Impact of a 3-year mass drug administration pilot project for taeniasis control in Madagascar.

Taenia solium is endemic in Madagascar and presents a significant burden on the population and the health system. The parasite cycles through humans who host the adult tapeworm, and pigs that host the larval stages. Accidental infection of humans may occur with the larval stages which encyst in the nervous central system causing neurocysticercosis, a major cause of seizure disorders and a public health problem. One of the interventions to facilitate the control of the disease is mass drug administration (MDA) of the human population with taeniacide. Here we describe a pilot project conducted in Antanifotsy district of Madagascar from 2015 to 2017 where three annual rounds of MDA (praziquantel, 10mg/Kg) were undertaken in 52 villages. Changes in the prevalence of taeniasis were assessed before, during and after the treatments. A total of 221,308 treatments were given to all eligible people above 5 years of age representing a 95% coverage of the targeted population. No major adverse effects were notified related to the implementation of the MDA. The prevalence of taeniasis was measured using Kato-Katz and copro-antigen techniques. Analyses undertaken combining the results of the Kato-Katz with copro-antigen, or using the Kato-Katz results alone, showed that there was a significant reduction in taeniasis 4 months after the last MDA, but 12 months later (16 months after the last MDA) the taeniasis prevalence had returned to its original levels. Results of the pilot project emphasize the need of a multi-sectorial One-Health approach for the sustained control of T. solium.

Current practice about the evaluation of antibody to streptolysin O (ASO) levels by physicians working in Antananarivo, Madagascar.

INTRODUCTION: The diagnosis of post streptococcal diseases is usually confirmed by immunological tests. Only the antistreptolysin O is usually prescribed by physician. This study aimed to describe the current practice of these requests in Antananarivo. METHODS: It was a retrospective and descriptive study conducted at the Para clinic Unit of Immunology at the University Center Hospital of Antananarivo. We analyzed all requests during seven years, from January 2003 to December 2009. We looked at age, gender, and clinical symptoms which led to the request and the result for each request. RESULTS: We retained 4143 requests for antistreptolysin O titration in our study. The mean age of the study participants was 32.9 years with 18.3% of participants being less than 15 years old. The main symptoms leading to the request of this analysis were rheumatologic (41%), followed by neurological (13.9%) and cardiologic symptoms (8.5%) and 19.4% were prescribed for various symptoms. Only 15% of all requests had a value more than 200 U/ml. CONCLUSION: Our study found that in most of requests, ASO titre levels were not significant.

High HIV type 1 subtype diversity and few drug resistance mutations among seropositive people detected during the 2005 second generation HIV surveillance in Madagascar.

Subtype determination and detection of drug resistant-associated mutations (DRM) were performed on 31 HIV-1 Western blot-positive sera during the 2005 second-generation HIV surveillance in Madagascar. Amplification and sequencing of at least one of the partial reverse transcriptase, protease, and partial envelope genes were successful for all strains. All three gene sequences were obtained for 28 strains. A high degree of subtype or circulating recombinant forms (CRF) was observed for these 28 strains: A-A1 (eight cases), CRF02_AG (six cases), B (five cases), C (three cases), CRF06_cpx (three cases), CRF10_CD, BC()CRF, and unique RF (one case each). According to the ANRS September 2005 DRM list and algorithm, no DRM was detected in the reverse transcriptase and only one strain bore three major DRM in the protease M46I, I84V, and L90M leading to resistance to indinavir, saquinavir, nelfinavir, atazanavir/ritonavir, and possibly lopinavir.