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PAHO Basic Health Indicator Data Base This is a multidimensional query tool that offers a collection of 108 indicators from 1995 to 2005. The system presents data and indicators on:
- demography
- socioeconomic
- mortality by cause indicators
- morbidity and risk factors
- access, resources and health services coverage.
Selected indicators are disaggregated into age groups, sex and/or urban/rural region. Generated tables can be exported and printed.
The data presented is updated annually with the latest country information.
GENERAL SITUATION AND TRENDS Guadeloupe is an archipelago of eight inhabited islands
covering an area of 1,750 km2. Its capital is Pointe-ŕ-Pitre. The
two largest islands are Basse-Terre , a mountainous island to the west, and
Grande-Terre , which has no significant mountain relief, to the east.
Demography:
According to the March 1999 census, Guadeloupe has a population of 422,496 inhabitants.
The average age of Guadeloupians is currently 34.2 years. The population age
gap is widening due to the decline in fertility and migration. There were 5%
of foreigners in Guadeloupe in 1999, mainly Haitians.
Economy:
In 1999, the economically active population numbered 191,400. 59% of the population
aged 15 and older participated in the labor market. Unemployment was 34.2% in
1999.
Mortality:
The crude mortality rate was 6.2 per 1,000 population in 1999. For the period
1993-1997, diseases of the circulatory system (rate per 100,000) presented the
highest mortality rates (366.1 in men, 278.2 in women), followed by neoplasms
(286.6 in men, 131.1 in women) and injuries and poisoning (131.9 in men, 40.2
in women).
SPECIFIC HEALTH PROBLEMS Analysis by population group Children: Perinatal
mortality fell to an average of 7.3 per 1,000 births during 1998-2000. The rate
of stillbirths remains high: 6.0 per 1,000 live births in 2000. Infant mortality
was 10.1 per 1,000 live births in 1998, a slight increase from 1995. The main
causes of death in the population under 1 year in 1995-1997 were perinatal conditions
(54%), congenital anomalies (15%), and accidents (8.9%). In the period 1999-2000,
10 of every 1,000 children suffered from confirmed hearing deficiencies, and
18 of every 1,000 had confirmed visual impairment.
Schoolchildren and adolescents: A
study of the causes of death in 5-15-year-olds found that between 1995 and 1997,
external causes and injuries caused 51% of all deaths, followed by neoplasms
(16%) and diseases of the nervous system (10%). Severe chronic respiratory insufficiency
and mental disorders account for over two-thirds of chronic illnesses. During
1995-1997, external causes and injuries were the leading cause of mortality
in 15-24-year-olds, followed by neoplasms (10%), diseases of the circulatory
system (4%) and infectious diseases (4%). According to a study, 15 % of students
in the second cycle of secondary school are habitual smokers. In 1999, 2.9%
of pregnancies corresponded to girls under 18.
Adults: Among
25-64-year-olds, the leading three causes of death are responsible for nearly
two-thirds of total mortality external causes and injuries (23%), neoplasms
(20%), and diseases of the circulatory system (20%). Diabetes, hypertension,
mental disorders, and tumors make up three-quarters of all diseases fully covered
by the insurance schemes. In 1999, the general fertility rate was 63.8 per 1,000
women of childbearing age. According to data from family planning and education
centers, 80% of women use some kind of contraceptive. In 1998, the abortion
rate was 41 per 100 conceptions. During 1993-1997, maternal mortality remained
stable at 46.9 deaths per 100,000 live births.
Elderly: In
1997, the life expectancy of Guadeloupians at age 60 was 19.8 years for men
and 24.3 for women. 99 % of the people 60 and older live at home thanks to the
protection afforded by a traditional way of life and the State's home care
policy. Deaths from diseases of the circulatory system and neoplasms account
for 61% of deaths in this age group, with no difference by sex.
Disabled:As
of January 1998, 5,600 people were receiving the benefit available to adults
who are at least 80% disabled, or are 50-80% disabled and cannot work. In 2000,
718 special education allowances were granted to children with a disability.
Analysis by type of health problem Natural disasters: Guadeloupe
is situated in a high-risk zone for natural disasters (earthquakes, tremors
and volcanic eruptions). In 1999, Hurricane Lenny brought considerable damage.
Vector-borne diseases: Each
year, there are seven to eight cases of imported malaria (mainly Plasmodium
falciparum). In 1995, seven cases of hemorrhagic dengue were reported, causing
three deaths. Dengue surveillance is undertaken through a network of 37 sentinel
doctors who report weekly.
Diseases preventable by immunization: Among
children born in 1998, coverage rates at 1 year are estimated at 87% for the
third dose of the vaccines against poliomyelitis, diphtheria, tetanus, pertussis,
and 74% for the third dose of the Haemophilus influenzae type b vaccine; 80%
of them have received two doses of the hepatitis B vaccine. 89 % of children
born in 1997 received a dose of the MMR vaccine before age 2. Pertussis is endemic
(88 cases) since 1983, with three epidemic outbreaks, the last one in 1994 (11
cases). From 1991 to 2000, there were 15 cases of tetanus, 6 of which in people
over 64. There was an epidemic of influenza (type A (H3N2) in 1996. In 2000,
the virus in circulation was also type A.
Chronic communicable diseases: The
general incidence of tuberculosis has fallen to an average of 8.2 per 100,000
population between 1998 and 2000. 60% of cases were contagious forms. The male
:female ratio for that period was 1:4. The incidence rate of leprosy has remained
low (0.24 per 10,000 population ). In 2000, 10 new cases and 2 relapses were
reported.
Acute respiratory infections: In
the period 1993-1997, the general mortality rate from acute respiratory diseases
was 20 per 100,000 population . In children under 5, the rate was 50 per 100,000.
Zoonoses:Since
1998, the number of cases of leptospirosis appears to have been increasing:
from fewer than 10 cases a year, it rose to 37 cases reported to the reference
center in 2000.
HIV/AIDS: As
of January 2000, a total of 950 cases of AIDS had been declared since the start
of the epidemic. The prevalence of HIV infection is estimated at 1% of the Department's
total population; the incidence rate in 1999 was over 111 per million population
. Heterosexual transmission dominates. There are some 30 cases of pediatric
AIDS. In Guadeloupe , antiretroviral treatment is accessible to all residents,
even foreigners, in three hospitals.
Sexually transmitted infections:The
regular appearance of new cases of syphilis and gonococcal infections raises
concerns as to the changes in behavior expected in view of the AIDS epidemic.
Nutritional, metabolic and genetic diseases:Type 2 diabetes prevails in Guadeloupe . Sickle cell
anemia is the most common genetic disease in Guadeloupe (one in every 8 inhabitants
has the genetic trait). Neonatal detection is undertaken systematically by all
maternity wards. In 2000, sickle cell anemia was detected in 20 newborns.
Diseases of the circulatory system:
Cardiovascular diseases are the leading cause of mortality. They caused 32%
of the total deaths every year between 1995 and 1997. Mortality due to cerebrovascular
conditions is particularly high. There exists a special program to combat arterial
hypertension.
Malignant neoplasms: Cancer
is the second leading cause of mortality (710 cases a year on average). Prostate
cancer in men and cervico-uterine cancer in women are very frequent.
Accidents and violence:Traffic
accidents are a priority public health problem. In the last 10 years, there
have been more than 80 deaths each year from traffic accidents and nearly 400
people have suffered serious injuries. Since 1994, a telephone hotline has been
in operation to take complaints of violence against children. In 1987-1997,
40 deaths from suicide were registered on average each year with a male :female
ratio of 3:1.
Mental health: According
to a 1999 survey, 32% of Guadeloupians suffer from anxiety, 15% suffer from
depression, and 15% have psychotic disorders. Alcoholism is a serious social
and public health problem (137 each year attributed to alcoholic psychoses,
cirrhosis of the liver, and neoplasms of the upper respiratory system between
1995 and 1997.) Between 1995 and 1997, an average of 167 deaths a year were
attributed to excess smoking. The number of drug addicts is constantly increasing,
the most consumed substance being marijuana (64%) and crack cocaine (26%).
RESPONSE OF THE HEALTH SYSTEM Institutional organization: Guadeloupe
's health system is comprised of 24 establishments (11 public, 13 private),
which operates on Basse-Terre and Grande-Terre . At the beginning of 2000, the
short-term care capacity was 1,072 beds in the public sector and 711 in the
private sector (2.2 beds per 1,000 population for medicine, 1.4 for surgery,
0.6 for gynecology, 0.9 for monitoring and rehabilitation, 0.6 for child and
adolescent psychiatry, and 1 for general psychiatry). There are 27 private and
8 public biomedical analysis laboratories on the island or 1 lab per 10,000
population; and 143 pharmacies or 3 per 10,000 population .
Disease prevention and control programs:A five-year perinatal plan began in 1996, with 13
measures to improve the monitoring of pregnancy and birth conditions (media
campaigns, dissemination of good clinical practice cards to professionals, restructuring
of maternity wards).
Epidemiological surveillance and public health
laboratories: There is a sentinel surveillance
network with the cooperation of some 40 physicians. Information is gathered
by phone weekly on dengue, influenza-like syndromes, gastroenteritis, diarrhea,
chickenpox, ciguatera poisoning, leptospirosis and outbreaks of foodborne illness.
This complements the national system, which includes a list of 23 diseases subject
to compulsory notification.
Potable water and sanitation: Water
is subject to strict and frequent controls at the levels of the catchment, treatment
plants and distribution network. The quality of the water distributed is generally
good or very good. In 2000, there were 23 communal purification stations for
36 municipalities, but due to the dispersion of the dwellings, individuals resort
to non-communal sanitation. Solid waste: Guadeloupe produces some 250,000 tons
of domestic waste per year, all of which goes to authorized dumps. There is
a departmental system for treating hospital waste.
Pollution prevention and control: Some
pollution prevention campaigns were conducted in 1997 and 1998 throughout the
city of Pointe-ŕ-Pitre and levels of nitrogen dioxide, sulfur dioxide and ozone
are well within the European standards on air quality.
Housing and sanitation:In
2000, 79% of families lived in a single-family home. Approximately 3.8% of dwellings
have no running water or electricity. 20% of the population lives in precarious
or unsanitary conditions.
Emergency services:emergencies are attended
by two regional university hospital services in Pointe-ŕ-Pitre and the general
community hospital in Basse-Terre , complemented by three mobile units. 44 private
companies provide land transport services for patients.
Specialized services: There
are two homes for workers with disabilities, five occupational homes and one
specialized home. Each year a campaign is carried out to promote free vaccination
against influenza in the elderly. Medical care and accommodation for the elderly
includes 142 residential beds; 241 beds in retirement homes; 350 beds for long-term
medical care and 433 placements for home nursing services. Since 1994, a permanent
hotline for the prevention of child abuse is available to the public. In 2000,
there were 25 psychiatrists in the public sector and 12 in private practice.
In 1999, 1,300 mental health patients were hospitalized, on average 39 days.
In prisons, 874 detainees received psychiatric care in 1999. In 1999, the percentage
of pregnant women who received little of no medical care remained high (3.8%).
Almost all medical care during childbirth and the puerperium was conducted by
trained personnel.
Health supplies: All
medicines and vaccines are imported from continental France and available to
the public.
Human resources: In
2000, the archipelago had 18.6 physicians, 45.3 nurses and 3.3 dentists per
10,000 population . The University of the Antilles and French Guiana runs courses
for the first year of medical school in Guadeloupe . There is a nursing school
and a school for ambulance personnel. Other professionals are trained in continental
France.
Health research and technology: The
National Institute of Medical Research has a unit dedicated to hemoglobinopathies
in Guadeloupe , as well as a guiding council that enables local research proposals
to be considered.
Health sector expenditure and financing:Financial resources come from the central-level ministries
and local communities, the social security system, non-governmental organizations
and the European Union.
