Has Madagascar lost its exceptional leptospirosis free-like status?

PLoS One. 2015 Apr 14;10(4):e0122683. doi: 10.1371/journal.pone.0122683. eCollection 2015.

Abstract

Background: Leptospirosis is a widespread but underreported cause of morbidity and mortality. It has rarely been reported in either humans or animals in Madagascar.

Methods: We conducted a cross-sectional survey of the inhabitants in Moramanga, Madagascar, in June 2011, to estimate the prevalence of human infection using the microscopic agglutination test (MAT). This activity was carried out as part of a workshop implemented by the Pasteur Institute of Madagascar, focusing on surveillance with a one week field study and targeting the health staff of the district level.

Results: In total, we sampled 678 inhabitants from 263 households. The sex ratio (M/F) was 0.65 and the mean age 26.7 years. We obtained a value of 2.9% for the first recorded seroprevalence of this disease in the human community of Moramanga. Questionnaire responses revealed frequent contacts between humans and rodents in Moramanga. However, activities involving cattle were identified as a risk factor significantly associated with seropositivity (OR=3).

Conclusion: Leptospirosis remains a neglected disease in Madagascar. This study highlights the need to quantify the public health impact of this neglected disease in a more large scale, in all the country and to establish point-of-care laboratories in remote areas.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Agglutination Tests
  • Animals
  • Animals, Domestic / microbiology
  • Antibodies, Bacterial / blood
  • Cattle
  • Cattle Diseases / epidemiology
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Disease Reservoirs
  • Female
  • Housing
  • Humans
  • Immunologic Surveillance
  • Infant
  • Leptospira / immunology
  • Leptospirosis / epidemiology*
  • Leptospirosis / veterinary
  • Madagascar / epidemiology
  • Male
  • Middle Aged
  • Poverty
  • Prevalence
  • Rats / microbiology
  • Rodent Diseases / epidemiology
  • Sampling Studies
  • Suburban Health
  • Surveys and Questionnaires
  • Young Adult
  • Zoonoses

Substances

  • Antibodies, Bacterial

Grants and funding

This network was supported by the Pasteur Institute of Madagascar. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.