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Volume 25, Number 2—February 2019

Synopsis

Trends of Human Plague, Madagascar, 1998–2016

Voahangy Andrianaivoarimanana1, Patrice Piola12, David M. Wagner, Fanjasoa Rakotomanana, Viviane Maheriniaina, Samuel Andrianalimanana, Suzanne Chanteau3, Lila Rahalison4, Maherisoa Ratsitorahina, and Minoarisoa RajerisonComments to Author 
Author affiliations: Institut Pasteur, Antananarivo, Madagascar (V. Andrianaivoarimanana, P. Piola, F. Rakotomanana, S. Chanteau, L. Rahalison, M. Rajerison); Northern Arizona University, Flagstaff, Arizona, USA (D.M. Wagner); Ministry of Public Health, Antananarivo (V. Maheriniaina, S. Andrianalimanana, M. Ratsitorahina)

Main Article

Table 3

Risk factors for death from plague, Madagascar, 1998–2016*

Factor No. patients Univariate analysis
 Multivariate analysis
OR (95% CI) p value OR (95% CI) p value
Delay to seek healthcare, d
0 (same day) 1,142 1 1
1 2,426 0.91 (0.73–1.14) 0.42
2 1,059 2.51 (2.00–3.16) <0.0001 3.24 (2.46–4.28) <0.0001
3 504 3.94 (3.01–5.14) <0.0001 4.93 (3.62–6.70) <0.0001
4 288 3.99 (2.92–5.44) <0.0001 4.98 (3.48–7.11) <0.0001
>5
 385
 2.20 (1.63–2.97)
 <0.0001
2.94 (2.08–4.14)
 <0.0001
Clinical form of plague
Bubonic 5,114 1 1
Pneumonic
 401
 2.00 (1.57–2.53)
 <0.0001
1.58 (1.21–2.06)
 <0.0001
Time period
Until 2009 3,977 1 1
After 2009
 1,843
 1.68 (1.46–1.93)
 <0.0001
1.58 (1.34–1.86)
 <0.0001
Contact with a plague case
No 5,275 1 1
Yes
 486
 1.92 (1.55–2.38)
 <0.0001
1.90 (1.47–2.41)
 <0.0001
Reporting dead rats
No 4,544 1 1
Yes
 971
 0.63 (0.50–0.77)
 <0.0001
0.66 (0.52–0.82)
 0.001
Age, y
<5 589 1 1†
5–18 2,964 0.88 (0.70–1.11) 0.28
19–35 1,383 0.93 (0.73–1.20) 0.58
36–54 614 1.42 (1.08–1.88) 0.01 1.25 (1.01–1.56) 0.04†
>55
 156
 1.38 (0.91–2.11)
 0.12
Sex ND ND
F 2,438 1 ND ND
M
 3,319
 0.86 (0.75–0.98)
 0.026
ND
 ND
Recent travel ND ND
No 5,214 1 ND ND
Yes 422 1.37 (1.07–1.75) 0.010 ND ND

*Model χ2 = 357, df = 10, p<0.0001. ND, not done.
†In multivariate analysis, age groups were merged into 2 groups: <36 y and >36 y.

Main Article

1These authors contributed equally to this article.

2Current affiliation: Institut Pasteur, Phnom Penh, Cambodia.

3Retired.

4Current affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Page created: January 18, 2019
Page updated: January 18, 2019
Page reviewed: January 18, 2019
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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