Taenia solium porcine cysticercosis in Madagascar: Comparison of immuno-diagnostic techniques and estimation of the prevalence in pork carcasses traded in Antananarivo city.

Taenia solium cysticercosis was reported in official veterinary and medical statistics to be highly prevalent in pigs and humans in Madagascar, but few estimates are available for pigs. This study aimed to estimate the seroprevalence of porcine cysticercosis among pigs slaughtered in Antananarivo abattoirs. Firstly, the diagnostic performance of two antigen-ELISA techniques (B158B60 Ag-ELISA and HP10 Ag-ELISA) and an immunoblotting method were compared with meat inspection procedures on a sample of pigs suspected to be infected with (group 1; n=250) or free of (group 2; n=250) T. solium based on direct veterinary inspection in Madagascar. Sensitivity and specificity of the antigen ELISAs were then estimated using a Bayesian approach for detection of porcine cysticercosis in the absence of a gold standard. Then, a third set of pig sera (group 3, n=250) was randomly collected in Antananarivo slaughterhouses and tested to estimate the overall prevalence of T. solium contamination in pork meat traded in Antananarivo. The antigen ELISAs showed a high sensitivity (>84%), but the B158B60 Ag-ELISA appeared to be more specific than the HP10 Ag-ELISA (model 1: 95% vs 74%; model 2: 87% vs 71%). The overall prevalence of porcine cysticercosis in Antananarivo slaughterhouses was estimated at 2.3% (95% credibility interval [95%CrI]: 0.09-9.1%) to 2.6% (95%CrI: 0.1-10.3%) depending on the model and priors used. Since the sample used in this study is not representative of the national pig population, village-based surveys and longitudinal monitoring at slaughter are needed to better estimate the overall prevalence, geographical patterns and main risk factors for T. solium contamination, in order to improve control policies.

How to reach the poor? Surveillance in low-income countries, lessons from experiences in Cambodia and Madagascar.

Surveillance of animal diseases in developing countries faces many constraints. Innovative tools and methods to enhance surveillance in remote and neglected areas should be defined, assessed and applied in close connection with local farmers, national stakeholders and international agencies. The authors performed a narrative synthesis of their own publications about surveillance in Madagascar and Cambodia. They analysed the data in light of their fieldwork experiences in the two countries' very challenging environments. The burden of animal and zoonotic diseases (e.g. avian influenza, African swine fever, Newcastle disease, Rift Valley fever) is huge in both countries which are among the poorest in the world. Being poor countries implies a lack of human and financial means to ensure effective surveillance of emerging and endemic diseases. Several recent projects have shown that new approaches can be proposed and tested in the field. Several advanced participatory approaches are promising and could be part of an innovative method for improving the dialogue among different actors in a surveillance system. Thus, participatory modelling, developed for natural resources management involving local stakeholders, could be applied to health management, including surveillance. Data transmission could benefit from the large mobile-phone coverage in these countries. Ecological studies and advances in the field of livestock surveillance should guide methods for enhancing wildlife monitoring and surveillance. Under the umbrella of the One Health paradigm, and in the framework of a risk-based surveillance concept, a combination of participatory methods and modern technologies could help to overcome the constraints present in low-income countries. These unconventional approaches should be merged in order to optimise surveillance of emerging and endemic diseases in challenging environments.

Description and analysis of the poultry trading network in the Lake Alaotra region, Madagascar: implications for the surveillance and control of Newcastle disease.

Madagascar's 36.5-million-head poultry industry holds a foremost place in its economy and the livelihood of its people. Unfortunately, regular Newcastle disease outbreaks associated with high mortality causes high losses for smallholders and threatens their livelihood. Therefore, Madagascar is seeking concrete, achievable and sustainable methods for the surveillance and the control of Newcastle disease. In this paper, we present and analyze the results of a field study conducted in Madagascar between December 2009 and December 2010. The study area was the Lac Alaotra region, a landlocked area in the north-eastern part of the country's center. Poultry trading is suspected of playing a major role in the spread of avian diseases, especially in developing countries characterized by many live-bird markets and middlemen. Therefore, the goals of our study were to: (i) describe and analyze smallholders' poultry trading network in the Lake Alaotra region using social network analysis; (ii) assess the role of the network in the spread of Newcastle disease; and (iii) propose the implementation of a targeted disease surveillance based on the characteristics of the poultry trading network. We focused our field study on the harvesting of two data sets. The first is a complete description of the poultry trading network in the landlocked area of Lac Alaotra, including a description of the poultry movements between groups of villages. The second set of data measures the occurrence of outbreaks in the same area by combining a participatory approach with an event-based surveillance method. These data were used to determine the attributes of the network, and to statistically assess the association between the position of nodes and the occurrence of outbreaks. By using social network analysis techniques combined with a classification method and a logistic model, we finally identified 3 nodes (set of villages), of the 387 in the initial network, to focus on for surveillance and control in the Lac Alaotra area. This result is of primary importance in the ongoing efforts to effectively improve the wellbeing of people in the region.

Risk factors for avian influenza and Newcastle disease in smallholder farming systems, Madagascar highlands.

Newcastle disease (ND) and avian influenza (AI) are issues of interest to avian producers in Madagascar. Newcastle disease virus (NDV) is the major constraint for village aviculture, and avian influenza viruses type A (AIAV) are known to circulate in bird flocks. This study aims at classifying smallholder poultry farms, according to the combination of risk factors potentially associated with NDV and AIAV transmission and to assess the level of infection for each farm class. Two study sites, Lake Alaotra and Grand Antananarivo, were chosen with respect to their differences in terms of agro-ecological features and poultry productions. A typology survey involving 526 farms was performed to identify possible risk factors for (i) within-village, and (ii) between-village virus transmission. A cross-sectional serological study was also carried out in 270 farms to assess sero-prevalences of NDV and AIAV for each farm class and the link between them and risk factor patterns. For within-village transmission, four classes of farms were identified in Grand Antananarivo and five in Lake Alaotra. For between-village virus transmission, four classes of farms were identified for each site. In both sites, NDV sero-prevalence was higher than for AIAV. There was no evidence of the presence of H5 or H7 subtypes of AIAV. Sero-prevalences were significantly higher in Lake Alaotra than in Grand Antananarivo for both viruses (OR=2.4, p=0.02 for NDV, and OR=9.6, p<0.0001 for AIAV). For within-village NDV transmission in Grand Antananarivo, backyard chicken farms (OR=3.6, p<0.001), and chicken farms with biosecurity awareness (OR=3.4, p<0.01) had greater odds of having antibodies against NDV than the others. For between-village virus transmission, farms with multiple external contacts, and farms using many small markets had greater odds of having antibodies against NDV than the others (OR=5.4, p<0.01). For AIAV, there were no differences in sero-prevalences among farm classes. In Lake Alaotra, the observed high density of palmipeds and widespread rice paddies were associated with high sero-prevalences for both viruses, and a homogeneous risk of virus transmission between the different farm classes. In Grand Antananarivo, farm visits by collectors or animal health workers, and farm contacts with several markets were identified as potential risk factors for NDV transmission. Further studies are needed to identify the circulating virus genotypes, model their transmission risk, and provide adapted control measures.