clove and Communicable-Diseases

Madagascar had been separated from african continent since 5 millions years and, if flora and fauna are endemic (40 species of lemuriens) all of parasites and humans populations are imported, from africa with respect to P. falciparum, P. malariae, S. mansoni and S. haematobium (but snails are endemic ), Fasciola gigantica (imported with zebus) and perhaps P. vivax, and from Asia with respect to W. bancrofti, N. americanus, C. cellulosae (imported with pigs) and perhaps P. vivax, chromoblastomycosis is autochthonous and of high frequency. Malagasy were natives of Indonesia, Africa, Arabia and Europe.

Topics: Communicable Diseases; Humans; Madagascar; Tropical Medicine

Few studies on neonatal severe bacterial infection are available in LMICs. Data are needed in these countries to prioritize interventions and decrease neonatal infections which are a primary cause of neonatal mortality. The BIRDY project (Bacterial Infections and Antimicrobial Drug Resistant among Young Children) was initially conducted in Madagascar, Senegal and Cambodia (BIRDY 1, 2012-2018), and continued in Madagascar only (BIRDY 2, 2018-2021). We present here the BIRDY 2 project whose objectives were (1) to estimate the incidence of neonatal severe bacterial infections and compare these findings with those obtained in BIRDY 1, (2) to identify determinants associated with severe bacterial infection and (3) to specify the antibiotic resistance pattern of bacteria in newborns.. The BIRDY 2 study was a prospective community-based mother and child cohort, both in urban and semi-rural areas. All pregnant women in the study areas were identified and enrolled. Their newborns were actively and passively followed-up from birth to 3 months. Data on clinical symptoms developed by the children and laboratory results of all clinical samples investigated were collected. A Cox proportional hazards model was performed to identify risk factors associated with possible severe bacterial infection.. A total of 53 possible severe bacterial infection and 6 confirmed severe bacterial infection episodes were identified among the 511 neonates followed-up, with more than half occurring in the first 3 days. For the first month period, the incidence of confirmed severe bacterial infection was 11.7 per 1,000 live births indicating a 1.3 -fold decrease compared to BIRDY 1 in Madagascar (p = 0.50) and the incidence of possible severe bacterial infection was 76.3, indicating a 2.6-fold decrease compared to BIRDY 1 in Madagascar (p < 0.001). The 6 severe bacterial infection confirmed by blood culture included 5 Enterobacterales and one Enterococcus faecium. The 5 Enterobacterales were extended-spectrum β-lactamases (ESBL) producers and were resistant to quinolones and gentamicin. Enterococcus faecium was sensitive to vancomycin but resistant to amoxicillin and to gentamicin. These pathogns were classified as multidrug-resistant bacteria and were resistant to antibiotics recommended in WHO guidelines for neonatal sepsis. However, they remained susceptible to carbapenem. Fetid amniotic fluid, need for resuscitation at birth and low birth weight were associated with early onset possible severe bacterial infection.. Our results suggest that the incidence of severe bacterial infection is still high in the community of Madagascar, even if it seems lower when compared to BIRDY 1 estimates, and that existing neonatal sepsis treatment guidelines may no longer be appropriate in Madagascar. These results motivate to further strengthen actions for the prevention, early diagnosis and case management during the first 3 days of life.

Topics: Anti-Bacterial Agents; Bacteria; Bacterial Infections; Child; Child, Preschool; Communicable Diseases; Female; Gentamicins; Humans; Incidence; Infant, Newborn; Madagascar; Neonatal Sepsis; Pregnancy; Prospective Studies; Risk Factors

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

The etiology and optimal clinical management of acute febrile illness (AFI) is poorly understood.. Blood samples taken from study participants with acute fever (≥37.5°C) or a history of fever and recruited into the previous Typhoid Fever Surveillance in Africa (TSAP) study were evaluated using a polymerase chain reaction (PCR)-based TaqMan-Array Card designed to detect a panel of bacterial, viral, and parasitic pathogens. Clinical metadata were also assessed.. A total of 615 blood samples available for analysis originated from Burkina Faso (n = 53), Madagascar (n = 364), and Sudan (n = 198) and were taken from participants ranging in age from 0-19 years. Through the TaqMan-Array Card, at least 1 pathogen was detected in 62% (33 of 53), 24% (86 of 364), and 60% (118 of 198) of specimens from Burkina Faso, Madagascar, and Sudan, respectively. The leading identified pathogen overall was Plasmodium spp., accounting for 47% (25 of 53), 2.2% (8 of 364), and 45% (90 of 198) of AFI at the respective sites. In Madagascar, dengue virus was the most prevalent pathogen (10.2%). Overall, 69% (357 of 516) of patients with clinical diagnoses of malaria, respiratory infection, or gastrointestinal infection were prescribed a World Health Organization guideline-recommended empiric antibiotic, whereas only 45% (106 of 237) of patients with pathogens detected were treated with an antibiotic exerting likely activity.. A PCR approach for identifying multiple bacterial, viral, and parasitic pathogens in whole blood unveiled a diversity of previously undetected pathogens in AFI cases and carries implications for the appropriate management of this common syndrome.

Topics: Adolescent; Adult; Burkina Faso; Child; Child, Preschool; Communicable Diseases; Fever; Humans; Infant; Infant, Newborn; Madagascar; Sudan; Young Adult

The rapid detection of ongoing outbreak - and the identification of causative pathogen - is pivotal for the early recognition of public health threats. The emergence and re-emergence of infectious diseases are linked to several determinants, both human factors - such as population density, travel, and trade - and ecological factors - like climate change and agricultural practices. Several technologies are available for the rapid molecular identification of pathogens [e.g. real-time polymerase chain reaction (PCR)], and together with on line monitoring tools of infectious disease activity and behaviour, they contribute to the surveillance system for infectious diseases. Web-based surveillance tools, infectious diseases modelling and epidemic intelligence methods represent crucial components for timely outbreak detection and rapid risk assessment. The study aims to integrate the current prevention and control system with a prediction tool for infectious diseases, based on regression analysis, to support decision makers, health care workers, and first responders to quickly and properly recognise an outbreak. This study has the intention to develop an infectious disease regressive prediction tool working with an off-line database built with specific epidemiological parameters of a set of infectious diseases of high consequences. The tool has been developed as a first prototype of a software solution called Infectious Diseases Seeker (IDS) and it had been established in two main steps, the database building stage and the software implementation stage (MATLAB

Topics: China; Communicable Diseases; Democratic Republic of the Congo; Disease Outbreaks; Female; Hemorrhagic Fever, Ebola; Humans; Madagascar; Male; Plague; Public Health Surveillance; Severe Acute Respiratory Syndrome; Software

Simple phenomenological growth models can be useful for estimating transmission parameters and forecasting epidemic trajectories. However, most existing phenomenological growth models only support single-peak outbreak dynamics whereas real epidemics often display more complex transmission trajectories.. We develop and apply a novel sub-epidemic modeling framework that supports a diversity of epidemic trajectories including stable incidence patterns with sustained or damped oscillations to better understand and forecast epidemic outbreaks. We describe how to forecast an epidemic based on the premise that the observed coarse-scale incidence can be decomposed into overlapping sub-epidemics at finer scales. We evaluate our modeling framework using three outbreak datasets: Severe Acute Respiratory Syndrome (SARS) in Singapore, plague in Madagascar, and the ongoing Ebola outbreak in the Democratic Republic of Congo (DRC) and four performance metrics.. The sub-epidemic wave model outperforms simpler growth models in short-term forecasts based on performance metrics that account for the uncertainty of the predictions namely the mean interval score (MIS) and the coverage of the 95% prediction interval. For example, we demonstrate how the sub-epidemic wave model successfully captures the 2-peak pattern of the SARS outbreak in Singapore. Moreover, in short-term sequential forecasts, the sub-epidemic model was able to forecast the second surge in case incidence for this outbreak, which was not possible using the simple growth models. Furthermore, our findings support the view that the national incidence curve of the Ebola epidemic in DRC follows a stable incidence pattern with periodic behavior that can be decomposed into overlapping sub-epidemics.. Our findings highlight how overlapping sub-epidemics can capture complex epidemic dynamics, including oscillatory behavior in the trajectory of the epidemic wave. This observation has significant implications for interpreting apparent noise in incidence data where the oscillations could be dismissed as a result of overdispersion, rather than an intrinsic part of the epidemic dynamics. Unless the oscillations are appropriately modeled, they could also give a false positive, or negative, impression of the impact from public health interventions. These preliminary results using sub-epidemic models can help guide future efforts to better understand the heterogenous spatial and social factors shaping sub-epidemic patterns for other infectious diseases.

Topics: Communicable Diseases; Epidemics; Forecasting; Hemorrhagic Fever, Ebola; Humans; Incidence; Madagascar; Models, Theoretical; Singapore

A healthcare utilization survey was conducted as a component of the Typhoid Fever Surveillance in Africa Program (TSAP). The findings of this survey in Madagascar contrasted with those in other sites of the program; namely, only 30% of the population sought healthcare at the government-provided healthcare facilities for fever. These findings promoted us to determine the drivers and barriers in accessing and utilizing healthcare in Madagascar. Here we review the results of the TSAP healthcare utilization initiative and place them in the context of the current organization of the Madagascan healthcare system. Our work highlights the demands of the population for access to appropriate healthcare and the need for novel solutions that can quickly provide an affordable and sustainable basic healthcare infrastructure until a government-funded scheme is in place.

Topics: Communicable Diseases; Health Services Accessibility; Humans; Insurance, Health; Madagascar; Patient Acceptance of Health Care; Poverty

Understanding the environmental conditions of disease transmission is important in the study of vector-borne diseases. Low- and middle-income countries bear a significant portion of the disease burden; but data about weather conditions in those countries can be sparse and difficult to reconstruct. Here, we describe methods to assemble high-resolution gridded time series data sets of air temperature, relative humidity, land temperature, and rainfall for such areas; and we test these methods on the island of Madagascar. Air temperature and relative humidity were constructed using statistical interpolation of weather station measurements; the resulting median 95th percentile absolute errors were 2.75°C and 16.6%. Missing pixels from the MODIS11 remote sensing land temperature product were estimated using Fourier decomposition and time-series analysis; thus providing an alternative to the 8-day and 30-day aggregated products. The RFE 2.0 remote sensing rainfall estimator was characterized by comparing it with multiple interpolated rainfall products, and we observed significant differences in temporal and spatial heterogeneity relevant to vector-borne disease modeling.

Topics: Animals; Communicable Diseases; Databases as Topic; Disease Vectors; Environment; Humidity; Madagascar; Models, Biological; Rain; Temperature; Time Factors; Weather

Complete health assessments were performed on 22 adult red ruffed lemurs (Varecia rubra), comprising nine males and 13 females, found within the Masoala National Park in northeast Madagascar. Each animal was anesthetized using tiletamine and zolazepam and underwent a thorough physical examination, including measurement of its weight and vital signs; blood collection for hematology, plasma total protein concentration, serum chemistries, fat-soluble vitamins, trace minerals, assessment of iron metabolism, toxoplasmosis serology, viral serologies, and examination for hemoparasites; fecal collection for bacterial culture and parasite examination; and collection of a representative number of any ectoparasites. Comparison of blood values with those of captive lemurs demonstrated a number of significant differences thought to be associated with physiologic state (e.g., reproductive stage and stress), hydration, and diet. There was no evidence of serious infectious diseases, and hemoparasites were not detected. The enteric flora appeared unremarkable; however, results may have been skewed toward more cold-tolerant bacteria. The fecal parasite burden was low. Lemurostrongylus spp. was identified in two of the lemurs, and there were moderate numbers of Laelapidae mites present on approximately one third of the lemurs. This study demonstrated the substantial amount of data that can be collected from free-ranging populations, considered invaluable in the management of captive populations, in reducing the incidence of captivity-related diseases, and in the risk assessment associated with reintroduction programs.

Topics: Animals; Animals, Wild; Blood Chemical Analysis; Communicable Diseases; Conservation of Natural Resources; Feces; Female; Health Status; Hematologic Tests; Lemur; Madagascar; Male; Mite Infestations; Physical Examination; Reference Values

The main public health issue in Madagascar at the beginning of the 21st century still involves transmissible infectious diseases including re-emerging diseases such as bubonic plague and emerging diseases such as HIV/AIDS, dengue fever and Chikungunya virus infection. Health and hygiene especially access to clean water is still poor especially in rural areas. No improvement in the public health situation with regard to malaria, schistomosomiais or cysticercosis as well as non-infectious diseases such as protein-energy malnutrition is expected within the next decade.

Topics: Anemia, Sickle Cell; Animals; Bites and Stings; Communicable Diseases; Delivery of Health Care; Demography; Diabetes Mellitus; Geography; Humans; Madagascar; Malnutrition; Neoplasms; Public Health; Sanitation

Complete health assessments were performed on 20 adult ring-tailed lemurs (Lemur catta), 10 males and 10 females, free ranging within the Tsimanampetsotsa Strict Nature Reserve in southwest Madagascar. Each animal was anesthetized using tiletamine and zolazepam, weighed, and given a thorough physical examination. Blood was collected for hematology, determination of plasma total protein concentration, serum chemistry, determination of fat-soluble vitamin and trace mineral concentrations, assessment of iron metabolism, toxoplasmosis and viral serologies, and examination for parasites. Feces were collected for bacterial culture and parasite examination, and representative numbers of ectoparasites were collected. Blood values differed significantly in a number of ways from values in captive lemurs, possibly associated with recent food consumption, hydration, and diet. There was no evidence of serious infectious disease and no hemoparasites. The enteric flora appeared unremarkable, although results may have been skewed toward cold-tolerant bacteria. The fecal parasite burden was low, but there were large numbers of ectoparasites (mites) present. Our study demonstrated that a substantial amount of data can be collected from free-ranging populations, information that is invaluable in the management of captive populations, particularly with regard to disease, and in assessing risks associated with reintroduction programs.

Topics: Animals; Animals, Wild; Antibodies, Protozoan; Antibodies, Viral; Bacteria; Blood Chemical Analysis; Communicable Diseases; Feces; Female; Hematologic Tests; Lemur; Madagascar; Male; Mite Infestations; Nematoda; Reference Values; Toxoplasmosis, Animal

Topics: Cause of Death; Communicable Diseases; Health Status; Humans; Infant Mortality; Infant, Newborn; Madagascar; Maternal Mortality; Morbidity; Population Surveillance; Primary Health Care; Public Health; Socioeconomic Factors

Topics: Child; Child, Preschool; Communicable Diseases; Deficiency Diseases; Humans; Madagascar; Noma

Topics: Asian People; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Madagascar; Norway

Topics: Asian People; Black People; Canada; Communicable Diseases; Cuba; Finland; Humans; Incidence; Internationality; Jamaica; Madagascar

Topics: Asian People; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Madagascar

Topics: Asian People; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Jamaica; Madagascar

Topics: Asian People; Black People; Canada; Communicable Diseases; Cuba; Humans; Incidence; Internationality; Jamaica; Madagascar

Topics: Asian People; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Madagascar

Topics: Asian People; Biometry; Black People; Canada; Communicable Diseases; Cuba; Humans; Incidence; Internationality; Madagascar

Topics: Asian People; Biometry; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Madagascar

Topics: Asian People; Black People; Canada; Communicable Diseases; Cuba; Humans; Incidence; Internationality; Jamaica; Madagascar

Topics: Asian People; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Madagascar; Norway

Topics: Asian People; Black People; Canada; Communicable Diseases; Humans; Incidence; Internationality; Madagascar