Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Influenza Other Respir Viruses. 2021 Jul;15(4):457-468. doi: 10.1111/irv.12845. Epub 2021 Feb 15.
Following the first detection of SARS-CoV-2 in passengers arriving from Europe on 19 March 2020, Madagascar took several mitigation measures to limit the spread of the virus in the country.
Nasopharyngeal and/or oropharyngeal swabs were collected from travellers to Madagascar, suspected SARS-CoV-2 cases and contact of confirmed cases. Swabs were tested at the national reference laboratory using real-time RT-PCR. Data collected from patients were entered in an electronic database for subsequent statistical analysis. All distribution of laboratory-confirmed cases were mapped, and six genomes of viruses were fully sequenced.
Overall, 26,415 individuals were tested for SARS-CoV-2 between 18 March and 18 September 2020, of whom 21.0% (5,553/26,145) returned positive. Among laboratory-confirmed SARS-CoV-2-positive patients, the median age was 39 years (IQR: 28-52), and 56.6% (3,311/5,553) were asymptomatic at the time of sampling. The probability of testing positive increased with age with the highest adjusted odds ratio of 2.2 [95% CI: 1.9-2.5] for individuals aged 49 years and more. Viral strains sequenced belong to clades 19A, 20A and 20B indicative of several independent introduction of viruses.
Our study describes the first wave of the COVID-19 in Madagascar. Despite early strategies in place Madagascar could not avoid the introduction and spread of the virus. More studies are needed to estimate the true burden of disease and make public health recommendations for a better preparation to another wave.
2020 年 3 月 19 日，马达加斯加首次在从欧洲抵达的乘客中检测到 SARS-CoV-2 后，采取了多项缓解措施，以限制该国病毒的传播。
对前往马达加斯加的旅行者、疑似 SARS-CoV-2 病例和确诊病例的接触者采集鼻咽和/或口咽拭子。拭子在国家参考实验室使用实时 RT-PCR 进行检测。从患者收集的数据输入电子数据库，以便随后进行统计分析。所有实验室确诊病例的分布均进行了映射，并对 6 株病毒进行了全基因组测序。
2020 年 3 月 18 日至 9 月 18 日期间，共对 26415 人进行了 SARS-CoV-2 检测，其中 21.0%（5553/26145）呈阳性。在实验室确诊的 SARS-CoV-2 阳性患者中，中位年龄为 39 岁（IQR：28-52），56.6%（3311/5553）在采样时无症状。检测呈阳性的概率随年龄增加而增加，年龄在 49 岁及以上的个体的调整后优势比最高，为 2.2 [95%CI：1.9-2.5]。测序的病毒株属于 19A、20A 和 20B 株，表明存在若干独立的病毒传入。
本研究描述了马达加斯加 COVID-19 的第一波疫情。尽管早期采取了策略，但马达加斯加仍无法避免病毒的传入和传播。需要进一步研究来估计疾病的真实负担，并提出公共卫生建议，以更好地为另一次疫情做好准备。
