Evaluation of diagnostic tests for plague in Madagascar

Madagascar is the country that reports most cases of plague in world. This an evaluation study diagnosis over a 2-year period from January 2017 to December 2018. For all suspected cases, peripheral RDT (performed locally), central laboratory) and PCR were performed. Parameters diagnostic tests used, year study, performance concordance between studied. 2981 collected, 21.6% confirmed, 28.4% probable 50% suspected. The sensitivities RDT, 96.55, 100 97.41%, respectively; specificities 41.43, 51.17 89.24%. Cohen's kappa was 0.12 culture; 0.17 culture 0.64 CRP culture. pneumonic (PP) patient samples, 80.00, 66.66 93.33%, 0.017 0.013 0.371 75.00 62.50% for 2017, respectively. null hypothesis rejected, discordance found. Sensitivity lowered during lung sampling 2017.   Key words: Plague, polymerase chain reaction, technology assessment.