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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.

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 (click to view)

Umulisa I, Omolo J, Muldoon KA, Condo J, Habiyaremye F, Uwimana JM, Muhimpundu MA, Galgalo T, Rwunganira S, Dahourou AG, Tongren E, Koama JB, McQuiston J, Raghunathan PL, Massung R, Gatei W, Boer K, Nyatanyi T, Mills EJ, Binagwaho A,


Umulisa I, Omolo J, Muldoon KA, Condo J, Habiyaremye F, Uwimana JM, Muhimpundu MA, Galgalo T, Rwunganira S, Dahourou AG, Tongren E, Koama JB, McQuiston J, Raghunathan PL, Massung R, Gatei W, Boer K, Nyatanyi T, Mills EJ, Binagwaho A, (click to view)

Umulisa I, Omolo J, Muldoon KA, Condo J, Habiyaremye F, Uwimana JM, Muhimpundu MA, Galgalo T, Rwunganira S, Dahourou AG, Tongren E, Koama JB, McQuiston J, Raghunathan PL, Massung R, Gatei W, Boer K, Nyatanyi T, Mills EJ, Binagwaho A,

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The American journal of tropical medicine and hygiene 2016 06 2795(2) 452-6 doi 10.4269/ajtmh.15-0643

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.

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