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The COVID-19 Epidemic in Madagascar: clinical description and laboratory results of the first wave, March-September 2020
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  • Rindra Randremanana,
  • Soa-Fy Andriamandimby,
  • Jean Marius Rakotondramanga,
  • Norosoa Razanajatovo,
  • Reziky Mangahasimbola,
  • Tsiry Randriambolamanantsoa,
  • Hafaliana Ranaivoson,
  • Harinirina Rabemananjara,
  • Iony Razanajatovo,
  • Richter Razafindratsimandresy,
  • Joelinotahina Rabarison,
  • Cara Brook,
  • Fanjasoa Rakotomanana,
  • Roger Rabetombosoa,
  • Helisoa Razafimanjato,
  • Vida Ahyong,
  • Vololoniaina Raharinosy,
  • Vaomalala Raharimanga,
  • Sandratana Raharinantoanina,
  • Mirella Randrianarisoa,
  • Barivola Bernardson,
  • Laurence Randrianasolo,
  • Léa Randriamampionona,
  • Cristina Tato,
  • Joseph Derisi,
  • Philippe Dussart,
  • Manuela Vololoniaina,
  • Fidiniaina Randriatsarafara,
  • Zely Randriamanantany,
  • Jean-Michel Heraud
Rindra Randremanana
Institut Pasteur de Madagascar

Corresponding Author:rrandrem@pasteur.mg

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Soa-Fy Andriamandimby
Institut Pasteur de Madagascar
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Jean Marius Rakotondramanga
Institut Pasteur de Madagascar
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Norosoa Razanajatovo
Institut Pasteur de Madagascar
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Reziky Mangahasimbola
Institut Pasteur de Madagascar
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Tsiry Randriambolamanantsoa
Institut Pasteur de Madagascar
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Hafaliana Ranaivoson
Institut Pasteur de Madagascar
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Harinirina Rabemananjara
Institut Pasteur de Madagascar
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Iony Razanajatovo
Institut Pasteur de Madagascar
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Richter Razafindratsimandresy
Institut Pasteur de Madagascar
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Joelinotahina Rabarison
Institut Pasteur de Madagascar
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Cara Brook
University of California Berkeley
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Fanjasoa Rakotomanana
Institut Pasteur de Madagascar
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Roger Rabetombosoa
Institut Pasteur de Madagascar
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Helisoa Razafimanjato
Institut Pasteur de Madagascar
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Vida Ahyong
Chan Zuckerberg Biohub
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Vololoniaina Raharinosy
Institut Pasteur de Madagascar
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Vaomalala Raharimanga
Institut Pasteur de Madagascar
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Sandratana Raharinantoanina
Institut Pasteur de Madagascar
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Mirella Randrianarisoa
Institut Pasteur de Madagascar
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Barivola Bernardson
Institut Pasteur de Madagascar
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Laurence Randrianasolo
Institut Pasteur de Madagascar
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Léa Randriamampionona
Government of Madagascar Ministry of Public Health
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Cristina Tato
Chan Zuckerberg Biohub
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Joseph Derisi
Chan Zuckerberg Biohub
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Philippe Dussart
Institut Pasteur de Madagascar
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Manuela Vololoniaina
Government of Madagascar Ministry of Public Health
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Fidiniaina Randriatsarafara
Government of Madagascar Ministry of Public Health
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Zely Randriamanantany
Government of Madagascar Ministry of Public Health
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Jean-Michel Heraud
Institut Pasteur de Madagascar
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Abstract

Background: Following the first detection of SARS-CoV-2 in passengers arriving from Europe on 19 March 2020, Madagascar took several mitigation measures to limit the spread of the virus in the country. Methods: Nasopharyngeal and/or oropharyngeal swabs were collected from travellers to Madagascar, suspected SARS-CoV-2 cases, and contact of confirmed cases. Swabs were tested at the national reference laboratory using real-time RT-PVR. Data collected from patients were entered in an electronic database for subsequent statistical analysis. All distribution of laboratory confirmed cases were mapped and six genomes of viruses were fully sequenced. Results: Overall, 26,415 individuals were tested for SARS-CoV-2 between 18 March and 18 September 2020, of whom 21.0% (5,553/26,145) returned positive. Among laboratory-confirmed SARS-CoV-2 positive patients, the median age was 39 years (CI95%: 28-52), 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: 1.9-2.5] for individuals aged 49 years and more. Viral strains sequenced belong to clades 19A, 20A, and 20B in favour of several independent introduction of viruses. Conclusions. Our study describes the first wave of the COVID-19 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.
27 Dec 2020Submitted to Influenza and other respiratory viruses
04 Jan 2021Submission Checks Completed
04 Jan 2021Assigned to Editor
17 Jan 2021Editorial Decision: Revise Minor
25 Jan 20211st Revision Received
27 Jan 2021Submission Checks Completed
27 Jan 2021Assigned to Editor
29 Jan 2021Editorial Decision: Accept