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Spatial and temporal dynamics of malaria in Madagascar
Felana A Ihantamalala1,2, Feno M J Rakotoarimanana1, Tanjona Ramiadantsoa3
1Epidemiology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Malaria incidence in Madagascar increased from 2010-2014, with high-risk areas expanding into new zones. This study highlights critical districts for targeted malaria control efforts.
Area of Science:
- Epidemiology
- Spatial analysis
- Public health
Background:
- Malaria poses a significant health challenge in Madagascar.
- The country is stratified into five zones based on malaria transmission intensity.
- Understanding spatial and temporal malaria dynamics is crucial for control.
Purpose of the Study:
- To analyze the spatial and temporal dynamics of malaria across Madagascar's epidemiological strata.
- To identify shifts in malaria incidence and high-risk areas over time.
Main Methods:
- Analysis of reported uncomplicated malaria cases from 112 health districts (2010-2014).
- Calculation of Standardized Incidence Ratio to detect anomalous district-level incidence.
- Identification and analysis of spatial and temporal malaria clusters.
Main Results:
- Malaria incidence rose across all strata between 2010 and 2014.
- High-incidence districts were primarily in the East and West strata, expanding into Highlands and Fringe zones.
- Malaria clusters in coastal regions migrated southward, with peak incidence from January to July.
Conclusions:
- Identified districts shifting from low to high malaria incidence and consistent high-incidence areas.
- Provides a detailed epidemiological description to guide Madagascar's national malaria program.
- Aids in targeting interventions to prevent disease expansion.
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