Abstract
Background: Malaria is endemic in Madagascar, with local specificities. Its transmission occurs throughout the year along the eastern coast, while it is unstable and seasonal on Central High- lands. In this study, we investigate the spatiotemporal patterns of the occurrence of malaria in relation to bioclimatic conditions. Methods & Materials: The Service for Health and Demographic Statistics of the Ministry of Public Health provided epidemio- logical data related to complicated and uncomplicated malaria cases from 2006 to April 2015. We integrated these data into a Geographic Information System to map monthly incidence for each health district and identify spatiotemporal clusters. We also acquired environmental information (meteorological and vegeta- tion indices) in order to assess relations with malaria incidences. Results: Since 2010, the report of malaria cases has improved and malaria incidence shows more regular trends. Malaria trans- mission generally starts with the rainy season and has a distinct peak on February and March. Children under 15 years old are the most vulnerable over the country. Coastal districts can be considered as a source of malaria because of their high incidence all over the year. Conclusion: The quality of epidemiological data is discussed regarding the provision and access to health services. Case reports show weaknesses for some remote areas and at the end of each year. The persistence of malaria on the coast could induce the emer- gence of malaria in Central Highlands following reintroduction by travelers.
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