REFLECTIONS ON THE CARTOGRAPHY OF ENDEMIC PLAGUE IN THE PROVINCE OF FIANARANTSOA FROM 1984 TO 1993

In Madagascar, plague is still a public health problem, notably in 36 out of 111 districts, where its reemergence has been recorded over the last few years. Furthermore, it is sometimes forgotten that old cente rs of the disease can suddenly reawaken and that zones which have been free of the it for a long time, can again fall prey to plague from on e season to another. Thus, in order better to limit the spread of plag ue in time and space in the province of Fianarantsoa, a classification based on its presence and cyclical evolution was specially drawn up s o as to serve as a parameter in a study covering the years 1984 to 199 3. Four different classes can be defined and presented as follows: cla ss I : Firaisampokontany (commune) where the number of years of appear ance of suspect cases of plague is superior to 5 over a period of ten years, class II : Firaisampokontany where the number of years varies b etween 3 to 5 for the same period; class III : a center where the numb er of years varies between 1 and 2 over a period of ten years. class I V: Firaisampokontany having had no suspect case of plague over the afo re mentioned period. This classification leads to the development and the settling of strategies for preventive action, fight against the di sease, and operational research to be carried out in a multisectorial, demedicalized, decentralized and integrated manner in order to reduce significantly the morbidity and mortality due to plague.