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Successful plague control in Namibia
1Ministry of Health and Social Services, Windhoek, 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.