scholarly journals Malaria Outbreak –in Hitsats Refugee Camp, Tigray Region, Ethiopia- 2017, A Case-Control Study

2020 ◽  
Author(s):  
Mekonen Gebrekidan Gebremichael ◽  
Samuel Gebresilassie Aregay ◽  
Kissanet Wedearegay Tesfay ◽  
Getahun Embaye Kebede ◽  
Alefech Gezihagn Adissu
Keyword(s):  
Risk Factor ◽  
Malaria Infection ◽  
Case Control Study ◽  
Signs And Symptoms ◽  
Refugee Camp ◽  
Case Control ◽  
Refugee Camps ◽  
Malaria Outbreak ◽  
Control Study ◽  
At Home

Abstract Background: Over 80% of current refugee camps worldwide are located in malaria-endemic areas and malaria accounts for up to 50% of all deaths among refugees. In 2016, 3,152 malaria cases were reported from Hitsats Refugee Camp located in northern Ethiopia. A malaria outbreak was reported from Hitsats Refugee Camp (Population=8498) on June 19th, 2017. We investigated to describe the epidemiology, identify risk factors, and implement control measures.Methods: We defined a malaria case as any person a resident of Hitsats Refugee camp with fever or fever with headache, rigor, back pain, chills, sweats, myalgia, nausea, and vomiting, or confirmed microscopically or by Rapid Diagnostic Test to have malaria parasites from June 6th to July 3rd, 2017. We identified cases by reviewing the refugee clinic records and conducted a 1:1 case-control study from July 3rd to 14th, 2017. Cases were selected randomly using the patient registration book and recruited neighborhood controls who have no signs and symptoms of malaria and tested negative for Plasmodium species during the outbreak period from the same camp. We collected socio-demographic, behavioral, and risk factor information using a pre-tested structured questionnaire. Data were entered and analyzed using Epi-Info version 7.2.2. Multivariable logistic regression analysis was conducted to identify independent factors associated with malaria infection. Result: We identified 4,911 malaria cases with no death. Of those cases, 3,290 (67%) were males, and 4,322 (88%) were aged ≥5years. The overall attack rate (AR) was 58% (4911/8498) and was highest among <5years (84%) and was 55% among people ≥5years. Seventy-eight malaria cases and 78 controls were interviewed. The presence of patient/s with similar signs and symptoms at home (Adjusted Odds Ratio (AOR) =3.5, 95% Confidence Interval (CI) =1.6-7.8) was an independent risk factor associated with malaria. Owning insecticide-treated mosquito nets (ITNs) (AOR=0.17; 95%CI=0.07-0.4) and using personal protective equipment (PPE) to prevent mosquito bites when staying outdoors (AOR=0.18; 95%CI=0.08-0.4) were disease protective factors.Conclusion: The presence of patient/s with similar signs and symptoms at home, lack of ITN ownership and not using PPE were variables associated with malaria infection. Prevention strategies that target ITN distribution and the use of PPE to prevent mosquito bites may mitigate and prevent further outbreaks of malaria in refugee camps.

scholarly journals Passive smoking at home is a risk factor for community-acquired pneumonia in older adults: a population-based case-control study

BMJ Open ◽  
2014 ◽  
Vol 4 (6) ◽  
pp. e005133-e005133 ◽  
Author(s):  
J. Almirall ◽  
M. Serra-Prat ◽  
I. Bolibar ◽  
E. Palomera ◽  
J. Roig ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Passive Smoking ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Community Acquired Pneumonia ◽  
Control Study ◽  
At Home

scholarly journals Factors Associated with a Malaria Outbreak at Tongogara Refugee Camp in Chipinge District, Zimbabwe, 2021: A Case-Control Study

2021 ◽  
Author(s):  
Kudzai Patience Takarinda ◽  
Simon Nyadundu ◽  
Emmanuel Govha ◽  
Addmore Chadambuka ◽  
Notion Tafara Gombe ◽  
...  
Keyword(s):  
Case Control Study ◽  
Refugee Camp ◽  
Case Control ◽  
Habitat Modification ◽  
Whole Body ◽  
Disease Notification ◽  
Breeding Sites ◽  
Factors Associated ◽  
Malaria Outbreak ◽  
Control Study

Abstract Background: Malaria is a leading cause of morbidity and mortality among forcibly displaced populations including refugees, approximately two-thirds of whom reside in malaria endemic regions. Data from the rapid disease notification system (RDNS) reports for Manicaland Province in Zimbabwe showed that despite implementation of malaria control initiatives, there was an increase in number of malaria cases above action thresholds at Tongogara Refugee Camp in Chipinge District during weeks 12-14. We investigated the malaria outbreak describing the outbreak by person, place and time, assessing malaria emergency preparedness and response and appropriateness of case management. We also determined the factors associated with contracting malaria to enable the formulation of appropriate interventions, establish control and prevent future malaria outbreaks among this vulnerable population.Methods: We conducted a 1:1 unmatched case control study involving 80 cases and 80 controls using interviewer-administered questionnaires at household level. Data was entered using Epi Data version 3.1 and analyzed using Epi InfoTM version 7.2.4 to generate medians, proportions, odds ratios and their 95% confidence intervals.Results: Malaria cases were distributed throughout the 10 residential sections within Tongogara Refugee Camp, the majority being from section 7, 28/80 (35%). Despite constituting 11% of the total population, Mozambican nationals accounted for 36/80 (45%) cases. Males constituted 47/80 (59%) among cases versus controls 43/80 (54%), p=0.524. Median age for cases was also lower compared to controls; 15 years [Interquartile range (IQR), 9-26] versus 17 years (IQR, 10-30). Several natural and manmade potential vector breeding sites were observed around the camp. Risk factors associated with contracting malaria were engaging in outdoor activities at night [AOR 4.26 (95% CI, 1.43-12.68)], wearing clothes that do not cover the whole body [AOR=2.74 (95% CI 1.04-7.22) while sleeping in a refugee housing unit reduced the risk of contracting malaria [AOR=0.18 (CI, 0.06-0.55)]. Conclusions: The malaria outbreak at Tongogara Refugee Camp reemphasizes the role of behavioral factors in malaria transmission. We recommend intensified health education to address human behaviors that expose residents to malaria and habitat modification with larviciding to eliminate mosquito breeding sites.

scholarly journals Factors associated with a malaria outbreak at Tongogara Refugee Camp in Chipinge District, Zimbabwe, 2021: A case-control study

2021 ◽  
Author(s):  
Kudzai Patience Takarinda ◽  
Simon Nyadundu ◽  
Emmanuel Govha ◽  
Addmore Chadambuka ◽  
Notion Tafara Gombe ◽  
...  
Keyword(s):  
Case Control Study ◽  
Refugee Camp ◽  
Case Control ◽  
Habitat Modification ◽  
Whole Body ◽  
Disease Notification ◽  
Breeding Sites ◽  
Factors Associated ◽  
Malaria Outbreak ◽  
Control Study

Abstract BackgroundMalaria is a leading cause of morbidity and mortality among forcibly displaced populations including refugees, approximately two-thirds of whom reside in malaria endemic regions. Data from the rapid disease notification system (RDNS) reports for Manicaland Province in Zimbabwe showed that despite implementation of malaria control initiatives, there was an increase in number of malaria cases above action thresholds at Tongogara Refugee Camp in Chipinge District during weeks 12-14. We investigated the malaria outbreak describing the outbreak by person, place and time, assessing malaria emergency preparedness and response and appropriateness of case management. We also determined the factors associated with contracting malaria to enable the formulation of appropriate interventions, establish control and prevent future malaria outbreaks among this vulnerable population.MethodsWe conducted a 1:1 unmatched case control study involving 80 cases and 80 controls using interviewer-administered questionnaires at household level. Data was entered using Epi Data version 3.1 and analyzed using Epi InfoTM version 7.2.4 to generate medians, proportions, odds ratios and their 95% confidence intervals.ResultsMalaria cases were distributed throughout the 10 residential sections within Tongogara Refugee Camp, the majority being from section 7, 28/80 (35%). Despite constituting 11% of the total population, Mozambican nationals accounted for 36/80 (45%) cases. Males constituted 47/80 (59%) among cases versus controls 43/80 (54%), p=0.524. Median age for cases was also lower compared to controls; 15 years [Interquartile range (IQR), 9-26] versus 17 years (IQR, 10-30). Several natural and manmade potential vector breeding sites were observed around the camp. Risk factors associated with contracting malaria were engaging in outdoor activities at night [AOR 4.26 (95% CI, 1.43-12.68)], wearing clothes that do not cover the whole body [AOR=2.74 (95% CI 1.04-7.22) while sleeping in a refugee housing unit reduced the risk of contracting malaria [AOR=0.18 (CI, 0.06-0.55)]. ConclusionsThe malaria outbreak at Tongogara Refugee Camp reemphasizes the role of behavioral factors in malaria transmission. We recommend intensified health education to address human behaviors that expose residents to malaria and habitat modification with larviciding to eliminate mosquito breeding sites.

scholarly journals SAT0077 CARDIOVASCULAR RISK ASSESSMENT WITH CAROTID ULTRASONOGRAPHY IN ADDITION TO THE TRADITIONAL CARDIOVASCULAR RISK FACTORS IN RHEUMATOID ARTHRITIS PATIENTS: A CASE CONTROL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 973-973
Author(s):  
R. Gonzalez Mazario ◽  
J. J. Fragio-Gil ◽  
P. Martinez Calabuig ◽  
E. Grau García ◽  
M. De la Rubia Navarro ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Disease Duration ◽  
Case Control Study ◽  
Case Control ◽  
Healthy Controls ◽  
Carotid Ultrasonography ◽  
Control Study

Background:Cardiovascular disease (CV) is the most frequent cause of death in rheumatoid arthritis (RA) patients. It is well known that RA acts as an independent cardiovascular risk factor.Objectives:To assess the CV risk in RA patients using carotid ultrasonography (US) additionally to the traditional CV risk factors.Methods:A prospective transversal case control study was performed, including adult RA patients who fulfilled ACR/EULAR 2010 criteria and healthy controls matched according to CV risk factors. Population over 75 years old, patients with established CV disease and/or chronic kidney failure (from III stage) were excluded. The US evaluator was blinded to the case/control condition and evaluated the presence of plaques and the intima-media thickness. Statistical analysis was performed with R (3.6.1 version) and included a multivariate variance analysis (MANOVA) and a negative binomial regression adjusted by confounding factors (age, sex and CV risk factors).Results:A total of 200 cases and 111 healthy controls were included in the study. Demographical, clinical and US data are exposed in table 1. Not any difference was detected in terms of CV risk factors between the cases and controls. In both groups a relationship between age, BMI and high blood pressure was detected (p<0.001).Table 1.Table 2.RA basal characteristicsDisease duration (years)16,98 (11,38)Erosions (X-Ray of hands/feet)163 (81,5%)Seropositive (RF/anti-CCP)146 (73%)Extra-articular symptoms44 (22%)Intersticial difusse lung disease10 (5%)Rheumatoid nodules14 (7%)Prednisone use103 (51,5%)Median dose of Prednisone last year (mg)2,34 (2,84)sDMARDsMethotrexate104 (52%)Leflunomide29 (14,5%)Hydroxycloroquine9 (4,5%)bDMARDs89 (44,5%) TNFi41 (20,5%) Abatacept15 (7,5%) IL6i22 (11%) RTX11 (5,5%)JAKi26 (13%) Baricitinib11 (5,5%) Tofacitinib15 (7,5%)DAS 28-ESR3,1 (2,3, 3,9)SDAI7,85 (4,04, 13,41)HAQ0,88 (0,22, 1,5)RF (U/mL)51 (15, 164,25)Anti-CCP (U/mL)173 (22, 340)Patients showed higher intima-media (both right and left) thickness compared to controls (p<0.006). Moreover it was also related to the disease duration and DAS28 score (p<0.001). A higher plaque account was noted in cases(p<0.004) and it was also related to the disease duration (p<0.001).Conclusion:RA implies a higher CV risk. Traditional CV risk factors explains only partially the global risk. These findings support that RA acts as an independent cardiovascular risk factor.Disclosure of Interests:None declared

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