@article{fdi:010046344,
  title = {{L}ongitudinal survey of malaria morbidity over 10 years in {S}aharevo ({M}adagascar) : further lessons for strengthening malaria control},
  author = {{R}abarijaona, {L}. {P}. and {R}andrianarivelojosia, {M}. and {R}aharimalala, {L}. {A}. and {R}atsimbasoa, {A}. and {R}andriamanantena, {A}. and {R}andrianasolo, {L}. and {R}anarivelo, {L}. {A}. and {R}akotomanana, {F}. and {R}andremanana, {R}. and {R}atovonjato, {J}. and {R}ason, {M}. {A}. and {D}uchemin, {J}. {B}. and {T}all, {A}. and {R}obert, {V}incent and {J}ambou, {R}. and {A}riey, {F}. and {D}omarle, {O}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}adagascar has been known for having bio-geo-ecological diversity which is reflected by a complex malaria epidemiology ranging from hyperendemic to malaria-free areas. {M}alaria-related attacks and infection are frequently recorded both in children and adults living in areas of low malaria transmission. {T}o integrate this variability in the national malaria control policy, extensive epidemiological studies are required to up-date previous records and adjust strategies. {M}ethods: {A} longitudinal malaria survey was conducted from {J}uly 1996 to {J}une 2005 among an average cohort of 214 villagers in {S}aharevo, located at 900 m above the sea. {S}aharevo is a typical eastern foothill site at the junction between a costal wet tropical area (equatorial malaria pattern) and a drier high-altitude area (low malaria transmission). {R}esults: {P}assive and active malaria detection revealed that malaria transmission in {S}aharevo follows an abrupt seasonal variation. {I}nterestingly, malaria was confirmed in 45% (1,271/2,794) of malaria-presumed fevers seen at the health centre. {A}ll four {P}lasmodia that infect humans were also found: {P}lasmodium falciparum; {P}lasmodium vivax, {P}lasmodium malariae and {P}lasmodium ovale. {H}alf of the malaria-presumed fevers could be confirmed over the season with the highest malaria transmission level, although less than a quarter in lower transmission time, highlighting the importance of diagnosis prior to treatment intake. {P}. falciparum malaria has been predominant (98%). {T}he high prevalence of {P}. falciparum malaria affects more particularly under 10 years old children in both symptomatic and asymptomatic contexts. {C}hildren between two and four years of age experienced an average of 2.6 malaria attacks with {P}. falciparum per annum. {M}oreover, estimated incidence of {P}. falciparum malaria tends to show that half of the attacks (15 attacks) risk to occur during the first 10 years of life for a 60-year-old adult who would have experienced 32 malaria attacks. {C}onclusion: {T}he incidence of malaria decreased slightly with age but remained important among children and adults in {S}aharevo. {T}hese results support that a premunition against malaria is slowly acquired until adolescence. {H}owever, this claims for a weak premunition among villagers in {S}aharevo and by extension in the whole eastern foothill area of {M}adagascar. {W}hile the {M}alagasy government turns towards malaria elimination plans nowadays, choices and expectations to update and adapt malaria control strategies in the foothill areas are discussed in this paper.},
  keywords = {},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {8},
  numero = {},
  pages = {190},
  ISSN = {1475-2875},
  year = {2009},
  DOI = {10.1186/1475-2875-8-190},
  URL = {https://www.documentation.ird.fr/hor/fdi:010046344},
}