Prescription of medications for acute diarrhea in infants in Antananarivo, Madagascar

Ravelomanana, L.; Tsifiregna, Rosa L.; Rakotomalala, L.H.; Razafimahatombo, C.; Ravelomanana, N.

doi:10.1684/mst.2018.0776

Cited by 2 publications

(4 citation statements)

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“…rendalli [ 66 ]. Exotic fish in Madagascar include predatory species such as largemouth bass ( Micropterus salmoides ), Nile arowana ( Heterotis niloticus ), and snakehead ( Channa striata ) [ 17 ], of which in particular snakehead have become widespread (detected at 22 sites in our survey) and probably contributed to declines and local extinctions of native species [ 67 ]. Furthermore, introduced poeciliids such as Xiphophorus helleri may prey heavily on eggs and larvae of native Malagasy fishes, and their occurrence seems to be linked to the disappearance of native bedotiids and aplocheiloids [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…Exotic fish in Madagascar include predatory species such as largemouth bass ( Micropterus salmoides ), Nile arowana ( Heterotis niloticus ), and snakehead ( Channa striata ) [ 17 ], of which in particular snakehead have become widespread (detected at 22 sites in our survey) and probably contributed to declines and local extinctions of native species [ 67 ]. Furthermore, introduced poeciliids such as Xiphophorus helleri may prey heavily on eggs and larvae of native Malagasy fishes, and their occurrence seems to be linked to the disappearance of native bedotiids and aplocheiloids [ 17 ]. Although negative effects of the exotic species on Madagascar’s native ichthyofauna are obvious, it has been poorly explored how these introduced species interact with habitat degradation, and under which conditions they may coexist vs. completely displace the native species.…”

Section: Resultsmentioning

confidence: 99%

“…In fact freshwater fishes are often considered to be the most threatened group of vertebrates on Madagascar. Riverine fishes are severely affected by a dramatic loss of forest habitats which causes sedimentation of spawning beds and alters water flow, quality and nutrient input [ 17 ]. Secondary vegetation growing on hills cleared by slash-and-burn agriculture is typically insufficient to anchor soils [ 18 ], leading to continuous erosion and thus sedimentation of aquatic habitats.…”

Section: Introductionmentioning

confidence: 99%

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Towards a DNA barcode library for Madagascar’s threatened ichthyofauna

Vences¹,

Stützer²,

Raminosoa

et al. 2022

PLoS ONE

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In order to improve the molecular resources available for conservation management of Madagascar’s threatened ichthyofauna, we elaborated a curated database of 2860 mitochondrial sequences of the mitochondrial COI, 16S and ND2 genes of Malagasy fishes, of which 1141 sequences of freshwater fishes were newly sequenced for this data set. The data set is mostly composed of COI (2015 sequences) while 16S and ND2 sequences from partly the same samples were used to match the COI sequences to reliably identified reference sequences of these genes. We observed COI uncorrected pairwise genetic distances of 5.2‒31.0% (mean 20.6%) among species belonging to different genera, and 0.0‒22.4% (mean 6.4%) for species belonging to the same genus. Deeply divergent mitochondrial lineages of uncertain attribution were found among Malagasy freshwater eleotrids and gobiids, confirming these groups are in need of taxonomic revision. DNA barcodes assigned to introduced cichlids (tilapias) included Coptodon rendallii, C. zillii, Oreochromis aureus (apparently a new country record), O. cf. mossambicus, O. niloticus, and one undetermined species of Oreochromis, with sequences of up to three species found per location. In aplocheiloid killifishes of the genus Pachypanchax, most species from northern Madagascar had only low mitochondrial divergences, three of these species (P. omalonotus, P. patriciae, and P. varatraza) were not reciprocally monophyletic, and one genetically deviant lineage was discovered in a northern locality, suggesting a need for partial taxonomic revision of this genus. While the lack of voucher specimens for most of the samples sequenced herein precludes final conclusions, our first step towards a DNA barcoding reference library of Madagascar’s fishes already demonstrates the value of such a data set for improved taxonomic inventory and conservation management. We strongly suggest further exploration of Madagascar’s aquatic environments, which should include detailed photographic documentation and tissue sampling of large numbers of specimens, and collection of preserved voucher specimens as well as of living fish for the buildup of ex situ assurance populations of threatened species complying with the One Plan Approach proposed by the IUCN SSC Conservation Breeding Specialist Group (CBSG).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Towards a DNA barcode library for Madagascar’s threatened ichthyofauna

Vences¹,

Stützer²,

Raminosoa

et al. 2022

PLoS ONE

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“…However, the authors did not distinguish between diarrheal episodes that required antibiotics and those that did not. In this study, physicians were found to justify antibiotic prescribing mainly by the presence of fever [ 22 ]. According to WHO, the prescription of antibiotics during an episode of diarrhea is indicated in the presence of bloody diarrhea or documented shigellosis.…”

Section: Discussionmentioning

confidence: 99%

Inappropriate antibiotic prescribing and its determinants among outpatient children in 3 low- and middle-income countries: A multicentric community-based cohort study

Ardillon¹,

Rambliere²,

Kermorvant‐Duchemin³

et al. 2023

PLoS Med

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Background Antibiotic resistance is a global public health issue, particularly in low- and middle-income countries (LMICs), where antibiotics required to treat resistant infections are not affordable. LMICs also bear a disproportionately high burden of bacterial diseases, particularly among children, and resistance jeopardizes progress made in these areas. Although outpatient antibiotic use is a major driver of antibiotic resistance, data on inappropriate antibiotic prescribing in LMICs are scarce at the community level, where the majority of prescribing occurs. Here, we aimed to characterize inappropriate antibiotic prescribing among young outpatient children and to identify its determinants in 3 LMICs. Methods and findings We used data from a prospective, community-based mother-and-child cohort (BIRDY, 2012 to 2018) conducted across urban and rural sites in Madagascar, Senegal, and Cambodia. Children were included at birth and followed-up for 3 to 24 months. Data from all outpatient consultations and antibiotics prescriptions were recorded. We defined inappropriate prescriptions as antibiotics prescribed for a health event determined not to require antibiotic therapy (antibiotic duration, dosage, and formulation were not considered). Antibiotic appropriateness was determined a posteriori using a classification algorithm developed according to international clinical guidelines. We used mixed logistic analyses to investigate risk factors for antibiotic prescription during consultations in which children were determined not to require antibiotics. Among the 2,719 children included in this analysis, there were 11,762 outpatient consultations over the follow-up period, of which 3,448 resulted in antibiotic prescription. Overall, 76.5% of consultations resulting in antibiotic prescription were determined not to require antibiotics, ranging from 71.5% in Madagascar to 83.3% in Cambodia. Among the 10,416 consultations (88.6%) determined not to require antibiotic therapy, 25.3% (n = 2,639) nonetheless resulted in antibiotic prescription. This proportion was much lower in Madagascar (15.6%) than in Cambodia (57.0%) or Senegal (57.2%) (p < 0.001). Among the consultations determined not to require antibiotics, in both Cambodia and Madagascar the diagnoses accounting for the greatest absolute share of inappropriate prescribing were rhinopharyngitis (59.0% of associated consultations in Cambodia, 7.9% in Madagascar) and gastroenteritis without evidence of blood in the stool (61.6% and 24.6%, respectively). In Senegal, uncomplicated bronchiolitis accounted for the greatest number of inappropriate prescriptions (84.4% of associated consultations). Across all inappropriate prescriptions, the most frequently prescribed antibiotic was amoxicillin in Cambodia and Madagascar (42.1% and 29.2%, respectively) and cefixime in Senegal (31.2%). Covariates associated with an increased risk of inappropriate prescription include patient age greater than 3 months (adjusted odds ratios (aOR) with 95% confidence interval (95% CI) ranged across countries from 1.91 [1.63, 2.25] to 5.25 [3.85, 7.15], p < 0.001) and living in rural as opposed to urban settings (aOR ranged across countries from 1.83 [1.57, 2.14] to 4.40 [2.34, 8.28], p < 0.001). Diagnosis with a higher severity score was also associated with an increased risk of inappropriate prescription (aOR = 2.00 [1.75, 2.30] for moderately severe, 3.10 [2.47, 3.91] for most severe, p < 0.001), as was consultation during the rainy season (aOR = 1.32 [1.19, 1.47], p < 0.001). The main limitation of our study is the lack of bacteriological documentation, which may have resulted in some diagnosis misclassification and possible overestimation of inappropriate antibiotic prescription. Conclusion In this study, we observed extensive inappropriate antibiotic prescribing among pediatric outpatients in Madagascar, Senegal, and Cambodia. Despite great intercountry heterogeneity in prescribing practices, we identified common risk factors for inappropriate prescription. This underscores the importance of implementing local programs to optimize antibiotic prescribing at the community level in LMICs.

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Prescription of medications for acute diarrhea in infants in Antananarivo, Madagascar

Cited by 2 publications

References 0 publications

Towards a DNA barcode library for Madagascar’s threatened ichthyofauna

Towards a DNA barcode library for Madagascar’s threatened ichthyofauna

Inappropriate antibiotic prescribing and its determinants among outpatient children in 3 low- and middle-income countries: A multicentric community-based cohort study

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