Malaria transmission and vector biology on Sainte Marie Island, Madagascar.

A 17-mo longitudinal malaria survey (November 1988-March 1990) was carried out on Sainte Marie Island, an area on the east coast of Madagascar which is frequently visited by tourists. During 706 man-nights of capture, 46,401 mosquitoes belonging to 32 species were caught. Sporozoite rates were determined by ELISA and incriminated Anopheles gambiae Giles s.s., An. funestus Giles, and An. mascarensis De Meillon as vectors of malaria. An. gambiae, the main vector, was highly anthropophilic but largely exophilic. Transmission by this species occurred mainly from November to April; the overall circumsporozoite antigen positivity rate was 1.7%, with a maximum of 3.2% in March-April. The nightly peak of transmission occurred between midnight and 0400 hours. The annual inoculation rate was calculated to be 100 infective bites per human, of which 92 were of Plasmodium falciparum. An. funestus played a minor role in transmission. An. mascarensis, an anopheline endemic to Madagascar, was incriminated for the first time, as a malaria vector. The sporozoite rate in this species varied from 0.4 to 0.9% as shown by both ELISA and salivary gland dissections. Parasite indices in humans up to 20 yr of age fluctuated during the year from 64 to 80%. Bed nets are recommended for malaria protection for the local population and tourists.

Rift Valley fever on the east coast of Madagascar.

In March 1990, a Rift Valley fever virus (RVFV) outbreak was suspected in the district of Fenerive on the east coast of Madagascar after an abnormally high incidence of abortions and disease in livestock. Sera from humans and cattle were tested for RVFV antibodies by immunofluorescence assay (IFA) and ELISA-IgM capture. Sera and mosquitoes collected in the same area were tested for virus isolation by tissue culture and suckling mouse intracerebral inoculation, and for antigen detection by an ELISA antigen capture assay. Among cattle from the area, RVFV antibody prevalence was 58.6% by IFA and 29.6% by ELISA-IgM. In contrast, human populations in the same area had a lower RVFV antibody prevalence, with 8.01% IFA and 5.4% IgM-positive sera. No RVFV antigen was detected and virus isolation was unsuccessful from the sera and mosquito pools tested. Different hypotheses concerning the emergence and diffusion of RVFV in this area and the occurrence of the outbreak are discussed.

Protective value of elevated levels of gamma interferon in serum against exoerythrocytic stages of Plasmodium falciparum.

In vitro experiments suggested that gamma interferon, CD8+ T cells, and anticircumsporozoite antibodies inhibited the exoerythrocytic stages of malaria parasites. To assess the role played in vivo by these factors, we conducted a prospective study in Madagascar. Forty individuals with a negative blood smear were followed for 8 weeks to detect the appearance of parasites in blood. Nineteen subjects remained negative for malaria, whereas 21 individuals became positive during follow-up. Among these, seven presented with blood parasites within the first 2 weeks and were excluded, as they probably were infected by sporozoites at enrollment. When measured at enrollment, antibodies to the synthetic peptide (NANP)5, lymphocyte proliferation with (NANP)5, and various lymphocytes subsets were similar among individuals that later presented with a Plasmodium falciparum blood infection or were not infected. Conversely, the level of gamma interferon in serum was higher in individuals that did not present with a P. falciparum infection during follow-up. These data suggest that gamma interferon may inhibit the malaria exoerythrocytic stages of development under in vivo conditions, as it does in vitro.

Transmission and epidemiology of newly transmitted falciparum malaria in the central highland plateaux of Madagascar.

The recent reappearance of Plasmodium falciparum in the central highland plateaux of Madagascar has led to an important increase in both morbidity and mortality in the population. To understand the phenomena that originated this outbreak, and to evaluate the clinical and biological reactions of the population, we conducted entomological surveys during the whole malaria transmission season of 1988. In parallel, 41 individuals presenting with a malaria attack in January were given a curative antimalarial treatment and were followed weekly for 20 weeks, until the end of the transmission season, in June. During the follow-up, individuals presenting with a clinical malaria attack or with a parasite density above 5000 per mm3 of blood were again given antimalarial treatment. Overall, individuals presented with an average of 5.6 thick blood smears positive for P. falciparum, and 1.4 malaria attacks requiring treatment. Plasmodium falciparum prevalence rates gradually increased to 53.8% in April, one to two months after the observed peak of transmission, then decreased to 15.4% at the end of follow-up. The proportion of P. falciparum infections with clinical symptoms did not follow a similar temporal evolution and was significantly lower than at enrollment. Splenic rates gradually decreased from 29.3-2.6%, while anti-P. falciparum and anti-Pfl55/RESA antibodies increased. For the whole transmission season individuals experienced a mean 1.5 infective bites; the malaria vectors were Anopheles gambiae s. 1 and An. funestus. This study demonstrates that, in this population newly exposed to P. falciparum infections, almost all sporozoite inoculations lead to blood parasite infection requiring treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Virus Manombo (Mg Ar 966), a provisionally new arbovirus isolated from Culicidae in Madagascar]. / Virus Manombo (Mg Ar 966), un arbovirus provisoirement nouveau isolé de Culicidés à Madagascar.

In April 1987, a virus strain was isolated from a pool of Mansonia uniformis caught on human bait, in a tropical primary rain forest area of the South-East coast of Madagascar. Antigenically, this virus may not be related to other known viruses, and constitutes a provisionally new Arbovirus called virus Manombo.

[Longitudinal study on malaria transmission and biology of vectors in the island of Sainte Marie, on the east coast of Madagascar, from 1988 to 1990]. / Etude longitudinale de la transmission du paludisme et de la biologie des vecteurs à l'île Sainte Marie, côte Est de Madagascar, de 1988 à 1990.

A 17-month longitudinal malaria survey was carried out in Sainte Marie Island, on the East Coast of Madagascar, from November 1988 to March 1990. During 706 man-nights of captures, 46401 mosquitoes belonging to 32 species were caught. Sporozoïte rates were calculated by Elisa. The malaria vectors were Anopheles gambiae sensu stricto, An. funestus and An. mascarensis. An. gambiae was the main vector. It was highly anthropophilic and partially exophilic. Transmission by this species mainly occurred from November to April, monthly sporozoïte antigene positivity rate varied from 0 to 3.85. The annual inoculation rate was about 100 infecting bites per man, in which 92 by Plasmodium falciparum. An. funestus intervened weakly in transmission. An. mascarensis, a malagasy endemic region anopheline is a newly discovered vector. The observed sporozoïte rate varied from 0.4 to 0.9 between September and March 1990. Parasite indexes in human fluctuated during the year from 64 to 80%. Because of the high level of transmission, recommendations for inhabitants and tourists are proposed.

[Prevalence of antibodies to West Nile virus in youngsters from 5 to 20 years old in Madagascar]. / Prévalence des anticorps anti-virus West Nile chez les jeunes de 5 a 20 ans a Madagascar.

In 1990 a serological investigation among 3,177 children (5 to 20 years old) sera has been conducted by the Pasteur Institute of Madagascar in several areas of Madagascar, in order to evaluate the prevalence of West Nile virus antibodies. 29.9% out of human sera tested by ELISA for West Nile IgG antibodies are positive, that shows a rather high level of West Nile virus circulation in Madagascar. Prevalence is increasing with age but no significant difference has been registered among prevalence according to sex. The diffusion of the virus appears lighter in Central Highlands.

Observations ultrastructurales sur les formes sanguines et la sporogonie de plasmodiums de lémuriens malgaches.

The ultrastructure of blood stages and oocysts of Plasmodium coulangesi and P. percygarnhami, both parasites of Madagascan lemurs, was studied. The main results are:

Antigenic variations in West Nile virus strains isolated in Madagascar since 1978.

The antigenic interrelationship between 52 Madagascan West Nile isolates and two prototype viruses (Eg101 and G2266) was assessed by an immunofluorescent technique using monoclonal antibodies. This analysis enabled us to define 5 groups of variants, 4 of which were closer to the Egyptian strain (Eg101) than to the Indian prototype (G2266). Groups II and V were dominant whereas strains of groups I and IV were less numerous. One strain belonging to group III was antigenically similar to the Indian strain. Antigenic variations were observed among viruses isolated from man, birds and different mosquito genera. Geographic variations were also observed. Exchanges exist between Madagascar and the African continent by means of migratory birds which seem to be instrumental in disseminating the virus and introducing the antigenic variants.

Humoral and cell-mediated immune responses to the Plasmodium falciparum antigens PF155/RESA and CS protein: seasonal variations in a population recently reexposed to endemic malaria.

Resurgence of falciparum malaria occurred in the Central Highlands of Madagascar in the 1980s and the disease is currently hyperendemic. We determined the humoral and cellular responses to synthetic peptides reproducing the repeat sequences of 2 major Plasmodium falciparum antigens: the Pf155/RESA and the circumsporozoite (CS) protein. Blood samples from 83 subjects living in a rural community near Antananarivo were obtained at the beginning and the end of the transmission season. At enrollment, 40 subjects presenting with and 43 without blood parasites had similar T cell proliferative response and antibody level to all antigens tested. However, P. falciparum-infected individuals exhibited a decrease in the absolute number of T lymphocytes, due to a diminished number of CD8+ and natural killer lymphocytes. The number of CD4+ cells was similar in both groups. In the overall population, 45% of subjects had a T cell response to at least 1 RESA peptide (29-35% responding to a given peptide) and 35% to the CS protein peptide. Thirty-two percent of the donors presented with RESA antibodies and 23% had CS protein antibodies. After 20 weeks, at the end of the transmission season, cellular proliferative responses to all antigens markedly decreased as evidenced by a decrease of both the number of responders and mean stimulation indexes. Humoral response to RESA, as detected by erythrocyte membrane immunofluorescence (number of responders and mean antibody titers) markedly increased. Humoral responses to the CS protein and RESA peptides were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Malaria transmission and vector biology in Manarintsoa, high plateaux of Madagascar.

To evaluate the factors which determine the transmission level of falciparum malaria, entomological and parasitological surveys were conducted from October 1988 to February 1990 in Manarintsoa in the central highland plateaux of Madagascar. Mosquitoes were collected for 928 man-nights in pit shelters and indoor resting sites. Malaria vectors were Anopheles arabiensis and An. funestus, with no evidence of the presence of An. gambiae sensu stricto. Vectors were mainly exophilic and zoophilic. The index of stability was less than 1.5. The sporozoite rate was 0.11 for An. gambiae sensu lato and 0.47 for An. funestus. The transmission level was low, with an inoculation rate of 0.91 infective bites/person/year and an infection risk of 0.62. Malaria transmission occurs 7 months of the year in this area, from November to May. Human parasite rates fluctuated from 29% in October to 53% in May.

Longitudinal study of the cellular response to Pf155/RESA and circumsporozoite protein in Madagascar.

In a community follow-up conducted in the Central Highlands of Madagascar, the cellular responses to synthetic peptides from the immunodominant regions of Pf155/RESA and the repeat region of the circumsporozoite protein were studied. Seasonal variations of the T cell response were measured at the individual level; the relationship between this response and the presence of parasites in blood was assessed; the question of the possible protective value of the lymphocyte proliferation in presence of a specific antigen was addressed.

[Serological surveillance of West Nile virus infection in a village of the Central Highlands in Madagascar]. / Surveillance sérologique de l'infection à virus West Nile dans un village des hauts plateaux à Madagascar.

A serological survey on the frequency of West Nile virus antibodies has been carried out in a village near Antananarivo. IgG antibodies were searched for by enzyme-linked immunosorbent assay on 460 sera collected in December 1988 and on 494 sera collected in July 1989. The prevalence of West Nile virus antibodies varied from 13.4% to 21.8% between the beginning and the end of the rainy season. Seroconversion was observed in 14.7% of 354 paired serum samples collected in December and July which had been negative in December. The distribution of seropositive samples in the hamlets, and their frequency in relation to the presence of domesticated animals were analysed. Results show that West Nile virus circulates in the human population of the central highlands of Madagascar, which might account for the pseudo-influenza pathology observed in the region.

[Ecological factors in the renewed outbreak of malaria in Madagascar]. / Facteurs écologiques de la recrudescence du paludisme à Madagascar.

The new epidemic of malaria which spread on the Madagascar high plateau in 1986-1987 is due to the combination of several factors (some of which are analysed by the authors, especially those related to anopheles, parasite and man). The authors compare the situations on the high Plateau and on St Mary Island, on the East Madagascar Coast, where the malaria is stable. Concerning the vector, the most interesting fact is the come-back of Anopheles funestus on the high Plateau from which it had disappeared at the beginning of the fifties. In this area, An.arabiensis seems to be the only representative of the gambiae complex whereas it is An. gambiae s.s. in St Mary Island. The parasite is getting more and more resistant to chloroquine. Nevertheless, man seems to develop protection, but it is difficult to analyse the markers which would prove the protection. However, that protection was assessed, on the humoral and cellular level, against the peptides of the RESA (Ring Infected Erythrocytes Surface Antigen), the circumsporozoite protein and the antigen E.

[Antibiotic resistance of strains of Shigella dysenteriae and flexneri isolated in Tananarive and on the east coast of Madagascar]. / Résistance aux antibiotiques de souches de Shigella dysenteriae et flexneri isolées à Tananarive et sur la côte-est de Madagascar.

From November 1988 to March 1989, stools from 804 Malagasy children were examined, thirty-seven strains of Shigella were isolated, from which 5 S. dysenteriae serotype 1 (= Shiga bacillus) strains were found to be resistant to ampicillin, carbenicillin, streptomycin, chloramphenicol, tetracycline, sulphonamide and even to trimethoprim. Resistance to trimethoprim has appeared only recently in Madagascar.

Newly transmitted Plasmodium falciparum malaria in the central highland plateaux of Madagascar: assessment of clinical impact in a rural community.

Plasmodium falciparum has recently reappeared in the central highland plateaux of Madagascar. To define its role in the overall malaria pathology occurring during the rainy season, we conducted a clinical and parasitological study among the 2776 consultants of a malaria field health centre which we established in the middle of the transmission area. From January to June 1988 the overall parasite rate was 63.2% and did not vary with age; the overall splenic rate was 46.9%, decreasing in individuals over 15 years of age. After the beginning of the main transmission season, an increase in parasite rates and parasite densities was observed, while febrile illnesses associated with malaria parasitaemia decreased. During the second part of the rainy season the parasite densities started to decrease, while parasite rates and malaria-associated fevers remained at the same level. The frequency of fevers was not related to the malaria parasite density owing to individual and seasonal variations.