One-year assessment of the cholera epidemic in Madagascar, from March 1999 to march 2000

: The seventh cholera pandemic reached Madagascar in March 1999, 30 years after its appearance in East Africa. Two waves of infection were observed during the first year. The second wave was the stronger of the two. It occurred in the warm rainy season and spread over six provinces of the country. The incidence of cholera was from 0.1% to 2% and the hospital case fatality rate was between less than 2% and 6%, depending on the geographical area and the period. This outbreak has raised the awareness of communities and their leaders with respect to the environmental, practical and cultural factors that increase the risk of diseases transmitted by feces.