Abstract

BackgroundMalaria is still a heavy public health concern in Madagascar. Few studies combining parasitology and entomology have been conducted despite the need for accurate information to design effective vector control measures. In a Malagasy region of moderate to intense transmission of both Plasmodium falciparum and P. vivax, parasitology and entomology have been combined to survey malaria transmission in two nearby villages.MethodsCommunity-based surveys were conducted in the villages of Ambohitromby and Miarinarivo at three time points (T1, T2 and T3) during a single malaria transmission season. Human malaria prevalence was determined by rapid diagnostic tests (RDTs), microscopy and real-time PCR. Mosquitoes were collected by human landing catches and pyrethrum spray catches and the presence of Plasmodium sporozoites was assessed by TaqMan assay.ResultsMalaria prevalence was not significantly different between villages, with an average of 8.0% by RDT, 4.8% by microscopy and 11.9% by PCR. This was mainly due to P. falciparum and to a lesser extent to P. vivax. However, there was a significantly higher prevalence rate as determined by PCR at T2 (chi_{2}^{2} = 7.46, P = 0.025). Likewise, mosquitoes were significantly more abundant at T2 (chi_{2}^{2} = 64.8, P < 0.001), especially in Ambohitromby. At T1 and T3 mosquito abundance was higher in Miarinarivo than in Ambohitromby (chi_{2}^{2} = 14.92, P < 0.001). Of 1550 Anopheles mosquitoes tested, 28 (1.8%) were found carrying Plasmodium sporozoites. The entomological inoculation rate revealed that Anopheles coustani played a major contribution in malaria transmission in Miarinarivo, being responsible of 61.2 infective bites per human (ib/h) during the whole six months of the survey, whereas, it was An. arabiensis, with 36 ib/h, that played that role in Ambohitromby.ConclusionsDespite a similar malaria prevalence in two nearby villages, the entomological survey showed a different contribution of An. coustani and An. arabiensis to malaria transmission in each village. Importantly, the suspected secondary malaria vector An. coustani, was found playing the major role in malaria transmission in one village. This highlights the importance of combining parasitology and entomology surveys for better targeting local malaria vectors. Such study should contribute to the malaria pre-elimination goal established under the 2018–2022 National Malaria Strategic Plan.

Highlights

  • Malaria is still a heavy public health concern in Madagascar

  • The suspected secondary malaria vector An. coustani, was found playing the major role in malaria transmission in one village. This highlights the importance of combining parasitology and entomology surveys for better targeting local malaria vectors

  • There were no significant associations for any variables for Plasmodium spp. prevalence rates when determined by microscopy or rapid diagnostic test (RDT)

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Summary

Introduction

Malaria is still a heavy public health concern in Madagascar. Malaria remains a major public health concern in Madagascar, with an increase in the number of cases and deaths in years 2017 and 2018, compared to the year 2016 [1]. Among the 26 Anopheles species described in the country, six have been reported as malaria vectors with different role according to geography and behaviour [5]. Three species belong to the Anopheles gambiae complex: Anopheles gambiae (sensu stricto), An. arabiensis and An. merus, the latter having a minor role in malaria transmission and being restricted to the most southern region of Madagascar [6]. Of the two other members of the An. gambiae complex, An. arabiensis is prevalent throughout Madagascar and plays a major role in malaria transmission along with An. funestus [7]. Endemic to Madagascar, and An. coustani, act as local or minor vectors [8,9,10]

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