Improved equity in measles vaccination from integrating insecticide-treated bednets in a vaccination campaign, Madagascar.

Objective: To evaluate the effect of integrating ITN distribution on measles vaccination campaign coverage in Madagascar.

Methods: Nationwide cross-sectional survey to estimate measles vaccination coverage, nationally, and in districts with and without ITN integration. To evaluate the effect of ITN integration, propensity score matching was used to create comparable samples in ITN and non-ITN districts.

Reemergence of recombinant vaccine-derived poliovirus outbreak in Madagascar.

Background: After the 2001-2002 poliomyelitis outbreak due to recombinant vaccine-derived polioviruses (VDPVs) in the Toliara province of Madagascar, another outbreak reoccurred in the same province in 2005.

Methods: We conducted epidemiological and virological investigations for each polio case patient and for their contacts.

Results: From May to August 2005, a total of 5 cases of acute flaccid paralysis were reported among unvaccinated or partially vaccinated children 2-3 years old.

Co-circulation and evolution of polioviruses and species C enteroviruses in a district of Madagascar.

Between October 2001 and April 2002, five cases of acute flaccid paralysis (AFP) associated with type 2 vaccine-derived polioviruses (VDPVs) were reported in the southern province of the Republic of Madagascar. To determine viral factors that favor the emergence of these pathogenic VDPVs, we analyzed in detail their genomic and phenotypic characteristics and compared them with co-circulating enteroviruses. These VDPVs appeared to belong to two independent recombinant lineages with sequences from the type 2 strain of the oral poliovaccine (OPV) in the 5'-half of the genome and sequences derived from unidentified species C enteroviruses (HEV-C) in the 3'-half.