• Project title: Study and data collection on malaria control interventions in Burkina Faso
• Host team: National Malaria Control Program
• Mobility dates: April 25 to June 30, 2022 and August 19 to September 30, 2022
• Keywords: Malaria; surveillance; interventions; Burkina Faso
• Summary for the general public:

Researching the link between malaria and the interventions put in place to tackle it, with the aim of optimizing them, is a key step in the fight against malaria. We are interested in this link and propose to evaluate the performance of interventions and control strategies, and also to propose if necessary a reorganization or redeployment of interventions in the appropriate time and space for an efficient result. Knowing the details and implementation methods of these interventions is therefore essential to address this work and support the malaria control strategy in Burkina Faso.

Our first task at the PNLP was therefore to collect data on interventions implemented to combat malaria. These interventions include the distribution of impregnated mosquito nets (pregnant women, children under 5 and the general population), seasonal chemoprevention, indoor residual spraying, intermittent preventive treatments, community health agents and rapid screening tests.

We then verified the data and corrected any outliers. Finally, we will use this good quality data to Research the link between malaria and interventions, and possibly propose a new strategy for implementing these interventions in collaboration with the PNLP. This work will therefore lead to the updating of the epidemiological malaria facies in Burkina Faso, and also to a stratification of the country into homogeneous zones to be strategically targeted when implementing control interventions.

• Thesis title: The human embryo: analysis of a socio-representational phenomenon
• Thesis supervisor: Lionel Dany (LPS) ; Thémis Apostolidis (co-supervisor, LPS)
• Doctoral school: ED 356
• Key words: Human embryo; biotechnologies; procreation; social representations

• Summary for the general public:

  An interview survey was carried out between 2023 and 2024 to investigate the impact of personal involvement in ways of thinking about the status of the human embryo and their links with processes of (de)legitimization of medical biotechnologies (PMA, human embryo research). The study involved 22 participants, including patients undergoing MAP, healthcare professionals (gynecologists and genetic counselors), and so-called "child-free" individuals. These groups were chosen for their level of involvement with the embryo: for example, for MAP patients, the embryo is technically present at every stage of the process, right up to the annual decision to preserve, destroy or donate the remaining embryos that are frozen following in vitro fertilization. Professionals are technically involved in the procreation process, have access to patients' views and are also subject to a legal framework governing their practice. Those who are "child-free", having no direct relationship with the embryo, could evoke ideological or societal aspects.

  Participants first reacted to images of embryos, one of which showed an umbilical cord and an amniotic sac. This task enabled us to observe the influence of these visual elements on the perception of the embryo: the image with a cord is often interpreted as the "success" of a PMA journey, while the other is perceived as a failure or a symbolic representation of death. Participants perceive the variability of embryo status according to context: for example, distinguishing between desired and terminated pregnancies, or recognizing the influence of religious socialization. As for biotechnologies, PMA patients are ambivalent about donating unused embryos to Research, some considering them almost like their own children. Professionals, on the other hand, emphasize the therapeutic benefits of Research, such as improved fertility treatments. Child-free" people, on the other hand, can sometimes be more critical of reproductive biotechnologies. They may see the use of these techniques as symptomatic of a consumer society where individual desires are prioritized, as is the desire for a child.

  The results show that the level of involvement and life paths influence the representations of the embryo. Experiences of MAP and healthcare work make the embryo an emotionally and socially charged object, which also implies a questioning of procreative norms. The status of the embryo is perceived at the crossroads of morality, science and the law, with a diversity of points of view that makes it complex to build a consensus, which should nevertheless be questioned.

• Thesis title: Profiles, practices and health of regular cannabis users in the French context
• Thesis supervisor: Perrine Roux (SESSTIM)
• Doctoral school: ED 62
• Date of 4th year: January 2024 to January 2025
• Keywords: Cannabis use; consumption pathways; self-medication; Harm Reduction; mixed methods
• Summary for the general public:

Despite prohibitive policies, the prevalence of cannabis use has continued to rise in the French population over recent decades. Moreover, modes of use and available products continue to diversify, with persistent uncertainty as to the quality of products in circulation. Against a backdrop of controversy surrounding cannabis (for example, with regard to its medical use or legal status), it is necessary to propose new public health strategies tailored to the needs of the people concerned, particularly in order to reduce the risks associated with cannabis. The overall aim of this thesis work is to describe and understand the use practices of regular cannabis users in France, as well as their perceptions of the benefits and risks associated with these practices.

This thesis work is based on the cross-referencing of data from three questionnaire surveys, conducted via the Internet in collaboration with community health associations, and data from 21 interviews with regular cannabis users aged between 18 and 68. A number of analyses of the questionnaire responses enabled us to describe the participants' profiles and motivations with regard to therapeutic uses (outside medical recommendation), and also with regard to product quality management. The analysis of interview participants' accounts enables us to describe the strategies they put in place to manage their consumption in their daily lives.

The results reveal profiles of "expert" users, socially integrated, who claim "responsible" and/or "therapeutic" uses. Indeed, many cannabis users voluntarily adapt their practices in order to maintain, or even improve, their physical, mental and social functioning in their daily lives. The strategies put in place take into account the context of consumption, the form and quality of the products, the source of supply, and the modes of consumption. Finally, these strategies are not implemented in the same way according to age, gender, level of education, state of health and material living conditions.

Finally, these results underline the possibility of non-problematic trajectories of cannabis use, or even positive trajectories. Public health policies and interventions could thus aim to strengthen the skills, knowledge and autonomy of people who use cannabis. They could also enable safer supply practices, notably by offering alternatives to the illegal market or by controlling the quality of products on the cannabis market.

• Project title: Caring for the pandemic: foreign-educated hospital staff in the southern region
• Date of event: December 2022 to February 2023
• Summary for the general public: (coming soon)

• Project title: AMADES - Colloque international francophone et multisite Anthropologie et Covid. States, experiences and uncertainties in times of pandemic.
• Mobility dates: June 15 to 17, 2022
• Summary for the general public:

The AMADES association, in association with its institutional and scientific partners, has organized a multisite, Internationally French-speaking colloquium, entitled "Anthropologie et Covid-19. States, experiences and uncertainties in times of pandemic".

The aim of the colloquium was to question anthropological Research on the health crisis caused by the SARS-CoV-2 pandemic, and the way in which this new pandemic renewed the objects and methods of the discipline.

The colloquium included plenary lectures, panels and round tables. Particular attention was paid to papers based on anthropological research, and more broadly to qualitative research based on ethnographic surveys.

In keeping with the values cherished by the AMADES association, presentations were programmed in an interdisciplinary and interprofessional way, with several voices (anthropology, sociology, medical sciences, environmental sciences, institutions, patient associations, etc.). Comparative approaches highlighting work carried out on other epidemics (Ebola, HIV) were also on the agenda.

The colloquium took place on June 15, 16 and 17, 2022 at the Cité des Associations in Marseilles, and brought together over 100 participants to discuss themes relating to the experiences and forms of the disease, from the point of view of both patients and carers; inequalities; the consequences of the pandemic on healthcare systems and policies; public health measures; and the relationship between environmental health and epidemic crises.

• Title of the thematic school, organizing structure: 3rd Corsican Summer School on Modern Methods in Biostatistics and Epidemiology, Université de Corse Pascal Paoli
• Date: July 4 to 8, 2022
• Keywords: Net Survival; Non-parametric estimation; Missing data; Multiple event analysis
• Summary for the general public:

From July 4 to 8, 2022, I was able to attend the Summer school organized by Pr. Giorgi and the CENSUR (Challenges in the Estimation of Net SURvival) working group and held at the Université de Corse Pascal Paoli in the town of Corte (CORSE). During these 5 days, I attended several theoretical presentations on net survival. The presentations covered a range of topics, including numerical methods for estimating parameters, practical applications in public health and the management of missing data in this type of analysis.

In addition to the theoretical presentations, we were also able to practice using these methods with R software, under the guidance of the people who had developed them. The alternation of theoretical and practical sessions enabled us to directly apply the methods we had learned about on the same day.

Last but not least, we were also able to interact with the speakers, not only during the presentations and practical sessions, but also over dinner and during the various breaks. What's more, the Summer school also gave me the opportunity to meet PhD students and researchers from other countries, and to exchange ideas with them on our respective research themes.

So this week of training was an opportunity for me to deepen my knowledge of a particular survival method from both a theoretical and practical point of view, and to have enriching exchanges with PhD students and researchers from various countries.

• Project title: Evaluation médico-économique de la prise en charge des patients hépatite B chronique dans le cadre de la cohorte Sen-B à Dakar (ECO-SenB)
• Host team: Department of Infectious and Tropical Diseases, Fann Hospital (SMIT, Pr Moussa Seydi)
• Mobility dates: February 4 to 15, 2024
• Keywords: economic evaluation; cost-effectiveness; chronic hepatitis B; Senegal
• Summary for the general public:

I carried out a ten-day mission in Senegal as part of my post-doctorate (IRD) carried out at SESSTIM on the evaluation of the efficiency and equity of viral hepatitis management models in sub-Saharan Africa.
As part of this assignment, I mainly worked in the Infectious and Tropical Diseases Department (SMIT) at Fann Hospital with the "Sen-B" research cohort team. Since 2019, the Sen-B cohort has recruited and followed nearly 1,000 patients with chronic hepatitis B virus (HBV) infection. It is the largest cohort of people living with chronic HBV infection (PLHIV) in sub-Saharan Africa.
The main objective of my assignment was to gather the data required to carry out a medico-economic evaluation of the cohort's proposed management of PLHIV. Using mathematical modelling tools, this evaluation enables us to project into the future and estimate the effectiveness (in terms of life-years gained, for example) and cost (for the healthcare system) of the cohort's proposed management of PLHV. These are very important data for public decision-makers and international funding agencies.
The medico-economic evaluation is based on simulating the fate of PLHIV, with and without medical follow-up. It is therefore first necessary to model their evolution by defining several possible states of health through which PLHIV may pass. A major part of my mission was to gain a clear understanding of the cohort's proposed follow-up, the indications for starting treatment and the possible evolution of patients, with and without treatment. These discussions led to the development of a clinical model specific to the cohort's HBV follow-up (see below).

The other part of the medico-economic analysis was based on a study of the costs associated with each health state in the model. The costs of biological examinations were collected from the SMIT and CRCF laboratories, the costs of consultations and imaging procedures were evaluated after interviews with the cohort staff, and the costs of medication were obtained from the Fann Hospital central pharmacy and several private pharmacies. Finally, I took advantage of this mission to meet Fatou Nguirane, president of the PVVHB association "Saafara Hépatites", to discuss future collaborations.
My mission ended with a meeting with the Research team to (i) present the progress and next steps of the cost-effectiveness analysis and (2) validate the plan for the quality of life analyses around two draft articles.