Cellule de l'Institut de Veille Sanitaire aux Antilles Guyane

ARS de Martinique, Centre d`affaires AGORA ZAC de l`Etang Z`Abricot - Pointe des Grives
BP 656, 97261 Fort-de-France Cedex, Martinique

Contact person:

Martine Ledrans

Tel. +596 (0)5 96 39 43 56
Fax. +596 (0)5 96 39 44 14

Description of the institute

The French Institute for Public Health Surveillance (Institut de veille sanitaire - InVS) is a governmental institution reporting to the Ministry of Health. The missions of the InVS are: i) to co-ordinate and implement public health surveillance, ii) to alert national public health authorities on potential threats to health, iii) to assist public health authorities in disease control and prevention and, iv) to study the determinants of changes of trends of diseases. The French territory comprises of 22 administrative regions. The Inter-regional Epidemiology Units (Cire) represent the InVS at the regional level and act on behalf of the national institution, mainly in the fields of communicable disease and environmental health. There are 17 Cire: 15 located in France and 2 overseas; one of them is the Cire Antilles Guyane (Cire AG) based in Martinique.

Training Site

The Cire AG is covering the French overseas territories of Martinique, Guadeloupe, French Guyana as well as St. Martin and St. Barthélemy. The Cire AG has three sites, the main site being Martinique with four senior epidemiologists (2 of them with a main focus on environmental epidemiology), 1 study technician and 1 secretary. Two epidemiologists each are located in French Guyana (2,5 hours flight from Martinique) and Guadeloupe (3/4 hour flight). Technical meetings for the staff of the Cire are held twice a year. In addition, there are daily telephone or video conferences between the sites to exchange information on current events and outbreaks.

The Cire AG :
i) provides methodological and technical expertise to health authorities in outbreak situations and occurrence of unexpected health events,
ii) coordinates regional health surveillance. (Dengue, Chikungunya, West Nile viruses, Malaria, Influenza-like-illness, Bronchiolitis, Gastro-intestinal illness, …), including retro-information of health personnel and decision-makers trough bulletins (Bulletins de Veille Sanitaire) and epidemiologic reports ,
iii) carries out epidemiological studies at local or regional level.

The Cire has links with international organizations in the region: Pan American Health Organization (PAHO) and the Caribbean Epidemiology Centre (CAREC) which is coordinating the control of infectious diseases for the countries belonging to the Caricom (Caribbean community).

The fellow will be fully integrated in the team and will have access to all information and databases of the unit. All necessary support including computer equipment, communication and library facilities (both, electronic and printed media) are available.

Cire AG is a training site for PH residents and MPH students from Bordeaux II university, Paris V University and Paris XI university.

Training opportunities

Dengue surveillance is important in the Caribbean region since the disease is both endemic and epidemic, with increasingly severe clinical forms. Data are collected from sentinel physicians and all laboratories and hospitals. Epidemics are monitored with this system to guide clinicians on treatment. Since July 2008, a secured internet site allows online reporting. The Cire produces a weekly update report (“Point epidemio”) on Dengue activity. These reports frequently raise the interest of the media. The fellow could monitor the reported cases, analyse incoming data and produce reports.

A similar sentinel surveillance system is used for ILI, gastroenteritis, varicella, bronchiolytis (RSV infections). The Cire regularly performs time series analysis, for example to (re)calculate epidemic thresholds. The fellow could perform time series analysis using the available datasets. In addition, seasonal or temporary surveillance has been set up for conjunctivitis, viral meningitis, hand mouth disease. Or, the consumption of anxiolytic drugs after a hurricanes/earthquakes has been measured. Other previous examples include the surveillance of sale of local antibiotics for otitis and gastroenteritis after a sewage spill in bathing water. Similar systems could be set up by the fellow if needed.

The Cire AG has easy access to outbreak investigations. Among others, outbreak investigations of clusters or outbreaks of gastroenteritis, typhoid fever, malaria (Guyana), pertussis, toxoplasmosis, scabies, meningitis, syphilis, sporadic legionellosis, histoplasmosis, cases of Q fever, Chagas disease have been performed in the past. In addition, clusters of non-infectious diseases such as cancers or psychological syndromes have been investigated. In some of these investigations, analytical studies were performed.

The Cire AG is also cooperating with PAHO and CAREC to implement the International Health Regulations. The Cire AG will provide technical assistance to evaluate surveillance and response mechanism in some of Caricom countries. The fellow could participate to these evaluation and also take part in an emergency response team from PAHO in case of emergency situations in the Caribbean region.

Risk assessment or collaboration to a project in environmental health is also possible.

Training Supervision

General supervision is provided by Philippe Quénel, MD, PhD, specialized in epidemiology and public health.

The EPIET fellow will be based in Martinique and projects will be directly supervised by the senior epidemiologists working in this unit. Projects in close collaboration with the French Guyana and Guadeloupe units will be available. The fellow will have access to good office space, with computer equipment, and access to both Intranet and Internet. The fellow will be fully integrated in the team and will have access to all information and databases of the Cire AG.

Language requirements

French and English.

Training history

Number of EPIET fellows trained at institute: none New site 2009!
Number of Profet (French FETP program) fellows trained at institute: five
Number of Profet alumni working at institute: two