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Risk factors for contracting plague in Nkayi district, Zimbabwe
P Manungo1, D E Peterson, C H Todd
1Matebeleland North Province, Ministery of Health and Child Welfare, Zimbabwe.
Objective:
To identify risk factors for contracting plague among the three to 16 year old age group.
Design:
A matched case control study, carried out in two parts.
Setting:
Nkayi District--a plague endemic area in Zimbabwe.
Subjects:
A total of 86 cases were randomly selected from a line listing of all reported plague cases in the district. Two neighbourhood controls were selected from households at least 500 m on either side of the case household.
Main Outcome Measures:
Maximum likelihood estimate of the odds ratio (OR) for the 17 risk factors studied (grouped as personal, environmental, domestic animals and rat reports).
Results:
Risk factors which were significantly associated with contracting plague were having a sick cat in the household (OR 3.4, 95% CI 1.1 to 13.0), herding cattle (OR 1.7, 95% CI 1.0 to 3.0), and age 10 years or older (OR 2.2, 95% CI 1.2 to 4.1). In a logistic model, only having a sick cat was found to be independently associated with being a case (OR 3.9, 95% CI 1.3 to 12.2).
Conclusion:
The presence of a sick domestic cat was identified as a risk factor for acquiring bubonic plague during this outbreak. Communities should be informed that sick cats may act as a warning of potential plague, and that if cats become sick they should be removed from the household.