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It has been endemic in Madagascar for a century but the 1990s saw major outbreaks and in 2006 the WHO described the plague as re-emerging in Madagascar and the world. This review highlights the variety of factors leading to plague re-emergence in Madagascar, including climate events, insecticide resistance, and host and human behaviour. It also addresses areas of concern for future epidemics and ways to mitigate these. Pinpointing and addressing current and future drivers of plague re-emergence in Madagascar will be essential to controlling future outbreaks both in Madagascar and worldwide.<\/jats:p>","DOI":"10.1042\/etls20200334","type":"journal-article","created":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T14:21:25Z","timestamp":1606832485000},"page":"423-433","update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Factors influencing the re-emergence of plague in Madagascar"],"prefix":"10.1042","volume":"4","author":[{"given":"Jennifer","family":"Alderson","sequence":"additional","affiliation":[{"name":"Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6551-4713","authenticated-orcid":false,"given":"Max","family":"Quastel","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Wilson","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan","family":"Bellamy","sequence":"additional","affiliation":[{"name":"The Jenner Institute, University of Oxford, Oxford OX3 7DQ, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"key":"2021111608153130600_ETLS-2020-0334C1","doi-asserted-by":"publisher","first-page":"e2382","DOI":"10.1371\/journal.pntd.0002382","article-title":"Understanding the persistence of plague foci in Madagascar","volume":"7","year":"2013","journal-title":"PLoS Negl. 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