Trends of human plague, madagascar, 1998–2016

Voahangy Andrianaivoarimanana, Patrice Piola, David M. Wagner, Fanjasoa Rakotomanana, Viviane Maheriniaina, Samuel Andrianalimanana, Suzanne Chanteau, Lila Rahalison, Maherisoa Ratsitorahina, Minoarisoa Rajerison

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Madagascar is more seriously affected by plague, a zoonosis caused by Yersinia pestis, than any other country. The Plague National Control Program was established in 1993 and includes human surveillance. During 1998–2016, a total of 13,234 suspected cases were recorded, mainly from the central highlands; 27% were confirmed cases, and 17% were presumptive cases. Patients with bubonic plague (median age 13 years) represented 93% of confirmed and presumptive cases, and patients with pneumonic plague (median age 29 years) represented 7%. Deaths were associated with delay of consultation, pneumonic form, contact with other cases, occurrence after 2009, and not reporting dead rats. A seasonal pattern was observed with recrudescence during September–March. Annual cases peaked in 2004 and decreased to the lowest incidence in 2016. This overall reduction occurred primarily for suspected cases and might be caused by improved adherence to case criteria during widespread implementation of the F1 rapid diagnostic test in 2002.

Original languageEnglish (US)
Pages (from-to)220-228
Number of pages9
JournalEmerging infectious diseases
Issue number2
StatePublished - Feb 1 2019

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases


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