Multimorbidity and mortality trends in the COVID19 syndemic in Madagascar covering 180 diseases 2015 2024
Year: 2025
Type: article
Study design: Observational Study
Abstract: Multimorbidity and mortality shape population health in Madagascar, where chronic and infectious diseases interact across regions. Using surveillance data covering 180 diseases across 22 regions from 2015 to 2024, we quantified geographic disparities, dominant contributors to disease burden, and shifts associated with the COVID-19 syndemic. Stroke was the leading cause of death, with regional case-fatality rates often exceeding 45% and reaching nearly 99% for cardiac arrest in some urban areas. Stroke also showed strong correlations with hypertension (r = 0.97) and diarrhea (r = 0.98), highlighting interconnected vulnerabilities. During the COVID-19 period, overall disease frequency increased by 6.12% on average, though responses varied widely across conditions. Post-lockdown, incidence declined substantially (MRD = -90.17%), and mortality decreased slightly (MRD = -3.93%), yet disparities persisted. Groups with cardiovascular and mental health disorders exhibited the greatest instability. These findings illustrate how interacting epidemics reshape population vulnerability and underscore the importance of integrated strategies to strengthen health-system resilience.
Source: iScience
Authors: Modeste Kameni Nematchoua, Diana Ratsiambakaina, Faratiana Jenny Rasoariseheno, Rija Onintsoa Andriamasinoro, Nivoarimelina Zoly Rakotomalala, Razafindramboho Samoelà Hérédia, Nirina Henintsoa Raveloharimino, Herisitraka Raotoson, Harimbola Fiononantsoa Razaiarilala Rakotovazaha, Alphonsine Mboty Reziky, Rakotoson Mariette, Raphaël Fidelis Randrianarivo, Vohangy Marie Anita Randriamihaja, Hery Henintsoa Randrianirina, Pâquerette Voahirantsoa Razanamiarana, Joseph Michel Razafimahenina, Wabo Gilles Cédric, Gaël Lauricia Lalanirina, Lindsay Kouatie Njonger, Philippe Manjakasoa Randriantsoa, Luc Narda Randrianahasina, Rakotomalala Vololoniana Razafimanalina, Assoumacou Noro Flavia, Larissa Lalatina Randriamialy, Andriarimanana Hery Nirina Rakotoarisoa, Lethicia Lydia Yasmine, Zely Arivelo Randriamanantany
Language: English
Subfield: Health Information Management
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,240
OpenAlex ID: W7115771885