brasil.
DPAC Fronteira. Oiapoque, Brasil.
Agence Régionale de Santé de la Guyane. Cayenne, French Guiana.
Ministério da Saúde. Programa Nacional de Controle da Malária. Brasília, DF, Brasil.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
National Malaria Control Pro‑gramme, Ministry of Health of Suriname. Paramaribo, Suriname.
National Malaria Control Pro‑gramme, Ministry of Health of Suriname. Paramaribo, Suriname.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Doenças Parasitárias. Rio de Janeiro, RJ, Brasil.
Foundation for the Advancement of Scientifc Research in Suriname. Paramaribo, Suriname.
Centre d’Investigation Clinique Antilles‑Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon. Cayenne, French Guiana.
Resumen en ingles
.Background: In French Guiana, gold miners working illegally represents a major reservoir of malaria. This mobile
population, mainly of Brazilian descent, enters the French Guianese forest from neighbouring countries, Suriname and
Brazil. A complex and innovative intervention was piloted as a cooperation with the three involved countries involved
to control malaria in this specifc population. The principle was that health workers called “facilitators” provide the
participants with a self-diagnosis and self-treatment kit along with adequate training and material to rapidly manage
an episode of malaria symptoms on their own, when they fnd themselves isolated from health care services.
Methods: This paper describes the design, development, content of the intervention and players’ organization of this
multi-country project, the opportunities and constraints encountered, and the lessons learnt at this stage.
Results: The choice not to implement the usual “Test and Treat” approach within the community is mainly driven by
regulatory reasons. The content of medical messages tends to balance the tension between thoroughness, accuracy
and efcacy. The wide range of tools developed through a participatory approach was intended to cope with the
challenges of the literacy level of the target population. Despite the difculties encountered due to language, regula‑
tion diferences and distance between partners, cooperation was fruitful, due to the complementary of stakeholders,
their involvement at all important stages and regular face-to-face meetings.
Discussion and conclusion: This experience shows the feasibility of an ambitious project of action-research in a
border malaria context, involving several countries and with a mobile and undocumented population. It reveals some
factors of success which may be transferable in analogous settings.
Palabras clave en portugues
Intervenção complexaPesquisa de ação
Ciência da implementação
Malária fronteiriça
Controle da malária
População mineira
População negligenciada
Migrantes móveis
Palabras clave en ingles
Complex interventionAction-research
Implementation science
Border malaria
Malaria control
Mining population
Neglected population
Mobile migrants
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