Madagascar is one of the poorest countries in the world. The country’s extreme weather conditions, poor sanitation, and weak economy facilitate the spread of parasitic diseases. Infections with intestinal parasites are particularly dangerous for children because they can cause malnutrition and anemia, which, in turn, have a negative effect on children’s cognitive functions and physical development. The aim of the present study was to analyze the prevalence of intestinal parasites and to assess hematological parameters in a group of children living in northern Madagascar. The screening was conducted in May 2024 in the Clinique Medicale Beyzym in Manerinerina, the Ambatoboeny district. It involved a sample of 208 children aged 0–17 years. Single stool samples were collected from all study participants. The samples were fixed in SAF fixative and then transported from Africa to Europe for further diagnostics at the Department of Epidemiology and Tropical Medicine, the Military Institute of Medicine–the National Research Institute in Poland. First, the samples were analyzed by light microscopy methods using three different diagnostic techniques (direct smear, decantation with distilled water, and the Fülleborn method). Next, they were tested by molecular biology methods (real-time PCR). Blood samples for the assessment of hematological parameters were collected at the healthcare center in Madagascar. The prevalence of intestinal parasites in the study sample was 61.5%. Helminths were found in 15.2% of the investigated children, and Giardia intestinalis (20.5%) was found to be the most prevalent parasite in the study population. Most infections were caused by potentially pathogenic stramenopila Blastocystis spp. (32.0%). Mean Hb, HCT, MCV, MCH, and MCHC levels in the study participants were below normal values. However, no correlation was found between the presence of a parasitic infection and low hematological parameters, which are a clinical sign of anemia. High rates of infections with intestinal parasites in children living in northern Madagascar support the necessity to introduce long-term preventive measures, which would limit the spread of parasitic diseases in the Malagasy population. Low hematological parameters in non-infected children may be indicative of persistent malnutrition or infection with other parasites, e.g., malaria or schistosomiasis.
Schistosomiasis is a parasitic disease that is considered a major threat to public health in Madagascar. The condition is endemic in more than 90% of the country’s districts. It is estimated that as much as 52% of the country’s general population is infected with Schistosoma spp. trematodes. The aim of the present study was to assess the prevalence values of Schistosoma haematobium infections in a population of children living in northern Madagascar and to determine the impact of trematode infections on the hematological profiles of the children included in the study. This screening study was conducted in 2024, and it involved a group of 170 children aged 0–17 years. The participants were required to provide urine samples for microscopic and molecular examination. The urine samples were preserved on Whatman 903 protein sever cards using the dried urine spot (DUS) sampling technique and then were transported from Madagascar to a molecular laboratory in Poland, where the samples were tested for the presence of S. haematobium. The present study found that the incidence of S. haematobium infections in the study group consisting of 170 children was as high as 67.6%. The authors observed a reduction in mean hemoglobin (Hb) and mean corpuscular hemoglobin concentration (MCHC) values in the infected children. In spite of continuous efforts to prevent the transmission of schistosomiasis in endemic countries (WHO-recommended mass drug administration campaigns), the incidence of S. haematobium infections was found to be exceptionally high among the study participants. S. haematobium infections present with a characteristic hematological picture showing signs of increased immune response and anemia. The DUS technique has been successfully used for the molecular diagnosis of S. haematobium. This method opens up possibilities for more effective and less expensive sample collection.
Background: Madagascar is one of the lowest-income countries in Africa, and it has a poorly developed healthcare system. Malagasy women face limited access to sexual and reproductive health services, which is a serious risk factor facilitating the spread of sexually transmitted infections (STIs). The aim of the present study was to assess the prevalence of STIs (Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, and HIV-1/HIV-2) and urogenital schistosomiasis, as well as to evaluate hematological parameters and nutritional status, in a group of women from northern Madagascar. Methods: The study was conducted in April 2024 at the Clinique Médicale Beyzym in Manerinerina, Ambatoboeny District. Samples, which included overnight urine, venous blood, and vaginal swabs, were collected from 159 women aged 15–80 years. The urine samples were examined for the presence of Schistosoma haematobium eggs by light microscopy, the vaginal swabs were tested for the presence of Trichomonas vaginalis and Neisseria gonorrhoeae infections (by light microscopy), and venous blood samples were collected into VACUTAINER SEC collection tubes without anticoagulant and were tested for HIV-1/HIV-2 and Treponema pallidum infections using test cassettes. Results: The prevalence of STIs in the study group was found to be 31.5%, while S. haematobium infections were found in 17.6% of the tested women. Cases of gonorrhea (20.1%), trichomoniasis (8.8%), syphilis (7.6%), and one case of HIV infection were identified. Conclusions: The study found a high prevalence of STIs and S. haematobium cases in Tsimihety women. In order to improve the quality of healthcare in Madagascar, it is necessary to improve accessibility to maternal, sexual, and reproductive health services.
Background/Objectives: Malaria remains a major cause of hospitalization in rural Madagascar, yet data on in-hospital clinical presentation, management, and patient outcomes remain limited. Methods: We conducted a three-year retrospective study (2023–2025) at a rural district hospital in Ambatoboeny, Madagascar, including patients of all ages hospitalized with malaria confirmed by rapid diagnostic testing and microscopy. Sociodemographic, clinical, laboratory, and treatment data were extracted from routine records. Length of hospital stay (LOS) was analyzed continuously and categorized as ≤2, 3–4, or ≥5 days. Seasonal admission patterns and factors associated with LOS were assessed using chi-square or Fisher’s exact tests, and associations with rainfall seasonality were explored using Spearman’s correlation. Results: Among 134 hospitalized patients, median age was 15 years (interquartile range (IQR) 7–25) and 52.2% were female. Plasmodium falciparum predominated (94.0%), while mixed-species infections were identified in 6.0% of cases; 20.1% of cases were classified as severe malaria, including 10.4% with cerebral malaria. Co-infections were frequent (52.2%), most commonly Schistosoma haematobium infection (14.2%) and typhoid fever (12.7%). Intravenous artesunate was initiated in 97.8% of patients; all received paracetamol and 94.8% received intravenous fluids. Median LOS was 2 days (IQR 2–3); 12.7% had prolonged hospitalization (≥5 days). Prolonged LOS was significantly associated with cerebral malaria, high parasitemia (≥5%), blood transfusion, and age < 15 years (all p ≤ 0.034), while co-infection and nutritional status were not. Conclusions: Hospitalized malaria in rural Madagascar presents with heterogeneous clinical phenotypes and a high burden of co-infections. Prolonged LOS is primarily driven by markers of severe disease and supportive care requirements, underscoring the need for early severity recognition and resource planning in low-resource hospitals.
1 January 2019 in European Journal of Translational and Clinical Medicine
The problem of malnutrition affects both developed and developing countries. The disease-related malnutrition in hospitalised patients is well-described and the treatment recommendations reflect the health care conditions of developed countries. However the diagnosis and treatment of children with severe acute malnutrition (SAM) is inconsistent both in the international and in the developing countries’ guidelines. The aim of this article is to start a discussion about the guidelines for the treatment and nutrition of malnourished infants and children in developing countries. The differences appear primarily in the hydration and nutritional status assessment, treatment of hypoglycaemia, additional supplementation and partly in nutrition itself. In general, we do know how to treat children with SAM, however the differences in the guidelines can cause a lot of difficulty in making decisions in emergencies, particularly for infants under 6 months.
Background: Ambatoboeny District in northern Madagascar faces significant health challenges due to widespread poverty, poor access to healthcare, and limited diagnostic capabilities. Despite high disease burden, data on morbidity patterns in the region are scarce. This study aims to identify the most prevalent diseases and most affected demographic groups, thus providing valuable insight into the region’s health profile. Methods: A retrospective analysis was conducted on medical records from 3678 patients who were admitted at Clinique Médicale BEYZYM, a secondary-level referral facility in Manerinerina, Boeny Region between January and December 2024. Diagnoses were retrieved from physician registration ledgers, hospitalization records, monthly laboratory reports, monthly general hospital activity reports and monthly reports from Centre de Traitement et de Diagnostic de la Tuberculose, which were cross-referenced and verified by trained clinical staff. Records were included if they contained identifiable demographic data and at least one clinical diagnosis. Diagnoses were coded using ICD-11 and were classified into 15 major categories. Results: The median patient age was 19.5 years (IQR: 7–42), with females accounting for 54% of the cohort. Most patients (87.2%) resided in Ambatoboeny. The most common reasons for admission were infectious and parasitic diseases (35.75%, 95% CI: 34.20–37.30), respiratory diseases (22.73%, 95% CI: 21.38–24.08), and diseases of the genitourinary system (13.95%, 95% CI: 12.83–15.07), collectively accounting for 72.43% of all recorded cases. Statistically significant differences in morbidity patterns were observed across age and sex groups. Conclusions: The findings underscore the multifaceted burden of disease in the Ambatoboeny District, where both infectious and chronic conditions coexist in a resource-limited setting. Delayed healthcare-seeking behavior, cultural beliefs, and diagnostic limitations further complicate care delivery. This study provides foundational data to inform targeted health policies, humanitarian medical missions, and diagnostic capacity-building tailored to local needs.