Publications by authors named "Rasamoelina Tahinamandranto"

Background: The COVID-19 pandemic has highlighted the need for more effective immunization programs, including in limited resource settings. This paper presents outcomes and lessons learnt from a COVID-19 vaccination campaign (VC), which used a tailored adaptive strategy to optimise vaccine uptake in the Boeny region of Madagascar.

Methods: Guided by the Dynamic Sustainability Framework (DSF), the VC implementation was regularly reviewed through multi-sectoral stakeholder feedback, key informant interviews, problem-solving meetings, and weekly monitoring of outcome indicators to identify and apply key adaptations.

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Background: Adequate knowledge and awareness regarding diseases are essential for appropriate, high-quality healthcare. Female Genital Schistosomiasis (FGS) is a non-sexually transmitted gynaecological disease that is caused by the presence of Schistosoma haematobium eggs in the female genital tract and the resulting immune response that causes tissue damage. It is estimated to affect 56 million women, mostly in sub-Saharan Africa (SSA), where healthcare workers (HCWs) have limited awareness and knowledge of FGS.

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Background: The WHO set the global immunisation threshold for COVID-19 at 70% to achieve worldwide protection against the disease. To date, global COVID-19 vaccine coverage is still below this threshold, in particular in several sub-Saharan African (SSA) countries, such as Madagascar. While factors influencing COVID-19 vaccine hesitancy have been widely explored in the past few years, research on drivers of COVID-19 vaccine uptake remains scarce.

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Background And Objectives: Data on HIV drug resistance in Madagascar are rare and outdated. In this study, we assessed the prevalence of HIV drug resistance mutations to antiretrovirals (ARVs) and genetic diversity of circulating strains in treatment-naive people living with HIV (PLHIV) in Madagascar.

Materials And Methods: We amplified the protease (PR), fragments of the Reverse Transcriptase (RT) and Integrase (IN) genes according to the French ANRS protocol.

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Article Synopsis
  • The study aimed to estimate the prevalence of Strongyloides stercoralis infection in four districts of Madagascar, focusing on coastal versus highland areas, where data on strongyloidiasis is limited.
  • Serum and fecal samples were analyzed using real-time PCR and serology, revealing a significantly higher prevalence of infection in coastal districts (20.9% and 35.2%) compared to highland districts (5.6% and 6.1%).
  • The research found a strong association between strongyloidiasis and hookworm infection, which was also linked to factors like male gender and lower education levels, suggesting potential public health interventions are needed in the most affected areas.
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Background: Post-exposure prophylaxis (PEP) using single-dose rifampicin reduces progression from infection with Mycobacterium leprae to leprosy disease. We compared effectiveness of different administration modalities, using a higher (20 mg/kg) dose of rifampicin-single double-dose rifampicin (SDDR)-PEP.

Methods: We did a cluster randomised study in 16 villages in Madagascar and 48 villages in Comoros.

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The widespread of chlorhexidine and antibiotics in the water bodies, which grew during the global COVID-19 pandemic, can increase the dispersion of antibiotic resistance. We assessed the occurrence of these pharmaceutical compounds as well as SARS-CoV-2 and analysed the bacterial community structure of hospital and urban wastewaters from Brazil, Cameroon, and Madagascar. Water and wastewater samples (n = 59) were collected between January-June 2022.

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Sporotrichosis is an implantation mycosis due to the genus . Cutaneous disseminated sporotrichosis is an unusual clinical form that often affects immunocompromised patients. We report a case of cutaneous disseminated sporotrichosis in an immunocompetent famer from a rural region of Madagascar, treated successfully with Itraconazole 200mg twice a day.

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Background: In Madagascar, no study has reported the impact of COVID-19 on people living with HIV (PLHIV). The present work aimed to analyze the seroprevalence of SARS-CoV-2 in Malagasy PLHIV before and during the three waves of COVID-19 pandemic.This is a retrospective study.

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Article Synopsis
  • A study in Madagascar from January 2018 to June 2021 examined IgG antibody prevalence against six arboviruses in people living with HIV-1, using a Luminex-based assay on 1036 samples.
  • The results indicated the highest antibody prevalence for O'nyong nyong virus (28.4%), Chikungunya virus (26.7%), and West Nile virus (27.1%), with lower rates for Zika and the other Dengue serotypes.
  • The study found that older individuals had higher seroprevalence for some viruses, and antibody rates varied by region and season, showing a correlation with rainfall and HIV-1 RNA levels, highlighting a significant exposure of PLWHIV to
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Introduction: Female genital schistosomiasis (FGS) is a neglected disease with long-term physical and psychosocial consequences, affecting approximately 50 million women worldwide and generally representing an unmet medical need on a global scale. FGS is the chronic manifestation of a persistent infection with . FGS services are not routinely offered in endemic settings with a small percentage of women at risk receiving adequate care.

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Background: Women's health in resource-limited settings can benefit from the integrated management of high-burden diseases, such as female genital schistosomiasis (FGS) and human papilloma virus (HPV)-related cervical cancer. In schistosomiasis-endemic countries such as Madagascar, data on FGS and HPV prevalence are lacking as well as preventive measures for both conditions. This study aims to estimate the prevalence of FGS and HPV in rural Madagascar, and to examine associated risk factors to identify opportunities for improving women's health.

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Madagascar is one of the countries with the highest burden of schistosomiasis worldwide. The release from the WHO of the new 2021-2030 neglected tropical disease (NTD) roadmap alongside with the schistosomiasis guidelines sets the ambitious goal of eliminating schistosomiasis as a public health problem worldwide. In Madagascar, implementation barriers exist.

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Article Synopsis
  • Sporotrichosis is a chronic fungal infection caused by Sporothrix fungi, primarily affecting the skin and subcutaneous tissues, especially in tropical regions like Madagascar.
  • A study from March 2013 to January 2019 examined 43 patients treated with 200 mg of itraconazole daily for 3 to 6 months, assessing their responses after 3 and 6 months.
  • Results showed a 46.5% cure rate, with higher success in patients with shorter disease durations, but overall cure rates were lower than those reported in the literature, and many patients were lost to follow-up.
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Article Synopsis
  • - The study highlights the need to shift schistosomiasis control programs from focusing solely on school-aged children to include adults, which is crucial for eliminating the disease and achieving universal health coverage by 2030.
  • - Conducted in Madagascar, the research involved 1,482 adults, revealing high prevalence rates of schistosomiasis, particularly among males and those contributing to family income, with protective factors identified as being older and not working as a farmer.
  • - The findings indicate that adults represent a significant risk group for schistosomiasis, suggesting that public health strategies should adopt a more comprehensive approach to better address the needs of all affected populations.
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Introduction: Chromoblastomycosis (CBM) is a chronic fungal infection of the skin and subcutaneous tissue caused by several pigmented fungi. It is frequently found in tropical and subtropical areas like Madagascar. This study primarily discusses the effects of antifungal therapy while also describing the epidemiological, clinical, and pathological features of CBM in our patients.

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Article Synopsis
  • * A survey across several cities in Burkina Faso, Madagascar, and Ghana found significant seroprevalence rates of SARS-CoV-2, with Bobo-Dioulasso showing 55.7% and Ouagadougou at 37.4% but only a small percentage of the population had been tested for acute infection.
  • * Despite high exposure levels, immunity within the population remains concerningly low, indicating a need for ongoing vaccination efforts and preventive measures due to the emergence of new variants.
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Chromoblastomycosis and sporotrichosis are the two main implantation mycoses that are now recognized as fungal neglected tropical diseases (NTDs). Their laboratory diagnosis mainly relies on direct microscopy, histopathology, and identification of the fungus by culture. However, to be appropriately used, these techniques require mycological expertise that is not widely available and may be absent in peripheral health care facilities in endemic areas.

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Background: Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes.

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The implementation of MALDI-TOF MS in medical microbiology laboratories has revolutionized practices and significantly reduced turnaround times of identification processes. However, although bacteriology quickly benefited from the contributions of this technique, adjustments were necessary to accommodate the specific characteristics of fungi. MALDI-TOF MS is now an indispensable tool in clinical mycology laboratories, both for the identification of yeasts and filamentous fungi, and other innovative uses are gradually emerging.

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Objectives: To identify patterns of spatial clustering of leprosy.

Design: We performed a baseline survey for a trial on post-exposure prophylaxis for leprosy in Comoros and Madagascar. We screened 64 villages, door-to-door, and recorded results of screening, demographic data and geographic coordinates.

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Sporotrichosis is a frequent subcutaneous mycosis in Madagascar. Extracutaenous forms are exceptional and are usually seen in immunosuppressed hosts. We report a case of an aggressive clinical evolution of lymphocutaneous sporotrichosis with osteoarticular involvement in an immunocompetent patient.

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Objective: To describe the clinical aspects of chromoblastomycosis (CBM) presented by patients who had received incomplete antifungal treatment before consultation.

Methods: A prospective study of patients with clinically suspected CBM was performed between 2013 and 2018 in the Department of Dermatology at the University Hospital Antananarivo, and during consultation campaigns.

Results: Patients develop CBM over a period of more than 10 years, and many will have already received antifungals prescribed by general practitioners before consulting with a dermatologist.

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Background: Schistosoma antigen detection in urine is a valuable diagnostic approach for schistosomiasis control programmes because of the higher sensitivity compared to parasitological methods and preferred sampling of urine over stool. Highly accurate diagnostics are important in low Schistosoma transmission areas. Pregnant women and young children could particularly benefit from antigen testing as praziquantel (PZQ) can be given to only confirmed Schistosoma cases.

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Chromoblastomycosis is an implantation fungal infection. Twenty years ago, Madagascar was recognized as the leading focus of this disease. We recruited patients in Madagascar who had chronic subcutaneous lesions suggestive of dermatomycosis during March 2013-June 2017.

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