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Am J Trop Med Hyg. 2016 Aug 3;95(2):452-6. doi: 10.4269/ajtmh.15-0643. Epub 2016 Jun 27.

A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012.

Author information

1
Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda. umulisa5@gmail.com.
2
CTS Global assigned to U.S. Centers for Disease Control and Prevention, Kigali, Rwanda.
3
University of British Columbia, Vancouver, Canada. University of Ottawa, Ottawa, Canada.
4
School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
5
Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda.
6
Epidemic Infectious Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda.
7
Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda. Epidemic Infectious Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda.
8
Division of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda.
9
Division of Global HIV/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda.
10
National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.
11
University of British Columbia, Vancouver, Canada. University of Ottawa, Ottawa, Canada. Stanford University, Stanford, California.
12
Ministry of Health Rwanda, Kigali, Rwanda. Harvard Medical School, Boston, Massachusetts. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

Abstract

In August 2012, laboratory tests confirmed a mixed outbreak of epidemic typhus fever and trench fever in a male youth rehabilitation center in western Rwanda. Seventy-six suspected cases and 118 controls were enrolled into an unmatched case-control study to identify risk factors for symptomatic illness during the outbreak. A suspected case was fever or history of fever, from April 2012, in a resident of the rehabilitation center. In total, 199 suspected cases from a population of 1,910 male youth (attack rate = 10.4%) with seven deaths (case fatality rate = 3.5%) were reported. After multivariate analysis, history of seeing lice in clothing (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [CI] = 1.1-5.8), delayed (≥ 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6-9.6), and delayed (≥ 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0-11) were associated with illness, whereas having stayed in the rehabilitation camp for ≥ 6 months was protective (aOR = 0.20, 95% CI = 0.10-0.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks.

PMID:
27352876
PMCID:
PMC4973199
DOI:
10.4269/ajtmh.15-0643
[Indexed for MEDLINE]
Free PMC Article

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