{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:10:56Z","timestamp":1790082656975,"version":"4.0.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012036","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000}}],"reference-count":56,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001710","name":"Branco Weiss Fellowship \u2013 Society in Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001949","name":"American Society of Tropical Medicine and Hygiene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001949","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Plague is a flea-borne fatal disease caused by the bacterium <jats:italic>Yersinia pestis<\/jats:italic>, which persists in rural Madagascar. Although fleas parasitizing rats are considered the primary vectors of <jats:italic>Y<\/jats:italic>. <jats:italic>pestis<\/jats:italic>, the human flea, <jats:italic>Pulex irritans<\/jats:italic>, is abundant in human habitations in Madagascar, and has been found naturally infected by the plague bacterium during outbreaks. While <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> may therefore play a role in plague transmission if present in plague endemic areas, the factors associated with infestation and human exposure within such regions are little explored. To determine the socio-ecological risk factors associated with <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> infestation in rural households in plague-endemic areas of Madagascar, we used a mixed-methods approach, integrating results from <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> sampling, a household survey instrument, and an observational checklist. Using previously published vectorial capacity data, the minimal <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> index required for interhuman bubonic plague transmission was modeled to determine whether household infestations were enough to pose a plague transmission risk. Socio-ecological risk factors associated with a high <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> index were then identified for enrolled households using generalized linear models. Household flea abundance was also modeled using the same set of predictors. A high <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> index occurred in approximately one third of households and was primarily associated with having a traditional dirt floor covered with a plant fiber mat. Interventions targeting home improvement and livestock housing management may alleviate flea abundance and plague risk in rural villages experiencing high <jats:italic>P<\/jats:italic>. <jats:italic>irritans<\/jats:italic> infestation. As plague-control resources are limited in developing countries such as Madagascar, identifying the household parameters and human behaviors favoring flea abundance, such as those identified in this study, are key to developing preventive measures that can be implemented at the community level.<\/jats:p>","DOI":"10.1371\/journal.pntd.0012036","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T19:02:15Z","timestamp":1709838135000},"page":"e0012036","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Socio-ecological risk factors associated with human flea infestations of rural household in plague-endemic areas of Madagascar"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6251-8890","authenticated-orcid":true,"given":"Ad\u00e9la\u00efde","family":"Miarinjara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annick Onimalala","family":"Raveloson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Gilbert","family":"Mugel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"An","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andry","family":"Andriamiadanarivo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minoarisoa Esther","family":"Rajerison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rindra Vatosoa","family":"Randremanana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Girod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7901-7248","authenticated-orcid":true,"given":"Thomas Robert","family":"Gillespie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"pntd.0012036.ref001","volume-title":"Fleas (Siphonaptera).","author":"LA Durden","year":"2002"},{"issue":"8","key":"pntd.0012036.ref002","doi-asserted-by":"crossref","first-page":"e667","DOI":"10.1016\/j.ijid.2009.11.011","article-title":"Fleas and flea-borne diseases","volume":"14","author":"I Bitam","year":"2010","journal-title":"International Journal of Infectious Diseases [Internet]."},{"issue":"1\u20132","key":"pntd.0012036.ref003","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.vetpar.2005.12.012","article-title":"Biological, seasonal and environmental factors associated with Pulex irritans infestation of dairy goats in Greece","volume":"137","author":"G Christodoulopoulos","year":"2006","journal-title":"Vet Parasitol"},{"issue":"1","key":"pntd.0012036.ref004","first-page":"1","article-title":"Risk factors associated with Ctenocephalides felis flea infestation of peri-urban goats: a neglected parasite in an under-appreciated host.","volume":"53","author":"JR Dahm","year":"2021","journal-title":"Trop Anim Health Prod."},{"issue":"2","key":"pntd.0012036.ref005","first-page":"43","article-title":"Flea infestation in farm animals and its health implication","volume":"3","author":"S Rahbari","year":"2008","journal-title":"Iran J Parasitol [Internet]."},{"key":"pntd.0012036.ref006","article-title":"Human Ectoparasites Are Highly Prevalent in the Rural Communities of Northwest Ethiopia: A Community-Based Cross-Sectional Study.","volume":"15","author":"Z Gizaw","year":"2021","journal-title":"Environ Health Insights [Internet]."},{"key":"pntd.0012036.ref007","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/jphp.12368","article-title":"Ectoparasites of medical and veterinary importance: Drug resistance and the need for alternative control methods [Internet].","volume":"67","author":"CM McNair","year":"2015","journal-title":"Journal of Pharmacy and Pharmacology"},{"key":"pntd.0012036.ref008","article-title":"Prevalence and risk factors associated with Tungiasis in Mayuge district, Eastern Uganda.","volume":"24","author":"ST Wafula","year":"2016","journal-title":"Pan African Medical Journal [Internet]."},{"key":"pntd.0012036.ref009","first-page":"77","article-title":"Fleas, the Siphonaptera","author":"KL Gage","year":"2004","journal-title":"Biology of Diseases Vectors."},{"key":"pntd.0012036.ref010","volume-title":"Medical and veterinary entomology","author":"GR Mullen","year":"2002"},{"issue":"4","key":"pntd.0012036.ref011","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/BF03179588","article-title":"Host dependency among haematophagous insects: a case study on flea-host association","volume":"96","author":"R. 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