clove and Schistosomiasis

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

Schistosomiasis and malaria constitute major health problems in Madagascar. The main objectives of the national schistosomiasis control programme--launched in 1998--are to improve knowledge about the modes of transmission of the disease and conduct mass treatment in hyperendemic areas, so as to lower incidence rates. A Geographic Information System (GIS) was established aiming to conduct a series of remote sensing studies based on digital image processing and analysis from Landsat TM and panchromatic Spot. The importance of local environmental and geographic characteristics in the Ihosy region such as proximity to roads and water were assessed by spatial analysis in order to construct a predictive model of Schistosoma mansoni endemicity. Unstable transmission in the Central Highlands of Madagascar caused severe outbreaks of malaria in the 1980s. Attempts to prevent such events reoccurring have been highlighted in the national malaria control programme. Thanks to intense vector control measures introduced in the area over a five-year period, a marked decrease in incidence of malaria was observed. This region borders on the Highlands as well as southern areas, allowing for vector control evaluation. The GIS and remote sensing system were applied to analyse ricefield areas, where the main vector are Anopheles funestus. Rice-field surfaces were statistically linked with abundance of vectors evaluated by entomological parametres.

Topics: Animals; Disease Outbreaks; Disease Vectors; Endemic Diseases; Geography; Humans; Information Systems; Madagascar; Malaria; Meteorological Concepts; Schistosomiasis; Spacecraft

Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years.. A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar's highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers.. This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research.. Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019.

Topics: Anthelmintics; Antigens, Helminth; Child, Preschool; Clinical Trials, Phase III as Topic; Female; Humans; Madagascar; Praziquantel; Pregnancy; Pregnant Women; Randomized Controlled Trials as Topic; Schistosomiasis

A controlled randomized trial of anti-helminthic treatment was undertaken in 1996-1997 in a rural area of Madagascar where populations were simultaneously infected with Ascaris lumbricoides, Plasmodium falciparum, and Schistosoma mansoni. Levamisole was administered bimonthly to 107 subjects, whereas 105 were controls. Levamisole was highly effective in reducing Ascaris egg loads in the treated group (P < 10(-3) at all visits), whereas it had no effect on schistosomiasis. Subjects 5-14 years of age, treated with levamisole, had a significant increase of their P. falciparum densities compared with controls (P = 0.003). There was no effect of the treatment on children 6 months to 4 years of age, nor on adults > 15 years of age. This study confirms the results of a randomized trial, which showed a negative interaction in those > 5 years of age between Ascaris and malaria parasite density in another Malagasy population, submitted to a higher malaria transmission.

Topics: Adolescent; Age Factors; Animals; Anthelmintics; Ascariasis; Ascaris lumbricoides; Child; Child, Preschool; Female; Humans; Infant; Levamisole; Madagascar; Malaria, Falciparum; Male; Parasite Egg Count; Plasmodium falciparum; Schistosoma mansoni; Schistosomiasis; Seasons; Time Factors

Madagascar is one of the countries with the highest burden of schistosomiasis worldwide. The release from the WHO of the new 2021-2030 neglected tropical disease (NTD) roadmap alongside with the schistosomiasis guidelines sets the ambitious goal of eliminating schistosomiasis as a public health problem worldwide. In Madagascar, implementation barriers exist. This paper has the objective of identifying strengths, weaknesses, opportunities and threats in order to build on their basis practices and policies that can help the country to align with the international global health agenda and reach the ambitious goal set by the WHO.

Topics: Global Health; Humans; Madagascar; Public Health; Schistosomiasis; World Health Organization

Schistosomiasis control requires multisectoral approaches including praziquantel treatment, access to safe water, sanitation and hygiene, and health education. Community input can help ensure health education programs are culturally appropriate to effectively direct protective behavior change. This study reports on the three-stage development of an education program for Malagasy children, with an impact evaluation on their knowledge, attitudes, and practices (KAP) related to intestinal schistosomiasis. A cross-sectional study took place in 2017 with follow-up in 2018 in the hard-to-reach Marolambo district, Madagascar. A novel schistosomiasis education program (SEP) was designed in collaboration with researchers, stakeholders, and local community and included cartoon books, games, songs, puzzles, and blackboard lessons, costing $10 USD per school. KAP questionnaires were completed by 286 children pre-SEP and 273 children post-SEP in 2017, and by 385 and 337 children pre-SEP and post-SEP, respectively, in 2018. Improvements were observed in responses to all questions between pre- and post-education answers in 2017 (53-77%, P < 0.0001) and 2018 (72-98%, P < 0.0001) and in the pre-education answers between years (53-72%, P < 0.0001). Praziquantel mass drug administration attendance improved, rising from 64% to 91% (P < 0.0001), alongside improved latrine use, from 89% to 96% (P = 0.005). This community-consulted and -engaged SEP resulted in substantial improvements in children's understanding of schistosomiasis, with improvements in praziquantel uptake and latrine use. Socioculturally tailored education programs can help gain schistosomiasis control. Continued investment in SEP will help promote the future well-being of children through increased participation in control and treatment activities.

Topics: Adolescent; Child; Child Health; Child, Preschool; Community Participation; Cross-Sectional Studies; Female; Follow-Up Studies; Health Education; Health Knowledge, Attitudes, Practice; Humans; Madagascar; Male; Program Evaluation; Schistosomiasis

Schistosomiasis (also known as bilharziosis) is a parasitic infection still endemic in Madagascar. Its transmission is perpetuated by population lifestyles in tropical countries. A genital location is relatively rare; diagnosis is histological. This is a retrospective, descriptive study of genital schistosomiasis observed in the anatomic pathology laboratory of Sampan'asa luteriana ho an'ny fahasalamana and the Joseph Ravoahangy Andrianavalona University Hospital Center over the 6-year period from January 2010 through December 2015. We collected 13 cases. The mean age of the patients was 31.6 years and ranged from 4 to 48 years. Localization was cervical (n = 10), tubo-ovarian (n = 2), and vulvar (n = 1). Clinical signs were isolated bleeding or associated with other signs for cervical localization, suspicion of cyst for the vulva, and suspicion of mass for the ovary. The diagnosis was based on the presence of schistosome eggs in all cases, associated with tuberculoid granulomas (n = 9), eosinophilic polynuclear cells (n = 1), and giant cells (n = 2). We observed one case of squamous cell carcinoma that developed on cervical schistosomiasis. Schistosomiasis is a neglected tropical diseases. Malignant transformation is possible. A cervical hemorrhage is not synonymous with cancer but may reveal a specific inflammatory lesion. Histological examination is necessary for diagnosis.

Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Madagascar; Middle Aged; Reproductive Tract Infections; Retrospective Studies; Schistosomiasis; Young Adult

Neglected tropical diseases (NTDs) account for a large disease burden in sub-Saharan Africa. While the general cost-effectiveness of NTD interventions to improve health outcomes has been assessed, few studies have also accounted for the financial and education gains of investing in NTD control.. We built on extended cost-effectiveness analysis (ECEA) methods to assess the health gains (e.g. infections, disability-adjusted life years or DALYs averted), household financial gains (out-of-pocket expenditures averted), and education gains (cases of school absenteeism averted) for five NTD interventions that the government of Madagascar aims to roll out nationally. The five NTDs considered were schistosomiasis, lymphatic filariasis, and three soil-transmitted helminthiases (Ascaris lumbricoides, Trichuris trichiura, and hookworm infections).. The estimated incremental cost-effectiveness for the roll-out of preventive chemotherapy for all NTDs jointly was USD125 per DALY averted (95% uncertainty range: 65-231), and its benefit-cost ratio could vary between 5 and 31. Our analysis estimated that, per dollar spent, schistosomiasis preventive chemotherapy, in particular, could avert a large number of infections (176,000 infections averted per $100,000 spent), DALYs (2,000 averted per $100,000 spent), and cases of school absenteeism (27,000 school years gained per $100,000 spent).. This analysis incorporates financial and education gains into the economic evaluation of health interventions, and therefore provides information about the efficiency of attainment of three Sustainable Development Goals (SDGs). Our findings reveal how the national scale-up of NTD control in Madagascar can help address health (SDG3), economic (SDG1), and education (SDG4) goals. This study further highlights the potentially large societal benefits of investing in NTD control in low-resource settings.

Topics: Adolescent; Anthelmintics; Child; Child, Preschool; Cost-Benefit Analysis; Elephantiasis, Filarial; Female; Health Education; Helminthiasis; Humans; Madagascar; Male; Schistosomiasis; Soil; Tropical Medicine

Schistosomiasis affects more than 800 million people, mostly in sub-Saharan Africa. A baseline sentinel site study was conducted in the Western half of Madagascar to determine the prevalence and intensity of schistosomiasis and soil-transmitted helminth (STH) infections prior to mass drug administration, and to explore the associations between infection and school attendance, and access to water, sanitation and hygiene (WASH) facilities.. A three-stage, cluster-randomised cross-sectional study was conducted in 29 sentinel sites in October 2015. Twenty school attending and 4 non-attending children in each of the age groups from 7 to 10 years old were randomly selected at each site for detection of Schistosoma haematobium eggs in a single urine slide by filtration, and of S. mansoni, Ascaris lumbricoides, Trichuris trichiura and hookworm eggs in duplicate Kato-Katz slides from a single stool sample. School attendance was registered individually, and school-level access to WASH facilities was scored through pre-defined observed and reported factors. Logistic regression analysis was performed, adjusting for gender, age and study site. School-level WASH status was analysed using Spearman's rank correlation coefficient.. A total of 1,958 children were included. The prevalence of S. haematobium infection and heavy-intensity infection was 30.5% and 15.1%, respectively. The prevalence of S. mansoni infection and heavy-intensity infection was 5.0% and 0.9%, respectively. The prevalence of any STH infection was 4.7%. There was no significant difference in prevalence of infection or heavy-intensity infection of either schistosome species between attending and non-attending children, apart from heavy-intensity S. mansoni infection that was significantly more common in children who did not attend school regularly (aOR = 7.5 (95% CI = 1.1-49.5); p = 0.037). Only a minority of schools had adequate access to WASH facilities, and in this study, we found no significant association between school-level WASH status and schistosomiasis.. This study found an alarmingly high prevalence and intensity of schistosomiasis, and the results warrant urgent scale-up of the national NTD control programme that will need to include both non-attending and attending school-age children in order to reach WHO roadmap targets for the control of schistosomiasis by 2020.

Topics: Animals; Child; Cross-Sectional Studies; Feces; Female; Humans; Hygiene; Madagascar; Male; Prevalence; Schistosoma; Schistosomiasis; Schools; Soil

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

Data collected by the GeoSentinel Surveillance Network for 1,415 ill travelers returning from Indian Ocean islands during 1997-2010 were analyzed. Malaria (from Comoros and Madagascar), acute nonparasitic diarrhea, and parasitoses were the most frequently diagnosed infectious diseases. An increase in arboviral diseases reflected the 2005 outbreak of chikungunya fever.

Topics: Adolescent; Adult; Aged; Alphavirus Infections; Chikungunya Fever; Communicable Diseases, Emerging; Comoros; Dengue; Female; Foodborne Diseases; Humans; Incidence; Madagascar; Malaria, Falciparum; Male; Middle Aged; Schistosomiasis; Sentinel Surveillance; Travel; Young Adult

Topics: Adult; Animals; Anthelmintics; Eosinophilia; Fever; Humans; Lung; Madagascar; Male; Praziquantel; Radiography; Schistosoma; Schistosomiasis; Tomography Scanners, X-Ray Computed; Travel

Madagascar is in the midst of a large HIV epidemic. Therefore, it is important to obtain relevant epidemiologic data that can be used to develop a preventive strategy.. The goal of the study was to assess sexual behavior and sexually transmitted infections (STIs) among men living in two coastal villages and one highland village with different levels of endemicity of urogenital schistosomiasis.. Data were obtained from cross-sectional studies on male reproductive health. All men aged 15 to 49 years were offered enrollment.. Of 401 men evaluated, 6.5% had used a condom and 45.6% reported having multiple partners in the previous 3 months. Symptoms of urethritis during the previous 7 days were reported by 128 men (31.9%). Urethritis was associated with the youngest age group (15-19 years) and the coastal villages, in which HIV antibodies were found in 0.9% and 2.5%, respectively. The prevalence of Schistosoma hematobium was 31.0% and 55.0% in these two villages, whereas none of the men in the highland village were infected. In bivariate analyses, urogenital schistosomiasis was associated with reported symptoms of urethritis, but it acted as a confounder in multivariate analyses.. Several risk factors for HIV propagation exist in these rural areas in Madagascar. Young men in particular should be targeted for HIV/STI prevention. Treatment of urogenital schistosomiasis could be considered part of the syndromic STI treatment in areas where S hematobium is endemic, for patients seeking primary care for urethritis.

Topics: Adolescent; Adult; Cross-Sectional Studies; Genital Diseases, Male; Humans; Madagascar; Male; Medically Underserved Area; Middle Aged; Prevalence; Risk Factors; Rural Health; Schistosomiasis; Sexual Behavior; Sexually Transmitted Diseases; Socioeconomic Factors

Lot quality assurance sampling (LQAS) was evaluated for rapid low cost identification of communities where Schistosoma mansoni infection was hyperendemic in southern Madagascar. In the study area, S. mansoni infection shows very focused and heterogeneous distribution requiring multifariousness of local surveys. One sampling plan was tested in the field with schoolchildren and several others were simulated in the laboratory. Randomization and stool specimen collection were performed by voluntary teachers under direct supervision of the study staff and no significant problem occurred. As expected from Receiver Operating Characteristic (ROC) curves, all sampling plans allowed correct identification of hyperendemic communities and of most of the hypoendemic ones. Frequent misclassifications occurred for communities with intermediate prevalence and the cheapest plans had very low specificity. The study confirmed that LQAS would be a valuable tool for large scale screening in a country with scarce financial and staff resources. Involving teachers, appeared to be quite feasible and should not lower the reliability of surveys. We recommend that the national schistosomiasis control programme systematically uses LQAS for identification of communities, provided that sample sizes are adapted to the specific epidemiological patterns of S. mansoni infection in the main regions.

Topics: Adolescent; Child; Endemic Diseases; Female; Humans; Madagascar; Male; Mass Screening; Quality Assurance, Health Care; ROC Curve; Sampling Studies; Schistosomiasis; Schools; Sensitivity and Specificity; Specimen Handling

The ancestors of present-day man (Homo sapiens sapiens) appeared in East Africa some three and a half million years ago (Australopithecs), and then migrated to Europe, Asia, and later to the Americas, thus beginning the differentiation process. The passage from nomadic to sedentary life took place in the Middle East in around 8000 BC. Wars, spontaneous migrations and forced migrations (slave trade) led to enormous mixtures of populations in Europe and Africa and favoured the spread of numerous parasitic diseases with specific strains according to geographic area. The three human plasmodia (Plasmodium falciparum, P. vivax, and P. malariae) were imported from Africa into the Mediterranean region with the first human migrations, but it was the Neolithic revolution (sedentarisation, irrigation, population increase) which brought about actual foci for malaria. The reservoir for Leishmania infantum and L. donovani--the dog--has been domesticated for thousands of years. Wild rodents as reservoirs of L. major have also long been in contact with man and probably were imported from tropical Africa across the Sahara. L. tropica, by contrast, followed the migrations of man, its only reservoir. L. infantum and L. donovani spread with man and his dogs from West Africa. Likewise, for thousands of years, the dog has played an important role in the spread and the endemic character of hydatidosis through sheep (in Europe and North Africa) and dromadary (in the Sahara and North Africa). Schistosoma haematobium and S. mansoni have existed since prehistoric times in populations living in or passing through the Sahara. These populations then transported them to countries of Northern Africa where the specific, intermediary hosts were already present. Madagascar was inhabited by populations of Indonesian origin who imported lymphatic filariosis across the Indian Ocean (possibly of African origin since the Indonesian sailors had spent time on the African coast before reaching Madagascar). Migrants coming from Africa and Arabia brought with them the two African forms of bilharziosis: S. haematobium and S. mansoni.

Topics: Africa; Animals; Disease Reservoirs; Echinococcosis; Elephantiasis, Filarial; Emigration and Immigration; Europe; History, Ancient; Humans; Insect Vectors; Leishmaniasis; Madagascar; Malaria; Parasitic Diseases; Schistosomiasis

Topics: Humans; Madagascar; Program Development; Public Health Administration; Schistosomiasis

The evaluation of a schistosomiasis control programme requires regular monitoring of the performance of technicians responsible for measuring prevalence rates and intensities of infection; simple quality control measures are the most effective form of monitoring. Quality control of microscopy has usually been carried out immediately after primary examination of fresh microscope specimens or by transport of preserved urine or stool samples to a central laboratory; the first method was impossible in Madagascar, and the second involved severe loss and breakage of specimen containers. A new method involving the transport of dried filters fixed on plastic sheets with adhesive tape was therefore used. Essential requirements of the quality control methods were simplicity, effectiveness, acceptability to field technicians, and the production of results valuable to the control programme. Acceptable limits of error (ALE) were determined by a combination of trial-and-error assessment of technicians' capabilities, and the application of a rule-of-thumb derived from quality control studies in clinical chemistry. Results were prepared in the form of simple 2 x 2 tables and easily understood charts for visual assessment of results. Technicians' work varied from excellent to poor; false negative rates (FNR) were usually higher than false positive rates (FPR) and technicians' field counts of eggs were most often lower than control counts. Control proved very useful in motivating technicians, in maintaining high work standards, and in identifying technicians needing further training.

Topics: Animals; False Negative Reactions; False Positive Reactions; Humans; Madagascar; Parasite Egg Count; Quality Control; Schistosomiasis; Specimen Handling

Topics: Humans; Kidney Diseases; Madagascar; Schistosomiasis

Topics: Adolescent; Child; Epidemiologic Methods; Feces; Humans; Madagascar; Schistosomiasis

Topics: Humans; Madagascar; Pyrazines; Schistosoma haematobium; Schistosoma mansoni; Schistosomiasis; Schistosomicides; Thiones; Thiophenes

Topics: Agriculture; Disease Reservoirs; Filariasis; Humans; Madagascar; Malaria; Parasitic Diseases; Schistosomiasis; Urinary Tract Infections; Water Supply

Topics: Animals; Biomphalaria; Bulinus; Ducks; Ecology; Humans; Madagascar; Plants; Schistosomiasis

Topics: Animals; Biomphalaria; Disease Reservoirs; Humans; Madagascar; Mollusca; Schistosoma mansoni; Schistosomiasis

Topics: Adolescent; Child; Child, Preschool; Female; Humans; Madagascar; Male; Pyrazines; Schistosomiasis; Schistosomicides; Thiones; Thiophenes; Urinary Tract Infections

Topics: Adult; Humans; Madagascar; Schistosomiasis; Socioeconomic Factors; Urinary Tract Infections

Topics: Adolescent; Animals; Biomphalaria; Body Weight; Child; Child, Preschool; Disease Vectors; Female; Fluorescent Antibody Technique; Humans; Madagascar; Male; Nitroquinolines; Oxamniquine; Parasite Egg Count; Schistosomiasis

An evaluation of health problems is done in a village in Eastern Madagascar, where takes place a development programme. 217 inhabitants go through physical examination and lab tests are performed (Blood smear - Thick drop. Emmel test. Stools examination for parasites and enteroviruses). The epidemiologic investigation reveals the prevalences of Malaria (39,4 p. 100) intestinal schistosomiasis (59,9 p. 100) Ascaridiasis (61,3 p. 100) Hookworm (29,9 p. 100) Trichuriasis (19,8 p. 100) and sickle cells anemia (4,80 p. 100). The signs and symptoms are analysed, particularly spleen enlargement which is shown to be due to schistosomiasis. The local transmition pattern of schistosomiasis is investigated and, according to the malacological findings, is thought to be intermittent. The determination of the local hookworm is started. It should be Necator americanus. The sanitary programme to be set is considered regarding the local contexte.

Topics: Age Factors; Anemia, Sickle Cell; Animals; Ascaridiasis; Disease Vectors; Feces; Health Surveys; Hookworm Infections; Humans; Madagascar; Malaria; Mollusca; Sanitation; Schistosomiasis; Splenomegaly; Trichuriasis

The course of an investigation trip through Madagascar is sketched. It allowed to analyze the parasitological situation. It is explained with the sociological and economical facts and the unusual fauna of this island. The two biggest problems are Malaria tropica and schistosomatosis (bilharziasis). Further, Ancylostoma, Ascaris, taeniids, and Wuchereria occur. Plague is rare. Fasciola gigantica has been introduced since short time only. Introduction of other parasites must be feared. Sleeping illness and nagana are lacking, as well as rabies, yellow fever, Fasciola hepatica, Echinococcus granulosus, Hymenolepis nana, Trichinella spiralis and Dracunculus medinensis. Effective control measures may not be reasonable at present because of the socio-economic structure as a result of the former colonial status.

Topics: Alcoholism; Environment; Expeditions; Helminthiasis; Humans; Madagascar; Malaria; Parasitic Diseases; Public Health; Schistosomiasis; Socioeconomic Factors; Tropical Climate

Topics: Adult; Aged; Female; Humans; Madagascar; Male; Middle Aged; Pyrazines; Schistosoma mansoni; Schistosomiasis; Schistosomicides; Thiones; Thiophenes

Topics: Animals; Biomphalaria; Child; Disease Vectors; Ecology; Humans; Madagascar; Mice; Mollusca; Parasite Egg Count; Rain; Schistosoma mansoni; Schistosomiasis; Tropical Climate

The region of Antananarivo, where Schistosomiasis is not yet endemic, is compared to Ambositra, a well established focus of S. mansoni, with regard to climate, hydrology and snail habitats. Higher mean temperatures and a more pronounced dry season in Antananarivo contribute to sometimes less favourable hydrological conditions. Biomphalaria is found in very few and limited habitats. Population dynamics were followed up in selected habitats and showed ecological parameters comparable to those of the Ambositra-strain. Trematode infections were very scarce. Both strains of Biomphalaria are equally susceptible to infections with the malagasy strain of S. mansoni (up to 100 p. 100). Mortality rates, prepatency periods and the electrophoretic pattern of egg proteins are very similar. Foreign snail species like B. glabrata (albino strain) and B. pfeifferi (South African strain) are hardly susceptible to malagasy S. mansoni. Some cases of S. mansoni-infections are mentioned, which presumably had been contracted in non-endemic areas of the province of Antananarivo. The possibility and risk of implantation of schistosomiasis in this region and in the town is evaluated following the discussion of epidemiological details. The author concludes that in spite of some unfavourable conditions for S. mansoni the establishment of the cycle can locally not be excluded. Attention is all the more important, as control of endemic schistosomiasis would be particularly difficult under malagasy conditions of geography, climate, snail dynamics and human behaviour.

Topics: Adult; Animals; Biomphalaria; Child; Climate; Ecology; Environment; Humans; Madagascar; Schistosoma mansoni; Schistosomiasis; Water

Topics: Humans; Intestinal Diseases, Parasitic; Madagascar; Schistosomiasis; Statistics as Topic; Urinary Tract Infections

Topics: Animals; Anti-Bacterial Agents; Disease Reservoirs; Disease Vectors; Epidemiologic Methods; Health Education; Humans; Madagascar; Mollusca; Morpholines; Pesticides; Schistosomiasis

Topics: Animals; Cattle; Cattle Diseases; Female; Madagascar; Male; Schistosomiasis

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Intestinal Diseases; Madagascar; Male; Middle Aged; Schistosomiasis

Topics: Humans; Imidazoles; Immunodiffusion; Immunoelectrophoresis; Madagascar; Schistosomiasis

Topics: Anemia; Humans; Hypersplenism; Hypertension; Hypertension, Portal; Madagascar; Schistosomiasis; Splenomegaly; Venous Pressure

Topics: Humans; Islands; Madagascar; Schistosomiasis

Topics: Asian People; Black People; Humans; Madagascar; Schistosomiasis; Schistosomiasis mansoni