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Madagascar reports more human plague (causative agent: Yersinia pestis) cases annually than any other country (1), often several hundred each season (typically September-March) (2). Y. pestis persists in multiple rural [...]

Sitraka Angelo Raharinavalona,1 Rija Eric Raherison,2 Rija Mikhaël Miandrisoa,1 Radonirina Lazasoa Andrianasolo,2 Andrianirina Dave Patrick Rakotomalala2 1Cardiovascular Diseases and Internal Medicine Departments, Soavinandriana Hospital Center, Antananarivo, Madagascar; 2Endocrinology Department, Joseph Raseta Befelatanana University Hospital Center, Antananarivo, MadagascarCorrespondence: Sitraka Angelo Raharinavalona, Cardiovascular Diseases and Internal Medicine departments, Soavinandriana Hospital Center, Antananarivo, Madagascar, Email sitrakarah@gmail.comBackground: Diabetes mellitus is already a major cardiovascular risk factor (CRF). Hypovitaminosis D is common in patients with type 2 diabetes mellitus (T2DM). It also increases the cardiovascular risk of these subjects.Objective: To determine the vitamin D status of Malagasy with T2DM seen at the Soavinandriana Hospital Center, and the association between hypovitaminosis D and CRF.Methods: This was a cross-sectional study, carried out over a period of 2 years. Assayed by the chemiluminescence technique, vitamin D was “normal”, “insufficient” and “deficient” if the 25-hydroxyvitamin D plasma was ≥ 30 ng/mL, 20– 29 ng/mL and ≤ 19 ng/mL, respectively. Hypovitaminosis D was the set of vitamin D insufficiency and deficiency.Results: Among the 318 T2DM, the prevalence of hypovitaminosis D was 66.0% (45.2% insufficiency and 20.8% deficiency). Their factors associated were age ≥ 70 years (OR = 2.15 [1.26– 3.66]), glycated haemoglobin ≥ 7% (4.97 [2.97– 8.39]), and retinopathy (OR = 4.15 [1.85– 9.32]). After adjustment for age, Hb A1c ≥ 7% and retinopathy, hypovitaminosis D was associated with hypertension (OR = 8.77 [4.76– 16.2]), dyslipidaemia (OR = 8.05 [3.98– 14.5]), ex-smoking (OR = 6.07 [2.78– 13.3]), microalbuminuria (OR = 2.95 [1.25– 6.97]) and carotid atherosclerosis (OR = 2.96 [1.83– 4.35]).Conclusion: Hypovitaminosis D was common in T2DM. Its treatment is primarily preventive. It is also important to control associated CRF, diabetes and its complications.Keywords: 25-hydroxyvitamin D, cardiovascular risk factors, hypovitaminosis D, Madagascar, type 2 diabetes mellitus

Abstract Background The rates of maternal and neonatal deaths in Madagascar are among the highest in the world. In response to a request for additional training from obstetrical care providers at the Ambanja district hospital in north-eastern Madagascar, a partnership of institutions in Switzerland and Madagascar conducted innovative training on respectful emergency obstetric and newborn care using e-learning and simulation methodologies. The training focused on six topics: pre-eclampsia, physiological childbirth, obstetric maneuvers, postpartum hemorrhage, maternal sepsis, and newborn resuscitation. Cross-cutting themes were interprofessional communication and respectful patient care. Ten experienced trainers participated in an e-training-of-trainers course conducted by the Swiss partners. The newly-trained trainers and Swiss partners then jointly conducted the hybrid remote/in-person training for 11 obstetrical care providers in Ambanja. Methods A mixed methods evaluation was conducted of the impact of the training on participants’ knowledge and practices. Trainees’ knowledge was tested before, immediately after, and 6 months after the training. Focus group discussions were conducted to elicit participants’ opinions about the training, including the content and pedagogical methods. Results Trainees’ knowledge of the six topics was higher at 6 months (with an average of 71% correct answers) compared to before the training (62%), although it was even higher (83%) immediately after the training. During the focus group discussions, participants highlighted their positive impressions of the training, including its impact on their sense of professional effectiveness. They reported that their interprofessional relationships and focus on respectful care had improved. Simulation, which was a new methodology for the participants native to Madagascar, was appreciated for its engaging and active format, and they enjoyed the hybrid delivery of the training. Participants (including the trainers) expressed a desire for follow-up engagement, including additional training, and improved access to more equipment. Conclusion The evaluation showed improvements in trainees’ knowledge and capacity to provide respectful emergency care to pregnant women and newborns across all training topics. The hybrid simulation-based training method elicited strong enthusiasm. Significant opportunity exists to expand the use of hybrid onsite/remote simulation-based training to improve obstetrical care and health outcomes for women and newborns in Madagascar and elsewhere.

Abstract Background Malnutrition remains a global problem and is increasing with the emergence of the COVID-19 pandemic. In Madagascar, half of the children under five years of age suffer from stunting. However, since 2006, vitamin A supplementation campaigns, deworming and free vaccinations have been implemented within the framework of the Mother and Child Health Week (MCHW) to strengthen the fight against micronutrient deficiencies and reduce mortality. On the other hand, rice, the staple food of the Malagasy population, can provide some of the micronutrients necessary for good nutrition. However, the country’s rice production is still insufficient, and the price has been rising steadily in recent years. This has led the government to resort to the policy of stabilizing rice prices through imported rice in 2017 and 2018. The aim of this paper is therefore to analyse the effects of these policies on the prevalence of malnutrition among children under five years of age in Madagascar. Which policy would be more effective: the nutrition policy or the price stabilisation policy? Methods Data from the Multiple Indicator Cluster Survey conducted by the National Institute of Statistics in 2018 are used, and logistic regressions for the analysis of the effects of nutrition policies on nutrition outcomes are performed. For the effect of price stabilisation policy, panel data on 22 regions of Madagascar from 2016 to 2019 are considered, and a fixed effect model is used. Results We found that the effects of the nutrition policy are not immediately visible. Only participation in the 2016 MCHW contributes to a lower probability of malnutrition occurrence. The odds ratios of the effects of this participation on stunting are 0.69 (p-value: 0.05); on underweight: 0.70 (p-value

Societal Impact Statement Palaeoecological investigations are crucial in understanding millennial to centennial land use and land cover change. By analysing the modern pollen rain from four main vegetation types across Madagascar, this research provides baselines for improving the interpretation of pollen records in palaeoecological studies. This study determines the modern pollen‐vegetation relationship in Madagascar and gives a better understanding of the island's landscapes. Despite some spatial limitations, this approach contributes to resolving the debated topic related to the origin of Madagascar's open ecosystems. Knowing the vegetation history prior to and after human settlement would help guide biodiversity management and its associated ecosystem services. Summary Modern pollen rain contributes to calibrating and defining palaeo‐records relative to the current vegetation of diverse landscapes. Quantifying past vegetation change is important to better frame sustainable and resilient management methods of biodiversity considering human needs. In this paper, we aim to assess modern pollen assemblages in different vegetation types in Madagascar and inform how these could contribute to the interpretation of palaeo‐records. We identified modern pollen assemblages from 21 samples across four major vegetation types in Madagascar, including seven (N = 7) newly generated samples from the tropical dry forest in the Northwest region and 14 datasets downloaded from the African Pollen Database website. The downloaded datasets are from core tops representing modern vegetation previously analysed in the tropical dry forests and spiny thickets, the wooded grassland–bushland mosaic and the littoral humid forest. We evaluated the frequency of different taxa in the samples and conducted multivariate analyses to evaluate the similarities and ecological affinities between samples. Pollen rain reflected the main vegetation types across Madagascar and provided information on the current structure and state of the landscape. Regarding the interpretation of pollen records, pollen rain samples revealed that: (i) Open mosaic ecosystems should contain a percentage of at least 40% grass pollen, informing on the origin of the vegetation in older samples and the state of degradation in more recent vegetation reconstructions; and (ii) Anthropogenic vegetation such as plantations are marked by the abundance of pioneer taxa such as Pinus and/or Eucalyptus spp. with a frequency >20%. Our findings improve the interpretations of pollen records and help differentiate past distribution of forest, open and mosaic vegetation, in Madagascar. It will contribute to further research on human practices, land use and into scenarios of conservation planning not only in Madagascar but also across the tropics.

Abstract The loss and degradation of forests and other ecosystems worldwide threaten both global biodiversity and the livelihoods of people who use natural resources. Understanding how natural resource use impacts landscape provisioning services for both people and wildlife is thus critical for designing comprehensive resource management strategies. We used data from community focus groups, botanical plots and an inventory of plant species consumed by the Critically Endangered red‐ruffed lemur (Varecia rubra) to assess the availability of key provisioning services for people and endemic wildlife on the Masoala Peninsula, a rainforest transformation landscape, in northeastern Madagascar (Masoala National Park and 13 surrounding communities). We constructed Poisson regression mixed models to evaluate the impact of community factors (i.e. community population size, plot distance to community) and changes over time on the count and species richness of timber trees, medicinal plants and red‐ruffed lemur food trees within botanical plots. Over three‐quarters of all plant species could be used for at least one purpose by local communities (n = 238 species). Of the 59 V. rubra food tree species, only 15% had no reported human use. Timber and ruffed lemur food tree availability declined both with community population size and time and were predicted to be lower outside of Masoala National Park. In contrast, medicinal plant availability was not strongly predicted by any tested factors. Provisioning service availability also differed strongly across sites, suggesting that additional, untested proxies of human pressure likely also have an effect. Our results highlight the importance of evaluating natural resource availability from a community‐based perspective and by resource purpose to inform forest landscape restoration efforts that can support both people and wildlife. Read the free Plain Language Summary for this article on the Journal blog.

Landscape mapping has the potential to address some of the most pressing research issues of our time, including climate change, sustainable development, and human well-being. In this paper, we propose an original method that lays the foundations for landscape mapping and overcomes some of the major limitations of existing biophysical methods. Based on the assumption that the primary components of the landscape can be extracted directly from the radiometric information of satellite image time series, this paper presents a new approach to landscape characterization and mapping based solely on remote sensing data. The approach relies on a conceptual model, which links the description, characteristics, structure and functions of the landscape to a set of Remote Sensing-based Essential Landscape Variables (RS-ELVs). The RS-ELVs are then processed according to geographic object-based image analysis (GEOBIA) approach to produce a radiometric landscape map. The model and the remote sensing data processing chain are tested on a case study in central Madagascar (about 13 000 km2) composed of contrasting landscapes resulting from different climatic conditions and agricultural practices. The RS-ELVs are extracted from MODIS image time series for the temporal and spectral variables, and from MODIS and Sentinel-2 images for the texture variables. The parameterization of the segmentation and clustering algorithms is determined by statistical optimization. The final result is a radiometric landscape map in six classes. The landscape classes are then characterized using an independent set of remote sensing variables, a global land cover map and ground observations. The approach successfully identifies and delineates the gradient and major landscape types of the complex region of central Madagascar, confirming our initial hypothesis. The production of such radiometric landscape maps opens the way for integrated territorial development, including the planning and protection of the living environment and human well-being, and the implementation of sectoral policies.

Dermoergasilus madagascarensis n. sp. is described from the gills of Paretroplus polyactis, an endemic cichlid fish in Madagascar, using a combined morphological (light microscopy and SEM) and molecular approach (partial 18S rDNA, 28S rDNA, and COI sequences). The new species is characterized mainly by possessing: (i) roughly pentagonal cephalosome; (ii) antennal endopodal segments covered with slightly inflated membrane; (iii) maxillule bearing 2 equally long outer setae and a minute inner seta; (iv) interpodal sternites of swimming legs ornamented with 3–4 rows of spinules; (v) genital segment and first abdominal somite both barrel-shaped; and (vi) a caudal ramus projecting into a digitiform process with inconspicuous terminal seta and bearing 3 terminal setae. The obtained DNA sequences of Malagasy species represent the first molecular data for species of Dermoergasilus. The 28S rDNA phylogeny showed the affiliation of D. madagascarensis n. sp. to Ergasilidae and its sister relationship with cosmopolitan Ergasilus sieboldi von Nordmann, 1832. The first checklist for all species of Dermoergasilus is provided.

Predicting future conservation needs can help inform conservation management but is subject to uncertainty. We measured deforestation rates during 2015–2017 for 114 protected areas in Madagascar, linked deforestation to the status of protection according to IUCN categories I–VI, used recent deforestation rates to extrapolate forest cover over 2017–2050 and linked the size of forest blocks to the projected persistence of lemur subpopulations. In the six IUCN categories for protected areas in Madagascar the median size of forest blocks is 9–37 km2 and median annual deforestation rates range from 0.02% in the single IUCN category III site to 0.19% in category II and 1.95% in category VI sites. In 2017, 40% of all forest blocks within protected areas were < 10 km2, and this is projected to increase to 45% in 2050. Apart from these small forest fragments, the modal site of forest blocks was 160–320 km2 in 2017, and this is projected to decrease to 80–160 km2 in 2050. The range of > 50% of all lemur species exclusively contains forest blocks of < 10 km2. The modal size of forest blocks > 10 km2 is predicted to remain at 120 km2 until 2050. Although uncertainty remains, these analyses provide hope that forest blocks within the protected areas of Madagascar will remain large enough to maintain lemur subpopulations for most species until 2050. This should allow sufficient time for the implementation of effective conservation measures.

AbstractTo combat food insecurity in Madagascar, organizations have promoted the Système de Riziculture Intensifiée (SRI), or System of Rice Intensification, an agroecological rice-growing technique. However, despite its many benefits, adoption remains low (and disadoption remains high) in Madagascar. To better understand these dynamics, we use data from two surveys of 328 rice farming households in southeastern Madagascar to conduct an analysis of decisions to adopt SRI, as well as look at the differences between adopters and non-adopters. Results show that despite strong intentions to adopt the technique, actual rates of adoption were lower than expected. Indeed, while 89.8% (n = 291) of respondents stated intention to adopt SRI, only 21.6% (n = 60) had trialed it one year later. Results also indicate that exposure to SRI trainings did not have spill-over effects to “untreated” farmers, as nearly all (95%, n = 57) of the farmers adopting SRI had registered for the training, with the majority (89.5%, n = 51) attending some days of training. Reasons given for not adopting SRI included lack of rice seeds deemed suitable by farmers, as well as insufficient labor, time and other resources. Furthermore, using an integrated Theory of Planned Behavior - Technology Acceptance Model framework and structural equation modeling (SEM), we find that perceived behavioral control, training participation and household assets are significant predictors of adoption. This research is important in efforts to better support uptake of improved agricultural practices among food insecure farming populations. It also fills a gap in the literature regarding SRI adoption among lowland coastal farming populations.