{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:39:56Z","timestamp":1760060396188,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Education in Poland","award":["667\/WIM\/2024"],"award-info":[{"award-number":["667\/WIM\/2024"]}]},{"name":"Military Institute of Medicine\u2013National Research Institute, Warsaw, Poland","award":["667\/WIM\/2024"],"award-info":[{"award-number":["667\/WIM\/2024"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Malaria is a parasitic disease caused by Plasmodium protozoa, which is a serious public health issue in Madagascar, an island country located off the coast of Africa in the Indian Ocean. Despite significant efforts to prevent the spread of communicable diseases, the country\u2019s epidemiological situation is worrying and has been deteriorating in recent years, mostly due to poverty and limited access to healthcare. The aim of the present study was to assess the prevalence rates of malaria in northern Madagascar, as exemplified by the Mampikony District, between 2023 and 2024, as well as to assess the effectiveness of the methods used for malaria diagnosis. Material and methods. The study was conducted on a sample of 782 local residents who reported to healthcare centres in Mampikony between 2023 and 2024. The methods used to establish the diagnosis of malaria included rapid diagnostic tests (mRDTs) and molecular assays (RT-PCRs). Results. The 2023 study conducted on a sample of 484 patients demonstrated malaria prevalence of 4.5% (by mRDTs) and 8.2% (by RT-PCR), while the 2024 study carried out on a sample of 298 patients demonstrated malaria prevalence of 8.4% (by mRDTs) and 12.4% (by RT-PCR). The analysis of demographic variables showed that malaria was more prevalent in women and in adults; however, the differences between individual study groups were not statistically significant. In this study, positive malaria cases were predominantly caused by P. falciparum, but we also found cases caused by P. vivax as well as mixed infections. Conclusions. The study results support the need to apply more sensitive diagnostic tools for malaria diagnosis, e.g., RT-PCR. Also, our findings indicate the necessity to reassess and update the strategies for the treatment of malaria in the region due to a growing asymptomatic malaria carriage. To control the spread of malaria in Madagascar, it is essential to apply a wide range of interventions.<\/jats:p>","DOI":"10.3390\/pathogens14090848","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T14:43:18Z","timestamp":1756219398000},"page":"848","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of Malaria in Northern Madagascar as Exemplified by the Mampikony District"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1290-2656","authenticated-orcid":false,"given":"Daria","family":"Ko\u0142odziej","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Tropical Medicine, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w St., 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1932-9784","authenticated-orcid":false,"given":"Wanesa","family":"Wilczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Tropical Medicine, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w St., 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6357-2418","authenticated-orcid":false,"given":"Daniel","family":"Kasprowicz","sequence":"additional","affiliation":[{"name":"Clinique Medicale Beyzym, Ambatoboeny District, Manerinerina 403, Madagascar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1920-0972","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Marchelek-My\u015bliwiec","sequence":"additional","affiliation":[{"name":"Clinic of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 72 Powsta\u0144c\u00f3w Wielkopolskich Av., 70-111 Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-6279","authenticated-orcid":false,"given":"Krzysztof","family":"Korzeniewski","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Tropical Medicine, Military Institute of Medicine\u2013National Research Institute, 128 Szaser\u00f3w St., 04-141 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.idc.2018.10.002","article-title":"Malaria. What\u2019s New in the Management of Malaria?","volume":"33","author":"Plewes","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.pt.2015.04.010","article-title":"Active migration and passive transport of malaria parasites","volume":"31","author":"Douglas","year":"2015","journal-title":"Trends Parasitol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Rakotoarison, N., Raholijao, N., Razafindramavo, L.M., Rakotomavo, Z.A.P.H., Rakotoarisoa, A., Guillemot, J.S., Randriamialisoa, Z.J., Mafilaza, V., Ramiandrisoa, V.A.M.P., and Rajaonarivony, R. (2018). Assessment of Risk, Vulnerability and Adaptation to Climate Change by the Health Sector in Madagascar. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15122643"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/S0140-6736(15)61526-4","article-title":"Madagascar\u2019s health challenges","volume":"386","author":"Barmania","year":"2015","journal-title":"Lancet"},{"key":"ref_5","unstructured":"World Bank Group (2025, March 27). Available online: https:\/\/www.worldbank.org\/en\/country\/madagascar\/publication\/madagascar-economic-update."},{"key":"ref_6","unstructured":"Ministere de L\u2019Economie et des Finanses (2025, March 23). Antananarivo, Available online: http:\/\/mef.gov.mg\/page_personnalisee\/index\/news\/122."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1186\/s12936-020-03417-z","article-title":"Malaria case management and elimination readiness in health facilities of five districts of Madagascar in 2018","volume":"19","author":"Anand","year":"2020","journal-title":"Malar. J."},{"key":"ref_8","unstructured":"Direction de Lutte Contre le Paludisme (2025, March 23). Plan Strat\u00e9gique National de Lutte Contre le Paludisme, 2018\u20132022. Elimination Progressive du Paludisme \u00e0 Madagascar. Available online: https:\/\/www.scribd.com\/document\/589248203\/PSN-2018-2022-avec-PSE."},{"key":"ref_9","unstructured":"World Health Organization (2024). World Malaria Report 2024, WHO."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/bcp.14474","article-title":"Advances and roadblocks in the treatment of malaria","volume":"88","author":"Hanboonkunupakarn","year":"2022","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_11","unstructured":"UNICEF (2025, March 23). Protection Against Malaria: At the Heart of the Prevention Campaign. Available online: https:\/\/www.unicef.org\/madagascar\/en\/stories\/protection-against-malaria-heart-prevention-campaign."},{"key":"ref_12","unstructured":"(2025, March 23). Atlas Visual de la Malaria, March 2025. Available online: https:\/\/atlasvisualdelamalaria.org\/paises\/malaria-madagascar."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"18129","DOI":"10.1038\/s41598-020-75189-0","article-title":"Spatiotemporal mapping of malaria prevalence in Madagascar using routine surveillance and health survey data","volume":"10","author":"Arambepola","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"995","DOI":"10.4269\/ajtmh.18-0417","article-title":"Risk Factors for Malaria Infection in Central Madagascar: Insights from a Cross-Sectional Population Survey","volume":"9","author":"Howes","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1038\/nrmicro3364","article-title":"Asymptomatic malaria infections: Detectability, transmissibility and public health relevance","volume":"12","author":"Bousema","year":"2014","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_16","unstructured":"World Health Organization (2025, March 23). Available online: https:\/\/www.who.int\/docs\/default-source\/documents\/global-technical-strategy-for-malaria-2016-2030.pdf."},{"key":"ref_17","unstructured":"Severe Malaria Observatory (2025, March 25). Available online: https:\/\/www.severemalaria.org\/countries\/madagascar."},{"key":"ref_18","unstructured":"SlidePlayer (2025, March 23). Available online: https:\/\/slideplayer.fr\/slide\/5486905\/."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s12098-017-2332-2","article-title":"Malaria: An Update","volume":"84","author":"Basu","year":"2017","journal-title":"Indian J. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5967","DOI":"10.1073\/pnas.0912496107","article-title":"Plasmodium vivax clinical malaria is commonly observed in Duffy-negative Malagasy people","volume":"107","author":"Bento","year":"2010","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"636","DOI":"10.4269\/ajtmh.17-0461","article-title":"Plasmodium vivax Infection in Duffy-Negative People in Africa","volume":"97","author":"Zimmerman","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_22","unstructured":"African Leaders Malaria Alliance (2025, March 27). Africa Malaria Progress Report 2023. Available online: https:\/\/alma2030.org\/heads-of-state-and-government\/african-union-malaria-progress-reports\/2023-africa-malaria-progress-report\/."},{"key":"ref_23","unstructured":"Centers fro Diseases Control and Prevention (2025, March 28). Available online: https:\/\/www.cdc.gov\/global-health\/media\/pdfs\/2024\/11\/Madagascar-2024-Fact-Sheet.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1186\/s12936-020-03423-1","article-title":"Variation in Anopheles distribution and predictors of malaria infection risk across regions of Madagascar","volume":"19","author":"Arisco","year":"2020","journal-title":"Malar. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1186\/s12889-021-11090-3","article-title":"Fine-scale variation in malaria prevalence across ecological regions in Madagascar: A cross-sectional study","volume":"21","author":"Rice","year":"2021","journal-title":"BMC Public Health"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"BMJ Global Health (2025, March 28). Using Routine Health Data to Evaluate the Impact of Indoor Residual Spraying on Malaria Transmission in Madagascar. Available online: https:\/\/gh.bmj.com\/content\/8\/7\/e010818.","DOI":"10.1136\/bmjgh-2022-010818"},{"key":"ref_27","first-page":"50","article-title":"Stratification \u00e9pid\u00e9miologique du paludisme \u00e0 Madagascar","volume":"60","author":"Mouchet","year":"1993","journal-title":"Arch. Inst. Pasteur Madagascar."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e0011827","DOI":"10.1371\/journal.pntd.0011827","article-title":"A regional One Health approach to the risk of invasion by Anopheles stephensi in Mauritius","volume":"18","author":"Iyaloo","year":"2024","journal-title":"PLoS Neglected Trop. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1186\/s12936-015-1004-9","article-title":"Malaria case in Madagascar, probable implication of a new vector, Anopheles coustani","volume":"14","author":"Nepomichene","year":"2015","journal-title":"Malar. J."},{"key":"ref_30","unstructured":"Institut Pasteur de Madagascar (2025, March 28). Available online: https:\/\/www.pasteur.mg\/projet-rise-missions-survano-paludisme-madagascar\/."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/9\/848\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:32:56Z","timestamp":1760034776000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/9\/848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":30,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["pathogens14090848"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14090848","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2025,8,26]]}}}