title: [Epidemiologic surveillance system and control of malaria in the central highlands of Madagascar: results 1999-2000].
abstract: The central highlands in Madagascar are characterized by an unstable occurrence of malaria with the risk of sporadic outbreaks. In major parts of the region DDT indoor spraying campaigns have been carried out from 1993 to 1998. This strategy was in 1999 replaced by another anti-vector intervention program targeting residual foci as detected by a surveillance and early warning system. This system is based on monitoring of presumptive malaria cases in the communities by which the number of presumptive cases exceeded a defined warning threshold value per month. The system was in the follow-up period shown to be very sensitive to variation of the coverage of anti-vector interventions: the number of presumptive cases decreased in the villages in which indoor spraying had been carried out and a minor increase was observed in those villages, where indoor spraying has been suspended. An increase of malaria cases was observed in 44 (20.8%) out of 212 study sites in the same period. The increase was in particular predominant in areas at lower attitude at the outer zones of the central highlands.
authors.affiliation: Ministère de la Santé, BP 460, 101 Antananarivo, Madagascar.
authors.forename: L J
authors.initials: LJ
authors.lastname: Sahondra Harisoa
authors.forename: V
authors.initials: V
authors.lastname: Pietra
authors.forename: M L
authors.initials: ML
authors.lastname: Tombo
authors.forename: M
authors.initials: M
authors.lastname: Albonico
authors.forename: L H
authors.initials: LH
authors.lastname: Ranaivo
authors.forename: F
authors.initials: F
authors.lastname: De Giorgi
authors.forename: J
authors.initials: J
authors.lastname: Razanakolona
authors.forename: F P
authors.initials: FP
authors.lastname: D'Ancona
authors.forename: G
authors.initials: G
authors.lastname: Sabatinelli
authors.forename: A
authors.initials: A
authors.lastname: Raveloson
authors.forename: D
authors.initials: D
authors.lastname: Modiano
authors.forename: D
authors.initials: D
authors.lastname: Rakotondramarina
mesh_terms: D000531:Altitude; D000818:Animals; D003634:DDT; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D006798:Housing; D006801:Humans; D015994:Incidence; D008270:Madagascar / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D009032:Mosquito Control / Q000379:methods*; D015397:Program Evaluation; D012307:Risk Factors; D012621:Seasons; D012680:Sensitivity and Specificity
chemical_list: D003634:DDT