Fourth Dengue Fever Outbreak Investigation in Ethiopia: A Case Control Study, July 2015

Abstract Background: Dengue fever is a rapidly emerging vector born infectious disease caused by Dengue virus and it is now one of WHO reportable diseases. About 50 -200 million cases, 20,000 deaths occur annually. In Ethiopia the first outbreak of Dengue fever appeared in Dire Dawa city in 2013, where 9441 cases were recorded. The second Dengue fever outbreak occurred in Afar Region. Third and fourth was in Somali Region in Godey town, 2014 and 2015. In Godey town acute febrile illness cases of unknown cause become increased started from May 27, 2015. We investigated to identify risk factors of Dengue fever outbreak and commence control measures. Methods: A case-control study was conducted in Godey town, Ethiopia from 8-22 July 2015. Cases were defined according to the WHO guideline and controls were individuals with no sign and symptoms living in the same town with cases. We recruited 50 cases and 100 controls in the study. Medical records and line lists were reviewed. Data were collected at household level using structured questionnaires. Twenty-four serum samples collected from cases. Data was analyzed using SPSS 20 software. Result: We identified 223 cases with 0 death, 116 (52%) were male. The mean age of cases was 25.8 years. Ten cases were positive for Dengue fever by PCR at national laboratory. Lack of formal education (AOR=3.1; 95%CI: 1.30-7.49), living with ill person (AOR=2.8; 95%CI: 1.22-6.52), open containers in household (AOR=3.6; 95%CI: 1.34-9.38) and presence of larvae in the water containers (AOR=5.4; 95%CI: 2.33-12.44) were risk factors for the outbreak. Conclusion: Poor household water handling, living with ill person and lack of formal education contributes for occurrence of Dengue fever outbreak in Godey town. Health education and all other interventions associated with use of water and sanitation needs to be part of long-term control of Dengue.

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Another dengue fever outbreak in Eastern Ethiopia—An emerging public health threat

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0008992 ◽

2021 ◽

Vol 15 (1) ◽

pp. e0008992

Author(s):

Mulugeta Asefa Gutu ◽

Alemayehu Bekele ◽

Yimer Seid ◽

Yusuf Mohammed ◽

Fekadu Gemechu ◽

...

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Case Control Study ◽

Larval Density ◽

Case Control ◽

Control Measures ◽

Severe Dengue ◽

Vector Surveillance ◽

Eastern Ethiopia ◽

Control Study

Background Dengue Fever (DF) is a viral disease primarily transmitted by Aedes (Ae.) aegypti mosquitoes. Outbreaks in Eastern Ethiopia were reported during 2014–2016. In May 2017, we investigated the first suspected DF outbreak from Kabridahar Town, Somali region (Eastern Ethiopia) to describe its magnitude, assess risk factors, and implement control measures. Methods Suspected DF cases were defined as acute febrile illness plus ≥2 symptoms (headache, fever, retro-orbital pain, myalgia, arthralgia, rash, or hemorrhage) in Kabridahar District residents. All reported cases were identified through medical record review and active searches. Severe dengue was defined as DF with severe organ impairment, severe hemorrhage, or severe plasma leakage. We conducted a neighborhood-matched case-control study using a subset of suspected cases and conveniently-selected asymptomatic community controls and interviewed participants to collect demographic and risk factor data. We tested sera by RT-PCR to detect dengue virus (DENV) and identify serotypes. Entomologists conducted mosquito surveys at community households to identify species and estimate larval density using the house index (HI), container index (CI) and Breteau index (BI), with BI≥20 indicating high density. Results We identified 101 total cases from May 12–31, 2017, including five with severe dengue (one death). The attack rate (AR) was 17/10,000. Of 21 tested samples, 15 (72%) were DENV serotype 2 (DENV 2). In the case-control study with 50 cases and 100 controls, a lack of formal education (AOR [Adjusted Odds Ratio] = 4.2, 95% CI [Confidence Interval] 1.6–11.2) and open water containers near the home (AOR = 3.0, 95% CI 1.2–7.5) were risk factors, while long-lasting insecticide treated-net (LLITN) usage (AOR = 0.21, 95% CI 0.05–0.79) was protective. HI and BI were 66/136 (49%) and 147 per 100 homes (147%) respectively, with 151/167 (90%) adult mosquitoes identified as Ae. aegypti. Conclusion The epidemiologic, entomologic, and laboratory investigation confirmed a DF outbreak. Mosquito indices were far above safe thresholds, indicating inadequate vector control. We recommended improved vector surveillance and control programs, including best practices in preserving water and disposal of open containers to reduce Aedes mosquito density.

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Risk factors of dengue fever in an urban area in Vietnam: a case-control study

BMC Public Health ◽

10.1186/s12889-021-10687-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Thang Nguyen-Tien ◽

Duy Cuong Do ◽

Xuan Luat Le ◽

Thi Hai Dinh ◽

Mats Lindeborg ◽

...

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Prevention And Control ◽

Case Control Study ◽

Case Control ◽

Younger Adults ◽

The Mean ◽

Dengue Prevention ◽

And Control ◽

Control Study

Abstract Background Dengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries. Methods During and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status. Results The mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16–30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR = 0.31; 95% CI 0.13–0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention. Conclusions All patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.

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Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

10.21203/rs.3.rs-624873/v1 ◽

2021 ◽

Author(s):

Abdulkareem Ali Hussein Nassar ◽

Amr Abdulaziz Torbosh ◽

Yassin Abdulmalik Mahyoub ◽

Mohammed Abdullah Al Amad

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Case Control Study ◽

Significant Risk ◽

Case Fatality ◽

Case Control ◽

Case Definition ◽

P Value ◽

Factors Associated ◽

Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

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Ecological and behavioural risk factors of scrub typhus in central Vietnam: a case-control study

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00893-6 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hanh Thi Duc Tran ◽

Jan Hattendorf ◽

Hung Manh Do ◽

Thanh Tien Hoang ◽

Hang Thi Hai Hoang ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Scrub Typhus ◽

Conditional Logistic Regression ◽

Febrile Illness ◽

Case Control ◽

Enzyme Linked Immunosorbent Assay ◽

Protective Equipment ◽

Related Factors ◽

Control Study

Abstract Background The risk factors for scrub typhus in Vietnam remain unknown. Scrub typhus caused by Orientia tsutsugamushi often presents as an undifferentiated febrile illness and remains under appreciated due to the limited availability of diagnostic tests. This tropical rickettsial illness is increasingly recognized as an important cause of non-malaria acute undifferentiated fever in Asia. This study aimed to investigate behavioural and ecological related risk factors of scrub typhus to prevent this potentially life-threatening disease in Vietnam. Methods We conducted a clinical hospital-based active surveillance study, and a retrospective residence-enrolment date-age-matched case–control study in Khanh Hoa province, Vietnam, from August 2018 to March 2020. Clinical examinations, polymerase chain reaction and enzyme-linked immunosorbent assay IgM tests were applied to define cases and controls. All enrolled participants filled out a questionnaire including demographic socio-economic status, personal behaviors/protective equipment, habitat connections, land use, and possible exposure to the vector. Multivariable conditional logistic regression was used to define the scrub typhus associated risk factors. Results We identified 44 confirmed cases and matched them with 152 controls. Among cases and controls, the largest age group was the 41–50 years old and males accounted for 61.4% and 42.8%, respectively. There were similarities in demographic characteristics between the two groups, with the exception of occupation. Several factors were significantly associated with acquisition of scrub typhus, including sitting/laying directly on household floor [adjusted OR (aOR) = 4.9, 95% CI: 1.6–15.1, P = 0.006], household with poor sanitation/conditions (aOR = 7.9, 95% CI: 1.9–32.9, P = 0.005), workplace environment with risk (aOR = 3.0, 95% CI: 1.2–7.6, P = 0.020), always observing mice around home (aOR = 3.7, 95% CI: 1.4–9.9, P = 0.008), and use of personal protective equipment in the field (aOR = 0.4, 95% CI: 0.1–1.1, P = 0.076). Conclusions Ecological and household hygiene-related factors were more associated with scrub typhus infection, than individual-level exposure activities in the hyper-endemic area. These findings support local education and allow people to protect themselves from scrub typhus, especially in areas with limitations in diagnostic capacity. Graphical abstract

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Risk factors for sporadic Campylobacter infection: an all-Ireland case-control study

Eurosurveillance ◽

10.2807/ese.14.07.19123-en ◽

2009 ◽

Vol 14 (7) ◽

Author(s):

K Danis ◽

M Di Renzi ◽

W O’Neill ◽

B Smyth ◽

P McKeown ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Population Attributable Fraction ◽

Case Control ◽

Control Measures ◽

Safety Education ◽

First Case ◽

The Republic ◽

Campylobacter Infection ◽

Control Study

We report the findings of the first case-control study conducted in both the Republic of Ireland and Northern Ireland to determine risk factors for sporadic Campylobacter infections. A total of 197 cases and 296 case-nominated controls matched for age, were included. Based on Population Attributable Fraction (PAF), the most important risk factors were consuming chicken [adjusted matched (am) OR 6.8; 95%CI 2.1-21.9], consuming lettuce (amOR 3.3; 95%CI 1.5-7.1) and eating in takeaways (amOR=3.1; 95%CI 1.4-6.6). Contact with sheep (amOR=11; 95%CI 1.6-78), peptic ulcer (amOR=19; 95%CI 3.8-93.7), hiatus hernia (amOR=20.3; 95%CI 2.3-183.3), lower bowel problems (amOR=4.5; 95%CI 1.2-16.8) were also independently associated with infection. Mains water supply showed protective effect (amOR=0.2; 95 CI 0.1-0.9). The findings highlight the continued need for consumer food safety education and further control measures throughout the food chain on the island of Ireland.

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Risk factors for still birth: a hospital based case control study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170567 ◽

2017 ◽

Vol 6 (3) ◽

pp. 970 ◽

Cited By ~ 6

Author(s):

Sujatha Thankappan Lakshmi ◽

Uma Thankam ◽

Preetha Jagadhamma ◽

Anuja Ushakumari ◽

Nirmala Chellamma ◽

...

Keyword(s):

Risk Factors ◽

Urinary Tract ◽

Birth Rate ◽

Case Control Study ◽

Febrile Illness ◽

Case Control ◽

Sleep Position ◽

Still Birth ◽

Still Births ◽

Control Study

Background: The study of the risk factors contributing to still birth is imperative in our attempts to bring about a decline in the still birth rate. By identifying the risk factors, we can understand the areas where specific interventions may be applied to bring about a reduction in the still birth rate. The aim of the present study was to identify the risk factors for stillbirth among the mothers attending Sri Avittom Thirunal Hospital, TrivandrumMethods: This was a prospective hospital based case control study conducted from March 2014- September 2015. Sample size was calculated as 100 cases and 200 controls. Odds ratios with 95% confidence interval were calculated using multi variate logistic regression.Results: The major risk factors associated with still births were maternal age, socio economic status, and obesity, sleep position during pregnancy, primi parity, hypertension and febrile illness during pregnancy. The risk of still birth was 3 times higher among mothers with hypertension compared to the control group. Although the prevalence of diabetes slightly more in the case group it was not statistically significant. By analyzing all the risk factors in preparing a model 42% of the risk for still birth was contributed by these factors.Conclusions: The modifiable risk factors seen in this study to prevent still births are maternal sleep position during pregnancy, diabetes, hypertension and febrile illness especially urinary tract infection. By better antenatal care we can detect complications like diabetes, hypertension and manage appropriately thereby preventing complications. By screening for urinary tract infections in every trimester morbidity can be reduced.

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Risk Factors of Stunting Among Children Aged 6-59 Months In Bensa District ISTRICT, Sidama Region, South Ethiopia: Unmatched Case-Control Study

10.21203/rs.3.rs-283465/v1 ◽

2021 ◽

Author(s):

TEMESGEN TAFESSE ◽

AMANUEL YOSEPH ◽

KALEB MAYISO ◽

TAYE GARI

Keyword(s):

Risk Factors ◽

Breast Feeding ◽

Formal Education ◽

Case Control Study ◽

Case Control ◽

Exclusive Breast Feeding ◽

Under Five ◽

South Ethiopia ◽

Male Sex ◽

Control Study

Abstract Background: Stunting remains one of the most common under-nutrition problems among children in the Ethiopia. Children aged 6-59 months share for 35–45% of the burden in endemic areas. Identifying the causes of stunting assists health planners to prioritize prevention strategies, and is a fundamental step for intervention. However, evidence scarce about risk factors of stunting among children aged 6-59 months in study area. Therefore, this study aimed to assess risk factors of stunting among children aged 6-59 months in Bensa district, South Ethiopia; 2019. Methods: A facility-based unmatched case-control study was conducted from January 10 to March 10, 2018 on a sample of 237(79 cases and 158 controls) children aged 6-59 months with their respective mothers. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered using EPINFO version 7 and WHO Anthro software version 3.0.1 and analyzed using SPSS version 20. Chi-square(X2) test was used to determine the overall association between explanatory and outcome variables. The variables were entered to the multivariable model using the backward stepwise regression approach. Multivariable logistic regression analysis was used to identify factors associated with stunting. Adjusted odds ratios (AORs) with a 95% confidence interval (CI) were computed to evaluate the presence and strength of associations. Results: Diarrhea in past two weeks (AOR = 2.71, 95% CI: 1.42-5.16) and male sex (AOR = 2.37, 95% CI: 1.224-4.59) were positively associated with stunting. The odds of stunting increased 2.7 times for children who had inappropriate exclusive breast feeding (AOR =2.07, 95%CI: 1.07-4.01) as compared to those who had the appropriate exclusive breast feeding. Having less than or equal to three under five children in the household (AOR = 2.18, 95%CI: 03-4.64), and mothers had no formal education (AOR =3.28, 95%CI: 1.56-6.924) were positively associated with stunting. Conclusions: Male sex, diarrhea in past two weeks, inappropriate exclusive breast feeding, number of the under five children in the household and mothers had no formal education were major predictors of the stunting. Educating mothers/care takers on Infant and Young Child Feeding practice. Findings support a focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition.

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Predictors for vancomycin resistant Enterococcus faecium transforming from colonization to infection: a case control study

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-019-0647-7 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

Pao-Yu Chen ◽

Yu-Chung Chuang ◽

Jann-Tay Wang ◽

Wang-Huei Sheng ◽

Yee-Chun Chen ◽

...

Keyword(s):

Risk Factors ◽

Enterococcus Faecium ◽

Case Control Study ◽

Case Control ◽

Control Measures ◽

Fourth Generation ◽

Surveillance Culture ◽

Icu Admission ◽

Vancomycin Resistant ◽

Control Study

Abstract Background Little is known about risk factors for subsequent infections among vancomycin resistant Enterococcus faecium (VREfm) colonizers, especially characterized by concordant pulsotypes (CP) of paired colonization and infection-related isolates. Methods This case-control study was conducted at a teaching hospital between 2011 and 2014. Targeted patients received active surveillance culture for VREfm by anal swabs at admission. Cases were those who developed VREfm infection within 180 days after colonization of VREfm. Controls were those colonized with VREfm without subsequent VREfm infection. CP were defined by similarities ≥86.7% using pulsed-field gel electrophoresis between paired colonization and infection-related isolates. Results Ninety-seven cases and 194 controls were enrolled. By conditional multivariable logistic regression analysis, the risk factors for subsequent infection among VREfm colonizers were intensive care unit (ICU) admission (adjusted odds ratio [aOR], 9.32; 95% CI, 3.61–24.02), receipt of central venous catheters (CVC) (aOR, 3.38; 95% CI, 1.30–8.82), and utilization of third- and fourth-generation cephalosporins (aOR, 4.06; 95% CI, 1.79–9.20, and aOR, 5.32; 95% CI, 1.85– 10.29, respectively) (all P ≤ 0.01). Fifty-six (57.7%) of case patients belonged to the CP group, which were associated with ICU admission (aOR, 3.74; 95% CI, 1.38–10.13), and infection developing within 30 days after colonization (aOR, 3.34; 95% CI, 1.25–8.91). Conclusions Among VREfm colonizers, being admitted to ICU and receiving CVC or broad spectrum cephalosporins, were the risk factors for subsequent infections. These findings highlight the importance of conducting more strict infection control measures on specific groups of VREfm colonizers.

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A community based case-control study to determine the risk factors of dengue fever in Bangladesh

10.1101/2021.08.24.21262563 ◽

2021 ◽

Author(s):

Md. Sahidur Rahman ◽

Fatema Mehejabin ◽

Rumana Rashid

Keyword(s):

Risk Factors ◽

Dengue Fever ◽

Potential Risk ◽

Case Control Study ◽

Dengue Infection ◽

Significant Risk ◽

Case Control ◽

College Hospital ◽

Tropical Country ◽

Control Study

In a tropical country like Bangladesh where the climatic condition favors the growth of Aedes mosquito vectors, the success of dengue prevention depends largely on the proper identification and controlling of the socio-demographic and lifestyle-related risk factors. A case-control study including 150 cases and 150 controls were conducted aimed to explore the potential risk and protective factors and their association with dengue virus infection in the Chattogram district of Bangladesh. Cases were confirmed for dengue patients admitted in Chattogram medical college hospital and Bangladesh institute of tropical and infectious diseases during August and September 2019. Whereas, controls were non-dengue patients admitted in other departments of the same hospitals through gender age and location matching. The questionnaire data were collected through telephone-based interviews which included information regarding general demography, daily life activities, housing with its surroundings status. Chi-square and binary logistic regression were performed for identifying potential risk factors and their association with the occurrences of dengue fever. The study found that travel history to the high incidence area, the place of staying most of the time, living in 21 to 40 years old houses, and the temporary residence of the city were statistically significant risk factors for getting the dengue infection. On contrary, Quality of indoor daylight, ventilation, bus stand/garage, stagnant water, and any construction site around 250 meters of the house did not show significant association with dengue fever.

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