Capital Of Madagascar Research Articles

Pre-transfusion compatibility tests in Malagasy sickle cell patients

Introduction: Blood transfusion is a key component of sickle cell disease management. However, iterative transfusions of labile blood products for sickle cell patients increase the risk of anti-erythrocyte alloimmunization. It is usual to perform pre-transfusion compatibility tests in order to check ABO compatibility and to detect the possible existence of irregular antibodies in patients against the donor's antigens. Methods: This is a prospective and descriptive study dealing with pre-transfusion compatibility tests over a 3-month period, from September 2018 to November 2018, at the Regional Blood Transfusion Centre (CRTS) of Analamanga Region, the capital of Madagascar. Results: We included 33 out of 113 patients during the study period. Compatibility test was positive in 21.21%, of all tested samples. Major and minor compatibility tests were positive alone respectively in 6.25% and 12.50%. And both were positive in 3.12%. The self-test was positive in 3.03% with a positive direct antiglobulin test. Positive compatibility tests were more frequent in patients who received more than two transfusions. Compatible blood bag for the patient was found after testing 2 donor pockets in 27.27% of cases, and after testing 3 pockets in 3.03%. Conclusion: Pre-transfusion compatibility tests are essential and have to be performed systematically on each blood bag before any transfusion. They are used to identify the presence of alloantibodies and provide compatible blood products to patients.

GLYCATED HEMOGLOBIN A1C: IMMUNOTURBIDIMETRY AND IMMUNOFLUORESCENCE METHODS

Objective: to compare the two immunological methods of HbA1c determination available at the two university hospital centers in the capital of Madagascar. Methods:Prospective comparative study between two HbA1C assay techniquesat the University Hospital Center Joseph RavoahangyAndrianavalona and University Hospital Center Joseph RasetaBefelatanana both localized at Antananarivo Madagascar was conducted. The two techniques used are immunoturbidimetry and immunofluorescence. Fifty samples were run simultaneously on both techniques to assess the dispersion and correlation of HbA1C values. A history of haemoglobin abnormalities is previously researched in the medical records for the samples. Results:The correlation coefficient for the 2 techniques is 0.97. The Bland –Altman plot shows a funnel-shaped appearance. The Interclass Correlation Coefficient is 0.851 CI [-0.036 - 0.962]. No hemoglobin abnormalities were documented in any of the 50 samples Conclusion: It is essential to keep the same technique for monitoring HbA1c. Our study shows poor reproducibility for the two techniques compared. A strong relationship between the technique used and the HbA1c value was found for the extreme values. It is important to specify the technique used to support prescribers.

Prévalence de la maladie rénale chronique à Antananarivo, Madagascar

IntroductionChronic kidney disease is defined as an inability of the kidney to perform its normal functions and which persists beyond three months. Nowadays, the estimated glomerular filtration rate based on plasmatic creatinine level remains the gold standard to assess renal function. In Madagascar, we miss national data concerning the epidemiology of chronic kidney disease probably due to the complexity of carrying out the serum creatinine assays. The recent availability of creatinometer using a creatinine strip test with capillary creatinine facilitated the determination of the creatinine level in epidemiological study. Patients and methodsThis simple technique allowed us to plan a pilot study in Antananarivo, the capital of Madagascar. The main objective was to assess the prevalence of chronic kidney disease determined from capillary creatinine level. The secondary objective was to determine the factors associated with chronic kidney disease in Madagascar. It is an analytical cross-sectional study over a period of three months. Chronic kidney disease is defined as a decrease of the glomerular filtration rate of capillary creatinine less than 60mL/min/1.73m2 and calculated with Chronic Kidney Disease Epidemiology formula (CKD-EPI). The minimum number of studied population has been assessed and settled at 210 people. Cluster sampling was performed for randomization of participants. ResultsAt the end of the study, 210 people were randomized for screening. The average age was 40 years old with 14.9 as standard deviation. The sex ratio (male/female) was 1.76. The prevalence of chronic kidney disease was 13.8% with extreme values of 9,1 and 18.5. With chronic kidney disease, high blood pressure (hypertension) and diabetes were found respectively in 41.3 and 17.2%. Chronic kidney disease affected mainly in 72.4% of population aged 25 to 54 years old. ConclusionThis is the first study in Africa to screen chronic kidney disease using a creatinine strip test. This prevalence is relatively different compared to other African countries. The limits of the study are the absence of a subsequent control and/or double control of the creatinine, which definitively confirms the chronicity of kidney disease, the absence evaluation of the urinary sediments to determine proteinuria. Nevertheless, the results of our study can be used as data awaiting the results of a multicenter studies. To determine the national prevalence of chronic kidney disease, screening in the six provinces is currently in progress.

Land cover maps of Antananarivo (capital of Madagascar) produced by processing multisource satellite imagery and geospatial reference data

We describe a reference spatial database and four land use maps of Antananarivo city produced over 2017 reference year using a methodology combining machine learning and object based image analysis (OBIA). These maps are produced by processing satellite images using the Moringa land cover processing chain developed in our laboratory. We use a single very high spatial resolution (VHSR) Pleiades image, a time series of Sentinel-2 and Landsat-8 images, a Digital Terrain Model (DTM) and the aforementioned reference database. According to the Moringa workflow, the Pleiades image is used to generate a suitable object layer at VHSR using a segmentation algorithm. Each object is then classified using variables from the time series and information from the DTM. The reference database used to train the supervised classification algorithm is here described, as well as the 4 land cover maps produced at four different hierarchically nested nomenclature levels. For a number of classes going from 2 to 20, overall accuracies range from 94% to 74%. Such land cover products are very rare in Madagascar, so we have decided to make them openly accessible and usable by land managers and researchers.

Analyzing Urban Agriculture’s Contribution to a Southern City’s Resilience through Land Cover Mapping: The Case of Antananarivo, Capital of Madagascar

High urbanization rates in cities lead to rapid changes in land uses, particularly in southern cities where population growth is fast. Urban and peri-urban agricultural land is often seen as available space for the city to expand, but at the same time, agricultural land provides many benefits to cities pertaining to food, employment, and eco-services. In this context, there is an urgent need to provide spatial information to support planning in complex urban systems. The challenge is to integrate analysis of agriculture and urban land-cover classes, and of their spatial and functional patterns. This paper takes up this challenge in Antananarivo (Madagascar), where agricultural plots and homes are interlocked and very small. It innovates by using a methodology already tested in rural settings, but never applied to urban environments. The key step of the analysis is to produce landscape zoning based on multisource satellite data to identify agri-urban functional areas within the city, and to explore their relationships. Our results demonstrate that the proposed classification method is well suited for mapping agriculture and urban land cover (overall accuracy = 76.56% for the 20 classes of level 3) in such a complex setting. The systemic analysis of urban agriculture patterns and functions can help policymakers and urban planners to design and build resilient cities.

Quality of Care Received by Children from 1 to 23 Months: Realities in The City of Antananarivo

<span>Children's health depends on the proper care they receive from their mothers. This study aims to describe the quality of care received by children from 1 to 23 months in the city of Antananarivo. This is a cross-sectional and analytical study for a period from December 2016 to April 2017 in the city of Antananarivo which is the capital of Madagascar. The study population was made up of 420 mother-child dyads living in the city of Antananarivo. Regarding the care received by children, 47.6%, 95% Confidence Interval (CI) [42.8–52.4] benefit from quality nutrition care, 92.3%, 95% CI [89.8-94.8], have a social care and 45.5%, 95% CI [40.9–50.5] receive health care. The hygiene of life 66.4%, 95% CI [61.6–70.6] and the body hygiene 35.3%, 95% CI [30.6–39.8] improve as the child grows up. The care received by children was complete for the five types in 7.6%, 95% CI [5.1–10.1]. With regard to the profile of the mother, mothers under the age of 18 (OR=3.25, 95% CI [1.07-9.46]) and those who are single (OR=3.47, 95% CI [1.24-9.35]) offer more acceptable care to their infants. Infant care depends on the socio-economic and demographic profile of the mother. Thus, it is important to strengthen the communication strategy on infant first aid gestures and mothers' education on childcare.</span>

Status of resistance to antimicrobial agents of <i>Staphylococcus aureus</i> strains at the laboratory of microbiology of the HU-JRA Antananarivo

Introduction: On contact of antibiotics, S. aureus has gradually acquired multiple antibiotic resistances, including the methicillin (MRSA) and without lose its virulence. The aim of the present study was to report the evolution of resistance of S. aureus to different common antibiotics and to determine the antibiotics active against MRSA.Materials and methods: This is a retrospective and descriptive study for 10 years from January 2005 to December 2014 at the Laboratory of Microbiology of the HU-JRA Antananarivo, the biggest academic hospital located in the capital of Madagascar. All demands for standard bacteriological examination were registered in the laboratory for various bacteriological exams or from samples taken from hospitalized patients and we included all positive cultures for S. aureus. The variables selected and used for the study were community or nosocomial sources of patients and results of susceptibility testing.Results: A total of 906 results from 282 (31.12%) community-acquired and 624 (68.88%) nosocomial infections were studied an average of 100±25strains by year of study. Overall, the prevalence of MRSA was 13.83% (39 of 282 isolates)for community-acquired strains, and 15.70% (98 of 624) for nosocomial infections (p> 0.05)with a total of 29.53%. Resistance rate to trimethoprim-sulfamethoxazole was significantly higher in nosocomial infection than in community-acquired. No significant difference was observed in other antibiotics. Of the 137 MRSA, except vancomycin, fusidic acid is the antibiotic that worked the most in 114 cases (83.21%) followed by gentamicin in 96 cases (70.07%). Apart from ciprofloxacin and tetracycline that we have noticed an increase in resistance rates in 2012 and 2013, almost all antibiotics tested have a stable rate of resistance.Conclusion: The antibiotics tested showed extremely high rates of resistance and that the problem of antibiotic resistance in S. aureus is effective in our center.Keywords: Resistance -antibiotics- S. aureus - HU-JRA Antananarivo

Availability and cost of major and first-line antiepileptic drugs: a comprehensive evaluation in the capital of Madagascar.

Background The prevalence of epilepsy is high in Madagascar (23.5/1000), as is the treatment gap (estimated at 92 %). The health system of the country is underfunded; some AEDs are used, and the national drug policy does not encourage price regulation or the administration of generic agents. We conducted a cross-sectional study to assess the availability and cost of solid oral AED formulations in Antananarivo, capital of Madagascar. Data were gathered from all officially registered pharmacies (according to the drug agency list, updated in 2015) by means of telephone interviews lasting no more than 10 min and conducted by a native Malagasy speaker. With regard to other sources (hospitals, illicit sales) data were obtained at specific visits. The study received ethical approval from the Madagascar Ministry of Health.Findings A total of 91 of 100 pharmacies (the nine not included were because of an inoperative phone number), two of three public hospitals, and two illegal outlets were investigated. Sodium valproate was available in 84.6 % of the pharmacies, while carbamazepine and phenobarbital were available in 68.1 % and 36.3 % of the pharmacies, respectively, but phenytoin was not available in any supply chain. There were more originator brands than generic formulations, with a higher cost (range 20.3–81.1 %, median 40.7 %) compared to the equivalent generic. The public system had only a very limited choice of AED, but offered the lowest costs. Illicit sources were more expensive by 54.3 % for carbamazepine and 62.5 % for phenobarbital. Concerning the annual cost of treatment, the average percentage of the gross national income per capita based on the purchasing power parity was 29.8 %/19.0 % (brand/generic) for sodium valproate, 16.4 %/7.3 % (brand/generic) for carbamazepine, 8.9 %/5.1 % (brand/generic) for phenobarbital.ConclusionsThe main sources of AEDs were private pharmacies, but the stocks held were low. The financial burden was still important in the capital of Madagascar, mainly the consequence of a highly developed private sector at the expense of the public sector. Although sodium valproate remains the most expensive solution, it still remains the most available instead of phenobarbital. The most striking feature of this study concerns the cost of AEDs in the informal sector, mostly used because they are deemed to provide less costly drugs, the opposite was observed there. The assessment of the cost and availability of medicines was easily and quickly implemented. It provided a relevant focus of the situation in areas difficult to investigate, in terms of road network and geographical situation.

METHODOLOGICAL APPROACH TO INSERT A MARKETING CHANNEL: CASE OF SQUASH MARKETING IN ANTANANARIVO

In Madagascar, vegetable producers or farmers rarely fix the price of their products. Moreover, their price does not necessarily follow the law of supply and demand. Because of external factors, farmers do not master the marketing process. It seems difficult for them to produce a significant added value which may ensure the sustainability of their livelihoods. This study aimed to help producers to choose a more beneficial method of marketing. Instead of proposing solutions, we decided to lead a squash (Cucurbita moshata D.) cropping campaign in Ambohimangakely, a village located 10 km to the east of Antananarivo, and to sell the harvested products and assess the economical results taking into consideration the chosen marketing channel. A sector analysis was previously conducted through an informal survey in the markets of the capital of Madagascar, in order to balance supply to demand. Market analysis of squash has shown an opportunity of about 2,300 t of demand gap. The most interesting marketing channel for better agricultural income is the shortest one, which includes the producer, the wholesaler/retailer and the consumer. In that case, the carrier function may be supported by the producer or the seller. However, marketing opportunity depends not only on the choice of differences between supply and demand. With vegetables, our experience also revealed the high resiliency of the squash with respect to hail, and its capacity to be conserved for more than a year in appropriate conditions.

La constitution de l'idéologie linguistique des chatteurs malgachophones dans les cybercafés de Tananarive

L’idéologie linguistique est devenue une question centrale en anthropologie linguistique parce qu’elle permet de s’interroger sur le lien entre les structures sociales et les manières de parler à travers l’étude des « idées sur la langue », soit en tant qu’elles sont explicitement formulées, soit en tant qu’elles sont incorporées dans les pratiques mêmes (Woolard & Schieffelin 1994). Généralement, l’idéologie linguistique est documentée au moyen de discours métapragmatiques produits en situations d’entretiens, censées permettre de recueillir des croyances et des représentations. Mais il s’agit d’une approche ex post qui renseigne au mieux sur l’écart entre les représentations que les locuteurs se forment de leurs langues et de leurs pratiques. Nous avons opté pour une approche différente en examinant les séquences interactionnelles où ce qui est en jeu se situe au niveau métapragmatique. Celui-ci nous semble être le lieu où l’on peut mettre au jour le processus de construction de l’idéologie linguistique. En nous appuyant sur notre corpus de données audiovisuelles d’interactions par chat recueillies dans les cybercafés de Tananarive, nous analysons particulièrement les moments interactionnels où font problème, pour les participants eux-mêmes, les manières d’écrire et les langues utilisées pour communiquer. Nous ne laisserons pas pour autant de côté le discours métapragmatique produit en situation d’entretien mais nous ne lui accorderons pas le rôle central qu’il a généralement dans les études consacrées à l’idéologie linguistique.

The perfect invader: a parthenogenic crayfish poses a new threat to Madagascar’s freshwater biodiversity

In 2007 an unusual crayfish found in food markets in the capital of Madagascar was preliminarily identified as Procambarus ‘Marmorkrebs’: a new world taxa and the only decapod known to reproduce by parthenogenesis. We present information on the identity, distribution and ecology of this recent invader and attempt to evaluate the threat it poses to Madagascar’s biodiversity and to livelihoods. The species appears to be currently limited to the area close to Antananarivo, but is being sold alive on major transport routes. We present molecular evidence of its taxonomic relationships and confirm that the Procambarus present in Madagascar is indeed the parthenogenic taxa. We investigate its reproductive ecology and find Procambarus ‘Marmorkrebs’ to have an extremely high fecundity; more than six times that of the native crayfish Astacoides. The limited evidence we have suggests that this species poses a serious threat to freshwater biodiversity and that it is likely to damage human livelihoods (through its impact on fishing and possibly rice agriculture). More research is urgently needed but in the meantime action is needed to reduce the rate of spread before it is too late.

Seroprevalence of malaria in inhabitants of the urban zone of Antananarivo, Madagascar

BackgroundAntananarivo, the capital of Madagascar, is located at an altitude of over 1,200 m. The environment at this altitude is not particularly favourable to malaria transmission, but malaria nonetheless remains a major public health problem. The aim of this study was to evaluate exposure to malaria in the urban population of Antananarivo, by measuring the specific seroprevalence of Plasmodium falciparum.MethodsSerological studies specific for P. falciparum were carried out with an indirect fluorescent antibody test (IFAT). In a representative population of Antananarivo, 1,059 healthy volunteers were interviewed and serum samples were taken.ResultsThe seroprevalence of IgG+IgA+IgM was 56.1% and that of IgM was 5.9%. The major risk factor associated with a positive IgG+IgA+IgM IFAT was travel outside Antananarivo, whether in the central highlands or on the coast. The abundance of rice fields in certain urban districts was not associated with a higher seroprevalence.ConclusionMalaria transmission levels are low in Antananarivo, but seroprevalence is high. Humans come into contact with the parasite primarily when travelling outside the city. Further studies are required to identify indigenous risk factors and intra-city variations more clearly.

Les pauvres, la démocratie et le marché : une analyse à partir de trois séries d'enquêtes auprès de la population malgache

Abstracts Empowerment and the participation of the population in the decision-making process are nowadays considered as one of the conditions of the success of development programs. Following this objective, this study presents an analysis of the attitudes of the poor towards the double – political (democratisation) and economic (liberalisation) – transition process in which many developing countries are engaged today. The study draws on a series of three detailed surveys conducted in 1995, 1998 and 2003 in the capital of Madagascar. The most common belief to explain the difficulty to implement democracy and market economy relies on the idea that people, especially the poor, have a tendency to resist to any reforms. According to this theory, their reluctance is due to their lack of instruction. Our findings show a negative relationship between the level of poverty and the support to market economy. But, on the contrary, the poor are strongly in favour of democracy as the rest of the population. This finding invalidates the hypothesis of a systematic resistance of the poor to change and innovation. Besides, the low level of education or information is not sufficient to explain the attitudes of the poor. The state, in spite of its shortcomings, is considered to be more capable of guaranteeing the equality of opportunities than the market. Finally, those marginalised in politics and the victims of the malfunctions of some institutions tend to have less confidence in the state and to be against democracy. Then, in order to consolidate the democratic process, state institutions must be reinforced to be more reliable, efficient and able to guarantee that the democratic principles are effectively applied.

Blood pressure, body mass index and socio-economic status in the urban population of Antananarivo (Madagascar).

In many developing countries and especially those in the Indian Ocean, the prevalences of hypertension and obesity have increased markedly over the past decade. In a community-based study set in Antananarivo, the capital of Madagascar, multi-level modelling has now been used to look for associations between blood pressure or body mass index (BMI) and levels of occupation, education and income, among 773 adults. Many (23%) of the subjects had elevated blood pressure (i.e. over 140/90 mmHg). The prevalence of such elevated blood pressure increased with age - with an odds ratio (OR) of 2.16 and a corresponding 95% confidence interval (CI) of 1.81-2.58 for each 10-year increase - but decreased with educational level (high school: OR=0.74; CI = 0.41-1.31) and income (fourth quartile: OR= 0.66; CI = 0.35-1.27). The BMI data indicated that 18.4% of the subjects were underweight, 6.0% were overweight but not obese and 2.4% were obese. Being overweight was directly associated with level of occupation (management level: OR= 3.49; CI = 1.18-10.29) and income (fourth quartile: OR= 3.55;CI = 1.48-8.50). Despite the trends, underweight and overweight individuals and cases of elevated blood pressure were found to co-exist in all socio-economic classes.

Pefloxacin for Falciparum Malaria: Only Modest Success

Brief Reports15 May 1991Pefloxacin for Falciparum Malaria: Only Modest SuccessPhilippe Deloron, MDPhD, Jean Paul Lepers, MD, Lucie Raharimalala, MD, Béatrice Dubois, MA, Pierre Coulanges, MD, Jean Jacques Pocidalo, PhDPhilippe Deloron, MDPhDSearch for more papers by this author, Jean Paul Lepers, MDSearch for more papers by this author, Lucie Raharimalala, MDSearch for more papers by this author, Béatrice Dubois, MASearch for more papers by this author, Pierre Coulanges, MDSearch for more papers by this author, Jean Jacques Pocidalo, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-10-874 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe spread of chloroquine-resistant Plasmodium falciparum strongly indicated the need for new safe and effective antimalarial drugs. In addition to their antibacterial action, fluoroquinolone antibiotics inhibit P. falciparum in vitro (1). Pefloxacin is effective against P. yoelii infection in mice (2), and norfloxacin, the main metabolite of Pefloxacin in humans, was reported to cure P. falciparum malaria in 9 adults in India (3). Therefore, we assessed the efficacy of Pefloxacin in treating chloroquine-resistant P. falciparum malaria in Madagascar (4).Patients and MethodsIn Ankazobe, 95 km west of Antananarivo, the capital of Madagascar, blood was collected from 396 adults to...

Journal of an Expedition to the Coast and Capital of Madagascar, in the suite of the late Mission to King Radama.

Journal of an Expedition to the Coast and Capital of Madagascar, in the suite of the late Mission to King Radama.