Éditeur(s) : DPLSH : Département Pluridisciplinaire de Lettres, Langues et Sciences humaines CRILLASH : Centre de Recherches Interdisciplinaires en Lettres, Langues, Arts et Sciences Humaines G.R.R.E.A. 17/18 : Groupe de Recherches sur les Représentations Européennes de l'Afrique aux XVIIe et XVIIIe siècles Mémorial ACTe
Extrait de : "Les représentations du Noir dans la littérature, l'histoire et les arts européens et américains des XVIIIe, XIXe et début du XXe siècle" : colloque pluridisciplinaire, du 27 février au 2 mars 2013. Université des Antilles et de la Guyane
Description : In discussing the "roles" and functions of black people at European courts, both genuine and imitation, I will show that a number of recurring patterns can be detected, which may explain why potentates found black people attractive to have around them.
Siècle(s) traité(s) : 18
Droits : CC-BY-NC-ND - Attribution - Pas d'utilisation commerciale - Pas de modification
Permalien : http://www.manioc.org/fichiers/V13059
V13059

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Background: Squamous cell carcinoma (SCC) is considered the most frequent skin cancer in black people. Its incidence is not known in the Afro-Caribbean population.Objective: To assess the incidence of SCC in Guadeloupe, the largest island of the Lesser Antilles (405 000 inhabitants, mostly black people of African and European descent). The second objective was to characterize clinical and histological patterns of SCC occurring in the Afro-Caribbean community.Methods: This retrospective study was conducted over an 11-year period (2000-2010). Data regarding 723 histological confirmed cases of SCC identified using the three Guadeloupean pathology laboratories computerized databases were retrieved from the records of 551 patients. Private practice dermatologists and general practitioners were contacted to obtain any missing data. Results: The annual age-adjusted incidence of SCC was 15 per 100.000 residents in Guadeloupe. In the Afro-Caribbean community, SCC had a greater size (i.e.: 2.8±2.8 cm versus 1.5±1.0 cm, p<0.001), was more often located on the anogenital area (i.e. :48/79-60.8% versus 14/320-4.4%, p<0.001) in association with an underlying dermatosis due to HPV infection (15/71- 21.1% versus 3/366, 0.8%, p<0.001) and led more frequently to metastasis (13/84-15.5% versus 10/366-2.7%, p<0.001) and/or fatal evolution (11/83-13.3% versus 7/365-1.9%, p<0.001). Conclusions: The results of this original study, which first estimated the incidence of SCC in West Indies, suggest that anogenital examination should be routinely performed in skin cancer screening of Afro-Caribbean people in order to detect the presence of SCC at an early stage.
ISSN: 0926-9959

inserm-01513116
http://www.hal.inserm.fr/inserm-01513116
http://www.hal.inserm.fr/inserm-01513116/document
http://www.hal.inserm.fr/inserm-01513116/file/2017%2C%20Cordel%20-%20Squamous%20cell%20carcinoma%20in%20the%20Afro-Caribbean%20community.pdf
http://www.hal.inserm.fr/inserm-01513116/file/CordeletalJ%20Eur%20Acad%20Dermatol%20Venereol2017.pdf

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. They are organized by geographical location.
Typical atmosphere of Downtown Port-au-Prince. People walking around and buying. Others selling. Very clean compared to now.
Haiti -- Caribbean region
Haiti
Haiti
Haiti

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 57:8
http://ufdc.ufl.edu/CA01200281/00001

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. They are organized by geographical location.
Several people at a voodoo ceremony, among them, one man (blue shirt) playing the tcha-tcha (empty gourd filled with seeds) and holding a candle.
Haiti -- Caribbean region
Haiti
Haiti
Haiti

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 47: 13
http://ufdc.ufl.edu/CA01200180/00001

Résumé : Recto color: red ; Verso color: black
Panama -- Kuna Yala -- San Blas Islands

Droits : The University of Florida George A. Smathers Libraries respect the intellectual property rights of others and do not claim any copyright interest in this item. This item may be protected by copyright but is made available here under a claim of fair use (17 U.S.C. §107) for non-profit research and educational purposes. Users of this work have responsibility for determining copyright status prior to reusing, publishing or reproducing this item for purposes other than what is allowed by fair use or other copyright exemptions. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder. The Smathers Libraries would like to learn more about this item and invite individuals or organizations to contact Digital Services (UFDC@uflib.ufl.edu) with any additional information they can provide.
2011.004.220
http://ufdc.ufl.edu/AA00016510/00001

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. They are organized by geographical location.
People on the airfield of the François Duvalier Airport in Port-au-Prince. Others standing on the second floor of the building.
Haiti -- Caribbean region
Haiti
Haiti
Haiti

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 56:10
http://ufdc.ufl.edu/CA01200265/00001

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. They are organized by geographical location.
On the left side, Haitian market in Port-au-Prince. People are selling clothes, bar soaps and all kind of goods inside. On the right side, the red cart is a ice cream cart, next to lottery booth.
Haiti -- Caribbean region
Haiti
Haiti
Haiti

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 56:13
http://ufdc.ufl.edu/CA01200268/00001

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. They are organized by geographical location.
People standing up and sitting down in their backyard. Almond trees and palm trees in the backyard.
Haiti -- Caribbean region
Haiti
Haiti
Haiti

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 56:11
http://ufdc.ufl.edu/CA01200266/00001

Éditeur(s) : HAL CCSD
Résumé : In Martinique in the eighteenth century, the "free people of color", both those free by birth and freedmen, black or mixed race, form a legal category, which was distinct from those of whites and slaves. Comparative studies with Spanish or English territories show that no legal regulation formalized a shift - from the category of free colored people to that of White - in the French colonies between the late seventeenth century and the French Revolution. Also, this thesis proposes to show the informal process that enabled some people - the "assimilated" - to cross the color barrier. I analysed the color prejudice, a racist system, whose ideology, supported by local regulations, legitimized the collective construction of a public and social order. In a second step, I examined the development of the color bar. The free colored people were the first to bear the brunt of the impermeability of the demarcation line and of the problems posed by the purity of blood; but some whites, through interracial unions, and Native Americans have also been targeted. Finally I thought about what made the whiteness, and the strategies to achieve whiteness, change in status. Notarial acts and 33,000 acts of parish registers treaties led to the reconstitution of genealogies, in order to examine individuals and families over generations; I observed the importance of the phenotype, whitening, legitimacy relations, privileged partners, choice of networks, wealth levels and the use of space.
À la Martinique au XVIIIe siècle, les « libres de couleur », qu’ils soient nés libres ou affranchis, noirs ou métis, forment une catégorie juridique distincte des Blancs et des esclaves. L’étude comparée, avec les territoires espagnols ou anglais, montre qu’aucune réglementation légale n’a officialisé un passage de la catégorie Libre de couleur à celle de Blanc dans les colonies françaises de la fin du XVIIe siècle à la Révolution française. Aussi, cette thèse se propose de montrer les processus officieux qui ont permis à certaines personnes – les « assimilés » – de franchir la barrière de couleur. Une réflexion a été menée sur le préjugé de couleur, système raciste dont l’idéologie, soutenue par la réglementation locale, a légitimé la construction collective d’un ordre public et social. Puis, on a examiné l’élaboration de la barrière de couleur. Les libres de couleur ont été les premiers à faire les frais de l’imperméabilisation de la ligne de démarcation et des problèmes posés par la pureté de sang ; mais les Blancs mésalliés, dans le cadre d’unions interraciales, et les Amérindiens ont aussi été visés. Enfin nous avons réfléchi à ce qui faisait la blancheur et aux stratégies adoptées pour réussir ce changement de statut. Le notariat et les 33 000 actes des registres paroissiaux traités ont donné lieu à la reconstitution de généalogies pour examiner des individus et des familles sur plusieurs générations ; on a ainsi observé l’importance du phénotype, le blanchiment, la légitimité des relations, les conjoints privilégiés, le choix des réseaux, les niveaux de fortune et l’usage de l’espace.
https://tel.archives-ouvertes.fr/tel-01221063

NNT : 2015AGUY0847
tel-01221063
https://tel.archives-ouvertes.fr/tel-01221063
https://tel.archives-ouvertes.fr/tel-01221063/document
https://tel.archives-ouvertes.fr/tel-01221063/file/These_Pierre-Louis.pdf

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. They are organized by geographical location.
People buying and selling at a Haitian market.
Haiti -- Caribbean region
Haiti
Haiti
Haiti

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 57:9
http://ufdc.ufl.edu/CA01200282/00001

Résumé : Recto color: red ; Verso color: black
Panama -- Kuna Yala -- San Blas Islands

Droits : The University of Florida George A. Smathers Libraries respect the intellectual property rights of others and do not claim any copyright interest in this item. This item may be protected by copyright but is made available here under a claim of fair use (17 U.S.C. §107) for non-profit research and educational purposes. Users of this work have responsibility for determining copyright status prior to reusing, publishing or reproducing this item for purposes other than what is allowed by fair use or other copyright exemptions. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder. The Smathers Libraries would like to learn more about this item and invite individuals or organizations to contact Digital Services (UFDC@uflib.ufl.edu) with any additional information they can provide.
2011.004.307
http://ufdc.ufl.edu/AA00016612/00001

Éditeur(s) : Whittlesey House, McGraw-Hill Book Co. Whittlesey House, McGraw-Hill Book Co. ( New York, London )
Résumé : Maps on lining-papers.
" ... scenes in the lives of a Negro people ... the Saramacca tribe ..."--Pref.
(Statement of Responsibility) by Melville J. Herskovits and Frances S. Herskovits.
Suriname
Suriname

01114525
34014521
1114525

Résumé : Recto color: red; Verso color: black
Panama -- Kuna Yala -- San Blas Islands

Droits : The University of Florida George A. Smathers Libraries respect the intellectual property rights of others and do not claim any copyright interest in this item. This item may be protected by copyright but is made available here under a claim of fair use (17 U.S.C. §107) for non-profit research and educational purposes. Users of this work have responsibility for determining copyright status prior to reusing, publishing or reproducing this item for purposes other than what is allowed by fair use or other copyright exemptions. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder. The Smathers Libraries would like to learn more about this item and invite individuals or organizations to contact Digital Services (UFDC@uflib.ufl.edu) with any additional information they can provide.
2011.004.617
http://ufdc.ufl.edu/AA00017042/00001

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. The are organized by geographical location.
People walking along a street on sidewalks. A black automobile is parked beside the two story building of Kelly's Bakery. Slide labeled Nassau Mar .'46.
Bahamas -- North America -- New Providence Island

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
Sheet 16:17
http://ufdc.ufl.edu/AA00029458/00001

Éditeur(s) : Université des Antilles Études caribéennes
Résumé : This paper examines the changing fortunes of Durban as a tourist city from the apartheid to the post apartheid eras. Durban has long earned its prime position as one of South Africa’s most popular year‑round tourist destination. In keeping with the dictates of apartheid, the city catered largely for the needs of the white minority, while that of the black majority was largely ignored. With political changes and shifts in both the international and domestic markets, an effort had to be made to reposition tourism in the city. In order to successfully promote its tourism opportunities, Durban attempted to enhance its image and appeal by promoting its sports, convention and cultural attractions. The democratic transition of the 1990s provided many challenges, the most enduring of which was the need to cater for the emerging black tourist market. There was also an urgency to address problems of crime and grime, disparities in the distribution of labour market opportunities, especially in terms of race and gender within the tourism sector. A serious threat to tourism in Durban is unemployment and alienation of the majority of African people from the industry.
Ce document examine l'évolution des dynamiques touristiques de la ville de Durban dans un contexte post-apartheided. La ville de Durban s’est imposée comme l'une des destinations touristiques les plus populaires d’'Afrique du Sud. En accord avec les diktats de l'apartheid, pour satisfaire les souhaits d’une minorité blanche, l’organisation de la ville avait ignoré les besoin de la majorité noire. Aujourd’hui la ville de Durban se repositionne sur l’échiquier touristique, portée par les changements politiques intérieurs et les opportunités des marchés touristiques internationaux et nationaux. Afin de se positionner avec succèssur ce marché, la ville de Durban renforce son image autour de la promotion son front de mer, des sports nautiques, du tourisme de congrés, et des animations culturelles. La transition démocratique des années 1990 a fourni de nombreux défis et oppportunités dans la première sur le plan touristique fut de se positionner sur le nouveau marché touristique noir. Cal passe aussi par les urgence à résoudre sur le plan de la criminalité, de l’hygiène et de la résorption des disparités sur le marché du travail, en particulier en termes de race et de l'égalité des sexes dans le secteur du tourisme. Les plus sérieuses limites pour le tourisme à Durban sont le chômage et la marginalisation de la majorité des African people.
Afrique du Sud
Durban

Droits : info:eu-repo/semantics/openAccess
urn:doi:10.4000/etudescaribeennes.1192
http://journals.openedition.org/etudescaribeennes/1192

Résumé : The slides were taken on collecting trips sponsored by the William L. Bryant Foundation, where books, music and art indigenous to the regions were gathered. The are organized by geographical location.
This image is of an exhibit featuring a classroom in the People’s Museum of Craft and Technology, Spanish Town, Saint Catherine, Jamaica. The exhibit has a chalk board discussing Christopher Columbus's exploration of Jamaica, a color classroom map of the West Indies, a black and white map of Jamaica, and student desks topped with slates and books. Slide labeled Jam. Museum of Spanish Town.
Jamaica -- Caribbean region -- Spanish Town, Saint Catherine

Droits : All rights to images are held by the respective holding institution. This image is posted publicly for non-profit educational uses, excluding printed publication. For permission to reproduce images and/or for copyright information contact Special Collections & University Archives, University of Central Florida Libraries, Orlando, FL 32816 phone (407) 823-2576, email: speccoll@mail.ucf.edu
CFM1972_01a
http://ufdc.ufl.edu/AA00031091/00001

Résumé : Recto color: black; verso color: red
Panama -- Kuna Yala -- San Blas Islands

Droits : The University of Florida George A. Smathers Libraries respect the intellectual property rights of others and do not claim any copyright interest in this item. This item may be protected by copyright but is made available here under a claim of fair use (17 U.S.C. §107) for non-profit research and educational purposes. Users of this work have responsibility for determining copyright status prior to reusing, publishing or reproducing this item for purposes other than what is allowed by fair use or other copyright exemptions. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder. The Smathers Libraries would like to learn more about this item and invite individuals or organizations to contact Digital Services (UFDC@uflib.ufl.edu) with any additional information they can provide.
2011.004.449
http://ufdc.ufl.edu/AA00016740/00001

Résumé : La banane plantain (Musa paradisiaca) est l’aliment de base de millions de personnes dans le monde et sa culture génère des revenus permanents pour un grand nombre d’agriculteurs, dans des plantations de taille petite ou moyenne. Comme dans d’autres régions tropicales, la culture du plantain en Guadeloupe et en Haïti est soumise à de fortes contraintes parasitaires aussi bien telluriques (i.e. du sol : nématodes phytoparasites et charançon du bananier) qu’aériennes (Cercosporiose noire notamment). Les moyens de lutte conventionnels reposent sur l’usage de produits de synthèse dont les effets néfastes sur l’environnement (sols, eaux, animaux) comme sur la santé humaine ne sont plus supportables. Il est donc urgent de réfléchir à des solutions agro-écologiques permettant de rétablir les équilibres biologiques, de maintenir une bonne qualité des sols et une production optimale dans les systèmes de culture plantains. C’est le but de ce travail de thèse qui couple la réalisation d’un diagnostic agro-écologique dans des parcelles paysannes, et le test d’alternatives agro-écologiques en milieu semi-contrôlé. Pour ce faire, une typologie des systèmes de culture plantains a été réalisée à l’issue d’une enquête agro-environnementale dans les deux zones d’étude. Elle a permis de sélectionner 23 parcelles en Guadeloupe et 12 en Haïti dans lesquelles un diagnostic agro-écologique a été conduit. Sur la base de ce diagnostic et de la recherche d’alternatives agro-écologiques à l’usage des produits chimiques, une expérimentation au champ a été mise en place en Guadeloupe en station de recherche, permettant le test de trois pratiques culturales innovantes pour le plantain (seules et combinées), à savoir : i) l’introduction d’une plante de service Paspalum notatum pour la gestion des adventices et la réduction de l’utilisation d’herbicides ; ii) l’apport de vermicompost pour le contrôle des nématodes phytoparasites inféodés au bananier plantain et la fertilisation de celui-ci ; iii) l’utilisation de plants sains PIF (Plants Issus de Fragments de tiges) indemnes de nématodes et de larves de charançon du bananier. La typologie des systèmes de culture plantains révèle que : i) en Guadeloupe les précédents : jachère, ananas et banane plantain sont prédominants avec un niveau d’intensification faible (apports d’intrants chimiques faibles et peu fréquents) ou élevé (apports d’intrants chimiques élevés et plus fréquents) ; ii) en Haïti, les précédents : jachère, banane plantain et manioc prédominent avec un niveau d’intensification faible ou nul (apport d’intrants inexistant). Les résultats du diagnostic agro-écologique montrent que, i) lorsque le niveau d’intensification est faible, les bananeraies plantains pérennes et le précédent-ananas permettent de maintenir une bonne qualité du sol et une bonne régulation des parasites telluriques ; ii) lorsque le niveau d’intensification est fort, les populations d’ingénieurs du sol diminuent drastiquement, alors que le cortège parasitaire tellurique augmente sans que cela n’affecte l’obtention de bons niveaux de rendement instantannés (parcelles précédées d’ananas ou d’une jachère principalement) ; iii) en absence totale de fertilisation, il résulte une diminution de l’activité biologique du sol mais aussi du rendement du plantain, exacerbé par le choix des précédents-culturaux (manioc ou banane plantain) en lien avec les contraintes pédoclimatiques et la maladie des raies noires (Cercosporiose noire) causée par Mycosphaerella fijiensis, notamment au sein des parcelles Haïtiennes ; iv) la succession plantain/plantain est la plus pénalisante vis-à-vis de la culture du plantain, car quelque soit le niveau d’intensification, le rendement reste relativement faible, en lien avec une dégradation de l’état sanitaire, comparativement aux autres précédents.
Plantain (Musa paradisiaca) is the staple food of millions of people worldwide and its cropping generates ongoing revenues for many farmers who are planting small or medium size areas. As in other tropical regions, plantain cultivation in Guadeloupe and Haiti is under heavy parasitic constraints terrestrial (plant-parasitic nematodes and banana weevil) as well as aerial (black Sigatoka in particular). Conventional means of control based on the use of synthetic products which adverse effects on the environment (soil, water, animals ...) as on human health are not bearable any more. It is thus urgent to think about agroecological solutions allowing to restore the biological balances, to maintain good soil quality and optimal plantain cropping systems.This is the ultimate goal of this thesis which couples the realization of an agroecological diagnosis in peasants’ plots, and the test of agroecological alternatives in semi-controlled conditions. To do this, a typology of plantain cropping systems was carried out from an agrienvironmental survey in the two study areas. It allowed to select 23 plots in Guadeloupe and 12 in Haiti in which an agroecological diagnosis was implemented. Based on this diagnosis and the research of agroecological alternatives to the use of chemicals, a field experiment was set up in Guadeloupe, in an experimental station allowing the test of three innovative practices for plantain cultivation (alone and combined), namely : i) the introduction of a cover-crop Paspalum notatum for weed control while reducing the use of herbicides ; ii) the input of worms’ compost to control plant-parasitic nematodes specific to plantain and to fertilize it ; iii) the use of healthy “PIF” plants (plants issued from stem fragments) free from telluric pests (nematodes and weevil’s larvaes).The typology of plantains cropping systems shows: i) in Guadeloupe the previous crops are: fallow pineapple and plantain predominate with a low level of intensification (low and infrequent chemical inputs) or high (high and frequent chemical inputs); ii) in Haiti, the previous crops are: fallow, plantain and cassava predominate with a low level or no intensification at all (no inputs). The results of the agroecological analysis show that : i) when the level of intensification is low, perennial plantain and pineapple as previous crops help maintaining a good soil quality and a good regulation of the telluric pests ; ii) when the level of intensification is strong, the soil engineers drastically reduce, while the density of telluric parasites increases without affecting good levels of instantaneous yields (plots where the previous crop is pineapple or mostly fallow) ; iii) when the fertilization is totally missing, it decreases the biological activity of the soil furthermore the plantain yields, exacerbated by the choice of the previous crop (cassava or plantain), in connection with soils and climate constraints and the black Sigatoka caused by Mycosphaerella fijiensis, especially in the Haitian plots ; iv) the crop succession plantain/plantain is the most critical regarding the plantain’s cropping, because whatever the level of intensification, the yields remain relatively low in connection with a degradation of the health state, compared to other previous crops.The driving of an experiment in a research station shows that on the scale of one year, the three tested innovative practices allow maintaining a good soils quality. Healthy plants "PIF" have a better health state (absence of plant parasitic nematodes in the roots) which helps a significant increase of the yields. Cover-crop P. notatum helps the weeds and the soil pests control and favors the improvement of soil biological activity and plantain yields. Worms’ compost contributes to the maintenance of a better soils quality while allowing the regulation of the populations of plant-parasitic nematodes of the plantains.

http://www.theses.fr/2014AGUY0758/document

Résumé : L’objet de cette thèse est de présenter les spécificités épidémiologiques, étiologiques et thérapeutiques de la pathologie neurovasculaire dans la population noire spécifique que constitue la population martiniquaise. En 1998, l’étude ERMANCIA I a permis de mettre en évidence une surincidence des accidents vasculaires cérébraux (AVC) en Martinique d’environ 40% par rapport à la métropole avec une haute prévalence de l’hypertension artérielle et du diabète. Ces résultats ont participé à la création en 2003 de la 1ère unité neurovasculaire aux Antilles. Le suivi à 5 ans des patients ERMANCIA I a révélé que la moitié était décédée et que 50% des survivants présentaient une démence vasculaire (soit le double des cohortes métropolitaines), probablement favorisé par une microangiopathie cérébrale sous-jacente souvent sévère amplifiant l’impact cognitif de l’AVC. Ce suivi a également permis d’identifier les faiblesses de la prévention secondaire en Martinique avec près de 80% des hypertendus qui restent mal équilibrés justifiant la création en 2006 d’un réseau de prévention. L’efficacité de ce réseau a été évaluée montrant un taux élevé de bon contrôle tensionnel (74% vs 39%, p=0,01) et une morbi-mortalité vasculaire moindre à 2,5 ans (8,3% vs 24%, p<0,001) que chez les patients contrôles. En 2012, ERMANCIA II a permis de révéler une diminution majeure (en moyenne 30%) de l’incidence des AVC dans la population martiniquaise et de la mortalité à 1 mois pour les patients ≤55 ans (20% vs 8%, p=0,03) probablement en raison d’une meilleure implémentation des mesures de prévention primaire et de la prise en charge en UNV respectivement. Nos données ont également permis de décrire certaines spécificités étiologiques des AVC chez les Martiniquais : grande fréquence de l’athérome intracrânien (pour lequel nous apportons des arguments en faveur d’une nouvelle classification), infarctus choroïdiens antérieurs dont nous décrivons le profil évolutif particulier, infarctus lacunaires multiples sévères. Deux étiologies plus « classiques » comme la drépanocytose et les IC sur morsure de serpent sont devenues anecdotiques. En revanche, une dysplasie carotidienne focale, étiologie déjà décrite mais supposée rare , pourrait être responsable d’un tiers des infarctus carotidiens d’origine indéterminée chez les Afro-Caribéens ≤55 ans exposant à un risque élevé de récidive sous traitement antiagrégant (28% à 14 mois), contre aucun pour les patients traités par endartériectomie. Sur le plan thérapeutique, nos résultats sont en faveur d’un surrisque hémorragique de la thrombolyse standard chez les patients martiniquais les plus âgés, probablement en rapport avec un cumul de lésions microangiopathiques plus important. En l’absence de neuroradiologie interventionnelle en Martinique, nos travaux montrent que certains patients avec occlusion artérielle proximale résistante à la thrombolyse IV standard peuvent bénéficier d’un complément de thrombolytique (0,1mg/Kg de tenecteplase). Une étude randomisée est prévue afin de mieux mesurer le potentiel thérapeutique de cette stratégie. Pour conclure, l’intérêt de ces données est que la population martiniquaise partage très probablement beaucoup de ses « particularités » avec d’autres populations noires encore peu décrites et pour lesquelles l’occidentalisation progressive du mode de vie risque d’accentuer le fardeau représenté par les AVC.
Our work presented herein aimed to describe the epidemiological, etiological and therapeutic features of the stroke pathology in the Martinican Afro-Caribbean population. In 1998, the first population-based epidemiological study, ERMANCIA I, showed a 40% greater firstever stroke incidence in Martinique compared to those observed in continental France, with a high prevalence of hypertension and diabetes. These results contributed to the creation, in 2003, of the first stroke unit in the Caribbean area. In the 5_year follow-up study, we found that half of the patients had died and that 50% of survivors were affected from vascular dementia (twice compared with continental French cohorts): this figure was probably favored by severe underlying cerebral microangiopathy that amplified the cognitive impact of stroke. We also identified a failure in the secondary prevention in Martinique, certified by nearly 80% of hypertensive patients still insufficiently controlled. As a result, in 2006, we developed a well-structured stroke prevention network. The efficiency of this network was attested by the high rate of good blood pressure control (74% vs. 39%, p=0.01) and the reduced vascular morbidity and mortality rate (8.3% vs. 24%, p <0.001) after a 30-month period of activity, in comparison with control “historic” patients. In 2012, ERMANCIA II study revealed a 30% reduction of first-ever stroke incidence and a reduced mortality rate at 1 month for patients ≤55 years (8% vs. 20%, p = 0.03), compared to these observed in ERMANCIA I, likely due to improvement of primary stroke prevention and the best stroke unit management at the acute phase, respectively. Based on our etiological data, we underline: 1) the relatively high frequency of symptomatic intracranial atherosclerosis, for which we propose a new definition; 2) the clinic-radiological features of stroke in the anterior choroidal artery; 3) the atypical picture of “malignant” multilacunar syndrome. On the other hand, stroke due to sickle cell disease or “trigonocephale” snakebite were only anecdotal. However, we found that carotid-bulb atypical fibromuscular dysplasia (CAFD), a very unusual previously described cause of stroke, could be responsible for up to the third of carotidterritory stroke of so-called undetermined etiology among patients ≤55 years. In addition, the relatively high rate of recurrence under antiplatelet (28% at 14 months), was dramatically reduced by endarterectomy in patients with CAFD. From a therapeutic point of view, our results showed an excess rate of post-thrombolysis symptomatic intracerebral hemorrhages in older patients, a figure probably linked to the severe underlying hypertension-triggered cerebral microangiopathy. Owing to the lack of neurointerventionnal option in Martinique, we tested a new therapeutic strategy in patients with a proximal arterial occlusion not responsive to standard IV thrombolysis, consisting in an additional administration of IV tenecteplase, 0.1mg/kg. Our preliminary results were promising, leading us to plan a randomized study. Finally, most of the characteristics of stroke in this Afro-Caribbean population are probably shared by the majority of black people. Thus, our results could have a universal impact in the understanding of stroke burden in blacks.

http://www.theses.fr/2015AGUY0909/document

Résumé : À la Martinique au XVIIIe siècle, les « libres de couleur », qu’ils soient nés libres ou affranchis, noirs ou métis, forment une catégorie juridique distincte des Blancs et des esclaves. L’étude comparée, avec les territoires espagnols ou anglais, montre qu’aucune réglementation légale n’a officialisé un passage de la catégorie Libre de couleur à celle de Blanc dans les colonies françaises de la fin du XVIIe siècle à la Révolution française. Aussi, cette thèse se propose de montrer les processus officieux qui ont permis à certaines personnes – les « assimilés » – de franchir la barrière de couleur. Une réflexion a été menée sur le préjugé de couleur, système raciste dont l’idéologie, soutenue par la réglementation locale, a légitimé la construction collective d’un ordre public et social. Puis, on a examiné l’élaboration de la barrière de couleur. Les libres de couleur ont été les premiers à faire les frais de l’imperméabilisation de la ligne de démarcation et des problèmes posés par la pureté de sang ; mais les Blancs mésalliés, dans le cadre d’unions interraciales, et les Amérindiens ont aussi été visés. Enfin nous avons réfléchi à ce qui faisait la blancheur et aux stratégies adoptées pour réussir ce changement de statut. Le notariat et les 33 000 actes des registres paroissiaux traités ont donné lieu à la reconstitution de généalogies pour examiner des individus et des familles sur plusieurs générations ; on a ainsi observé l’importance du phénotype, le blanchiment, la légitimité des relations, les conjoints privilégiés, le choix des réseaux, les niveaux de fortune et l’usage de l’espace.
In Martinique in the eighteenth century, the "free people of color", both those free by birth and freedmen, black or mixed race, form a legal category, which was distinct from those of whites and slaves. Comparative studies with Spanish or English territories show that no legal regulation formalized a shift - from the category of free colored people to that of White - in the French colonies between the late seventeenth century and the French Revolution. Also, this thesis proposes to show the informal process that enabled some people - the "assimilated" - to cross the color barrier. I analysed the color prejudice, a racist system, whose ideology, supported by local regulations, legitimized the collective construction of a public and social order. In a second step, I examined the development of the color bar. The free colored people were the first to bear the brunt of the impermeability of the demarcation line and of the problems posed by the purity of blood; but some whites, through interracial unions, and Native Americans have also been targeted. Finally I thought about what made the whiteness, and the strategies to achieve whiteness, change in status. Notarial acts and 33,000 acts of parish registers treaties led to the reconstitution of genealogies, in order to examine individuals and families over generations; I observed the importance of the phenotype, whitening, legitimacy relations, privileged partners, choice of networks, wealth levels and the use of space.

http://www.theses.fr/2015AGUY0847/document