clove and Acute-Disease

We report the case of an American traveler who developed acute pulmonary schistosomiasis after swimming in a lake in Madagascar, and we review the literature on acute pulmonary schistosomiasis. Schistosomiasis is one of the world's most prevalent parasitic diseases, with three species (Schistosoma mansoni, Schistosoma haematobium and Schistosoma japonicum) causing the greatest burden of disease. Pulmonary manifestations may develop in infected travelers from non-endemic areas after their first exposure. The pathophysiology of acute pulmonary disease is not well-understood, but is related to immune response, particularly via inflammatory cytokines. Diagnosis of schistosomiasis may be either through identification of characteristic ova in urine or stool or through serology. Anti-inflammatory drugs can provide symptomatic relief; praziquantel, the mainstay of chronic schistosomiasis treatment, is likely not effective against acute disease; the only reliable prevention remains avoidance of contaminated freshwater in endemic areas, as there is no vaccine. Travelers who have been exposed to potentially contaminated freshwater in endemic areas should seek testing and, if infected, treatment, in order to avoid severe manifestations of acute schistosomiasis and prevent complications of chronic disease. Clinicians are reminded to elicit a detailed travel and exposure history from their patients.

Topics: Acute Disease; Adult; Animals; Anthelmintics; Humans; Lung Diseases, Parasitic; Madagascar; Male; Praziquantel; Schistosoma; Schistosomiasis; Travel; Travel Medicine

Quantitative polymerase chain reaction (qPCR) of dried blood spots (DBS) for pathogen detection is a potentially convenient method for infectious disease diagnosis. This study tested 115 DBS samples paired with whole blood specimens of children and adolescent from Burkina Faso, Sudan, and Madagascar by qPCR for a wide range of pathogens, including protozoans, helminths, fungi, bacteria, and viruses. Plasmodium spp. was consistently detected from DBS but yielded a mean cycle threshold (Ct) 5.7 ± 1.6 higher than that from whole blood samples. A DBS qPCR Ct cutoff of 27 yielded 94.1% sensitivity and 95.1% specificity against the whole blood qPCR cutoff of 21 that has been previously suggested for malaria diagnosis. For other pathogens investigated, DBS testing yielded a sensitivity of only 8.5% but a specificity of 98.6% compared with whole blood qPCR. In sum, direct PCR of DBS had reasonable performance for Plasmodium but requires further investigation for the other pathogens assessed in this study.

Topics: Acute Disease; Adolescent; Burkina Faso; Child; Communicable Diseases; Dried Blood Spot Testing; Fever; Humans; Madagascar; Polymerase Chain Reaction; Sudan

Influenza and respiratory syncytial virus (RSV) infections are responsible for substantial global morbidity and mortality in young children and elderly individuals. Estimates of the burden of influenza- and RSV-associated hospitalization are limited in Africa.. We conducted hospital-based surveillance for laboratory-confirmed influenza- and RSV-associated severe acute respiratory illness (SARI) among patients of any age at one hospital and a retrospective review of SARI hospitalizations in five hospitals situated in Antananarivo during 2011-2016. We estimated age-specific rates (per 100 000 population) of influenza- and RSV-associated SARI hospitalizations for the Antananarivo region and then extrapolated these rates to the national level.. Overall, the mean annual national number of influenza-associated SARI hospitalizations for all age groups was 6609 (95% CI: 5381-7835-rate: 30.0; 95% CI: 24.4-35.6), 4468 (95% CI: 3796-5102-rate: 127.6; 95% CI: 108.4-145.7), 2141 (95% CI: 1585-2734-rate: 11.6; 95% CI: 8.6-14.8), and 339 (95% CI: 224-459-rate: 50.0; 95% CI: 36.3-74.4) among individuals aged <5, ≥5, and ≥65 years, respectively. For these same age groups, the mean annual number of RSV-associated SARI hospitalizations was 11 768 (95% CI: 10 553-12 997-rate: 53.4; 95% CI: 47.9-59.0), 11 299 (95% CI: 10 350-12 214-rate: 322.7; 95% CI: 295.6-348.8), 469 (95% CI: 203-783-rate: 2.5;95% CI: 1.1-4.2), and 36 (95% CI: 0-84-rate: 5.8; 0.0-13.5), respectively.. The burden of influenza- and RSV-associated SARI hospitalization was high among children aged <5 years. These first estimates for Madagascar will enable government to make informed evidence-based decisions when allocating scarce resources and planning intervention strategies to limit the impact and spread of these viruses.

Topics: Acute Disease; Adolescent; Adult; Aged; Child; Child, Preschool; Cost of Illness; Female; Hospitalization; Humans; Infant; Influenza, Human; Madagascar; Male; Middle Aged; Respiratory Syncytial Virus Infections; Retrospective Studies; Risk Factors; Young Adult

To evaluate the professional practices of physicians in Antananarivo in managing acute diarrhea in infants.. This prospective study was conducted from March 19 to April 21, 2012, as an anonymous survey of randomly selected general practitioners and pediatricians working in the public or private sector in the city of Antananarivo.. The survey included 125 physicians: 105 general practitioners, 11 pediatricians, and 9 other specialist physicians (7.2%) with pediatric activity. Only 4.8% of the physicians questioned had not received training about diarrhea in the previous two years. One doctor in 4 (25.6%) did not prescribe oral rehydration solution. The reasons given were lack of signs of dehydration (50%) and recommendation of other beverages (15.5%). Zinc prescription was rare (9.6%). Early refeeding was recommended by 41.6% of physicians. Almost half (47.2%) routinely use antibiotics, and 86.4% prescribe antidiarrheal medications.. The WHO recommendations for the treatment of acute diarrhea in children are not followed. Continuing and repeated medical education is necessary.

Topics: Acute Disease; Anti-Bacterial Agents; Antidiarrheals; Cross-Sectional Studies; Diarrhea, Infantile; Drug Prescriptions; Female; Humans; Infant; Madagascar; Male; Practice Patterns, Physicians'; Prospective Studies

Acute mediastinitis, also called descending necrotizing mediastinitis and cervicomediastinal necrotizing fasciitis, is a disease due to the spread of severe cervical or oropharyngeal infection. Our retrospective study examined clinical records of patients admitted to the surgical intensive care unit for the management of acute mediastinitis during the four-year period 2009-2012. The records showed 14 cases admitted during these four years. The patients' mean age was 30 years and 8 months, and the M/F sex-ratio was 1.33. The main predisposing factors found were the presence of a severe cervical infection, such as fasciitis, of odontogenic origin or the administration of anti-inflammatory drugs. The diagnosis is based on clinical data findings of thoracic pain with dyspnea or orthopnea, fever, or even septic shock and is confirmed by radiologic findings. The patient's multidisciplinary management combines medical management (supportive medical care in an intensive care unit and broad-spectrum antibiotic therapy) and surgical treatment by bilateral cervicotomy with mediastinal drainage. The mortality rate was high at 71.42%. In Madagascar, neglect of dental health can cause odontogenic fasciitis, which plays an important role in descending mediastinitis, a disease that still has a catastrophic prognosis today.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Female; Hospitals; Humans; Madagascar; Male; Mediastinitis; Mediastinum; Middle Aged; Necrosis; Retrospective Studies; Time Factors; Young Adult

Few comprehensive data exist regarding the epidemiology of severe acute respiratory infections (SARI) in low income countries. This study aimed at identifying etiologies and describing clinical features of SARI-associated hospitalization in Madagascar.. It is a prospective surveillance of SARI in 2 hospitals for 3 years. Nasopharyngeal swabs, sputum, and blood were collected from SARI patients enrolled and tested for viruses and bacteria. Epidemiological and clinical information were obtained from case report forms.. Overall, 876 patients were enrolled in the study, of which 83.1% (728/876) were tested positive for at least one pathogen. Viral and bacterial infections occurred in 76.1% (667/876) and 35.8% (314/876) of tested samples, respectively. Among all detected viruses, respiratory syncytial virus (RSV) was the most common (37.7%; 348/924) followed by influenza virus A (FLUA, 18.4%; 170/924), rhinovirus (RV, 13.5%; 125/924), and adenovirus (ADV, 8.3%; 77/924). Among bacteria, Streptococcus pneumoniae (S. pneumoniae, 50.3%, 189/370) was the most detected followed by Haemophilus influenzae type b (Hib, 21.4%; 79/370), and Klebsiella (4.6%; 17/370). Other Streptococcus species were found in 8.1% (30/370) of samples. Compared to patients aged less than 5 years, older age groups were significantly less infected with RSV. On the other hand, patients aged more than 64 years (OR = 3.66) were at higher risk to be infected with FLUA, while those aged 15-29 years (OR = 3.22) and 30-64 years (OR = 2.39) were more likely to be infected with FLUB (influenza virus B).. The frequency of influenza viruses detected among SARI patients aged 65 years and more highlights the need for health authorities to develop strategies to reduce morbidity amongst at-risk population through vaccine recommendation. Amongst young children, the demonstrated burden of RSV should guide clinicians for a better case management of children. These findings reveal the need to develop point-of-care tests to avoid overuse of antibiotics and to promote vaccine that could reduce drastically the RSV hospitalizations.

Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Epidemiological Monitoring; Female; Hospitalization; Hospitals; Humans; Infant; Infant, Newborn; Logistic Models; Madagascar; Male; Prevalence; Respiratory Tract Infections; Young Adult

Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar.. Handwritten patient registries on all emergency department patients presenting between 1 January 2011 and 30 September 2012 were reviewed and data entered into a database. Data included age, sex, diagnosis, and disposition. We classified diagnoses into Clinical Classifications Software (CCS) multi-level categories. The population was 53.5% male, with a median age of 31 years. The five most common presenting conditions were 1) Superficial injury; contusion, 2) Open wounds of head; neck; and trunk, 3) Open wounds of extremities, 4) Intracranial injury, and 5) Unspecified injury and poisoning. Trauma accounted for 48%, Infectious Disease for 15%, Mental Health 6.1%, Noncommunicable 29%, and Neoplasms 1.2%. The acuity seen was high, with an admission rate of 43%. Trauma was the most common reason for admission, representing 19% of admitted patients.. This study describes the burden of acute disease at a large referral center in northern Madagascar. The Centre Hôpitalier Universitaire de Mahajanga sees a high volume of acutely ill and injured patients. Similar to other reports from the region, trauma is the most common pathology observed, though infectious disease was responsible for the majority of adult mortality. Typhoid fever other intestinal infections were the most lethal CCS-coded pathologies. By utilizing a widely understood classification system, we are able to highlight contrasts between Mahajanga's acute and overall disease burden as well as make comparisons between this region and the rest of the globe. We hope this study will serve to guide the development of context-appropriate emergency medicine systems in the region.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Emergency Medical Services; Female; Humans; Infections; Madagascar; Male; Mental Health; Referral and Consultation; Wounds and Injuries; Young Adult

Acute schistosomiasis is a regularly encountered disease in travelers. Because of the temporal delay, its unspecific presentation and the spontaneous resolution, acute schistosomiasis can easily remain unrecognized by physicians who are not familiar with tropical pathologies. In December 2011, a female traveler was admitted to the hospital with undetermined fever after having returned from Madagascar where she bathed in fresh water. Acute schistosomiasis was diagnosed and infection was suspected among other travelers of her group. Seroconversion was confirmed among 78% of participants. This article intends to clarify the preventive and diagnostic strategies based on the lessons learned from this cluster of 42 travelers exposed to schistosomiasis.

Topics: Acute Disease; Adolescent; Adult; Aged; Female; Fever; Humans; Madagascar; Male; Middle Aged; Schistosomiasis; Travel

Topics: Acute Disease; Amoxicillin; Anti-Bacterial Agents; Bacteremia; Combined Modality Therapy; Diabetes Mellitus, Type 2; Disease Susceptibility; Facial Paralysis; Fatal Outcome; Female; Humans; Immunoglobulins, Intravenous; Madagascar; Middle Aged; Pneumonia, Pneumococcal; Polyradiculoneuropathy; Quadriplegia; Respiration Disorders; Respiration, Artificial; Smoking

In Madagascar, very little is known about the etiology and prevalence of acute respiratory infections (ARIs) in a rural tropical area. Recent data are needed to determine the viral and atypical bacterial etiologies in children with defined clinical manifestations of ARIs.. During one year, we conducted a prospective study on ARIs in children between 2 to 59 months in the community hospital of Ampasimanjeva, located in the south-east of Madagascar. Respiratory samples were analyzed by multiplex real-time RT-PCR, including 18 viruses and 2 atypical bacteria. The various episodes of ARI were grouped into four clinical manifestations with well-documented diagnosis: "Community Acquired Pneumonia"(CAP, group I), "Other acute lower respiratory infections (Other ALRIs, group II)", "Upper respiratory tract infections with cough (URTIs with cough, group III)"and "Upper respiratory tract infections without cough (URTIs without cough, group IV)".. 295 children were included in the study between February 2010 and February 2011. Viruses and/or atypical bacteria respiratory pathogens were detected in 74.6% of samples, the rate of co-infection was 27.3%. Human rhinovirus (HRV; 20.5%), metapneumovirus (HMPV A/B, 13.8%), coronaviruses (HCoV, 12.5%), parainfluenza virus (HPIV, 11.8%) and respiratory syncytial virus A and B (RSV A/B, 11.8%) were the most detected. HRV was predominantly single detected (23.8%) in all the clinical groups while HMPV A/B (23.9%) was mainly related to CAP (group I), HPIV (17.3%) to the "Other ALRIs" (group II), RSV A/B (19.5%) predominated in the group "URTIs with cough" (group III) and Adenovirus (HAdV, 17.8%) was mainly detected in the "without cough" (group IV).. This study describes for the first time the etiology of respiratory infections in febrile children under 5 years in a malaria rural area of Madagascar and highlights the role of respiratory viruses in a well clinically defined population of ARIs.

Topics: Acute Disease; Bacteria; Bacterial Infections; Child, Preschool; Coinfection; Community-Acquired Infections; Cough; Fever; Humans; Madagascar; Paramyxoviridae Infections; Polymerase Chain Reaction; Prevalence; Prospective Studies; Respiratory Syncytial Virus Infections; Respiratory Tract Infections; Rural Population; Seasons; Tropical Climate; Virus Diseases; Viruses

Topics: Abnormalities, Multiple; Acute Disease; Calcinosis; Female; Fetal Diseases; Fetus; Humans; Intestinal Obstruction; Madagascar; Male; Middle Aged; Pregnancy; Pregnancy Complications; Pregnancy, Ectopic; Time Factors

Leaf extracts of Ugni molinae Turcz. (Myrtaceae) are used in Chilean folk medicine as analgesic and anti-inflammatory. The antinociceptive effect of dichloromethane (DCM), ethyl acetate (EA) and methanol (ME) leaf extracts was assessed by intraperitoneal, oral and topical administration in writhing, tail flick, and tail formalin tests in mice. The extracts showed a dose-dependent antinociceptive activity in all the assays under different administration routes. The ED(50) values for the different tests for the DCM, EA, ME extract and reference drug (ibuprofen) were as follows. Writhing test in acetic acid (i.p. administration): 0.21, 0.37, 1.37 and 0.85mg/kg, respectively; tail flick test (oral administration): 199, 189, 120 and 45.9mg/kg. The EC(50) values for tail flick test were (topical administration): 2.0, 0.35, 1.4 and 8.2% (w/v), respectively; and the topical analgesic effects were (formalin assay) 75.5, 77.5, 31.6 and 76.5%, respectively. Ugni molinae extracts produce antinociception in chemical and thermal pain models through a mechanism partially linked to either lipooxygenase and/or cyclooxygenase via the arachidonic acid cascade and/or opioid receptors. Flavonoid glycosides and triterpenoids have been isolated from the plant and can be associated with the observed effect. Our results corroborate the analgesic effects of Ugni molinae, and justify its traditional use for treating pain.

Topics: Acute Disease; Analgesics; Animals; Flavonoids; Glycosides; Ibuprofen; Male; Mice; Myrtaceae; Pain; Phytotherapy; Plant Extracts; Plant Leaves; Triterpenes

An epidemiological investigation (Ministry of Health/Institut Pasteur de Madagascar (IPM)) was conducted in July 2002, in two districts of a same province (Fianarantsoa: Fianarantsoa II and Ikongo) considering the high frequency of deaths linked with acute respiratory infection (ARI). Morbidity and mortality data was collected in the Centre de Santé de Base (CSB) which gave the alert (village of Sahafata, district Fianarantsoa II). Analysis of monthly activity reports (MAR) allowed calculation of incidence rates of ARI/pneumonia in Fianarantsoa province. Virological data was based on the analysis of nasopharyngeal samples collected during the investigations. Clinical symptoms and homogeneity of laboratory results are consistent with an origin of these epidemics being related to the circulation of an influenza virus A subtype H3N2. Attack rates were very high. CFR was significantly higher in individuals of less than 1 year and more than 65 years. This data was confirmed by posterior investigations of teams from MoH/WHO. Surprisingly, this large epidemic was due to a known influenza virus that previously circulated in countries of northern hemisphere (the year before) and even in Antananarivo weeks before. Different hypothesis could be proposed to explain such phenomenon: great restriction of exchanges between different geographical zones, nutritional status..... The epidemic episodes of acute respiratory infections in Madagascar in July 2002 were due to an influenza virus A subtype H3N2 without any genotypic or phenotypic features. Various factors, could explain the importance of the epidemic and particular high lethality found in some age groups. This epidemic illustrates the relative incapacity for a developing country, to face and manage a flu epidemic caused by a classical influenza virus.

Topics: Acute Disease; Adolescent; Adult; Age Distribution; Aged; Cause of Death; Child; Child, Preschool; Disease Notification; Disease Outbreaks; Epidemiologic Methods; Humans; Incidence; Infant; Influenza A virus; Madagascar; Middle Aged; Morbidity; Nasopharynx; Population Surveillance; Residence Characteristics; Respiratory Tract Infections; Risk Factors; Seasons

The authors describe one case of acute flaccid paralytic of lower limbs in a 10-year-old boy with Echovirus 7 isolated in the stool and a high titer of homologous antibodies (> or = 1,024). At the final stage of poliomyelitis program eradication, paralysis associated with non polio enterovirus may replace cases of paralytic poliomyelitis. In the present study, the authors highlight the needs to confirm virologically all suspect cases of acute flaccid paralytic. Aetiological function of the virus isolated and interpretation of the diagnostic methods are discussed.

Topics: Acute Disease; Antibodies, Viral; Child; Diagnosis, Differential; Echovirus Infections; Enterovirus B, Human; Feces; Humans; Madagascar; Male; Paraplegia

In this article, the authors summarize studies on hepatitis B virus infection in Madagascar. Estimated prevalence rate for acute or chronic HBs antigen infection is 23% among general population which classify the country in high endemicity area. Vertical and horizontal transmissions for the childhood are high with an estimated prevalence rate for HBs antigen infection of 10 to 35% among children under less than 5-year-old according to areas. This situation indicates that an expanded program of immunization against hepatitis B virus is warranted.

Topics: Acute Disease; Adolescent; Adult; Age Distribution; Child; Child, Preschool; Chronic Disease; Endemic Diseases; Female; Hepatitis B; Humans; Infant; Infectious Disease Transmission, Vertical; Madagascar; Male; Population Surveillance; Prevalence; Public Health; Seroepidemiologic Studies; Sex Distribution; Vaccination

In the framework of the poliomyelitis program eradication, the World Health Organization suggests two markers to survey the circulation of the poliovirus: notification of all cases of acute flask paralysis (AFP) and etiological research of these AFP from two stool samples. The authors reported the case of a AFP, occurring after a polio vaccination in a 5-year-old boy who had later an acute rhinopharyngitis treated by antibiotics and quinine intramuscular injections. A left lower limb AFP justified his hospitalisation. The isolation of a Sabin type 3 poliovirus was a pitfall because clinical and complementary investigations demonstrate a peripheral neuromuscular paralysis. This demonstrative case shows the need for health staff to be trained to perform correctly an usual act like intramuscular drug injections.

Topics: Acute Disease; Anti-Bacterial Agents; Child, Preschool; Diagnosis, Differential; Disease Notification; Feces; Humans; Injections, Intramuscular; Madagascar; Male; Nasopharyngitis; Paralysis; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Oral; Quinine; Sciatic Nerve

Topics: Acute Disease; Age Distribution; Child, Preschool; Female; Hospitalization; Hospitals, General; Hospitals, Pediatric; Hospitals, University; Humans; Infant; Infant Mortality; Infant, Newborn; Madagascar; Male; Meningitis, Bacterial; Prognosis; Prospective Studies; Risk Factors; Sex Distribution

62 rhinopharingeal samples from malagasy children, aged of 6 days to 14 years old, hospitalized because of acute respiratory infections, with doubtful viral etiology case, during June to August 1992, at the "Hôpital des Enfants" in Antananarivo, were examined by two methods: inoculation by embryonned eggs and inoculation by MDCK cells. 24.1% of the samples were positive. The repartition of the cases by age and by sex were studied. The children aged of 1 to 12 months were the most affected with 65.7% of all cases (male: 60%, female: 40%). One subtype was detected: A(H3N2).

Topics: Acute Disease; Adolescent; Age Distribution; Child; Child, Preschool; Cough; Dyspnea; Fever; Hemagglutination Inhibition Tests; Hospitalization; Hospitals, Pediatric; Humans; Infant; Infant, Newborn; Influenza A virus; Influenza, Human; Madagascar; Morbidity; Population Surveillance; Rhinitis; Seasons; Sex Distribution; Virus Cultivation

The purpose of this retrospective study carried out by 1997 in two paediatric units of Antananarivo: paediatric unit of the General hospital of Befelatanana (Marfan) and paediatric unit of the Hospital Center of Soavinandriana (CI), was to evaluate direct service costs for an hospitalization of a child affected by lower acute airway diseases. In the first unit, there is partial charge, in the second, there is full charge. Direct services were continued by complementary tests, therapy and meals. The length of the hospitalization changes according to the cause and the severity of diseases. Average direct service costs were of 19 and 38 US$ respectively. Maximum direct service costs were of 77 and 154 US$ respectively. Amounts of direct service costs were crippled especially by inappropriate use of antibiotics.

Topics: Acute Disease; Anti-Bacterial Agents; Child; Child, Preschool; Direct Service Costs; Drug Utilization Review; Health Services Research; Hospital Costs; Hospitals, General; Humans; Infant; Length of Stay; Madagascar; Morbidity; Pediatrics; Respiratory Tract Infections; Retrospective Studies; Severity of Illness Index

Endonasal dacryorhinocystostomy is a surgical procedure performed to re-establish continuity of the lacrimal duct by partial diversion followed by dilatation. A simultaneous rhinologic and ophthalmologic approach is used. This simple and elegant procedure that results in no residual scarring is indicated for any blockage of the lacrimal duct due to congenital or acquired causes. Except for children under 6 years of age and in patients in poor general condition, contra-indications are uncommon. Operative and postoperative complications are rare. After a review of the relevant anatomy the authors of this report describe the equipment and basic techniques used to perform dacryorhinocystostomy. Endonasal dacryorhinocystostomy was performed in 15 patients presenting chronic (n = 14) or acute (n = 1) dacryocystitis in Madagascar. At six months follow-up the procedure was successful in 14 cases and unsuccessful in one case due a cutaneous fistula. Because it is simple and well-tolerated and results in no residual scarring, endonasal dacryorhinocystostomy is the method of choice for treatment of lacrimal duct obstruction in tropical areas in general and in Black Africa in particular.

Topics: Acute Disease; Adult; Age Factors; Chronic Disease; Contraindications; Dacryocystitis; Dacryocystorhinostomy; Female; Follow-Up Studies; Humans; Madagascar; Male; Nose

We reported the case of a young woman who presented simultaneously HBs antigen and HBs antibodies in blood. From historical datas, we suspected that the patient was infected by hepatitis B virus and developed a chronic infection. Lately, she received hepatitis B vaccine. Subtypes of the infectious hepatitis B virus and the immunogenic hepatitis B antigen were different and induced independent immunological responses.

Topics: Acute Disease; Adolescent; Female; Hepatitis B Antibodies; Hepatitis B Surface Antigens; Hepatitis B Vaccines; Hepatitis B, Chronic; Humans; Liver Function Tests; Madagascar; Virus Replication

The authors relate the 1992 results of influenza surveillance in Antananarivo. 24 influenza virus A (H3N2) strains were isolated from 467 pharyngeal swabs. The virus had been continually spreading from January to September, with a peak in July, along with some monthly sporadic isolations. The highest respiratory morbidity was observed in June and July. The collection processes of influenzal and respiratory morbidity statistics are also discussed in order to standardize data and to define the real impact of influenza and other acute affections of respiratory tracts on the population.

Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Influenza A virus; Influenza B virus; Influenza, Human; Madagascar; Male; Morbidity; Pharynx; Population Surveillance; Seasons; Urban Population

A total of 80 nasopharyngeal secretions collected from malagasy children (53 boys and 27 girls) with viral acute respiratory infection, aged from 6 days to 10 year old admitted to the Pediatric Department of Antananarivo General Hospital from may to July 1983, were investigated by indirect immunofluorescence method. 54--samples were found positive for respiratory viruses. Distribution according age groups and sex has been studied: children belonging to 25-36 month age group and male sex were more infected. Following viral strains were detected in increasing frequency: Para-influenzae 3: 25 p. 100; RSV: 18 p. 10/; Adenovirus: 18 p. 100; Influenzae A: 13 p. 100; Influenzae B: 9 p. 100; Para-influenzae 1: 5 p. 100.

Topics: Acute Disease; Adenoviruses, Human; Child; Child, Preschool; Female; Fluorescent Antibody Technique; Humans; Infant; Infant, Newborn; Influenza A virus; Influenza B virus; Madagascar; Male; Nasopharynx; Parainfluenza Virus 1, Human; Parainfluenza Virus 3, Human; Respiratory Syncytial Viruses; Respiratory Tract Infections; Sex Factors; Virus Diseases

Topics: Acute Disease; Adolescent; Adult; Aged; Child; Child, Preschool; Conjunctivitis; Disease Outbreaks; Female; Hemorrhage; Humans; Madagascar; Male; Middle Aged