{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:41:31Z","timestamp":1791186091957,"version":"4.1.0"},"reference-count":13,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,3]]},"abstract":"<jats:p>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\u20135.8), delayed (\u2265 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6\u20139.6), and delayed (\u2265 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0\u201311) were associated with illness, whereas having stayed in the rehabilitation camp for \u2265 6 months was protective (aOR = 0.20, 95% CI = 0.10\u20130.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0643","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T17:10:39Z","timestamp":1467220239000},"page":"452-456","source":"Crossref","is-referenced-by-count":13,"title":["A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012"],"prefix":"10.4269","volume":"95","author":[{"given":"Irenee","family":"Umulisa","sequence":"first","affiliation":[{"name":"1Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Omolo","sequence":"additional","affiliation":[{"name":"2CTS Global assigned to U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Muldoon","sequence":"additional","affiliation":[{"name":"3University of British Columbia, Vancouver, Canada."},{"name":"4University of Ottawa, Ottawa, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine","family":"Condo","sequence":"additional","affiliation":[{"name":"5School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Habiyaremye","sequence":"additional","affiliation":[{"name":"1Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Marie","family":"Uwimana","sequence":"additional","affiliation":[{"name":"1Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Aimee","family":"Muhimpundu","sequence":"additional","affiliation":[{"name":"6Epidemic Infectious Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tura","family":"Galgalo","sequence":"additional","affiliation":[{"name":"2CTS Global assigned to U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Rwunganira","sequence":"additional","affiliation":[{"name":"1Rwanda Field Epidemiology and Laboratory Training Program, School of Public Health, University of Rwanda, Kigali, Rwanda."},{"name":"6Epidemic Infectious Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anicet G.","family":"Dahourou","sequence":"additional","affiliation":[{"name":"2CTS Global assigned to U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Tongren","sequence":"additional","affiliation":[{"name":"7Division of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Baptiste","family":"Koama","sequence":"additional","affiliation":[{"name":"8Division of Global HIV\/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"McQuiston","sequence":"additional","affiliation":[{"name":"9National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratima L.","family":"Raghunathan","sequence":"additional","affiliation":[{"name":"8Division of Global HIV\/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Massung","sequence":"additional","affiliation":[{"name":"9National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wangeci","family":"Gatei","sequence":"additional","affiliation":[{"name":"8Division of Global HIV\/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Boer","sequence":"additional","affiliation":[{"name":"8Division of Global HIV\/AIDS, Center for Global Health, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Nyatanyi","sequence":"additional","affiliation":[{"name":"6Epidemic Infectious Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Mills","sequence":"additional","affiliation":[{"name":"3University of British Columbia, Vancouver, Canada."},{"name":"4University of Ottawa, Ottawa, Canada."},{"name":"10Stanford University, Stanford, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Binagwaho","sequence":"additional","affiliation":[{"name":"11Ministry of Health Rwanda, Kigali, Rwanda."},{"name":"12Harvard Medical School, Boston, Massachusetts."},{"name":"13Geisel School of Medicine at Dartmouth, Hanover, New 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