End-stage renal disease and cardiovascular disease : the burden of chronic disease in French Guiana. ; Insuffisance rénale terminale et maladies cardiovasculaires : le poids des maladies chroniques en Guyane

Non communicable chronic diseases, notably cardiovascular diseases are one of the main causes of death. Numerous studies have studied risk factors throughout the world. In French Guiana, most research themes focus on tropical infectious diseases. However, the epidemiologic transition is well underway, and cardiovascular diseases represent a major public health problem. Hence strokes and coronary syndrome are the main cause of premature death after accidents. As elsewhere, chronic renal failure also represents a rising problem in French Guiana. French Guiana is an overseas French Territory with a large Afro-caribbean population profile in terms of cultural and socioeconomic aspects with a French health system. Despite the universal healthcare system, there are frequent health inequalities. Diabetes and high blood pressure are 2 major risk factors for cardiovascular diseases and for end stage renal failure. In order to alleviate the lack of epidemiologic data, the present work aims to describe the epidemiology of these diseases in French Guiana using different data sources: the hospital’s « programme médicalisé des systems d’information (PMSI) », the data from the INDIA prospective cohort a collaboration between the clinical investigation center in Cayenne and Dijon hospital, and data from the end stage renal disease registry. These results will hopefully help improve access to care, and reduce mortality.The present thesis thus shows the particularities of the epidemiology of these highly incident and fatal diseases. It also shows the importance of health inequalities in French Guiana, as for other diseases, the more vulnerable populations become sick younger, with more severe diseases, and more deaths. Hypertension and diabetes are prime targets for preventive interventions, with special efforts to reach the most vulnerable social groups. ; Les maladies non transmissibles et chroniques, et notamment les maladies cardio-vasculaires sont une des principales causes de mortalité. De nombreuses études concernant la ...