Umulisa Irenee, Omolo Jared, Muldoon Katherine A, Condo Jeanine, Habiyaremye Francois, Uwimana Jean Marie, Muhimpundu Marie Aimee, Galgalo Tura, Rwunganira Samuel, Dahourou Anicet G, Tongren Eric, Koama Jean Baptiste, McQuiston Jennifer, Raghunathan Pratima L, Massung Robert, Gatei Wangeci, Boer Kimberly, Nyatanyi Thierry, Mills Edward J, Binagwaho Agnes
Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda.
CTS Global assigned to U.S. Centers for Disease Control and Prevention, Kigali, Rwanda.
Am J Trop Med Hyg. 2016 Aug 3;95(2):452-6. doi: 10.4269/ajtmh.15-0643. Epub 2016 Jun 27.
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.
2012年8月，实验室检测证实卢旺达西部一家男性青少年康复中心爆发了流行性斑疹伤寒和战壕热混合疫情。76例疑似病例和118名对照者被纳入一项非匹配病例对照研究，以确定疫情期间出现症状性疾病的危险因素。疑似病例为2012年4月以来该康复中心居民中的发热患者或有发热史者。总共报告了来自1910名男性青少年群体中的199例疑似病例（发病率=10.4%），其中7人死亡（病死率=3.5%）。多变量分析后发现，衣服上发现虱子史（调整优势比[aOR]=2.6，95%置信区间[CI]=1.1-5.8）、衣服洗涤延迟（≥2天）（aOR=4.0，95%CI=1.6-9.6）以及被褥洗涤延迟（≥1个月）（aOR=4.6，95%CI=2.0-11）与患病有关，而在康复营地停留≥6个月具有保护作用（aOR=0.20，95%CI=0.10-0.40）。加强监测和改善卫生状况可预防未来的疫情爆发。
