Madagascar Research Articles

Sensitizations to pollen differ between Central European and Sub-Saharan African atopic dermatitis patients

Summary Background Atopic dermatitis (AD) is often associated with allergic comorbidities, such as allergic asthma or allergic rhinoconjunctivitis (ARC). Sensitizations to pollen can directly impact AD, as patients can experience exacerbation during pollen season. This study aims to gain more insights into the pollen sensitization patterns of AD patients in Central Europe compared with sub-Saharan Africa (SSA). Methods We performed a case–control study involving a total of 90 participants: 20 AD patients and 10 healthy controls (HC) each from Switzerland (CH), Tanzania (TZ), and Madagascar (MD). We collected clinical data and serum samples and performed a multiplex IgE test (ALEX2 Allergy Explorer, MacroArray Diagnostics, Vienna, Austria). Results The prevalence of ARC and asthma in AD patients was similar in all countries (ARC: 60% TZ, 70% CH, 75% MD; asthma: 25% TZ, 30% CH, 20% MD). Total IgE levels were significantly higher in both SSA HC populations compared with the Swiss HC. The analysis of specific IgE levels revealed major differences in sensitization patterns between Africa and Europe, especially regarding grass pollen allergens. Swiss AD patients were sensitized to various grass pollen such as Bahia grass, Bermuda grass, common reed, perennial ryegrass, rye, and timothy grass. However, these allergens were irrelevant in the SSA population: no AD patient or HC subject was sensitized to the tested grass pollen. Conclusion The considerably different sensitization patterns between European and SSA AD patients warrant the development of allergy testing and desensitization therapies tailored to the African setting. Therefore, there is a need to characterize local pollen types and counts.

Movement of the A-strain maize streak virus in and out of Madagascar

The maize streak virus belongs in the genus Mastrevirus, in the family Geminiviridae. The A-strain of the virus (MSV-A) is recognised as the principal causative agent of the most severe manifestation of maize streak disease (MSD). This disease continues to be a persistent limitation on maize output across sub-Saharan Africa and the nearby Indian Ocean islands. Irrespective of the causes behind the spread of MSV-A, we can determine the paths and speeds with which MSV-A spreads by analysing MSV genome sequence data along with information on when and where samples were taken. This information is valuable for identifying the geographical origins of viral strains that cause sporadic MSD epidemics in specific places and the geographical regions where viruses remain in reservoirs and contribute to prolonged epidemics during outbreaks. Our aim is to utilise these analyses to estimate the timing and origin of the MSV-A that arrived on the island of Madagascar in the Indian Ocean. Specifically, we employ model-based phylogeographic analyses on 524 complete MSV-A genome sequences, which consist of 56 newly obtained genomes from infected maize plants collected in Madagascar. These studies allow us to reconstruct the most likely paths of MSV-A to Madagascar. We found strong evidence for the existence of at least four separate movements of MSV-A variants from East and southern Africa to Madagascar. These movements took place between roughly 1979 (with a 95% highest probability density interval [HPD] ranging from 1976 to 1982) and 2003 (with a 95% HPD ranging from 2002 to 2003). While we inferred that MSV-A variants are spreading at an average rate of 38.9 km/year (with a 95% highest posterior density interval of 34.0–44.4) across their geographical range. Since their arrival in Madagascar, MSV-A variants have been migrating at an average rate of 47.6 km/year (with a 95% highest posterior density interval of 36.05–61.70). Human influences are likely significant contributors to both sporadic long-range movements of MSV-A between mainland Africa and Madagascar, as well as shorter to medium range movements within the island.

Mid-pass whole-genome sequencing in a Malagasy cohort uncovers body composition associations

The majority of human genomic research studies have been conducted in European-ancestry cohorts, reducing the likelihood of detecting potentially novel and globally impactful findings. Here, we present mid-pass whole-genome sequencing data and a genome-wide association study in a cohort of 264 self-reported Malagasy individuals from three locations on the island of Madagascar. We describe genetic variation in this Malagasy cohort, providing insight into the shared and unique patterns of genetic variation across the island. We observe phenotypic variation by location and find high rates of hypertension, particularly in the Southern Highlands sampling site, as well as elevated self-reported malaria prevalence in the West Coast site relative to other sites. After filtering to a subset of 214minimally related individuals, we find a number of genetic associations with body composition traits, including many variants that are only observed in African populations or populations with admixed African ancestry from the 1000 Genomes Project. This study highlights the importance of including diverse populations in genomic research for the potential to gain novel insights, even with small cohort sizes. This project was conducted in partnership and consultation with local stakeholders in Madagascar and serves as an example of genomic research that prioritizes community engagement and potentially impacts our understanding of human health and disease.

Quantifying the seasonal reproductive cycle in three species of Malagasy fruit bats with implications for pathogen and population dynamics.

Bats (order Chiroptera) are hosts for highly virulent zoonotic pathogens. Many bats demonstrate seasonally varying antiviral responses, including antibody responses which have been observed to peak during the nutritionally depleted dry-season and female gestation periods, suggesting some impact of resource deficits on bat virus immunity. Given the frequent overlap in these energetically demanding periods, it is likely that endocrinological changes associated with pregnancy might partially explain the aforementioned pattern in antibody dynamics. Regardless, we know little about the seasonality of reproduction in many fruit bat species, despite the importance of reproductive biology to informing conservation management (e.g. population viability) and disease dynamics. Here, we aimed to elucidate the reproductive biology of three species of endemic fruit bat native to the island of Madagascar: Pteropus rufus, Eidolon dupreanum, and Rousettus madagascarensis. To do so, we leveraged plasma samples collected in part with a longitudinal field study, from 2018 to 2020. We adapted three standard reproductive assays previously validated in humans to quantify seasonal changes in reproductive hormones for bats and applied a mixture model approach to determine hormone cutoffs for pregnancy. As expected, we found that pregnant females showed the highest levels of estradiol and progesterone and adult males the highest levels of testosterone. Additionally, female P. rufus and R. madagascariensis showed clear seasonality in reproduction with peaks in estradiol and progesterone in August and October, respectively. Seasonality was less clearly discernible in the female E. dupreanum and male data. In general, we found that the commercially available assays were successful in quantifying endocrinological hormones for bats; when paired with histological embryo sections or field data, these offer a powerful tool to elucidate bat reproductive calendars.

Uncontrolled deforestation and population growth threaten a tropical island's water and land resources in only 10 years.

Rapid demographic growth in tropical islands can exacerbate conflicts and pressures on natural resources, as illustrated by the French island of Mayotte where resources are limited. In only 10 years, uncontrolled migration and population growth (+80% of population between 2002 and 2021) have led to a pronounced 3600% increase in deforestation rates (2010-2014) and an intensification of agricultural practices, escalating conflicts over limited land, water, and biodiversity resources. Implementing an original multi-proxy approach to sediment cores, our study reveals a staggering 300% acceleration in erosion during the first wave of migration (2011-2015), followed by a further 190% increase (2019-2021) under sustained migratory and demographic pressures. Sedimentary DNA analysis provided insights into increased connectivity and community changes. By 2050, the population of this region will increase by 74 and 103%, in Comoros and Madagascar islands, respectively. Urgent conservation measures are needed to avoid major socio-environmental crises and to protect resources for future generations.

The evolution and history of Vinca alkaloids: From the Big Bang to the treatment of pediatric acute leukemia.

An attractive flower from the island of Madagascar has in part saved the lives of thousands of children with acute lymphoblastic leukemia (ALL). Random mutations and alterations to the genome led to the evolution of genes encoding enzymes, which would provide the periwinkle flower an arsenal of secondary metabolites to survive within the Madagascar ecosystem. Of the over 200 alkaloid compounds synthesized by the periwinkle, vincristine and vinblastine are the two most well-known being used for chemotherapy treatments, including for children with ALL. The complexities of the multi-step biosynthesis of vincristine and vinblastine, which has taken years to decode, highlight the importance of protecting the vast biodiversity on earth as other natural products that can save lives await to be discovered. This review addresses the discovery of vincristine and vinblastine, as well as the history of their existence, in nature.

Diverse Circular DNA Viral Communities in Blood, Oral, and Fecal Samples of Captive Lemurs.

Few studies have addressed viral diversity in lemurs despite their unique evolutionary history on the island of Madagascar and high risk of extinction. Further, while a large number of studies on animal viromes focus on fecal samples, understanding viral diversity across multiple sample types and seasons can reveal complex viral community structures within and across species. Groups of captive lemurs at the Duke Lemur Center (Durham, NC, USA), a conservation and research center, provide an opportunity to build foundational knowledge on lemur-associated viromes. We sampled individuals from seven lemur species, i.e., collared lemur (Eulemur collaris), crowned lemur (Eulemur coronatus), blue-eyed black lemur (Eulemur flavifrons), ring-tailed lemur (Lemur catta), Coquerel's sifaka (Propithecus coquereli), black-and-white ruffed lemur (Varecia variegata variegata), and red ruffed lemur (Varecia rubra), across two lemur families (Lemuridae, Indriidae). Fecal, blood, and saliva samples were collected from Coquerel's sifaka and black-and-white ruffed lemur individuals across two sampling seasons to diversify virome biogeography and temporal sampling. Using viral metagenomic workflows, the complete genomes of anelloviruses (n = 4), cressdnaviruses (n = 47), caudoviruses (n = 15), inoviruses (n = 34), and microviruses (n = 537) were determined from lemur blood, feces, and saliva. Many virus genomes, especially bacteriophages, identified in this study were present across multiple lemur species. Overall, the work presented here uses a viral metagenomics approach to investigate viral communities inhabiting the blood, oral cavity, and feces of healthy captive lemurs.

Prevalence and Factors Associated with Regular Khat Chewing Among College and University Students in Harar Town 2024

Background: Khat (Catha edulis) is an evergreen shrub that is a natural stimulant native, planted and chewed in eastern through southern parts of Africa and the Arabian Peninsula with distribution in parts of the Middle East and on the island of Madagascar. Khat chewing is becoming a common practice and great concern in university and college students because they think that it helps increase their academic performance especially during exams and for recreational purposes. It is widely understood that the consumption of Khat creates a remarkable problem for today’s youth which is not limited to individual users; rather its adverse negative consequence is believed to be challenging to a family, the community as a whole, economy and political arena of a given nation. Objective of the Study: To assess Prevalence and factors associated with regular khat chewing among college and university students in Harar town 2024. Methodology: Facility based cross sectional study was conducted in Harar Town from December 13 up to 29, 2023 on selected university and colleges. A total sample of 371 students was including on the study. Data was collected through structured questioner. Training was given for data collectors and data evaluation done on daily based. Cleaned data were entered to SPSS version 20 and multiple logistic regression analysis was used for better prediction of determinants and to reduce bias due to confounders. Those variables with P-value < 0.20 was entered in to multiple logistic regression analysis. Associations with P - value less than 0.05 was declared as statistically significant. Result: The Prevalence of khat chewing on this study was 57.4%. In multivariable analysis marital status, religion, Peers who chew khat, peers who smoke cigarette, students whose lives in rented house, Smoke cigarette while chewing chat, currently drink alcohol were associated with outcome variables. Conclusion and Recommendation: Majority of students was khat chewers for a long period of time and there also start chewing before their joining university and or college. Peer pressure, living condition and alcohol usage were significant predictors of khat chewing therefore to alleviate this problem effort on preventive measure is need by all stake holders at different levels.

Spatial patterns of roadkill within Ankarafantsika National Park, Madagascar

AbstractWildlife‐vehicle collisions can be a significant cause of mortality for animals with ranges that overlap roads. Not all species are equally affected by roads and thus conservation practitioners need empirical data to determine appropriate mitigation measures. However, there is a lack of data on how tropical animals, in particular those on the island of Madagascar, are affected by roads and vehicular mortality. In order to fill in this gap in the literature we investigated the ecological and spatial factors influencing roadkill observations along Route National 4 in Ankarafantsika National Park, Madagascar. We observed 80 cases of roadkill along the highway belonging to at least 13 species, including the first published record of a lemur as roadkill. We also found that the density of roadkill was lower in the area between two speedbumps, suggesting these are an effective measure to mitigate wildlife‐vehicle collisions. These results showcase that even within protected areas of Madagascar animals are at risk of vehicular mortality but mitigation measures are possible. Given the high rates of endemicity coupled with vulnerability to extinction of many Malagasy fauna there is an urgent need for more research on road ecology in Madagascar.

Centres of Development and Patterns of Distribution of the Family Melastomataceae in Indo-Malesia

1.The Melastomataceae is a homogeneous family of about 220 genera and 5300 species and is generally confined to the tropical and subtropical regions, avoiding arid conditions and attaining prolific developments in the rain forests between the tropic of cancer and the tropic of capricorn. More than one half of the World's melastomataceous genera (about 120) and two-thirds of the total number of species (about 3353) are confined to the New World. The melastomataceous flora of Indo-Malesia consists of 64 genera and about 1300 species. In the Old World the incidence of melastomataceous species for Indo-Malesia and Africa is in the ratio of 2:1.2.The present distribution of Melastomataceae in both the New World and the Old World is discussed on the basis of Wegener's hypothesis of "Continental Drift". Instead of considering the island of Madagascar as the centre of origin of the family in a restricted way, it is considered that "Gondwanaland" was ideally suited for the melastomataceous flora and those blocks that moved away after the breaking up of this huge continental mass in the Late Cretaceous, each carried their own share of melastomataceous species which, after gradual establishment in new situations during a long span of time and space, proliferated into several new taxa by an intensive process of evolution.3.The Deccan Peninsula + Ceylon block in drifting over the Indian Ocean must have carried the original Gondwanaland stock and gene-pool of the Melastomataceae which later-when this block was fused with Laurasia and the Tethys Sea had disappeared-became the centre of development of the family in continental Asia. Then Melastomataceae could further develop on the southern part of Laurasia and from there migrate eastward to the Malesian islands, the Western Pacific and northern Australia.This implies the conclusion that, though Australia also formed part of the ancient Gondwanaland, this cannot have carried part of the ancient Gondwanaland Melastomataceae when Australia drifted apart.4.An attempt has been made to assess the centres of distribution of Indo-Malesian Melastomataceae and from this study the following four centres of development are proposed : (i) The Deccan-Ceylon centre, (ii) The Himalayan-Yunnan centre, (iii) The Sunda centre and (iv) The Philippine-Papuan centre.5.The Island of Borneo is unique in having the largest number of genera-42 out of the Indo-Malesian total of 64 genera-and the largest number of species i.e. 257. Perhaps, it is due to the part played by the mountain of Kinabalu in enriching the floristic composition of Borneo. It is generally considered by phytogeographers that Kinabalu is a great sanctuary of flora, past and present, and a nursery of endemic elements.

The burden and treatment of non-communicable diseases among healthcare workers in sub-Saharan Africa: a multi-country cross-sectional study.

Non-communicable diseases (NCDs), the leading cause of death globally, are estimated to overtake communicable diseases in sub-Sahara Africa, where healthcare workers (HCWs) play a crucial role in prevention and treatment, but are in extreme shortage, thereby increasing the burden of NCDs among this specific population. To provide evidence for policy-making, we assessed the NCD burden, associated factors and treatment among HCWs in four sub-Saharan African countries. We conducted a cross-sectional study across four sub-Saharan African countries [Côte d'Ivoire (CIV), Democratic Republic of the Congo (DRC), Madagascar (MDG), and Nigeria (NIG)] between February and December 2022. In a standardized questionnaire, sociodemographic, chronic disease and treatment data were self-reported. We estimated the prevalence of (1) at least one chronic disease, (2) hypertension, and used backward elimination logistic regression model to identify risk factors. We recruited a total of 6,848 HCWs. The prevalence of at least one chronic disease ranged between 9.7% in NIG and 20.6% in MDG, the prevalence of hypertension between 5.4% in CIV and 11.3% in MDG. At most, reported treatment rates reached 36.5%. The odds of each of both outcomes increased with age (at least one chronic disease adjusted odds ratio: CIV: 1.04; DRC: 1.09; MDG: 1.06; NIG: 1.10; hypertension: CIV: 1.10; DRC: 1.31; MDG: 1.11; NIG: 1.11) and with BMI (at least one chronic disease: CIV: 1.10; DRC: 1.07; MDG: 1.06; NIG: 1.08; hypertension: CIV: 1.10; DRC: 1.66; MDG: 1.13; NIG: 1.07). Odds of both outcomes were lower among males, except in CIV. In NIG, the odds of both outcomes were higher among medical doctors and odds of hypertension were higher among those working in secondary care. In MDG, working in secondary care increased and working as auxiliary staff decreased the odds of at least one chronic disease. The prevalence of self-reported chronic disease varied across the four sub-Saharan countries with potentially very low treatment rates. We identified several individual (age, sex, and BMI) and occupational (profession, level of healthcare) factors that influence the odds of NCDs. These factors should be taken into account when developing interventions addressing the burden and management of NCDs among HCWs.

Archaeology in the Fourth Dimension: Studying Landscapes with Multitemporal PlanetScope Satellite Data

AbstractFor the last seven years, PlanetScope satellites have started near-daily imaging of parts of the Earth’s surface, making high-density multitemporal, multispectral, 3-m pixel imagery accessible to researchers. Multitemporal satellite data enables landscape archaeologists to examine changes in environmental conditions at time scales ranging from daily to decadal. This kind of temporal resolution can accentuate landscape features on the ground by de-emphasizing non-permanent signatures caused by seasonal or even daily changes in vegetation. We argue that the availability of high spatial and temporal resolution multispectral imagery from Planet Inc. will enable new approaches to studying archaeological visibility in landscapes. While palimpsests are discrete overlapping layers of material accumulation, multitemporal composites capture cyclical and seasonal time and can be used to interpret past landscape histories at multiple scales. To illustrate this perspective, we present three case studies using PlanetScope imagery in tropical environments on the Indian Ocean islands of Madagascar, Mauritius, and Zanzibar.

The Malagasy phrasal comparative

AbstractThere is no consensus in the literature on the analysis of phrasal comparatives. Both reduced clause analyses, in which the standard phrase contains elided clausal structure, and direct analyses, in which the standard of comparison is a direct complement to the standard marker, have been proposed. This paper argues for a direct analysis of the phrasal comparative in Malagasy, an Austronesian language spoken on the island of Madagascar. Evidence for the direct analysis comes from the lack of overt clausal comparatives, Binding Theory, scope, and Malagasy‐specific characteristics of the standard. The conclusion contributes to the rapidly expanding picture of cross‐linguistic variation in comparative syntax.

Keanekaragaman Burung Lovebird (Agapornis fischeri) : Review

Birds are wild animals that live in nature and have an important role in preserving the environment, for example as pest controllers, seed dispersers, and as pollinators. Lovebirds are animals from the aves group. This bird reproduces by oviparous or laying eggs. Eight of these bird species originate from the African continent, while the grey-headed lovebird species originates from the island of Madagascar. This bird is about 13-17 cm long, weighs 40-60 grams, and has a friendly nature. Lovebirds are the smallest birds from the parrot family. Lovebirds have compact bodies, short, blunt-tipped tails, and sharp beaks. Wild lovebirds are predominantly green with various colors on the upper body, depending on the species. There are many species of chirping birds/lovebirds. Each of them has their own unique sound and has their own strengths and weaknesses. There are some of them who sing (Agapornis fischeri) for a long time without stopping. There are also those who only make a slight, intermittent sound. Likewise, if you look at their physical appearance and color, each bird has its own unique color, most of them have beautiful and beautiful colors.

The evolutionary history of three Baracoffea species from western Madagascar revealed by chloroplast and nuclear genomes.

The wild species of the Coffea genus present a very wide morphological, genetic, and biochemical diversity. Wild species are recognized more resistant to diseases, pests, and environmental variations than the two species currently cultivated worldwide: C. arabica (Arabica) and C. canephora (Robusta). Consequently, wild species are now considered as a crucial resource for adapting cultivated coffee trees to climate change. Within the Coffea genus, 79 wild species are native to the Indian Ocean islands of Comoros, Mayotte, Mauritius, Réunion and Madagascar, out of a total of 141 taxa worldwide. Among them, a group of 9 species called "Baracoffea" are particularly atypical in their morphology and adaptation to the sandy soils of the dry deciduous forests of western Madagascar. Here, we have attempted to shed light on the evolutionary history of three Baracoffea species: C. ambongensis, C. boinensis and C. bissetiae by analyzing their chloroplast and nuclear genomes. We assembled the complete chloroplast genomes de novo and extracted 28,800 SNP (Single Nucleotide Polymorphism) markers from the nuclear genomes. These data were used for phylogenetic analysis of Baracoffea with Coffea species from Madagascar and Africa. Our new data support the monophyletic origin of Baracoffea within the Coffea of Madagascar, but also reveal a divergence with a sister clade of four species: C. augagneurii, C. ratsimamangae, C. pervilleana and C. Mcphersonii (also called C. vohemarensis), belonging to the Subterminal botanical series and living in dry or humid forests of northern Madagascar. Based on a bioclimatic analysis, our work suggests that Baracoffea may have diverged from a group of Malagasy Coffea from northern Madagascar and adapted to the specific dry climate and low rainfall of western Madagascar. The genomic data generated in the course of this work will contribute to the understanding of the adaptation mechanisms of these particularly singular species.

Explaining extreme differences in species richness among co-occurring palm clades in Madagascar

Abstract Imbalance in species richness among related clades is a pervasive, yet incompletely understood feature of biodiversity. Comparison of species-poor and species-rich clades that have evolved within the same region can shed light on the mechanisms underlying this phenomenon. The long-isolated island of Madagascar is an ideal place for doing this. Madagascar harbours at least ten clades of palms (Arecaceae) that have colonized the island independently and diversified to widely differing degrees, ranging from one to 180 known species. We estimated colonization times and diversification rates for these clades based on an extensive phylogenomic dataset and tested the degree to which clades that arrived in Madagascar earlier have more species (time-for-speciation effect), finding a moderate effect. For context, we tested for time-for-speciation effects in other plant and animal lineages, finding variable but qualitatively similar results. Our findings suggest that variation in diversification rate (i.e. speciation and/or extinction rate) is a major driver of species richness imbalance among Malagasy clades, both in palms and elsewhere. We demonstrate that in palms, differences in diversification rates originated long before colonization of the island, suggesting a minor role of classical ‘island radiation’ and a stronger role of heritable traits driving diversification rate. Ability to colonize new climates also appears to play a role. Future work should address the interplay between the dynamic environment of Madagascar and the inherited traits of colonizing lineages to fully explain the island’s intriguing mix of species-poor and species-rich clades.

Revision of Trigastrotheca Cameron (Hymenoptera, Braconidae, Braconinae) with descriptions of 13 new species.

The Old World braconine wasp genus Trigastrotheca Cameron is revised. The genus is recorded from the island of Madagascar for the first time based on two new species, T.christianhenrichi Quicke & Butcher, sp. nov. and T.formosa Quicke & Friedman, sp. nov. Trigastrothecagriffini Quicke, sp. nov. is described from Australia; T.aethiopica Quicke & Friedman, sp. nov. is described from Ethiopia; T.braeti Quicke & Butcher, sp. nov. is described from Congo; T.simba van Noort, sp. nov. is described from Tanzania; T.freidbergi Quicke & Friedman, sp. nov., T.carinata Ranjith, sp. nov., T.flava Ranjith, sp. nov. and T.similidentata Ranjith, sp. nov. are described from India; T.khaoyaiensis Quicke & Butcher, sp. nov., T.naniensis Quicke & Butcher, sp. nov., and T.sublobata Quicke & Butcher, sp. nov. are described from Thailand. Trigastrothecatridentata is recorded from Thailand for the first time. A putative female of T.sureeratae is described for the first time. Acroceriliatricolor Quicke & Ingram, 1993 is transferred into Trigastrotheca, as T.acroceropsis nom. nov. A key is provided for the identification of species.

Aye-aye middle finger kinematic modeling and motion tracking during tap-scanning

The aye-aye (Daubentonia madagascariensis) is a nocturnal lemur native to the island of Madagascar with a unique thin middle finger. Its slender third digit has a remarkably specific adaptation, allowing them to perform tap-scanning to locate small cavities beneath tree bark and extract wood-boring larvae from it. As an exceptional active acoustic actuator, this finger makes an aye-aye’s biological system an attractive model for pioneering Nondestructive Evaluation (NDE) methods and robotic systems. Despite the important aspects of the topic in the aye-aye’s unique foraging and its potential contribution to the engineering sensory, little is known about the mechanism and dynamics of this unique finger. This paper used a motion-tracking approach for the aye-aye’s middle finger using simultaneous video graphic capture. To mimic the motion, a two-link robot arm model is designed to reproduce the trajectory. Kinematics formulations were proposed to derive the motion of the middle finger using the Lagrangian method. In addition, a hardware model was developed to simulate the aye-aye’s finger motion. To validate the model, different motion states such as trajectory paths and joint angles, were compared. The simulation results indicate the kinematics of the model were consistent with the actual finger movement. This model is used to understand the aye-aye’s unique tap-scanning process for pioneering new tap-testing NDE strategies for various inspection applications.

Cost-effectiveness of community-based distribution of intermittent preventive treatment of malaria in pregnancy in Madagascar, Mozambique, Nigeria, and the Democratic Republic of Congo

IntroductionMalaria in pregnancy is a major driver of maternal and infant mortality in sub-Saharan Africa. The WHO recommends the administration of intermittent preventive treatment with sulfadoxine pyrimethamine (IPTp-SP) at antenatal...

The economic costs of malaria in pregnancy: evidence from four sub-Saharan countries.

Background Malaria in pregnancy is a major public health problem in sub-Saharan Africa (SSA), which imposes a significant economic burden. We provide evidence on the costs of malaria care in pregnancy to households and the health system in four high-burden countries in SSA. Methods Household and health system economic costs associated with malaria control in pregnancy were estimated in selected areas of the Democratic Republic of Congo (DRC), Madagascar (MDG), Mozambique (MOZ) and Nigeria (NGA). An exit survey was administered to 2,031 pregnant women when leaving the antenatal care (ANC) clinic from October 2020 to June 2021. Women reported the direct and indirect costs associated to malaria prevention and treatment in pregnancy. To estimate health system costs, we interviewed health workers from 133 randomly selected health facilities. Costs were estimated using an ingredients-based approach. Results Average household costs of malaria prevention per pregnancy were USD6.33 in DRC, USD10.06 in MDG, USD15.03 in MOZ and USD13.33 in NGA. Household costs of treating an episode of uncomplicated/complicated malaria were USD22.78/USD46 in DRC, USD16.65/USD35.65 in MDG, USD30.54/USD61.25 in MOZ and USD18.92/USD44.71 in NGA, respectively. Average health system costs of malaria prevention per pregnancy were USD10.74 in DRC, USD16.95 in MDG, USD11.17 in MOZ and USD15.64 in NGA. Health system costs associated with treating an episode of uncomplicated/complicated malaria were USD4.69/USD101.41 in DRC, USD3.61/USD63.33 in MDG, USD4.68/USD83.70 in MOZ and USD4.09/USD92.64 in NGA. These estimates resulted in societal costs of malaria prevention and treatment per pregnancy of USD31.72 in DRC, USD29.77 in MDG, USD31.98 in MOZ and USD46.16 in NGA. Conclusions Malaria in pregnancy imposes a high economic burden on households and the health system. Findings emphasize the importance of investing in effective strategies that improve access to malaria control and reduce the burden of the infection in pregnancy.