Institute Pasteur in Madagascar

Antananarivo, Madagascar

Institute Pasteur in Madagascar

Antananarivo, Madagascar
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Padget M.,French Institute of Health and Medical Research | Padget M.,Institute Pasteur Paris | Padget M.,University of Versailles | Tamarelle J.,French Institute of Health and Medical Research | And 43 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2017

Background: Antibiotic resistance is growing in low-income countries (LICs). Children in LICs are particularly at risk. Information on antibiotic consumption is needed to control the development and spread of resistant bacteria. Methods: To measure antibiotic consumption and related factors, a community surveywas undertaken in two sites in Madagascar (Antananarivo and Moramanga) and in Senegal (Guediawaye) among children under 2. Face-toface interviews were conducted with parents or caregivers of eligible children. Regression analysis was used to determine variables associated with reported antibiotic consumption. Availability of health structures and health policies were also investigated. Results: Populationestimates forantibiotic consumptionin the last3 monthswere37.2%(95%CI 33.4%-41.2%)in Guediawaye, 29.3%(95%CI 25.0%-34.1%) in Antananarivo and 24.6%(95%CI 20.6%-29.1%) inMoramanga. In all sites, the largemajority of antibioticswere takenwith a prescription (92.2%, 87.0%and 92.0%for Antananarivo, Moramanga and Guediawaye, respectively) and purchased in pharmacies (89.4%, 73.5%and 78.5%, respectively). Living in houseswithout flushing toilets and baby agewere significantly associatedwith any antibiotic consumption afteradjusting for site. Ahigher density of public health structureswas associatedwith lowerantibiotic consumption levels, while a higher density of private pharmacies was associated with higher levels across sites. Conclusions: These data are crucial for the implementation of local programmes aimed at optimizing antibiotic consumption. Factors such as density of healthcare facilities, prescriber training and national policy must be taken into account when developing strategies to optimize antibiotic consumption in LICs. © The Author 2016.


Randremanana R.,Institute Pasteur in Madagascar | Randrianirina F.,Institute Pasteur in Madagascar | Gousseff M.,Institute Pasteur in Madagascar | Dubois N.,Institute Pasteur in Madagascar | And 12 more authors.
PLoS ONE | Year: 2012

Background: Acute diarrhea is a major cause of childhood morbidity and mortality worldwide. Its microbiological causes and clinico-epidemiological aspects were examined during the rainy seasons from 2008 to 2009 in 14 districts in Madagascar. Methods: Stool specimens of 2196 children with acute diarrhea and 496 healthy children were collected in a community setting. Intestinal parasites were diagnosed by microscopy and bacteria by culturing methods. Rota-, astro and adenoviruses were identified using commercially available ELISA kits and rotaviruses were confirmed using reverse transcriptase polymerase chain reaction (RT-PCR). Results: Intestinal microorganisms were isolated from 54.6% of diarrheal patients and 45.9% of healthy subjects (p = <0.01). The most common pathogens in diarrheic patients were intestinal parasites (36.5%). Campylobacter spp. and Rotavirus were detected in 9.7% and 6.7% of diarrheic patients. The detection rates of Entamoeba histolytica, Trichomonas intestinalis and Giardia lamblia were much greater in diarrheal patients than in non diarrheal subjects (odds ratios of 5.1, 3.2, 1.7 respectively). The abundance of other enteropathogens among the non diarrheal group may indicate prolonged excretion or limited pathogenicity. Conclusion: In developing countries, where the lack of laboratory capacities is great, cross sectional studies of enteropathogens and their spatial distribution, including diarrheal and non diarrheal subjects, are interesting tools in order to advise regional policies on treatment and diarrheic patient management. © 2012 Randremanana et al.


PubMed | Institute Pasteur in Madagascar
Type: Journal Article | Journal: PloS one | Year: 2012

Acute diarrhea is a major cause of childhood morbidity and mortality worldwide. Its microbiological causes and clinico-epidemiological aspects were examined during the rainy seasons from 2008 to 2009 in 14 districts in Madagascar.Stool specimens of 2196 children with acute diarrhea and 496 healthy children were collected in a community setting. Intestinal parasites were diagnosed by microscopy and bacteria by culturing methods. Rota-, astro and adenoviruses were identified using commercially available ELISA kits and rotaviruses were confirmed using reverse transcriptase polymerase chain reaction (RT-PCR).Intestinal microorganisms were isolated from 54.6% of diarrheal patients and 45.9% of healthy subjects (p=<0.01). The most common pathogens in diarrheic patients were intestinal parasites (36.5%). Campylobacter spp. and Rotavirus were detected in 9.7% and 6.7% of diarrheic patients. The detection rates of Entamoeba histolytica, Trichomonas intestinalis and Giardia lamblia were much greater in diarrheal patients than in non diarrheal subjects (odds ratios of 5.1, 3.2, 1.7 respectively). The abundance of other enteropathogens among the non diarrheal group may indicate prolonged excretion or limited pathogenicity.In developing countries, where the lack of laboratory capacities is great, cross sectional studies of enteropathogens and their spatial distribution, including diarrheal and non diarrheal subjects, are interesting tools in order to advise regional policies on treatment and diarrheic patient management.

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