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Comparative Study
. 2014 Jun;90(6):1047-58.
doi: 10.4269/ajtmh.14-0035. Epub 2014 Mar 31.

Identification of risk factors for plague in the West Nile Region of Uganda

Rebecca J Eisen  1 , Katherine MacMillan  2 , Linda A Atiku  2 , Joseph T Mpanga  2 , Emily Zielinski-Gutierrez  2 , Christine B Graham  2 , Karen A Boegler  2 , Russell E Enscore  2 , Kenneth L Gage  2
Affiliations
Comparative Study

Identification of risk factors for plague in the West Nile Region of Uganda

Rebecca J Eisen et al. Am J Trop Med Hyg. 2014 Jun.

Abstract

Plague is an often fatal, primarily flea-borne rodent-associated zoonosis caused by Yersinia pestis. We sought to identify risk factors for plague by comparing villages with and without a history of human plague cases within a model-defined plague focus in the West Nile Region of Uganda. Although rat (Rattus rattus) abundance was similar inside huts within case and control villages, contact rates between rats and humans (as measured by reported rat bites) and host-seeking flea loads were higher in case villages. In addition, compared with persons in control villages, persons in case villages more often reported sleeping on reed or straw mats, storing food in huts where persons sleep, owning dogs and allowing them into huts where persons sleep, storing garbage inside or near huts, and cooking in huts where persons sleep. Compared with persons in case villages, persons in control villages more commonly reported replacing thatch roofing, and growing coffee, tomatoes, onions, and melons in agricultural plots adjacent to their homesteads. Rodent and flea control practices, knowledge of plague, distance to clinics, and most care-seeking practices were similar between persons in case villages and persons in control villages. Our findings reinforce existing plague prevention recommendations and point to potentially advantageous local interventions.

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Figures

Figure 1.
Figure 1.
Locations of case (shaded) and control (unshaded) villages within Vurra and Okoro Counties, West Nile Region, Uganda. County locations within Uganda are shown in the inset.
Figure 2.
Figure 2.
Schematic of small mammal and flea trapping locations, West Nile Region, Uganda.
See this image and copyright information in PMC

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