Andriamandimby Soa Fy, Volasoa Marie Hermelienne, Razafindraibe Nivohanitra Perle, Ranoaritiana Dany Bakoly, Razafindramparany Mino Harimbola, Rafisandratantsoa Théophile, Nomenjanahary Lalaina Arivony, Rakotondrabe Naltiana, Andriamananjara Mamitiana Aimé, Guis Hélène, Lacoste Vincent, Dreyfus Anou
Unité de Virologie, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
Département des Enseignements des Sciences et de Médecine Vétérinaire, Université d'Antananarivo, Antananarivo, Madagascar.
Front Vet Sci. 2023 Oct 12;10:1270532. doi: 10.3389/fvets.2023.1270532. eCollection 2023.
Rabies is endemic in Madagascar and a neglected disease. The aim of this study was to summarize human and animal rabies surveillance activities in Madagascar from 2011 to 2021. Samples from terrestrial mammals and humans were tested for rabies virus infection using direct fluorescent antibody, RT-PCR and virus isolation by the National Reference Laboratory (NRL) for rabies at the Institut Pasteur de Madagascar. Among 964 animal and 47 human samples tested, 66.7 and 70.2% were positive, respectively. The NRL received these suspect rabies samples from 48 of 114 districts of Madagascar. Most of them were submitted from the district of the capital city Antananarivo (26.3%) and mainly from its region Analamanga (68.9%). Animal samples were mainly from dogs (83%), cats (9.5%) and cattle (5.8%). Pigs, lemurs, goats accounted for less than 1%. During the 11 years of surveillance, 48 human skin and/or brain biopsy samples were received from 20 districts, mainly from Antananarivo and its surroundings ( = 13), Toamasina and its surroundings ( = 8) and Moramanga ( = 6). The high positivity rate for all species and the non-homogeneous spatial distribution of samples suggests substantial underreporting of rabies cases. There is a clear need to better understand the reasons for underreporting and prioritize rabies surveillance, prevention and control in Madagascar, with improvements in budget, education and infrastructure. A joint animal and human health rabies control program including vaccination of at least 70% of the dog population, is needed to achieve the goal of eliminating dog-transmitted human rabies by 2030 from Madagascar.
狂犬病在马达加斯加是地方病，也是一种被忽视的疾病。本研究的目的是总结2011年至2021年马达加斯加人类和动物狂犬病监测活动。马达加斯加巴斯德研究所的国家狂犬病参考实验室使用直接荧光抗体、逆转录聚合酶链反应和病毒分离技术，对陆生哺乳动物和人类的样本进行狂犬病病毒感染检测。在检测的964份动物样本和47份人类样本中，阳性率分别为66.7%和70.2%。国家参考实验室从马达加斯加114个区中的48个区收到了这些疑似狂犬病样本。其中大部分样本来自首都塔那那利佛所在的区（26.3%），主要来自其所在的阿纳拉芒加地区（68.9%）。动物样本主要来自狗（83%）、猫（9.5%）和牛（5.8%）。猪、狐猴、山羊占比不到1%。在11年的监测期间，从20个区收到了48份人类皮肤和/或脑活检样本，主要来自塔那那利佛及其周边地区（ = 13）、图阿马西纳及其周边地区（ = 8）和莫拉芒加（ = 6）。所有物种的高阳性率以及样本的非均匀空间分布表明狂犬病病例报告严重不足。显然有必要更好地了解报告不足的原因，并将马达加斯加狂犬病监测、预防和控制作为优先事项，同时改善预算、教育和基础设施。为了实现到2030年在马达加斯加消除狗传播的人类狂犬病这一目标，需要实施一项包括至少70%的犬类接种疫苗在内的动物和人类健康联合狂犬病控制计划。
