Successful plague control in Namibia.

OBJECTIVE

To demonstrate that plague can be successfully controlled.

DESIGN

A descriptive study outlining patterns of plague occurrence in relation to variables such as age group, gender, place and time.

SETTING

Two northern districts, namely Engela in Ohangwena region and Onandjokwe in Oshikoto region, an area of 2,000 km2.

SUBJECTS: All patients who presented to the health facilities with signs and symptoms of plague were considered. Diagnosis was made on the basis of clinical symptomatology and laboratory confirmation.

OUTCOME MEASURES: A plague control programme was established involving the following components: management capability at the local level, case recognition and management, dusting programme, rodent trapping programme, health education, establishment of plague laboratory, and plague surveillance system.

RESULTS

Following the establishment of the control programme plague cases were reduced from 1,092 to zero within 3 years and deaths from 45 to zero within 2 years. The case fatality rate was reduced from 4.12% to 0% over a 3-year period. No cases have been reported in Namibia for the past 3 years.

CONCLUSION

The Namibian experience has demonstrated that plague can be controlled through a combination of strategies taking local conditions into consideration.