title: Has Madagascar lost its exceptional leptospirosis free-like status?
abstract: BACKGROUND
  Leptospirosis is a widespread but underreported cause of morbidity and mortality. It has rarely been reported in either humans or animals in Madagascar.
  
  
  METHODS
  We conducted a cross-sectional survey of the inhabitants in Moramanga, Madagascar, in June 2011, to estimate the prevalence of human infection using the microscopic agglutination test (MAT). This activity was carried out as part of a workshop implemented by the Pasteur Institute of Madagascar, focusing on surveillance with a one week field study and targeting the health staff of the district level.
  
  
  RESULTS
  In total, we sampled 678 inhabitants from 263 households. The sex ratio (M/F) was 0.65 and the mean age 26.7 years. We obtained a value of 2.9% for the first recorded seroprevalence of this disease in the human community of Moramanga. Questionnaire responses revealed frequent contacts between humans and rodents in Moramanga. However, activities involving cattle were identified as a risk factor significantly associated with seropositivity (OR=3).
  
  
  CONCLUSIONS
  Leptospirosis remains a neglected disease in Madagascar. This study highlights the need to quantify the public health impact of this neglected disease in a more large scale, in all the country and to establish point-of-care laboratories in remote areas.
authors: Epidemiology Unit, Pasteur Institute of Madagascar, BP 1274, Antananarivo, Madagascar.
authors: Maherisoa
authors: M
authors: Ratsitorahina
authors: Plague Unit, Pasteur Institute of Madagascar, BP 1274, Antananarivo, Madagascar.
authors: Soanandrasana
authors: S
authors: Rahelinirina
authors: Biology, Virology and Parasitology Units, Centre Hospitalier Universitaire (CHU Sud), St. Pierre, Reunion Island, France.
authors: Alain
authors: A
authors: Michault
authors: Plague Unit, Pasteur Institute of Madagascar, BP 1274, Antananarivo, Madagascar.
authors: Minoarisoa
authors: M
authors: Rajerison
authors: Epidemiology Unit, Pasteur Institute of Madagascar, BP 1274, Antananarivo, Madagascar.
authors: Soatiana
authors: S
authors: Rajatonirina
authors: Epidemiology Unit, Pasteur Institute of Madagascar, BP 1274, Antananarivo, Madagascar; Epidemiology Unit, Pasteur Institute of Dakar, BP 220, Dakar, Senegal.
authors: Vincent
authors: V
authors: Richard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000372:Agglutination Tests; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D000907:Antibodies, Bacterial / Q000097:blood; D002417:Cattle; D002418:Cattle Diseases / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004197:Disease Reservoirs; D005260:Female; D006798:Housing; D006801:Humans; D007157:Immunologic Surveillance; D007223:Infant; D007919:Leptospira / Q000276:immunology; D007922:Leptospirosis / Q000453:epidemiology* / Q000662:veterinary; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D051381:Rats / Q000382:microbiology; D012376:Rodent Diseases / Q000453:epidemiology; D012494:Sampling Studies; D018881:Suburban Health; D011795:Surveys and Questionnaires; D055815:Young Adult; D015047:Zoonoses
chemical_list: D000907:Antibodies, Bacterial