{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T04:27:23Z","timestamp":1779942443921,"version":"3.53.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Hard-to-reach, vulnerable and cross-border populations are often disproportionately affected by communicable diseases. Epidemiological data on viral hepatitis in French Guiana and Suriname are available for urban areas, but not for remote communities. The Maroni River, which separates FG and Suriname, is home to Tribal and Indigenous communities. Reaching these populations is challenging due to logistical constraints, cultural and language barriers, and mistrust of outsiders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to conduct an epidemiological study of viral hepatitis [Maroni Hepatites Virales (MaHeVi)] in this remote and complex area. Here, we describe the operational hurdles and solutions required to achieve this.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We undertook a preliminary assessment of the area with local community leaders and health workers to gain approval of MaHeVi, acceptance of blood sampling, and suggestions for adapting the study to cultural and logistical constraints. Anthropological assessments were conducted through focus groups and interviews with key individuals to assess knowledge, beliefs and risk factors for VH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MaHeVi was well received by the local communities. The approval of the community leaders was crucial for the implementation and acceptance of the study. The main adaptations were hiring community health mediators to overcome cultural and language differences, using blotting paper instead of venipuncture for logistical and acceptability reasons, and adapting communication materials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Careful preparation and tailoring of the communication materials and research protocol have enabled the successful implementation of the study. This process could be replicated in this area and transferred to other complex contexts combining borders, logistical hurdles and populations requiring cultural adaptations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1162705","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T04:47:58Z","timestamp":1685508478000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Involving hard-to-reach populations is pivotal for the tailoring and implementation of an epidemiological study in cross-border communities of French Guiana and Suriname"],"prefix":"10.3389","volume":"11","author":[{"given":"Roxane","family":"Schaub","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Sigrid Mac Donald","family":"Ottevanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soeradj","family":"Harkisoen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Pesna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine","family":"Duijves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Heemskerk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Polime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edouard","family":"Tuaillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Vreden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Nacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e44611","DOI":"10.1371\/journal.pone.0044611","article-title":"Seroprevalence of chronic hepatitis B virus infection and prior immunity in immigrants and refugees: a systematic review and meta-analysis","volume":"7","author":"Rossi","year":"2012","journal-title":"PLoS One"},{"key":"ref2","volume-title":"HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2018","year":"2018"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/liv.12063","article-title":"Best strategies for global HCV eradication","volume":"33","author":"Hagan","year":"2013","journal-title":"Liver Int"},{"key":"ref4","first-page":"e488","article-title":"First nations hepatitis C virus infections: six-year retrospective study of on-reserve rates of newly reported infections in northwestern Ontario","volume":"63","author":"Gordon","year":"2017","journal-title":"Can Fam Physician"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"467","DOI":"10.3851\/IMP2597","article-title":"Distribution of viral hepatitis in indigenous populations of North America and the circumpolar Arctic","volume":"18","author":"Osiowy","year":"2013","journal-title":"Antivir Ther"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/S0140-6736(09)60914-4","article-title":"Indigenous health part 1: determinants and disease patterns","volume":"374","author":"Gracey","year":"2009","journal-title":"Lancet"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1742","DOI":"10.1086\/421268","article-title":"Globalization of infectious diseases: the impact of migration","volume":"38","author":"Gushulak","year":"2004","journal-title":"Clin Infect Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2661","DOI":"10.1016\/j.vaccine.2019.04.001","article-title":"Vaccine-preventable diseases and immunisation coverage among migrants and non-migrants worldwide: a scoping review of published literature, 2006\u20132016","volume":"37","author":"Charania","year":"2019","journal-title":"Vaccine"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"175","DOI":"10.2147\/RMHP.S70173","article-title":"Barriers to health care for undocumented immigrants: a literature review","author":"Hacker","year":"2015","journal-title":"Risk Manag Healthc Policy"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1016\/S0140-6736(15)60910-2","article-title":"Rural health inequities: data and decisions","volume":"385","year":"2015","journal-title":"Lancet"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"22","DOI":"10.2105\/AJPH.2006.093641","article-title":"Indigenous ways of knowing: implications for participatory research and community","volume":"98","author":"Cochran","year":"2008","journal-title":"Am J Public Health"},{"key":"ref12","article-title":"PAHO\/WHO country cooperation strategy: Suriname 2012\u20132016. 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