▁death s ▁per ▁ 1 0 0 , 0 0 0   people , ▁in ▁part ▁because ▁of ▁the ▁highest ▁frequency ▁use ▁of ▁insect ic ide ▁treated ▁n ets ▁in ▁Africa . ▁Ad ult ▁life ▁expect ancy ▁in ▁ 2 0 0 9 ▁was ▁ 6 3 ▁years ▁for ▁men ▁and ▁ 6 7   year s ▁for ▁women . ▁ ▁In ▁ 2 0 1 7 , ▁Mad agas car ▁had ▁an ▁out break ▁of ▁the ▁b ub onic ▁pl ague ▁that ▁affected ▁urban ▁areas . ▁ ▁Education ▁ ▁Prior ▁to ▁the ▁ 1 9 th ▁century , ▁all ▁education ▁in ▁Mad agas car ▁was ▁inform al ▁and ▁typically ▁served ▁to ▁teach ▁practical ▁skills ▁as ▁well ▁as ▁social ▁and ▁cultural ▁values , ▁including ▁respect ▁for ▁ancest ors ▁and ▁el ders . ▁The ▁first ▁formal ▁European - style ▁school ▁was ▁established ▁in ▁ 1 8 1 8 ▁at ▁To am as ina ▁by ▁members ▁of ▁the ▁London ▁Mission ary ▁Society ▁( L MS ). ▁The ▁L MS ▁was ▁invited ▁by ▁King ▁Rad ama ▁I ▁to ▁expand ▁its ▁schools ▁throughout ▁I mer ina ▁to ▁teach ▁basic ▁liter acy ▁and ▁numer acy ▁to ▁arist ocr atic ▁children . ▁The ▁schools ▁were ▁closed ▁by ▁Ran aval ona ▁I ▁in ▁ 1 8 3 5 ▁but ▁re open ed ▁and ▁expanded ▁in ▁the ▁dec ades ▁after ▁her ▁death . ▁ ▁By ▁the ▁end ▁of ▁the ▁ 1 9 th ▁century , ▁Mad agas car ▁had ▁the ▁most ▁developed ▁and ▁modern ▁school ▁system ▁in ▁pre - colon ial