Madagascar: Humanitarian Snapshot (August to November 2018)

Originally published



There are currently some 1.26 million people estimated to be severely food insecure in the Grand Sud and Grand Sud-Est regions of Madagascar. This number is projected to decrease to about 1.2 million between November 2018 and March 2019, according to the results of the Integrated Phase Classification food insecurity analysis conducted in October 2018. The slight improvement in food security is attributed to a multisectorial humanitarian response.
However, the situation continues to be critical in the Grand Sud with about 256,750 people likely to face Emergency food insecurity (IPC phase 4), and nearly 631,900 people expected to be in Crisis (IPC phase 3) as the area has not been able to recover from the drought effect of the El Nino in 2016 and has received below average rainfall during the 2017-2018 agricultural season unlike the rest of the country. As a result, according to the Inter-cluster multi-sector assessment conducted in October in Beloha district, many households are selling livestock in higher numbers and at lower prices than usual affecting their ability to pay for and access basic services including school fees and potable water.

According to a newly piloted Nutrition Surveillance System, 20,234 children are acutely malnourished in the drought-prone districts. 1,419 of these children suffer from severe acute malnutrition. The nutrition cluster has strengthened the management of GAM services in the pockets of malnutrition, increasing the number of mobile teams to reach children in remote villages and providing continuous nutrition supplies in health facilities and community nutrition sites.

Early action is urgently required to avert a greater loss of life due to the plague outbreak ahead of an expected seasonal peak between November 2018 to March 2019. The timing also coincides with a Presidential elections period of October-December which will significantly increases the risk of transmission due to daily meetings of large crowds in all major cities in the country. A number of pneumonic cases have already been recorded in several districts close to the Capital and Pneumonic plague is highly transmissible (person-to-person) and can quickly cause death in the absence of treatment.
Since 19 August the cumulative number of confirmed and suspected cases in the country is higher than the average and the maximum of 2012-2016. From August to 05 November 2018, a total of 106 cases of plague have been reported, in 23 out of 114 districts in the country; out of which, 36 are confirmed in 12 districts and 8 regions. To date, 9 deaths (case fatality rate 9.4%) have been registered, among which 6 cases were pneumonic and 4 of bubonic form. It is important to note that all of these deaths occurred in the community, highlighting weaknesses in the early warning system and low community awareness, both of which increase the risk of the outbreak spreading.

Since 3 October 2018, a measles outbreak has been reported in 4 regions and 8 districts, including 4 urban districts of Antananarivo. To date, a total of 1, 662 cases have been reported among which 79 are confirmed. No death has been reported so far. According to surveillance reports, 80% of cases are among children between 1-14 years. Given immunization rate of only 58%, there is a risk of a wider spread of the outbreak. WHO/UNICEF continue to support the MoH to mobilize resources to undertake emergency vaccinations in 4 affected urban districts and high risk districts.

UN Office for the Coordination of Humanitarian Affairs
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