Archives de l'Institut Pasteur de Madagascar最新文献

Unlabelled: An epidemiological investigation (Ministry of Health/Institut Pasteur de Madagascar (IPM)) was conducted in July 2002, in two districts of a same province (Fianarantsoa: Fianarantsoa II and Ikongo) considering the high frequency of deaths linked with acute respiratory infection (ARI). Morbidity and mortality data was collected in the Centre de Santé de Base (CSB) which gave the alert (village of Sahafata, district Fianarantsoa II). Analysis of monthly activity reports (MAR) allowed calculation of incidence rates of ARI/pneumonia in Fianarantsoa province. Virological data was based on the analysis of nasopharyngeal samples collected during the investigations. Clinical symptoms and homogeneity of laboratory results are consistent with an origin of these epidemics being related to the circulation of an influenza virus A subtype H3N2. Attack rates were very high. CFR was significantly higher in individuals of less than 1 year and more than 65 years. This data was confirmed by posterior investigations of teams from MoH/WHO. Surprisingly, this large epidemic was due to a known influenza virus that previously circulated in countries of northern hemisphere (the year before) and even in Antananarivo weeks before. Different hypothesis could be proposed to explain such phenomenon: great restriction of exchanges between different geographical zones, nutritional status....

Conclusion: The epidemic episodes of acute respiratory infections in Madagascar in July 2002 were due to an influenza virus A subtype H3N2 without any genotypic or phenotypic features. Various factors, could explain the importance of the epidemic and particular high lethality found in some age groups. This epidemic illustrates the relative incapacity for a developing country, to face and manage a flu epidemic caused by a classical influenza virus.

This study aims to evaluate the prevalence and density of haemoparasites in wild malagasy bats. Among the 440 bats, belonging to 14 species sampled in 5 localities in different bio-climatic zones of the island, 93 (21%) showed at least 1 haemoparasite with, by order of frequency, Haemoproteidae (15.7% of 440 bats), microfilariae (7.0%) and Trypanosoma (0.7%). Among these 93 bats, 92 (99%) belonged to the family Vespertilionidae. Four bat species, all endemic to the Madagascar region (Madagascar and Comoros), were found to harbour parasites: Miniopterus manavi with Haemoproteidae (38% of 129 individuals), microfilariae (23%) and Trypanosoma (2%); Myotis goudoti with Haemoproteidae (24% of 68 individuals) and microfilariae (1%); Miniopterus gleni with Haemoproteidae (23% of 13 individuals); and Triaenops furculus with Haemoproteidae (4% of 28 individuals). The sex of bats was not linked to parasite prevalence. Within Miniopterus manavi, those individuals with greater weight also had a higher prevalence of microfilariae; and within the individuals harbouring microfilariae the greatest weights corresponded to the highest density of microfilariae. Ten bat species (with 202 individuals examined) were negative for any haemoparasite. This study is the first to provide evidence of haemoparasites in Malagasy bats; it provides interesting insights, especially concerning the parasite distribution per bat species and families, the pathogenicity of this type of parasitism and the parasite transmission by arthropod vectors.

Anopheles arabiensis and Anopheles funestus are the principal vectors of malaria on the central highlands of Madagascar. These two species of mosquito are directly or indirectly the targets of indoor insecticide spread. The survey of the susceptibility of these two vectors to insecticides is essential specifying for the anti-vectorial current directives and for the future programs. This paper describes: --the recent tests of susceptibility and the study of the knock-down effect of four pyrethroids (deltamethrin 0.50%, permethrin 0.250%, alpha-cypermethrin 0.025%, cyfluthrin 0.150%) and DDT 4% on An. arabiensis collected from December 2002 to May 2003 in three villages on the district of Tsiroanomandidy and in Alasora, a rural area near the capital, Antananarivo. --the susceptibility tests of An. funestus realised in Morafeno, against cyfluthrin 0.150%, deltaméthrin 0.050%, lambda-cyhalothrin 0.050% and DDT 4%. --the preliminary study of the kdr gene mutation, which might account for the pyrethrinoid and DDT resistance, of An. arabiensis in Alasora. The data indicate a decrease in the efficiency of alpha-cypermethrin 0.025% (Tkd99 = 21 mn) and of DDT 4% (Tkd99 = 191.5 mn) on An. arabiensis in Analamiranga. Nevertheless, the effectiveness of permethrin 0.250% has been notified. In Soanierana, alpha-cypermethrin 0.025% was effective against An. arabiensis, whilst the ineffectiveness of the DDT 4% (Tkd99 = 116 mn) in Andranonahoatra was observed. In Alasora, a fall in the effectiveness of alpha-cypermethrin 0.025% (Tkd99 = 21 mn) and the resistance to DDT 4% (Tkd99 = 6894 mn) was noted. No kdr mutation was detected on the kd gene of An. arabiensis resistant to the alpha-cypermethrin 0.025% and to DDT 4%, collected in Alasora. An. funestus collected in the district of Miandrivazo is susceptible to pyrethroids and to DDT. To conclude, in the Malagasy Central Highlands, An. arabiensis is ordinary sensitive to pyrethroid and poorly sensitive, or even resistant to DDT (as observed in Antananarivo plain). However, An. funestus remains sensitive to all tested insecticides; this observation is crucial because this anopheles vector is the first target of the campaigns of indoor spraying insecticides.

A retrospective survey of cases of cancer of the small intestine observed in the Institut Pasteur de Madagascar (IPM), in the Centre Hospitalier de Soavinandriana (CenHoSoa) and in the Centre Hospitalier Universitaire d'Antananarivo/Hôpital Joseph Ravoahangy Andrianavalona (CHUA/HJRA), has been undertaken with the goal to find out epidemiological and diagnostical particularities, as well as the therapeutic measures and their results. Only 25 cases have been found in 10 years (from 1992 to 2001). They represent 5.4% of the digestive cancers diagnosed by the Institut Pasteur de Madagascar. They concern 14 women and 11 men with a mean age of 36 years old at the time of diagnosis. The motive of hospitalization was an acute abdomen (peritonitis, perforation, occlusive syndrome, König's syndrome) in 64.3%, and a chronic abdominal pain often associated with abdominal mass in 35.7%. The duodenum is the predilection seat of the small bowel cancers (50%), followed by the ileum (25%) and the jejunum (10%). A diffuse shape has been observed in 15% of the cases. The most frequent histological type is the lymphoma (40%) followed by the adenocarcinoma (32%).