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Table 1 Biological data according to periods defined by the diagnostic protocols in place (1998–2019)

From: Performance of plague rapid diagnostic test compared to bacteriology: a retrospective analysis of the data collected in Madagascar

 

Period 0

1998–2001

Period 1

2002–2007

Period 2

2008–2016

Period 3*

2017–2018

Period 4

2018–2019

Description

Before RDT introduction

Implementation of RDT in healthcare centers (HCCs) and the CLP

RDTs used as screening tests: only cases with positive RDT were tested by bacteriology

2017–2018 plague season (including pulmonary plague epidemic)

2018–2019 plague season (August 2018 – April 2019)

Available tests according to protocol

- Bacteriology

- Elisa (serology)

- CLP RDT

- HCC RDT

- Bacteriology

- CLP RDT

- HCC RDT

- Bacteriology only when RDT positive (CLP or HCC)

- CLP RDT

- HCC RDT

- Bacteriology

- Molecular biology

- CLP RDT

- HCC RDT

- Bacteriology

- Molecular biology

Number of cases

4955 cases

(4689 BP,

136 PP)

4221 cases

(3728 BP,

260 PP,

233 NP)

4000 cases

(3223 BP,

599 PP,

178 NP)

2786 cases

(529 BP,

2044 PP,

1 SP**,

212 NP)

259 cases

(208 BP,

46 PP,

5 NP)

  1. *Period 3, 2017–2018, is divided into three sub-periods according to the diagnostic protocols (Protocol 1: in 2017, before Sept 11 and after Oct 3: only cases with a positive RDT result were tested by bacteriological culture; Protocol 2: Sept 11 – Oct 3: all PP cases from non-endemic zones were tested by bacteriological culture (independently of the RDT result) and other cases from endemic districts were tested by bacteriological culture only if the RDT results was positive; Protocol 3: From Jan 2018: all notified cases were tested by bacteriological culture)