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. 2025 Jul 8;15(1):95.
doi: 10.1007/s44197-025-00392-z.

What are the Main Diagnoses in Hospitalized Patients in Madagascar ? A Sentinel Surveillance in 18 Hospitals from 2014 to 2018

Laurence Randrianasolo  1 , Tojonirina Rabehasimbola  2 , Léa Randriamampionona  3 , Mireille Randria  3 , Toky Ramarokoto  2 , Barivola Bernardson  2 , Feno Manitra Rakotoarimanana  2 , Maherisoa Ratsitorahina  2 , Roland Razanatsimba Andriamasoandro  3 , Hasina Alain Randimbitsialonina  3 , Hajalalaina Razafindrazaka  3 , Jery Soa Bakolitiana Rafaliarisoa  3 , Nirinarilala Ramanantoanina  3 , Haja Randrianary  3 , Solofinirina Rakotonimanana  3 , Gisèle Ranarijaona  3 , Giovanie Djaosany  3 , Ramananarivo Rasoamirantsoa  3 , Jacqueline Rasolofoharizanany  3 , Iharisoa Ravaonandrasana  3 , Delbert Radama Andriamanjava  3 , Liva Fanambinantsoa  3 , Victor Ralijaona  3 , Prosper Randrianasolo  3 , Randrianavelo  3 , Jaona Ralaivao  3 , Noelson Rakotovao  3 , Nyelsen Amaïde Tsikomia  3 , Antoine Olivier Randrianantenaina  3 , Jean Erick Botoihely  3 , Stéphan Pierre  3 , Aimé Bruno Zafilahy Totohako  3 , Claude Marcel Andrianantenaina  3 , Patrice Piola  2 , Laurence Baril  2 , Anou Dreyfus  4   5 , Rindra Randremanana  2
Affiliations

What are the Main Diagnoses in Hospitalized Patients in Madagascar ? A Sentinel Surveillance in 18 Hospitals from 2014 to 2018

Laurence Randrianasolo et al. J Epidemiol Glob Health. .

Abstract

Background: In Madagascar, a sentinel surveillance system was set up in 18 hospitals since 2014 and was managed by the Ministry of Public Health and the Institut Pasteur de Madagascar. In order to improve the access to appropriate health care in Madagascar, the main clinical diagnoses in hospitalized patients were analyzed.

Methods: At hospitalization of a patient, each unit involved in the sentinel surveillance recorded the clinical diagnosis through an e-health platform. Data from September 2014 to July 2018 were analyzed. Morbidity and annual incidence of diseases according to ICD-10 were reported.

Results: A total of 140,789 inpatients information was recorded. The median age was 28.2 years (IQR: 18.3; 45.3). 21.6% of the children < 15 years suffered from communicable diseases. The hospital morbidity was 4.01% for malaria, 0.84% for tuberculosis, 0.09% for HIV/AIDS and 0.05% for plague. The hospital morbidity of non-communicable diseases was higher compared to communicable diseases with 7.8%, 7.1% and 3.1% for "Diseases of the circulatory system", "Injury, poisoning and certain other consequences of external causes" and "Mental and behavioural disorders", respectively. "Pregnancy, childbirth and puerperium" represented 20.5% of the hospitalized patients.

Conclusions: The e-health platform enabled continuous and standardized data collection. Communicable diseases affect mainly children < 15 years. Non-communicable diseases are on the rise and need more attention by national health authorities. A number of hospitalizations could be prevented by a better health care management at the community-based health care level and by implementation of a Universal Health Coverage (UHC) in Madagascar.

Keywords: Communicable diseases; Hospital sentinel network; Madagascar; Non-communicable diseases; Web-based database; e-Health platform.

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Conflict of interest statement

Declarations. Conflict of Interest: The authors declare no competing interests. Ethical Approval and Consent to Participate: Data were collected within the activities of the national public health surveillance systems in Madagascar. All methods were carried out in accordance with relevant guidelines and regulations of the Ethical Review Committee of Biomedical Research in Madagascar. Anonymized data was collected using a line list developed for the hospitalization registration. The line list was available in the hospital centers. The patient's information was recorded on the line list. The use of the data collected in patients hospitalized in these hospitals participating in sentinel surveillance was exempted from ethical review of human subject research by the Ethical Review Committee of Biomedical Research in Madagascar (letter N° 111MSANP/SG/AMM/CERBM on May 26th, 2023). Consent for Publication: All authors consent to the publication of this article.

Figures

Fig. 1
Fig. 1
Geographical location of the 18 sentinel hospital, Madagascar, 2014–2018. CHRD: District reference hospitals. CHRR: Regional reference hospitals. CHU: University-based hospitals
See this image and copyright information in PMC

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