Bovine tuberculosis detection in dairy cows in Antanifotsy District, Madagascar

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Epidemiological Situation of African Swine Fever in Lake Alaotra Region (Madagascar) and Possible Consequences on the Organization of Disease Control and Surveillance

An epidemiological survey was undertaken from April to July 2004 at the slaughterhouse of Ambatondrazaka, in the region of lake Alaotra (Madagascar), to study the incidence of the African swine fever (ASF). Out of 200 pig carcasses examined, 155 (78%) presented ASF-like lesions: hemorrhagic lymph nodes and/or discolored kidneys with petechiae on their surfaces. Samples were taken and tested for the ASF virus using an antigen-ELISA technique and a PCR method. Eighteen percent of suspect carcasses were infected: prevalence of 14% (95% confidence interval: 9 to 19%). The PCR test was twice more sensitive than the ELISA test, and twice cheaper. In places where both equipments and technicians are available, PCR should be the preferred technique for this kind of survey. Farms were difficult to trace back from the carcasses: it was possible in 32 cases (16%). The only risk factor identified was the previous occurrence of swine fever in the farms, as reported by the breeders. To improve the control and surveillance of ASF in Ambatondrazaka, the most urgent measures would be to build a new slaughterhouse away from the town and market, to ban pigs straying and to set up a traceability system between slaughterhouse and farms. The relative importance of African and classical swine fevers should also be specified to improve control and epidemiosurveillance

Factors associated with anaemia among preschool- age children in underprivileged neighbourhoods in Antananarivo, Madagascar.

Anaemia occurs in children when the haemoglobin level in the blood is less than the normal (11 g/dL), the consequence is the decrease of oxygen quantity in the tissues. It is a prevalent public health problem in many low-income countries, including Madagascar, and data on risk factors are lacking. We used existing data collected within the pathophysiology of environmental enteric dysfunction (EED) in Madagascar and the Central African Republic project (AFRIBIOTA project) conducted in underprivileged neighbourhoods of Antananarivo to investigate the factors associated with anaemia in children 24 to 59 months of age. Children included in the AFRIBIOTA project in Antananarivo for whom data on haemoglobin and ferritin concentrations were available were included in the study. Logistic regression modelling was performed to identify factors associated with anaemia. Of the 414 children included in this data analysis, 24.4% were found to suffer from anaemia. We found that older children (adjusted OR: 0.95; 95% CI: 0.93-0.98) were less likely to have anaemia. Those with iron deficiency (adjusted OR: 6.1; 95% CI: 3.4-11.1) and those with a high level of faecal calprotectin (adjusted OR: 2.5; 95% CI: 1.4-4.4) were more likely to have anaemia than controls. To reduce anaemia in the children in this underprivileged area, more emphasis should be given to national strategies that improve children's dietary quality and micronutrient intake. Furthermore, existing measures should be broadened to include measures to reduce infectious disease burden

An open-label, randomized, non-inferiority trial of the efficacy and safety of ciprofloxacin versus streptomycin + ciprofloxacin in the treatment of bubonic plague (IMASOY): study protocol for a randomized control trial

Background Bubonic plague is the primary manifestation of infection with Yersinia pestis, accounting for 90% of all plague cases and with 75% of global cases reported in Madagascar. All drugs in use for treating plague are registered based on experimental data and anecdotal evidence, and no regimen currently recommended is supported by a randomized clinical trial. The IMASOY trial intends to fill this knowledge gap by comparing two 10-day regimens included in the national guidelines in Madagascar. The primary objective of the trial is to test the hypothesis that ciprofloxacin monotherapy is non-inferior to streptomycin followed by ciprofloxacin for the treatment of bubonic plague, thus avoiding the need for injectable, potentially toxic, aminoglycosides. Methods A two-arm parallel-group randomized control trial will be conducted across peripheral health centres in Madagascar in five districts. Males and non-pregnant females of all ages with suspected bubonic or pneumonic plague will be recruited over the course of three plague ‘seasons’. The primary endpoint of the trial is to assess the proportion of patients with bubonic plague who have a therapeutic response to treatment (defined as alive, resolution of fever, 25% reduction in the size of measurable buboes, has not received an alternative treatment and no clinical decision to continue antibiotics) as assessed on day 11. Discussion If successful, the trial has the potential to inform the standard of care guidelines not just in Madagascar but in other countries afflicted by plague. The trial is currently ongoing and expected to complete recruitment in 2022. Trial registration ClinicalTrials.gov NCT04110340. Registered on 1 October 2019</p