{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:15:42Z","timestamp":1774548942972,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["Cooperation Agreement 72068719CA00001"],"award-info":[{"award-number":["Cooperation Agreement 72068719CA00001"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014220","name":"Innovative Genomics Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014220","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"U.S. Department of Health and Human Services","doi-asserted-by":"publisher","award":["IDSEP190051\u201001\u20100200"],"award-info":[{"award-number":["IDSEP190051\u201001\u20100200"]}],"id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005224","name":"National Center for Immunization and Respiratory Diseases","doi-asserted-by":"publisher","award":["U5\/IP000812\u201005"],"award-info":[{"award-number":["U5\/IP000812\u201005"]}],"id":[{"id":"10.13039\/100005224","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["GCE\/ID OPP1211841"],"award-info":[{"award-number":["GCE\/ID OPP1211841"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Influenza Resp Viruses"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Following the first detection of SARS\u2010CoV\u20102 in passengers arriving from Europe on 19 March 2020, Madagascar took several mitigation measures to limit the spread of the virus in the country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nasopharyngeal and\/or oropharyngeal swabs were collected from travellers to Madagascar, suspected SARS\u2010CoV\u20102 cases and contact of confirmed cases. Swabs were tested at the national reference laboratory using real\u2010time RT\u2010PCR. Data collected from patients were entered in an electronic database for subsequent statistical analysis. All distribution of laboratory\u2010confirmed cases were mapped, and six genomes of viruses were fully sequenced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 26,415 individuals were tested for SARS\u2010CoV\u20102 between 18 March and 18 September 2020, of whom 21.0% (5,553\/26,145) returned positive. Among laboratory\u2010confirmed SARS\u2010CoV\u20102\u2013positive patients, the median age was 39\u00a0years (IQR: 28\u201052), 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\u20102.5] for individuals aged 49\u00a0years and more. Viral strains sequenced belong to clades 19A, 20A and 20B indicative of several independent introduction of viruses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study describes the first wave of the COVID\u201019 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/irv.12845","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T16:39:32Z","timestamp":1613579972000},"page":"457-468","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["The COVID\u201019 epidemic in Madagascar: clinical description and laboratory results of the first wave, march\u2010september 2020"],"prefix":"10.1111","volume":"15","author":[{"given":"Rindra Vatosoa","family":"Randremanana","sequence":"first","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soa\u2010Fy","family":"Andriamandimby","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0490-7665","authenticated-orcid":false,"given":"Jean Marius","family":"Rakotondramanga","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norosoa Harline","family":"Razanajatovo","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reziky Tiandraza","family":"Mangahasimbola","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsiry Hasina","family":"Randriambolamanantsoa","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafaliana Christian","family":"Ranaivoson","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harinirina Aina","family":"Rabemananjara","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iony","family":"Razanajatovo","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richter","family":"Razafindratsimandresy","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joelinotahiana Hasina","family":"Rabarison","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara E.","family":"Brook","sequence":"additional","affiliation":[{"name":"University of California Berkeley Berkeley CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanjasoa","family":"Rakotomanana","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger Mario","family":"Rabetombosoa","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helisoa","family":"Razafimanjato","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vida","family":"Ahyong","sequence":"additional","affiliation":[{"name":"Chan Zuckerberg Biohub San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vololoniaina","family":"Raharinosy","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaomalala","family":"Raharimanga","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandratana Jonhson","family":"Raharinantoanina","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirella Malala","family":"Randrianarisoa","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barivola","family":"Bernardson","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurence","family":"Randrianasolo","sequence":"additional","affiliation":[{"name":"Epidemiology and Clinical Research Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e9a Bricette Nirina","family":"Randriamampionona","sequence":"additional","affiliation":[{"name":"Ministry of Public Health Government of the Republic of Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina M.","family":"Tato","sequence":"additional","affiliation":[{"name":"Chan Zuckerberg Biohub San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph L.","family":"DeRisi","sequence":"additional","affiliation":[{"name":"Chan Zuckerberg Biohub San Francisco CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1931-3037","authenticated-orcid":false,"given":"Philippe","family":"Dussart","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela Christoph\u00e8re","family":"Vololoniaina","sequence":"additional","affiliation":[{"name":"Ministry of Public Health Government of the Republic of Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fidiniaina Mamy","family":"Randriatsarafara","sequence":"additional","affiliation":[{"name":"Ministry of Public Health Government of the Republic of Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zely Arivelo","family":"Randriamanantany","sequence":"additional","affiliation":[{"name":"Ministry of Public Health Government of the Republic of Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1107-0859","authenticated-orcid":false,"given":"Jean\u2010Michel","family":"Heraud","sequence":"additional","affiliation":[{"name":"Virology Unit Institut Pasteur de Madagascar Antananarivo Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2008-3"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2012-7"},{"key":"e_1_2_9_4_1","unstructured":"The World Health Organization (WHO).WHO Director\u2010General's opening remarks at the media briefing on. COVID\u201019 \u2010 11 March 2020.2020.https:\/\/www.who.int\/director\u2010general\/speeches\/detail\/who\u2010director\u2010general\u2010s\u2010opening\u2010remarks\u2010at\u2010the\u2010media\u2010briefing\u2010on\u2010covid\u201019\u2013\u201011\u2010march\u20102020"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30120-1"},{"key":"e_1_2_9_6_1","unstructured":"Worldometers.info.COVID\u201019 CORONAVIRUS PANDEMIC Dover Delaware USA.2020updated 30 November 2020.https:\/\/www.worldometers.info\/coronavirus\/"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.05.026"},{"key":"e_1_2_9_9_1","unstructured":"The US. Central Intelligence Agency (CIA).The World Factbook \u2010 Africa \u2010. Madagascar.2020.https:\/\/www.cia.gov\/library\/publications\/the\u2010world\u2010factbook\/geos\/ma.html"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/hvaa029"},{"key":"e_1_2_9_11_1","unstructured":"The World Health Organization (WHO).WHO COVID\u201019: Case Definitions 2020.https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/333912\/WHO\u20102019\u2010nCoV\u2010Surveillance_Case_Definition\u20102020.1\u2010eng.pdf?sequence=1&isAllowed=y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0037067"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.16.171280"},{"key":"e_1_2_9_14_1","unstructured":"The World Health Organization (WHO).Maintaining surveillance of influenza and monitoring SARS\u2010CoV\u20102 \u2013 adapting Global Influenza surveillance and Response System (GISRS) and sentinel systems during the COVID\u201019 pandemic: Interim guidance. Geneva: World Health Organization; 2020 (WHO\/2019\u2010nCoV\/Adapting_GISRS\/2020.1).2020.https:\/\/apps.who.int\/iris\/handle\/10665\/336689"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.17.194514"},{"key":"e_1_2_9_16_1","unstructured":"The World Health Organization (WHO).Molecular assays to diagnose COVID\u201019: Summary table of available protocols 2020https:\/\/www.who.int\/publications\/m\/item\/molecular\u2010assays\u2010to\u2010diagnose\u2010covid\u201019\u2010summary\u2010table\u2010of\u2010available\u2010protocols"},{"key":"e_1_2_9_17_1","unstructured":"The World Health Organization (WHO).Molecular assays to diagnose COVID\u201019: Summary table of available protocols2020.https:\/\/www.who.int\/publications\/m\/item\/molecular\u2010assays\u2010to\u2010diagnose\u2010covid\u201019\u2010summary\u2010table\u2010of\u2010available\u2010protocols"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2020.25.3.2000045"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_21_1","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2013"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.01800"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa434"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12308"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205124"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0017579"},{"key":"e_1_2_9_27_1","unstructured":"The World Health Organization (WHO).Weekly epidemiological update \u2010 21 September 2020 2020.https:\/\/www.who.int\/publications\/m\/item\/weekly\u2010epidemiological\u2010update\u2013\u201021\u2010september\u20102020"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0961-x"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002699"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05683-8"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0117919"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2020.10.081"},{"key":"e_1_2_9_33_1","doi-asserted-by":"crossref","first-page":"w20331","DOI":"10.4414\/smw.2020.20331","article-title":"Barriers to seeking emergency care during the COVID\u201019 pandemic may lead to higher morbidity and mortality \u2010 a retrospective study from a Swiss university hospital","volume":"150","author":"Hautz WE","year":"2020","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1401"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12824"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2020.100822"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1017\/S095026882000206X"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.001231"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001316"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12557"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17218155"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.11.151"},{"key":"e_1_2_9_43_1","article-title":"Spike mutation D614G alters SARS\u2010CoV\u20102 fitness and neutralization susceptibility","author":"Plante JA","year":"2020","journal-title":"bioRxiv"},{"key":"e_1_2_9_44_1","doi-asserted-by":"crossref","unstructured":"LuoT CaoZ WangY ZengDD ZhangQ.Role of Asymptomatic COVID\u201019 Cases in Viral Transmisssion: Findings from a Hierarchical Community Contact Network Model.https:\/\/doi.org\/10.2139\/ssrn.3676211","DOI":"10.2139\/ssrn.3676211"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.35057"}],"container-title":["Influenza and Other Respiratory Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.12845","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/irv.12845","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/irv.12845","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T15:18:13Z","timestamp":1693408693000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/irv.12845"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,15]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1111\/irv.12845"],"URL":"https:\/\/doi.org\/10.1111\/irv.12845","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/IRV.12845\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.12845\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/IRV.12845\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1750-2640","1750-2659"],"issn-type":[{"value":"1750-2640","type":"print"},{"value":"1750-2659","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,15]]},"assertion":[{"value":"2020-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}