1. Risk Factors for Spotted Fever Group Rickettsioses in Kilimanjaro Region, Tanzania.
- Author
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Bowhay, Thomas R, Rubach, Matthew P, Mendes, Ângelo J F, Nicholson, William L, Perniciaro, Jamie L, Maze, Michael J, Moorthy, Ganga S, Halliday, Jo E B, Allan, Kathryn J, Mmbaga, Blandina T, Saganda, Wilbrod, Lwezaula, Bingileki F, Kazwala, Rudovick R, Cleaveland, Sarah, Sharples, Katrina J, Maro, Venance P, and Crump, John A
- Abstract
Background Knowledge gaps exist on risk factors for spotted fever group rickettsioses (SFGR) in sub-Saharan Africa. We sought to identify SFGR risk factors in Kilimanjaro Region, Tanzania. Methods We recruited febrile patients presenting at 2 hospitals in Moshi from February 2012 through May 2014. Standardized clinical and risk factor questionnaires were administered. SFGR exposure was defined as a Rickettsia africae immunofluorescence antibody reciprocal titer ≥64, and acute SFGR as a ≥4-fold rise between paired sera. Logistic regression was used to identify associations. Results Of 1190 participants providing ≥1 serum sample, the median age was 21.8 (range, 0.3–100.2) years, 646 (54.3%) were female, and 650 (54.6%) had SFGR exposure. Of 731 participants with paired sera, 67 (9.2%) had acute SFGR. On multivariable analysis, odds of acute SFGR were higher in the age group 0–2 years (adjusted odds ratios [aORs] for older age groups, <0.36; P <.011), rural residence (aOR, 4.1; P =.007), and areas with maximum daily temperature <26°C (aORs for higher temperature groups, <0.42; P <.035). Odds of SFGR exposure were higher in those working in the garden (aOR, 1.8; P =.010) and seeing a dog (aOR, 1.5; P =.010). Odds of SFGR exposure were lower in the age group 0–2 years (aORs for older age groups, >1.5; P <.026), female sex (aOR, 0.62; P <.001), and being from the Chaga tribe (aOR, 0.68; P =.003). Conclusions Those aged <2 years, rural residents, and persons residing in areas with cooler temperatures had increased odds of SFGR. Our results identify groups for further research on tick exposure and for targeted prevention interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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