Wild poliovirus circulation among healthy children immunized with oral polio vaccine in Antananarivo, Madagascar. (1/380)

From July 1995 to December 1996, 3185 stool specimens from healthy children aged 6-59 months attending 6 dispensaries in the Antananarivo area were examined for poliovirus. The children had been routinely immunized according to the Expanded Programme on Immunization (EPI) schedule and received the last dose of oral polio vaccine (OPV) more than 1 month before stool collection. 99.4% of the children were immunized with at least 3 doses of OPV. HEp-2 cell culture revealed virus infections in 192 stools (6.0%), including 9 poliovirus (0.3%) and 183 nonpolio enterovirus isolates (5.7%). Infections occurred throughout the year, but incidence was higher during the hot and rainy season (P=0.01). Using a neutralization test with monoclonal antibodies and PCR-RFLP in two genomic regions coding for the VP1 capsid and RNA polymerase, 4 wild polioviruses (3 type 1 and 1 type 3) and 5 vaccine-related polioviruses (2 Sabin 1-like variants, 1 Sabin 2-like and 2 Sabin 3-like) strains were identified. The wild polioviruses were isolated at the beginning and the end of the dry season. Similar RFLP patterns were observed for the 3 wild type 1 polioviruses. Comparison of partial genomic sequences in the VP1/2 A region of 1 of the wild type 1 isolates with 2 wild type strains isolated in Antananarivo in 1992 and 1993 showed a divergence of at least 10% between the strains, suggesting at least two different pathways of transmission during this period. Our findings demonstrate that immunization with 3 doses of OPV did not prevent intestinal carriage of wild poliovirus strains, and that there is a risk of wild poliovirus transmission to susceptible children in the area. Multiple strategies are required to improve immunization coverage in Madagascar.  (+info)

High amounts of genetic differentiation between populations of the malaria vector Anopheles arabiensis from West Africa and eastern outer islands. (2/380)

Polymorphism at nine microsatellite loci was examined to assess the level of genetic differentiation between four Anopheles arabiensis populations from Senegal, the high plateau of Madagascar, and Reunion and Mauritius islands. Eight of nine loci showed great polymorphism (2-16 alleles/locus) and significant genetic differentiation was revealed between all four populations by F- and R-statistics, with Fst estimates ranging from 0.080 to 0.215 and equivalent Rst values ranging between 0.022 and 0.300. These high amounts of genetic differentiation are discussed in relation to geographic distance including large bodies of water, and history of mosquito settlement, and insecticide use on the islands. The results suggest that historical events of drift rather than mutation are probably the forces generating genetic divergence between these populations, with homogenization of the gene pool by migration being drastically restricted across the ocean.  (+info)

Chancroid, primary syphilis, genital herpes, and lymphogranuloma venereum in Antananarivo, Madagascar. (3/380)

Ulcer material from consecutive patients attending clinics in Antananarivo, Madagascar, was tested using multiplex polymerase chain reaction (M-PCR) to detect Treponema pallidum, Haemophilus ducreyi, and herpes simplex virus. Sera were tested for syphilis and for IgG and IgM antibodies to Chlamydia trachomatis by microimmunofluorescence testing (MIF). By M-PCR, 33% of 196 patients had chancroid, 29% had syphilitic ulcers, and 10% had genital herpes; 32% of the ulcer specimens were M-PCR negative. Compared with M-PCR, syphilis serology was 72% sensitive and 83% specific. The sensitivity of clinical diagnosis of syphilis, chancroid, and genital herpes was 93%, 53%, and 0% and specificity was 20%, 52%, and 99%, respectively. Less schooling was associated with increased prevalence of syphilitic ulcers (P=.001). Sixteen patients (8%) were clinically diagnosed with lymphogranuloma venereum (LGV); 1 plausible case of LGV was found by MIF. In Madagascar, primary care of genital ulcers should include syndromic treatment for syphilis and chancroid.  (+info)

Diagnosis of bubonic plague by PCR in Madagascar under field conditions. (4/380)

The diagnostic value of a PCR assay that amplifies a 501-bp fragment of the Yersinia pestis caf1 gene has been determined in a reference laboratory with 218 bubo aspirates collected from patients with clinically suspected plague managed in a regional hospital in Madagascar. The culture of Y. pestis and the detection of the F1 antigen (Ag) by enzyme-linked immunosorbent assay (ELISA) were used as reference diagnostic methods. The sensitivity of PCR was 89% (57 of 64) for the Y. pestis-positive patients, and 80.7% (63 of 78) for the F1 Ag-positive patients. The specificity of PCR for the culture-, F1 Ag-, and antibody-negative patients (n = 105) was 100%. Because in Madagascar most patients with plague are managed and their clinical samples are collected in remote villages, the usefulness of PCR was evaluated for routine diagnostic use in the operational conditions of the control program. The sensitivity of PCR was 50% (25 of 50) relative to the results of culture and 35.2% (19 of 54) relative to the results of the F1 Ag immunocapture ELISA. The specificity of PCR under these conditions was 96%. In conclusion, the PCR method was found to be very specific but not as sensitive as culture or the F1 Ag detection method. The limitation in sensitivity may have been due to suboptimal field conditions and the small volumes of samples used for DNA extraction. This technique is not recommended as a routine diagnostic test for plague in Madagascar.  (+info)

Soaring and non-soaring bats of the family pteropodidae (flying foxes, Pteropus spp.): wing morphology and flight performance. (5/380)

On oceanic islands, some large diurnal megachiropteran bat species (flying foxes; Pteropus spp.) frequently use thermal or slope soaring during foraging flights to save energy. We compared the flight morphology and gliding/soaring performance of soaring versus non-soaring Pteropus species, one pair on American Samoa and one pair on the Comoro Islands, and two other soaring/flap-gliding species and one non-soaring species. We predicted that the soaring species should have a lower body mass, longer wings and, hence, lower wing loadings than those species that use mainly flapping flight. This would give a lower sinking speed during gliding, a higher glide ratio, and enable the bats to make tighter turns with lower sinking speeds than in the non-soaring species. We theoretically calculated the gliding and circling performances of both the soaring and non-soaring species. Our results show that there are tendencies towards longer wings and lower wing loadings in relation to body size in the gliding/soaring flying foxes than in the non-soaring ones. In the species-pair comparison of the soaring and non-soaring species on American Samoa and the Comoro Islands, the soarers on both islands turn out to have lower wing loadings than their non-soaring partners in spite of opposite size differences among the pairs. These characteristics are in accordance with our hypothesis on morphological adaptations. Most differences are, however, only significant at a level of P<0.1, which may be due to the small sample size, but overlap also occurs. Therefore, we must conclude that wing morphology does not seem to be a limiting factor preventing the non-soarers from soaring. Instead, diurnality in the soaring species seems to be the ultimate determinant of soaring behaviour. The morphological differences cause visible differences in soaring and gliding performance. The glider/soarers turn out to have lower minimum sinking speeds, lower best glide speeds and smaller turning radii than the non-soarers. When the wing measurements and soaring performance are normalized to a body mass of 0.5 kg for all species, the minimum sinking speed becomes significantly lower (P<0.05) in the three soaring and the one flap-gliding species (0.63 m s(-)(1)) than in the three non-soaring species (0.69 m s(-)(1)). Interestingly, the zones in the diagrams for the glide polars and circling envelopes of these similar-sized bats become displaced for the glider/soarers versus the non-soarers. The glide polars overlap slightly only at the gliding speeds appropriate for these bats, whereas the circling envelopes do not overlap at the appropriate bank angles and turning radii. This points towards adaptations for better gliding/soaring performance in the soaring and gliding species.  (+info)

Seroepidemiology of human plague in the Madagascar highlands. (6/380)

We conducted a seroepidemiological survey of human plague in the general population using random sampling in the area of Ambositra, the main focus of plague in the central highlands of Madagascar (520 confirmed and presumptive cases notified during the past 10 years). Sera were tested using an ELISA IgG F1 assay. Considering the internal validity of the assay and the sampling method, the overall corrected prevalence of F1 antibodies was 0.6% (95% CI: 0.2%-1.8%). Being nearly 0 up to the age of 40, the corrected prevalence increased markedly after 45 years to 6.2%. Six of 20 individuals who declared to have been treated for clinical suspicion of bubonic plague in the past had F1 antibodies. The seroprevalence did not differ according to gender except in individuals > 60, where antibodies were significantly more frequent in males. This study suggests that the number of clinically suspected cases of plague provided by the surveillance network was plausible, despite some true cases being missed and a significant number of false positives. We also confirm that Yersinia pestis infections may occur without marked clinical manifestations and patients may recover without treatment, in accordance with old observations of pestis minor.  (+info)

Successful contracting of prevention services: fighting malnutrition in Senegal and Madagascar. (7/380)

There are very few documented large-scale successes in nutrition in Africa, and virtually no consideration of contracting for preventive services. This paper describes two successful large-scale community nutrition projects in Africa as examples of what can be done in prevention using the contracting approach in rural as well as urban areas. The two case-studies are the Secaline project in Madagascar, and the Community Nutrition Project in Senegal. The article explains what is meant by 'success' in the context of these two projects, how these results were achieved, and how certain bottlenecks were avoided. Both projects are very similar in the type of service they provide, and in combining private administration with public finance. The article illustrates that contracting out is a feasible option to be seriously considered for organizing certain prevention programmes on a large scale. There are strong indications from these projects of success in terms of reducing malnutrition, replicability and scale, and community involvement. When choosing that option, a government can tap available private local human resources through contracting out, rather than delivering those services by the public sector. However, as was done in both projects studied, consideration needs to be given to using a contract management unit for execution and monitoring, which costs 13-17% of the total project's budget. Rigorous assessments of the cost-effectiveness of contracted services are not available, but improved health outcomes, targeting of the poor, and basic cost data suggest that the programmes may well be relatively cost-effective. Although the contracting approach is not presented as the panacea to solve the malnutrition problem faced by Africa, it can certainly provide an alternative in many countries to increase coverage and quality of services.  (+info)

Humoral immune response in chromoblastomycosis during and after therapy. (8/380)

A longitudinal study was carried out in Madagascar, the most important focus of chromoblastomycosis (P. Esterre, A. Andriantsimahavandy, E. Ramarcel, and J. L. Pecarrere, Am. J. Trop. Med. Hyg. 55:45-47, 1996), to investigate natural immunity to this disease. Sequential blood samples were obtained before, during, and at the end of a successful therapeutic trial with terbinafine, a new antifungal drug. Using enzyme-linked immunosorbent assay and immunoblot methods, detailed analyses of antibody concentration and antigen mapping were conducted for 136 serum samples and tentatively correlated to epidemiological and pathobiological data. Two different cytoplasmic antigens, corresponding to the two fungal species involved (Fonsecaea pedrosoi and Cladophialophora carrionii), were used to analyze the distribution of different classes of immunoglobulins. This was done with respect to the origin of the isolates, clinical and pathobiological. Although strong individual variations were noticed, some major antigens (one of 18.5 kDa specific for F. pedrosoi and two of 23.5 and 33 kDa, respectively, specific for C. carrionii) corresponded to high antibody prevalence and concentration. As some antigenic components were also detected by immunoglobulin M (IgM) and IgA antibodies, the role that these specific antibodies could play in the immune response is discussed.  (+info)