• WEEKLY EPIDEMIOLOGICAL RECORD, No. 43, 25 OCTOBER 1996 RELEVÉ ÉPIDÉMIOLOGIQUE HEBDOMADAIRE, No 43, 25 OCTOBRE 1996 bility of coinfection with more than one agent should be puyer sur les examens cliniques et les examens de laboratoire qui considered. Early stages of LD usually are treated with permettent de différencier toutes ces affections et évoquer la possi- amoxicillin or doxycycline; the treatments of choice for bilité d’une co-infection par d’autres agents pathogènes. Aux pre- ehrlichiosis and babesiosis are tetracyclines and clindamy- miers stades, on traite généralement la maladie de Lyme par cin/quinine, respectively. l’amoxicilline ou la doxycycline; dans le cas de l’ehrlichiose et de la babésiose, le traitement de choix repose respectivement sur les tétracyclines et la clindamycine associée à la quinine. Participants in the Second National Conference on the Les participants à la Deuxième Conférence nationale sur le Serologic Diagnosis of Lyme Disease (October 1994) re- diagnostic sérologique de la maladie de Lyme (octobre 1994) ont commended that laboratories use a 2-test approach for the recommandé de pratiquer 2 épreuves pour le diagnostic sérologi- serological diagnosis of LD. Specimens should be tested que de la maladie de Lyme. On commencera par soumettre les first by using the more sensitive enzyme-linked immuno- échantillons à des épreuves plus sensibles comme le test immuno- sorbent assay (ELISA) or indirect immunofluorescence enzymatique ELISA ou l’immunofluorescence indirecte. Les assay (IFA). Specimens that are positive or equivocal then échantillons positifs ou douteux seront ensuite soumis à un Wes- should be tested with the more specific IgG and IgM tern blot (IgG et IgM), plus spécifique. Comme la sensibilité et la Western blot (WB). Because sensitivity and specificity of spécificité des méthodes ELISA et Western blot peuvent varier the ELISA and WB vary in relation to the timing of speci- selon le moment où le prélèvement a été effectué, l’interprétation men acquisition, clinical and exposure histories must be des examens sérologiques doit se faire en tenant compte de l’exa- considered in the interpretation of serological results. men clinique et des antécédents d’exposition. (Based on: Morbidity and Mortality Weekly Report, Vol. 45, (D’après: Morbidity and Mortality Weekly Report, Vol. 45, No 43, No. 43, 1996; US Centers for Disease Control and Pre- 1996; US Centers for Disease Control and Prevention.) vention.)

Monkeypox Orthopoxvirose simienne Zaire. Monkeypox virus has been isolated from one of the Zaïre. L’orthopoxvirus simien a été isolé d’un des cas étudiés cases investigated in an outbreak reported in Katako- durant une flambée signalée à Katako-Kombe, dans la sous-région Kombe in the Sankuru Sub-region of Kasai Oriental de Sankuru, Région du Kasaï oriental en juillet et août 1996. Les Region during July and August 1996. The first cases oc- premiers cas s’étaient produits à la mi-février 1996, mais la flambée curred in mid-February 1996, but the outbreak was not n’est devenue apparente et n’a été signalée qu’à la fin juillet, apparent and reported until the end of July when more d’autres personnes ayant été infectées. Au 30 août, 71 cas, dont people became infected. Seventy-one cases, of which 6 mortels, avaient été signalés dans 13 villages (15 698 habitants 6 were fatal, had been reported in 13 villages (total popu- au total). Depuis lors, la flambée a décliné. Des échantillons ont été lation of 15 698) up to 30 August. The outbreak has since recueillis par le Ministère de la Santé et Médecins sans Frontières declined. Specimens were collected by the Ministry of et ont été envoyés au Centre collaborateur OMS pour la variole et Health and Médecins sans Frontières and were forwarded to les autres poxviroses aux Centers for Disease Control and Prevention, the WHO Collaborating Centre for Smallpox and other Atlanta, Géorgie, Etats-Unis d’Amérique, pour confirmation au Poxvirus Infections at the Centers for Disease Control and laboratoire. Les enquêtes ont indiqué la présence d’une ortho- Prevention, Atlanta, Georgia, United States of America for poxvirose dans tous les sérums disponibles, et l’orthopoxvirus laboratory confirmation. The investigations showed evi- simien a été isolé d’un patient sur 2 sujets encore malades au dence of orthopoxvirus infection in all sera available and moment du recueil des échantillons en septembre 1996. monkeypox virus was isolated from 1 of the 2 patients still ill when the specimens were collected in September 1996.

Influenza Grippe Canada (22 October 1996). A confirmed case of in- Canada (22 octobre 1996). Un cas confirmé de grippe A a été fluenza A was reported by the area and city of Québec in signalé par la région et la ville de Québec au cours de la deuxième the second week of October 1996. It was the first case of semaine d’octobre 1996. Il s’agit du premier cas de grippe enregis- influenza reported in the 1996-1997 season. tré pour la saison 1996-1997.

Infected areas as at 24 October 1996 Zones infectées au 24 octobre 1996 For criteria used in compiling this list, see No. 24, 1996, p. 188. Les critères appliqués pour la compilation de cette liste sont publiés dans le No 24, 1996, p. 188. X - Newly reported areas X - Nouvelles zones signalées

••• Arivonimamo S. Préf Ambohimahasoa S. Préf. Manandriana S. Préf. Zimbabwe Plague Peste Betafo S. Préf. Manandroy District Mahajanga Province Matabeleland North • Alakamisy-Anativato District Ambositra S. Préf. Toamasina Province Lupane District Africa Afrique Fanandriana S. Préf. Moramanga S. Préf. Madagascar Ambatomarina District Nkayi District Faratsiho S. Préf. Ambohimahazo District Antananarivo Province Manjakandriana S. Préf. Mozambique • Ambohidratrimo S. Préf. Ambovombe Centre America Amérique Miarinarivo S. Préf. Andina District Tete Province Bolivia - Bolivie Antananarivo-Avaradrano S. Préf. Analavory District Anjoma N’Ankona District Mutarara District La Paz Department Ambatolampy S. Préf. Anosibe Ifanja District Anjozorobe S. Préf. Anjomà Navona District Tanzania, United Rep. of Franz Tamayo Province Renivohitra S. Préf. Ankazoambo District Tanzanie, Rép.-Unie de Sud Yungas Province Antananarivo S. Préf. Soavinandriana S. Préf. Antananarivo District Ivato District Tanga Region Valle Grande Province Ambatoasana Centre Ivony District Antanifotsy S. Préf. Tsiroanomandidy S. Préf Lushoto District Brazil ••• Brésil Antsirabe I S. Préf. Antsiranana Province Talata-Vohimena District Tanga District Bahia State Tsarasaotra District Antsirabe II S. Préf. Andapa S. Préf. Uganda ••• Ouganda Biritinga Municipio Ambodiala District Doany District Fandriana S. Préf. Candeal Municipio Fiadanana District Western Region Ambohitsimanova District Fianarantsoa Province Nebbi District Central Municipio Ampasatanety District Ambatofinandrahana S. Préf. Fianarantsoa I. S. Préf. Conceição Municipio Manandona District Ambondromisotra District Mahatsinjo District Zaire ••• Zaïre Feira de Santana Municipio Soanindrariny District Andrefambohitra District Fianarantsoa II. S. Préf. Haut Zaïre Province Iraquara Municipio Tsarofar District Bevonotany District Andoharanomaitso District Ituri Sub-Region Irecê Municipio Vinaninkarena District Soaniherenana District Fianarantsoa II District Mahagi Administrative Zone Itaberaba Municipio

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Jussara Municipio Sal Island – Ile de Sal Ogun State Brazil • Brésil Cortes Department Retirolândia Municipio Santiago Island – Ile de Santiago Ondo State Acre State El Paraiso Department Riachão do Jacuipe Municipio São Nicolau Island – Ile de São Oyo State Alagoas State Francisco Morazan Department Senhor do Bonfim Municipio Nicolau Plateau State Amapá State Omoa State Serrinha Municipio São Vicente Island – Ile de São Rivers State Amazonas State Santa Barbara Department Teofilandía Municipio Vicente Sokoto State Bahia State Valle Department Paraiba State • Taraba State Ceará State Yoro Department Araba Municipio Chad Tchad Yobe State Batha Préfecture Distrito Federal State Mexico • Mexique Barra de S. Rosa Municipio Rwanda Espírito Santo State Cubati Municipio Bet Préfecture Campeche State Biltine Préfecture Cyangugu Préfecture Maranhão State Chiapas State Olivedos Municipio Mato Grosso State Chari Baguirmi Préfecture Gisenyi Préfecture Chihuahua State Queimadas Municipio Minas Gerais State Remigio Municipio Guera Préfecture Sao Tome and Principe Colima State Kanem Préfecture Pará State Distrito federal Solânea Municipio São Tomé-et-Principe Paraíba State Lac Préfecture Lemba District Guanajuato State Peru • Pérou Logone Occidental Préfecture Paraná State Guerrero State São Tomé Pernambuco State Cajamarca Department Logone Oriental Préfecture Hidalgo State Piaui State Chota Province Njamena Préfecture Senegal • Sénégal Jalisco State Llama District Ouaddaï Préfecture Région de Dakar Rio de Janeiro State Mexico State Rio Grande do Norte State Miracosta District Tandjile Préfecture Département de Dakar Michoacan State Tocmoche District Département de Pikine Rondônia State Morelos State Côte d’Ivoire San Miguel Province Département de Rufisque São Paulo State Neuvo León State Nanchoc District Département du Centre Région de Diourbel Sergipe State Oaxaca State San Gregorio District Bouaké District Département de Louga Colombia • Colombie Puebla State San Miguel District Département du Nord Département de Mbacke Amazonas Department Querétaro State San Pablo Province Touba Sous-Préfecture Département de Touba Antioquia Department Quintana Roo State San Louis District Département de l’Ouest Région de Fleuve Atlantico Department San Luis Potosi State La Libertad Department Giuglo District Département de St.-Louis Bolivar Department Sonora State (Area not specified – Zone non Man Sous-Préfecture Région de Thiès Boyaca Department Tabasco State précisée) Département du Sud Département de Thiès Caldas Department Tamaulipas State Lambayeque Department Tabou District Région de Siné-Saloum Caqueta Intendency Tlaxcala State (Area not specified – Zone non Djibouti Département de Fatick Cauca Department Veracruz State précisée) Sierra Leone Cesar Department Yucatan State Piura Department Ghana Choco Department Zacateca State Ayabaca Province Accra Region Northern Province Kambia District Cordoba Department Nicaragua Canales District Accra District Cundinamarca Department Lagunas District Greater Accra District Western Province Boaco Department Freetown Guajira Department Montero District Ashanti Region Huila Department Carazo Department Paimas District Central Region Somalia • Somalie Magdalena Department Chinandega Department Sapillica District Eastern Region Baidoa District Meta Department Chontales Department Suyo District Upper East Region Bardera District Narino Department Esteli Department Huancabamba Province Volta Region Belet Uen District Norte de Santander Department Granada Department C. de la Frontera District Western Region Bossaso District Puntumayo Department Jinotega Department Canchaque District • Johar District Quindio Department Léon Department Guinea Guinée Madriz Department Huancabamba District Conakry Province Kismayo District Risaralda Department Managua Department Piura Province Forécariah Préfecture Merca District San Andres Intendency Las Lomas District Mogadishu District San José del Guaviare Department Masaya Department Guinea-Bissau Matagalpa Department • Swaziland Santa Fe de Bogota Department Asia Asie Guinée-Bissau Santander Department Nueva Segovia Department Viet Nam Bissau District (Area not specified – Zone non Rio San Juan Department précisée) Sucre Department Gia-Lai-Công Tum Province Gabu District Tolima Department Rivas Department Lâm Dông Province Kenya Togo Valle Department Panama Phù Khán Province (Area not specified – Zone non Golfe District Costa Rica Colon Province Kloto District • précisée) Limon Province Comarca de San Blas • • Kozah District Darien Province Cholera Choléra Liberia Libéria Lacs District San José Province • Bong County Panama Province Africa Afrique Ogou District Ecuador • Equateur Montserrado County Peru • Pérou Angola Sotouboua District Azuay Province Bengo Province Malawi Vo District Amazonas Department Bolivar Province Ancash Department Benguela Province Northern Region Yoto District Cañar Province Cabinda Province Chitipa District Apurimac Department Uganda • Ouganda Carchi Province Arequipa Department Huambo Province Karonga District Kasese District Chimborazo Province Ayacucho Department Huila Province Southern Region Cotopaxi Province Kuando-Kubango Province United Rep. of Tanzania Cajamarca Department Mali El Oro Province Callao Province Kunene Province Rép.-Unie de Tanzanie Esmeraldas Province Kayes Région Cuzco Department Kwanza-Norte Province Arusha Region Galapagos Province Kwanza-Sul Province Kayes Cercle Dar es Salaam Region Huancavelica Department Guayas Province Huanuco Department Luanda Province Koulikoro Région Ilala District Imbabura Province Luanda, Cap. Nara Cercle Kinondoni District Ica Department Loja Province Junin Department Malanga Province Mopti Région Kigoma Region Los Rios Province Ségou Région La Libertad Department Namibe Province Kilimanjaro Region Manabi Province Tombouctou Région Lambayeque Department Uige Province Mara Region Morona Province Zaire Province Mauritania • Mauritanie Mtwara Region Lima Department Napo Province Loreto Department • Nouakchott District Rukwa Region Benin Bénin Pastaza Province Madre de Dios Department 1re Région Shinyanga Region Pichincha Province Département de Borgou Moquegua Department Hodh el Chargui Tanga Region Sucumbios Province Burkina Faso Pasco Department 2e Région Zaire • Zaïre Tungurahua Province Boulgou Province Hodh el Gharbi Piura Department Bandundu Province Zamora-Chinchipe Province Puno Department Soum Province 3e Région Bandundu District El Salvador San Martin Department Burundi Assaba et Guidimakha Haut Zaïre Province 4e Région Central Region Tacna Department Bubanza Province Kinshasa Province Tumbes Department Gorgol Barumbu District Metropolitan Region Bubanza Arrondissement e Occidental Region Ucayali Department Cibitoke Arrondissement 5 Région Kinshasa District Oriental Region Suriname Bujumbura Province Brakna Limete/Kingaba District 6e Région Paracentral Region Bujumbura Arrondissement Lingwala District Marowijne District Bururi Province Trarza Kivu Province French Guiana Venezuela Makamba Arrondissement Mozambique Shaba Province Guyane française Anzoátegui State Rumonge Arrondissement • Apure State Cabo Delgado Province Zambia Zambie Guatemala Gitega Province Ancuabe District Central Province Aragua State Gitega Arrondissement Lusaka Alta Verapaz Department Barinas State Chiure District Baja Verapaz Department • Sofala Province Copperbelt Province Carabobo State Cameroon Cameroun Chimaltenango Department Delta Amacuro State Province de l’Extrême-Nord Beira City Eastern Province Luapula Province Chiquimula Department Federal District Diamare Département Niger El Progreso Department Guarico State Logone-et-Chari Département Northern Province Diffa Département Southern Province Escuintla Department Merida State Mayo-Danai Département Dosso Département Guatemala Department Miranda State Mayo-Sava Département Maradi Département • Huehuetenango Department Monagas State Mayo-Tsanaga Département America Amérique Niamey Département • Izabal Department Nueva Esparta State Province Littoral Argentina Argentine Jalapa Department Tahoua Département Jujuy Province Sucre State Moungo Département Tillabéry Département Jutiapa Department Mendoza Province Tachira State Wouri Département Zinder Département Petén Department Zulia State Province du Nord Salta Province • Quetzaltenango Department Benoué Département Nigeria Nigéria Tucuman Province Quiché Department • Abuja State Asia Asie Province de l’Ouest Belize Retalhuleu Department Afghanistan Haut Nkam Département Akwa Ibom State Cayo District Sacatepéquez Department Anambra State Badakhshan Province Mifi Département Toledo District San Marcos Department Baghlan Province Province du Sud Bauchi State Santa Rosa Department Bendel State Bolivia • Bolivie Balkh Province Océan Département Sololá Department Helmand Province Province du Sud-Ouest Benue State Beni Department Suchitepéquez Department Borno State Chuquisaca Department Herat Province Manyu Département Totonicapán Department Kabul Province Mémé Département Gongola State Cochabamba Department Zacapa Department Imo State El Alto Department Kandahar Province Cape Verde • Cap-Vert Kaduna State La Paz Department Guyana Kapisa Province Boa Vista Island – Ile de Boa Vista Kano State Oruro Department Region I (Barina/Waini) Kunduz Province Brava Island – Ile de Brava Katsina State Potosi Department Region II (Pomeroon/Supenaam) Nangarhar Province Fogo Island – Ile de Fogo Kebbi State Riberalta Department Zabul Province Maio Island – Ile de Maio Kwara State Santa Cruz Department Honduras Bhutan • Bhoutan Porto Novo Island – Ile de Porto Lagos State Tarija Department Camayagua State Mongar District Novo Niger State Tupiza Department Choluteca Department Pemagatsel District

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Phuntsholing District Lao People’s Democratic Simferopol Quinuni Province Peru ••• Pérou Punakha District Republic Simferopol Oblast Sud Yungas Province Amazonas Department Samdrupjongkhar District République démocratique Santa Cruz Department Ancash Department Tashigang District populaire lao ••• Andrés Ibañez Province Ayacucho Department Thimphu District Attapue Province Yellow fever Fièvre jaune Cordillera Province Huanta Province Bokeo Province • Florida Province San Josè Santillana District Cambodia ••• Cambodge Kahammouane Province Africa Afrique Gutièrrez Province Angola Cusco Department Kampot Province Luangnamtha Province Ichilo Province La Convencion Province Kompong Cham Province Louangprabang Province Bengo Province Luanda Province Brazil ••• Brésil Echarate District ••• Ouodomxay Province Kitani District China Chine Saravanne Province ••• Amapá State (Area not specified – Benin Bénin Macapá Municipio Maranura District Savannakhet Province Département de l’Atakora Santa Ana District Zone non précisée) Phine District Amazonas State Kérou S. Préf. Careiro Municipio Huanuco Department India ••• Inde Sayaboury Province ••• Huamalies Province Sekong Province Cameroon Cameroun Maranhaõ State Andhra Pradesh State Province de l’Extrême-Nord Barra do Corda Municipio Monzon District Hyderabad District Mongolia ••• Mongolie Mayo Sava Département Mirador Municipio Leoncio Prado Province Visakhapatnam District Orkhon Province Mayo Tsanaga Département Pará State Alonia Robles District Assam State Ulantolgoi District Agua Azul do Norte Gabon Aucayacu District Delhi Territory Selenge Province Municipio J.C. Castello District Gujarat State Khotol District Province Ogooué-Ivindo Alenquer Municipio Makouko Leoncio Prado District Haryana State Tuv Province São Felix do Xingú Monzon District Zaamar District Karnataka (Mysore) State Gambia ••• Gambie Municipio P. Luyando District Bangalore District Myanmar Upper River Division Tucumá Municipio Rupa Rupa District Bidar District Yangon Division Colombia ••• Colombie Marañon Province Chitradurga District Ghana Yangon Antioquia Department Cholon District Gulburga District Upper West Region Nepal ••• Népal Jiripa District Anori Municipio Junin Department Hassan District Taraza Municipio Chanchamayo Province Kolar District Baitadi District Guinea ••• Guinée Jhapa District Yondo Municipio Chanchamayo District Mandya District Siguiri Région Arauca Intendencia Khatmandu District Perene District Raichar District Liberia ••• Libéria Arauca Municipio San Luis Sevaro District Tumkur District Philippines Bassa County Saravena Municipio Viloc District Kerala State National Capital Region Buchanan District Boyaca Department Satipo Province Madhya Pradesh State Region 4 Bomi County Chita Municipio Coviriali District Maharashtra State Aurora Province Tubmanburg Puerta Boyaca Municipio Mazamari District Akola District Cavite Province Bong County Caquetá Intendencia Pangoa District Amrawati District Mindoro Province Salala Belén de los Andaquiés Pichanali District Nagpur District Palawan Province Sinoe County Municipio Rio Negro District Nandad District Rizal Province Greenville El Doncello Municipio Rio Tambo District Osmanabad District Region 5 San Vicente de Caguán Nigeria ••• Nigéria Municipio Satipo District Parbhani District Albay Province Loreto Department Pune District Camarines Norte Province Anambra State Casanare Intendencia Bauchi State Hato Corozal Municipio Ucayali Province Sangli District Camarines Sur Province Contamana District Catanduanes Province Bendel State Tamara Municipio Thane District Purus District Masbate Province Benue State Yopal Municipio Manipur State Madre de Dios Department Punjab State Sorsogon Province Cross River State Cesar Department Region 6 Kaduna State Valledupar Municipio Manu Province Tamil Nadu State Madre de Dios District Anna District Iloilo Province Kwara State Choco Department Imo State Rio Sucio Municipio Manu District Chingleput District Region 7 Lagos State Cundinamarca Department Tambopata Province Madras District Cebu Province Niger State Maya Municipio Inambari District Madurai District Region 8 Leyte North Province Ogun State Guaviare Intendencia Las Piedras District North Arcot District Ondo State Miraflores Municipio Tambopata District Pudukkottai District Leyte South Province Samar Western Province Oyo State San Juan del Guaviare Pasco Department Thanjavur District Region 9 Plateau State Municipio Puno Department Tiruchirapalli District Meta Intendencia Zamboanga City Sierra Leone Sandia Province Tirunelvelli District Zamboanga Norte Province Cabuyaro Municipio San Juan del Oro District Vellore District Eastern Province La Primavera Municipio Region 11 Kenema District San Roman District Villipuram District Davao City San Carlo de Guaroa Vilcabamba District Uttar Pradesh State Gen. Santos City Sudan ••• Soudan Municipio San Martín Department West Bengal State Region 12 Territory South of 12° N. Villavicencio Municipio Huallaga Province Vista Hermosa Municipio Calcutta Cotabato City Territoire situé au sud Bellavista District Norte de Santander Department du 12° N. Saposoa District Iraq Viet Nam Cucuta Municipio Al-Basra Governorate Binh Tri Thiên Province ••• Tibu Municipio Lamas Province Zaire Zaïre Lamas District Al-Anbar Governorate Nghia Binh Province Territory North of 10 S. Cucuta Intendencia ° Tabalazos District Al-Mathna Governorate Phú Khánh Province Territoire situé au nord Toledo Municipio Mariscal Caceres Province Al-Najef Governorate du 10° S. Putumayo Intendencia Al-Qadisiya Governorate Puerto Asis Municipio Campanilla District Arbil Governorate Europe America • Amérique Santander Department San Martín Province Babil Governorate Republic of Moldova ••• Bucaramanga Municipio Juan Guerra District République de Moldova Bolivia Bolivie Baghdad Governorate Beni Department Cimitarra Municipio Sauce District Chisinev Raion (region) Dohuk Governorate Ballivian Province El Carmen Municipio Tocache Province Dyala Governorate Slobozajskiy Raion (region) Vichada Department La Polvora District Stefan-Voda Raion (region) Itenez Province Karbala Governorate Cochabamba Department Puerto Trujillo Municipio Nuevo Progreso District Tiraspol Raion (region) Mesan Governorate Ayopayo Province Ecuador ••• Equateur Tocache District Nineveh Governorate Ukraine Carrasco Province Morona-Santiago Province Uchiza District Salah El-Din Governorate Cherson Chapare Province Napo Province Ucayali Department Sulaimaniyah Governorate Nicolaev Region La Paz Department Humayacu District Coronel Portillo Province Tamim Governorate Odesskaya Region Larecaja Province Pastaza Province Calleria District Tikar Governorate Republic of Crimea Murillo Province Sucumbios Province Padre Abad Province Wasit Governorate République de Crimée Nor Yungas Province Zamora-Chinchipe Province Padre Abad District

Notifications received from 18 to 24 October 1996 Notifications reçues du 18 au 24 octobre 1996 C – cases, D – deaths, ... – data not yet received, C – cas, D – décès, ... – données non encore disponibles, i – imported, r – revised, s – suspect i – importé, r – révisé, s – suspect

••• Costa Rica 35.VII-1.VIII • Cholera Choléra Asia Asie ...... 19(11i)1 CD • El Salvador 1.I-20.VIII Japan – Japon 1.VII-30.IX America Amérique ...... 179 2 ...... 22 (14i)0 CDGuatemala 7.IV-28.IX Belize 18.II-10.VIII ••• ...... 883 7 Plague Peste ...... 12 0 Honduras 1.I-31.VII Bolivia – Bolivie 21-IV-27.VII ...... 491 14 Africa • Afrique ...... 269 8 Mexico – Mexique 10.III-15.IX CD Brazil – Brésil 25.IV-3.VII ...... 645 ... Madagascar 11-17.X ...... 824 2 Nicaragua 5.II-15.IX Mahajanga Province ...... 1 233 ... Mahajanga I District ...... 13(5s)2

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