clove and Cholera

We describe the development and evaluation of a rapid diagnostic test for Vibrio cholerae O1 and O139 based on lipopolysaccharide detection using gold particles. The specificity ranged between 84 and 100%. The sensitivity of the dipsticks ranged from 94.2 to 100% when evaluated with stool samples obtained in Madagascar and Bangladesh. The dipstick can provide a simple tool for epidemiological surveys.

Topics: Bangladesh; Cholera; Chromatography, Affinity; Enterotoxins; Feces; Gold Colloid; Humans; Madagascar; Sensitivity and Specificity

Topics: Cholera; Humans; Madagascar; Microbial Sensitivity Tests; Seasons; Tetracycline Resistance; Vibrio cholerae

Madagascar was cholera free until March 1999. The first case was reported in Mahajanga, a north west coast harbor. Ten months later and despite a massive use of tetracycline as prophylactic drug, cholera had reached every region of the island. All suspected cholera samples were analysed at the Pasteur Institute of Madagascar where susceptibility to tetracycline was systematically performed. On February 2000, a multidrug resistant strain of V. cholerae was isolated. We studied this strain by performing Minimal Inhibitory Concentration (MIC) and by plasmidic and conjugative assay. As the original strain, this multiresistant V. cholerae showed a resistance to cotrimoxazole, to streptomycin and chloramphenicol but, in addition to, appeared strongly resistant to ampicillin and tetracycline. This strain harboured a 26 kb self-transmissible plasmid. Conjugation tests showed the possibility of plasmidic segregates or acquisition of two different plasmids. The weak transfer rate could explain why we have isolated only one multiresistant strain. The emergence of a such multiresistant strain should encourage the medical authorities to reinforce the epidemic survey in every medical Malagasy district and to carry out new antimicrobial surveys to describe the mechanisms of the spread of these resistances.

Topics: Cholera; Communicable Diseases, Emerging; Conjugation, Genetic; Disease Outbreaks; Drug Resistance, Multiple, Bacterial; Humans; Madagascar; Microbial Sensitivity Tests; Population Surveillance; R Factors; Serotyping; Vibrio cholerae

In November 1999, CARE Madagascar, Population Services International (PSI), and the Centers for Disease Control and Prevention (CDC) selected 30 poor communities in urban Antananarivo as the target population for launch of the Safe Water System. The system consists of behavior change techniques along with point-of-use treatment and safe storage of water. The project was launched in March 2000, ahead of schedule, because a cholera epidemic struck Madagascar in January. Because of the enormous demand created by the cholera epidemic and by 3 cyclones that followed in the next 3 months, the project grew to national scale in less than a year. The combination of community mobilization and social marketing resulted in increased demand for and use of the Safe Water System.

Topics: Cholera; Cooperative Behavior; Disasters; Disinfection; Health Promotion; Humans; Madagascar; Program Evaluation; Sodium Hypochlorite; Water Microbiology; Water Purification; Water Supply

Topics: Cholera; Disease Outbreaks; Food Microbiology; Humans; Madagascar; Water Microbiology; Water Purification; Water Supply

Ravages caused by cholera among children are well known. The disease invaded Madagascar in 1999 May. This retrospective study reported the first childhood cholera cases. The survey was carried out at the Befelatanana Hospital during the period of cholera outbreak from April 23th to July 31st. The purpose of the study was to specify clinical, epidemiological and bacteriological characteristics of the disease. 5 out of 178 suspected cholera cases were less than 15 years old. 2 young girls out these 5 children, inhabitants of Antananarivo-City were hospitalized for acute diarrhoea with serious dehydratation. Their disease was confirmed by bacteriology. Vibrio cholera O1 strain, serovar Ogawa was identified. Epidemiological investigation allowed to identify the contamination modal in the file no 1. The authors conclude that cholera is an important problem of public health in developing country like Madagascar. Disease control needs environmental sanitation and good individual hygiene practices.

Topics: Age Distribution; Anti-Bacterial Agents; Child; Cholera; Developing Countries; Disease Outbreaks; Female; Fluid Therapy; Hospitalization; Hospitals, General; Humans; Madagascar; Male; Population Surveillance; Public Health Practice; Retrospective Studies; Serotyping; Tetracycline; Vibrio cholerae O1

Topics: Cholera; Disease Outbreaks; Humans; Madagascar