Thomas R Bowhay, Matthew P Rubach, Ângelo J F Mendes, William L Nicholson, Jamie L Perniciaro, Michael J Maze, Ganga S Moorthy, Jo E B Halliday, Kathryn J Allan, Blandina T Mmbaga, Wilbrod Saganda, Bingileki F Lwezaula, Rudovick R Kazwala, Sarah Cleaveland, Katrina J Sharples, Venance P Maro, John A Crump
{"title":"Risk Factors for Spotted Fever Group Rickettsioses in Kilimanjaro Region, Tanzania.","authors":"Thomas R Bowhay, Matthew P Rubach, Ângelo J F Mendes, William L Nicholson, Jamie L Perniciaro, Michael J Maze, Ganga S Moorthy, Jo E B Halliday, Kathryn J Allan, Blandina T Mmbaga, Wilbrod Saganda, Bingileki F Lwezaula, Rudovick R Kazwala, Sarah Cleaveland, Katrina J Sharples, Venance P Maro, John A Crump","doi":"10.1093/ofid/ofae664","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 <i>Rickettsia africae</i> immunofluorescence antibody reciprocal titer ≥64, and acute SFGR as a ≥4-fold rise between paired sera. Logistic regression was used to identify associations.</p><p><strong>Results: </strong>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; <i>P</i> < .011), rural residence (aOR, 4.1; <i>P</i> = .007), and areas with maximum daily temperature <26°C (aORs for higher temperature groups, <0.42; <i>P</i> < .035). Odds of SFGR exposure were higher in those working in the garden (aOR, 1.8; <i>P</i> = .010) and seeing a dog (aOR, 1.5; <i>P</i> = .010). Odds of SFGR exposure were lower in the age group 0-2 years (aORs for older age groups, >1.5; <i>P</i> < .026), female sex (aOR, 0.62; <i>P</i> < .001), and being from the Chaga tribe (aOR, 0.68; <i>P</i> = .003).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae664"},"PeriodicalIF":3.8000,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651152/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae664","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Risk Factors for Spotted Fever Group Rickettsioses in Kilimanjaro Region, Tanzania.
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.
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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