Les maladies diarrhéiques demeurent une cause majeure de mortalité infantile dans les pays en développement (PED). Du fait de l'insuffisance des plateaux techniques, les diagnostics étiologiques sont rarement réalisés et les traitements sont alors probabilistes. A Madagascar les données sur les diarrhées sont souvent parcellaires et anciennes. Le Réseau de surveillance sentinelle développé par l'Institut Pasteur de Madagascar à partir de 2007 nous a permis d'étudier la distribution spatio-temporelle des consultations pour diarrhée. Mais cette surveillance syndromique n'est pas couplée systématiquement à une surveillance biologique. Pour étudier les agents étiologiques des diarrhées, nous avons réalisé une enquête cas-témoins menée en 2008-2009 en milieu communautaire, chez les enfants de moins de 5 ans dans 14 districts. Nous avons pu identifier au moins un pathogène chez plus de la moitié des enfants (55%), avec une prédominance des étiologies parasitaires (37,2% des diarrhées), suivies par les bactéries (15%) puis les virus (6,7% de rotavirus). Les parasites ont été les seules étiologies pour lesquelles une pathogénicité a pu être mise en évidence. Parmi les étiologies bactériennes, l'infection à Campylobacter a été la plus fréquente (9,5%). Pour analyser le rôle de Campylobacter et les effets des facteurs environnementaux dans la survenue des diarrhées infantiles, nous avons initié et coordonné depuis 2010 une étude de cohorte dynamique d'enfants inclus avant l'âge de 24 mois et suivis jusqu'à l'âge de 36 mois à Moramanga, site où la prévalence de Campylobacter a été la plus élevée au cours de l'étude de 2008 (20,6%). Une surveillance des diarrhées a été menée 2 fois par semaine et les portages asymptomatiques évalués à l'inclusion et tous les 2 mois. Une étude de portage familial a été mise en œuvre ainsi qu'un suivi coprologique bi-annuel de la population avicole, des points d'eaux collectifs et de l'eau de boisson des familles. La recherche de Campylobacter chez les volailles portait sur les écouvillonnages rectaux. De janvier 2010 à mai 2012, 508 enfants correspondant à 256 346 enfant-jour ont participé à l'étude. La prévalence globale d'isolement de Campylobacter a été de 9,3%. Plus de 2/5 des enfants (43,3%) ont eu au moins un épisode d'infection à Campylobacter au cours de leur suivi. Les taux d'incidence annuelle des diarrhées ainsi que des infections symptomatiques ont été faibles, respectivement de 0,7 épisode /enfant et de 5,8 épisodes/100 enfant pouvant s'expliquer par le faible niveau d'exposition environnementale des enfants. Nous avons pu étudier l'importance des facteurs liés à l'hôte comme l'âge. Le pic d'infection à Campylobacter se situe entre 18 à 29 mois, celui des diarrhées entre 6 à 11 mois puis diminue ensuite. La 1ère infection à Campylobacter a été toujours pathogène chez les plus jeunes. Elle se situe vers le 8ème mois de la vie pour 10% d'entre eux. Les réinfections se font à des distances différentes de l'événement initial en fonction de l'âge. Ce profil d'infection pourrait traduire une compétence immunitaire différente selon l'âge et/ou une immunité acquise au cours du temps suite aux expositions répétées des enfants. L'environnement pourrait avoir un effet indirect dans l'entretien d'une immunité protectrice s'exprimant par un taux élevé d'infection asymptomatique. Il apparaît nécessaire de poursuivre des études de cohorte dans des zones à plus fort risque de transmission avec des données immunologiques car la compréhension actuelle des interactions entre l'hôte, le Campylobacter et l'environnement ne permet pas d'expliquer la variabilité de l'expression clinique de l'infection. / Diarrheal diseases remain a major cause of infant mortality in developing countries (DCs). Due to the lack of technical platforms, the etiologic diagnoses are rarely made and treatments are then probabilistic. In Madagascar data on diarrhea are often fragmented and old. The sentinel surveillance network developed by the Institut Pasteur of Madagascar from 2007 allowed us to study the spatial and temporal distribution of consultations for diarrhea. But this syndromic surveillance cannot be coupled to biological monitoring for many diseases. In this context, we have no information on the causative agents of diarrhea. To achieve the coupling of syndromic and etiologic data, we performed a case-control study conducted in 2008-2009 in children less than 5 years in 14 districts. We have identified at least one pathogen in more than half of the children (55%), with a predominance of parasitic etiologies (37.2% diarrhea), followed by bacteria (15%) and viruses (6.7% rotavirus). Parasites were the only etiologies for which pathogenicity has been demonstrated. Among the bacterial etiologies, Campylobacter infection was the most common (9.5%). To better understand the role of Campylobacter in the occurrence of diarrhea in children and analyze the effect of environmental factors, we initiated and coordinated a dynamical cohort study including of children before the age of 24 months and followed up till the age of 36 months in Moramanga site, where the prevalence of Campylobacter was highest during the 2008 study (20.6%). Diarrhea surveillance was conducted two times per week and asymptomatic carriers assessed at baseline and every 2 months. A family study has been implemented and bi-annual stool follow-up in poultry population, water points and community drinking water for families. Campylobacter monitoring in poultry focused on rectal swabs. From January 2010 to May 2012, 508 children - corresponding to 256,346 child days -participated in the study. The overall prevalence of Campylobacter isolation was 9.3%. More than two fifths of children (43.3%) had at least one episode of Campylobacter during follow-up. The annual incidence of diarrhea and symptomatic infections were low, respectively 0.7 episodes / child and 5.8 episodes /100 children, can be explained by the low level of environmental exposure of children. We have studied the role of host factors such as age. The peak of Campylobacter infection is between 18 to 29 months, the diarrhea between 6 to 11 months then decreases. The first Campylobacter infection was always pathogen in the youngest children. It happens to the eighth month of life for 10% of them. Reinfections are at different distances from the initial event according to the age. This pattern of infection may reflect a variation of the immune competence according the age and / or acquired immunity over time after repeated exposure of the children. The local environment may have an indirect impact on maintaining protective immunity expressed by a high rate of asymptomatic infection. However, it is necessary to continue cohort study with immunologic data in a high risk transmission area as the current understanding of the interactions between the host, the environment and Campylobacter does not explain the variability of the clinical expression of infection.

No description available.

M.A. (Politics) / This study examines the four democratic elections that have been held in Malawi, Zambia, South Africa and Madagascar in order to establish whether there has been an improvement in the quality of elections over the years, to ascertain the challenges faced in each country, and to determine the possible implications for the future of democracy in each of the countries. The criteria according to which elections are assessed in the SADC region guided the investigation. These are the PEMMO standards which, in contrast to a reliance on generalised terms such as „free and fair‟, offer practical guidelines on establishing progress in the electoral process, as well as the SADC-PF and SADC standards. The discussion has been structured along the lines of the three phases of the electoral process, namely, the pre-election period, the election period, and the post-election period, each with its own set of indicators to be met. The study finds that despite the minimal achievements, the overall management of the electoral processes in Malawi, Zambia and Madagascar has stagnated over the years. The institutional and legal framework is one of the major areas that need improvement in Malawi. The Malawi Electoral Commission (MEC), which was charged with the responsibility of organising the various elections, experienced enormous difficulties in establishing a level playing field as well as in exercising its full mandate. Other problem areas include the voter registration process, the use of state resources by the incumbent party, and the acceptance of the electoral outcome by some opposition leaders. In the case of Zambia, the procedure for the appointment of members of the Electoral Commission of Zambia (ECZ) undermines the independence of this body. The other difficult aspects (as in the case of Malawi) are the lack of public funding of political parties, the use of state resources by the ruling party, biased media access and coverage for the ruling party, and the acceptance of election results by some of the opposition parties. The inadequate training of the electoral staff has also been a major contributing factor to these challenges. In contrast to the abovementioned countries (including South Africa), the legal framework in Madagascar did not provide for the establishment of an independent electoral management body. Consequently, the various elections resulted in recurrent shortcomings in the voter registration process, the use of state resources, and the management of election material. However, despite the above bleak picture regarding the elections in Malawi, Zambia and Madagascar, there were some marginal improvements in the conduct of the elections over the years. The polling and counting exercises in Malawi, for instance, proved to be generally well-managed by the fourth election. Similarly, the Zambian elections over the years have improved in terms of the voter registration process, and the decrease in acts of political violence and intimidation. In Madagascar the campaign periods were generally peaceful. However, the government has since been overthrown in a coup d’état in 2009. In contrast with Malawi, Zambia and Madagascar, the four elections in South Africa have been of a high standard, notwithstanding the few flaws, particularly during the first elections in 1994. The independence and credibility of the Independent Electoral Commission (IEC) over the years, as well as its continuation of members for all the elections, have among other reasons, contributed to the high standard of elections in the country. The continuous significant flaws in the elections in Malawi and Zambia pose a serious problem for the advancement of democracy in these countries. In other words, if the basic requirements of democracy – that is "free and fair" elections – are not met it does not bode well for the democratic future of these countries. The legitimacy of the elections and that of the resultant governments can be undermined, as has since been illustrated in the instance of Madagascar. The case of South Africa demonstrates the direct link between the "freeness" and "fairness" of elections and the extent to which its political system is labelled a democracy.

Magister Educationis - MEd / The objective of this research was to investigate the relationships between the political change and the access policy changes in Madagascar since independence. In this study qualitative and quantitative data were used. The qualitative research consisted of eleven in-depth interviews and the collection of policy documents from 1960 to 2008. Open-ended questionnaires were utilized to collect data and to achieve the objectives of the research. Policy documents were analyzed to identify government policy changes. The main findings from the research showed that access policy changed with each major change in political leadership. Four major political periods and four respective main access policy changes were identified from 1960 to 2008. Higher education policy in general changed when there was a major change in presidential leadership. The main conclusions of this study were that access policy changes were the result of major changes in presidential leadership and that in spite of rhetoric to the contrary, universities did not have the autonomy to resist changes in access policy because of the top-down state system and the institutional financial dependence on the national government. / South Africa

Dissertation (LLM)--University of Pretoria, 2013 / gm2015 / Centre for Human Rights / LLM / Unrestricted

The play, Madagascar Mayhem, was devised as a means of developing ecological understanding about rain forest preservation and educating and expanding upon the use of drama as it relates to environmental education. By being involved in and learning about issues addressed in the play's content, students learned about how their actions may have a positive impact on rain forest preservation, the biodiversity of Madagascar, its agricultural loss and the movement to protect it.

The seagrass extent has been declining globally. The human activities that are most likely to cause seagrass loss are those which affect the water quality and clarity. However, turbidity following coastal erosion is often left out from marine ecosystem vulnerability indices. This study quantified the coastal erosion for Tsimipaika Bay in northwestern Madagascar by using change detection analysis of satellite imageries. The annual coastal erosion data was then used to create an index for seagrass vulnerability to turbidity following coastal erosion. Considering that the height of seagrass species plays an important role in their survival following turbidity, the seagrass vulnerability index (SVI) was based on two factors; seagrass species height and their distance to the nearest possible erosion place. The results for the coastal erosion showed that the amount of erosion was particularly high in 1996, 2001 and 2009 for Tsimipaika Bay. The highest erosion occurred in 2001 with a land loss area of about 6.2 km2 . The SVI maps revealed that 40% of the seagrass communities had minimum mean SVI values in 2001 and 50% had the maximum mean SVI during the year 2009. This study showed that it is possible to use coastal erosion to measure seagrass vulnerability; however, the index requires configuration such as including the total amount of annual coastal erosion and incorporating bathymetric data. The entire project was built and automated in Jupyter Notebook using Python programming language, which creates a ground for future studies to develop and modify the project.

Over the last 2000 years, climatic and anthropogenic factors have influenced vegetation in Madagascar, but the contribution of these two factors has been the subject of intense debate, a debate hampered by the scarcity of palaeoecological studies on the island. Southwest Madagascar is semi-arid and comprises fragmented tropical dry forests where human subsistence strategies are diverse. Therefore, it provides a perfect setting to generate new palaeoecological records and investigate vegetation response to changes in human land-use and rainfall variability. The aim of this thesis is to understand how and when land-use changed, and rainfall variability impacted the landscape in the southwest region, using dendroclimatological and palaeoecological approaches. Carbon isotopes in the rings of four baobab trees (Adansonia spp.), were compared with pre-existing palaeoclimate data to produce rainfall records for the past 1700 years. Pollen, carbon isotopes, and charcoal in sediment cores from two lakes namely Lake Longiza and Lake Tsizavatsy (located in the northern and southern sites respectively in southwest Madagascar) were analysed to produce vegetation and fire records during the late Holocene in the region. Combination of the four baobab isotope records yields a new 700-year record for the southwest, which suggests an aridity trend over time, associated with a long-term reduction and increase in the duration of wet and dry periods respectively. Drying was more pronounced for the southern site than the northern site. A comparison with a high-resolution record from the northwest region allowed the rainfall of the southwest to be extended back to the last 1700 years as follows: from AD 300-500, the southwest region experienced a dry period which was followed by a wet period until AD 1000. Subsequently, there was a dry period from AD 1000-1250, followed by a wet period in the southwest. The period from AD 1300-1400 represented the wettest period in the record, followed by a decreasing wet period until AD 1600. The period between AD 1600 and 1800 represented the driest period, peaking around AD 1700. This was followed by a relatively wet period of about 50 years and another 100-year dry period. The last period assessed, from AD 1985 to 2000, was a relatively wet period. Such variability of the rainfall might have affected ecosystems and human land-use in the region. The tropical dry forest biome of southwest Madagascar has taxa from the dry forest, riparian forest and savanna woodland in the pollen records of both sites. In the core from the northern site (Lake Longiza), the pollen record suggests a heterogeneous mosaic of dry forest and riparian forest that was present over the last 2400 years. In the earliest part of the record, the community was dominated by trees from both the dry forest and riparian ecosystems. The onset of changes was recorded around AD 420, with a decrease in dry forest and riparian trees and an increase in grasses and xerophytics, possibly driven by dry conditions. This was followed by a short recovery of trees and C3 plants around AD 870 punctuated by a decrease in dry forest taxa around AD 980, possibly associated with the suggested expansion of pastoralism. After this period, the landscape became more open and grassier, as indicated by the dominance of C4 plants in the stable isotope record. Similar patterns of change in the pollen record, with a further increase in grasses and pioneer taxa, were recorded around AD 1900. Charcoal influx also started to increase drastically at this time, suggesting fire and forest clearance associated with a shift to agriculture. These large shifts in human land-use (probably a combination of both pastoralism and agriculture) coincided with the decline of floral diversity of the landscape, as indicated by pollen rarefaction. However, the diversity of the floral community gradually recovered, because of the persistent heterogeneity of the landscape. The core from the southern site (Lake Tsizavatsy) had a basal date of approximately 700 years BP but presented a hiatus of about 500 years from AD 1420-1910. The preceding period of AD 1300-1420 was marked by a decrease in the abundance of trees during the wettest period in the region, which was most likely because of human activities (foraging and pastoralism), as inferred by the increase in charcoal influx and pioneer taxa. During the second period, from AD 1910- 2010, there was an increase in xerophytic taxa, which suggests a long dry climate, recorded prior to this period. In addition, from AD 1950, trees decreased while pioneer taxa increased, despite the stable influx of charcoal recorded during this period. This possibly indicates the effect of human activities that did not involve the use of fire, probably conducted by ethnicities other than the forager communities, which are still present in the area today. This thesis contributes significantly to the understanding of palaeoclimate, palaeoecology and the history of human subsistence in a biodiverse region of Madagascar, where no other record is currently available. Results from stable isotope analysis from baobabs showed a drying trend over the past 700 years, which has interacted with land-use to affect vegetation structure and composition over time. The pollen and charcoal results suggest the northern site, where vegetation was a mosaic of dry forest and riparian forest, experienced an impact of human activities through a shift to agriculture especially in the last 100 years. The savanna woodland of the southern site, however, was less affected by humans, probably as occupants were subsistence foragers, but the vegetation had a higher response to aridity. The results show that two distinctive human subsistence (pastoralism and foraging) were present simultaneously in the region until modern times. The northern site has evolved possibly from foraging into extensive agriculture, probably related to the fertility of the alluvial soil in the area, while the southern community remained dominated by foragers, while adopting today a seasonal practice of agriculture. From a conservation perspective, strategies of conservation for each ecosystem investigated here are proposed. In the northern site, monitoring and reducing fire-use within the dry forest ecosystem would allow tree recovery. In addition, restoring and establishing protected areas within the riparian forest would allow these ecosystems to act as refugia for regional biodiversity. Such measures will likely reduce the pressure on these ecosystems, where agriculture is a threat due to the availability of both water and fertile soil in their surroundings. Alternative livelihoods are required for the northern populace, for example through the exploitation of invasive aquatic plants such as Typha, which can be used in making of handcrafted artefacts, to reduce pressure on forest ecosystems through agricultural practices. For the southern site, maintaining the resilience of the savanna woodland through reforestation of functional species is also important to allow sustainability of services provided by these ecosystems. These strategies are applicable locally for Madagascar and for worldwide tropical dry forests, one of the globally most threatened vegetation types due to anthropogenic pressure and climate change.

Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents' tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13-15 years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors.Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females' tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents' tobacco use.

Background: The tobacco industry has globalized and tobacco use continues to increase in low- and middle-income countries. Yet, the data and research to inform policy initiatives for addressing this phenomenon is sparse. This study aims to estimate the prevalence of adult tobacco use in 17 Sub-Saharan Africa (SSA) countries, and to identify key factors associated with adult tobacco consumption choices (smoked, smokeless tobacco and dual use) in Madagascar. Methods. We used Demographic Health Survey for estimating tobacco use prevalence among adults in SSA. A multinomial logistic regression model was used to identify key determinants of adult tobacco consumption choices in Madagascar. Results: While differences in tobacco use exist in SSA, Madagascar has exceptionally higher prevalence rates (48.9% of males; 10.3% of females). The regression analyses showed complexity of tobacco use in Madagascar and identified age, education, wealth, employment, marriage, religion and place of residence as factors significantly associated with the choice of tobacco use among males, while age, wealth, and employment were significantly associated with that of females. The effects, however, differ across the three choices of tobacco use compared to non-use. Conclusions: Tobacco use in Madagascar was higher than the other 16 SSA countries. Although the government continues to enact policies to address the problem, there is a need for effective implementation and enforcement. There is also the need for health education to modify social norms and denormalize tobacco use.