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Volume 9, Number 12—December 2003

Research

Risk Factors for Marburg Hemorrhagic Fever, Democratic Republic of the Congo

Daniel G. Bausch*1Comments to Author , Matthias Borchert†2, Thomas Grein‡, Cathy Roth‡, Robert Swanepoel§, Modeste L. Libande¶, Antoine Talarmin#3, Eric Bertherat**4, Jean-Jacques Muyembe-Tamfum¶, Ben Tugume††, Robert Colebunders†, Kader M. Kond采5, Patricia Pirard§§, Loku L. Olinda¶, Guénaël R. Rodier‡, Patricia Campbell¶¶, Oyewale Tomori‡‡, Thomas G. Ksiazek*, and Pierre E. Rollin*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta Georgia, USA; †Institute of Tropical Medicine, Antwerp, Belgium; ‡World Health Organization, Geneva, Switzerland; §National Institute for Communicable Diseases, Johannesburg, South Africa; ¶Ministry of Health, Kinshasa, Democratic Republic of the Congo; #Institut Pasteur, Cayenne, French Guiana; **Le Pharo, Marseille, France; ††Uganda Virus Research Institute, Entebbe, Uganda; ‡‡World Health Organization, AFRO, Harare, Zimbabwe; §§Doctors without Borders, Brussels, Belgium; ¶¶Doctors without Borders, Amsterdam, the Netherlands; 1Present address: Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.; 2Present address: London School of Hygiene and Tropical Medicine, London, England.; 3Present address: Institut Pasteur, Bangui, Central African Republic.; 4Present address: World Health Organization, Geneva, Switzerland.; 5Present address: World Health Organization, AFRO, Ouagadougou, Burkina Faso.

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Table 3

Antibody to Marburg virus and possible risk factors for Marburg hemorrhagic fever in Durba, Democratic Republic of the Congo, 1999a

Characteristic All participants
(%) Antibody positive (%) Antibody negative (%) OR (95% CI) p value
Behavior in the minesb





Wear mask
4/289 (1)
1/13 (8)
3/276 (1)
7.6 (0. to 78.4)
0.17
Drink water from sources in the mine
160/289 (55)
9/13 (69)
151/276 (55)
1.9 (0.6 to 6.2)
0.40
Use explosives
129/289 (45)
7/13 (54)
122/276 (44)
1.5 (0.5 to 4.5)
0.57
Wear boots
46/289 (16)
2/13 (15)
44/276 (16)
1.0 (0.2 to 4.5)
1.00
Household/village exposures to someone with
Durba syndromec





Touched corpse
88/905 (10)
4/15 (27)
84/890 (9)
3.5 (1.1 to 11.2)
0.05
Touched blood, feces, or urine
60/903 (7)
3/15 (20)
57/888 (6)
3.6 (1.0 to 13.3)
0.07
Worked with someone with syndrome
248/906 (27)
7/15 (47)
241/891 (27)
2.4 (0.8 to 6.6)
0.15
Been in the same room with someone with syndrome
179/902 (20)
4/15 (27)
175/887 (20)
1.5 (0.5 to 4.7)
0.51
Touched skin of person during illness
286/903 (32)
6/15 (40)
280/888 (32)
1.4 (0.5 to 4.1)
0.58
Someone in the household sick with
syndrome
210/906 (23)
4/15 (27)
206/891 (23)
1.2 (0.4 to 3.8)
0.76
Participated in burial
393/904 (43)
6/15 (40)
387/889 (44)
0.9 (0.3 to 2.5)
1.00
Healthcare-related exposures





Had Durba syndrome yourself
60/912 (7)
4/15 (27)
56/897 (6)
5.4 (1.7 to 17.7)
0.01
Received injections in the last year
505/907 (56)
13/15 (87)
492/892 (55)
5.2 (1.2 to 23.6)
0.02
Underwent surgery in the last year
85/905 (9)
2/15 (13)
83/890 (9)
1.5 (0.3 to 6.7)
0.64
Received scarificationd in the last year
209/906 (23)
4/15 (27)
205/891 (23)
1.2 (0.4 to 3.9)
0.76
Animal exposures





Rodents





Touched
437/897 (49)
4/14 (29)
433/883 (49)
0.4 (0.1 to 1.3)
0.18
Ate
271/892 (30)
1/15 (7)
270/877 (31)
0.2 (0.0 to 1.2)
0.05
Bitten by
200/896 (22)
3/15 (20)
197/881 (22)
0.9 (0.2 to 3.1)
1.00
Bats





Touched
169/901 (19)
4/14 (29)
165/887 (19)
1.8 (0.5 to 5.6)
0.31
Ate
31/898 (3)
0/15 (-)
31/883 (4)
-
1.00
Bitten by
8/896 (1)
0/15 (-)
8/881 (1)
-
1.00
Monkeys





Touched
502/892 (56)
6/14 (43)
496/878 (57)
0.6 (0.2 to 1.7)
0.42
Atee
682/895 (76)
11/14 (79)
671/881 (76)
1.1 (0.3 to 4.2)
1.00
Bitten by 76/895 (8) 1/15 (7) 75/880 (9) 0.8 (0.1 to 5.9) 1.00

aOdds ratios (OR) and p values are for the comparison between antibody-positive and -negative participants. CI, confidence interval.
     bIncludes only responses from persons who stated that they currently worked in the mines.
     cBefore questioning began, Durba syndrome was described to the participant as “a severe illness with high fever and bleeding from the nose, mouth, and/or anus.”
     dScarification is the practice of intentionally scarring the skin with sharp instruments. It may be done for aesthetic reasons or because of a belief that it has medicinal or spiritual value.
     eMany participants reported the meat was smoked or cured at the time of purchase, so potential exposure to viable virus may have been limited.

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