ABSTRACT
A review of plague records from 1986 to 2002 and household interviews were carried out in the plague endemic villages to establish a pattern and spatial distribution of the disease in Lushoto district; Tanzania. Spatial data of households and village centres were collected and mapped using a hand held Global Positioning System and Geographical Information System. During the 16-year period; there were 6249 cases of plague of which 5302 (84.8) were bubonic; 391 (6.3)septicaemic; and 438 (7.0) pneumonic forms. A total of 118 (1.9) cases were not categorized. Females and individuals aged 7-18 years old were the most affected groups accounting for 54.4(95CI: 52.4-56.0) and 47.0(95CI: 45- 49) of all reported cases; respectively. Most cases were found in villages at high altitudes (1700-1900m); and there was a decline in case fatality rate (CFR) in areas that experienced frequent outbreaks. Overall; there was a reduction in mean reporting time (from symptoms onset to admission) to an average of 1.35 days (95CI: 1.30-1.40) over the years; although this remained high among adult patients (18 years). Despite the decrease in the number of cases and CFR over the years; our findings indicate that Lushoto district experiences human plague epidemic every year; with areas at high altitudes being more prone to outbreaks. The continued presence of plague in this focus warrants further studies. Nonetheless; our findings provide a platform for development of an epidemic preparedness plan to contain future outbreaks