Measles outbreak in 2018-2019, Madagascar: epidemiology and public health implications

Variation in SARS-CoV-2 outbreaks across sub-Saharan Africa

“…China and Germany (which have been relatively successful in controlling the virus) shown for comparison at the bottom right. Although multi-annual features might drive measles incidence (for example, dynamics in Madagascar are largely dominated by a honeymoon outbreak that occurred in 2018-2019 66 ) for countries that slowed the SARS-CoV-2 pandemic, signatures of reduction in measles can be identified (for example, Germany and China; similar patterns are seen in Viet Nam).…”

Towards better targeting: lessons from a posthoneymoon measles outbreak in Madagascar, 2018–2019

“…In September 2018, a cluster of laboratory-confirmed measles cases was detected via Madagascar's national febrile/rash surveillance system for measles and rubella, whereby local health centres send samples taken from suspected cases in to the national reference lab in Antananarivo. [6][7][8] At that time, the positivity rate of measles suspected cases reached 2.12% every year compared with an average of 0.54% during the last previous 5 years (ranged from 0.22% to 0.95%). By October 2018, increasing numbers of measles cases were detected by the health system (figure 1B).…”

“…Subsequently, over 100 000 suspected cases were reported, with 37% of the 2930 tested individuals being confirmed measles cases. 8 The outbreak began on the highlands in the region of Analamanga (province of Antananarivo) and spread to every region in the country (online supplemental figure S1). Typically, in the absence of vaccination, the average age of measles infection ranges from 2 to 5 years.…”

Comparing transmission potential networks based on social network surveys, close contacts and environmental overlap in rural Madagascar

“…Here, we take a network-based approach to investigate potential disease transmission pathways in a rural human population in Madagascar. Infectious diseases impacting public health in Madagascar include recurring plague epidemics [18,19], large-scale measles outbreaks [20][21][22] and diseases associated with Leptospira, hantaviruses and enteroviruses such as astroviruses and coronaviruses [23][24][25]. Some of these pathogens are transmitted by close contact between humans, while others are environmentally transmitted through indirect contact with infected domesticated animals, wildlife or their waste products.…”