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Volume 29, Number 5—May 2023
Research

Environmental, Occupational, and Demographic Risk Factors for Clinical Scrub Typhus, Bhutan

Tandin ZangpoComments to Author , Yoenten Phuentshok, Kezang Dorji, Chencho Dorjee, Sithar Dorjee, Peter Jolly, Roger Morris, Nelly Marquetoux, and Joanna McKenzie
Author affiliations: Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan (T. Zangpo, Y. Phuentshok, K. Dorji, C. Dorjee, S. Dorjee); Massey University, Palmerston North, New Zealand (T. Zangpo, Y. Phuentshok, K. Dorji, P. Jolly, N. Marquetoux, J. McKenzie); Ministry of Health, Thimphu (T. Zangpo, K. Dorji); World Organisation for Animal Health, Paris, France (Y. Phuentshok); Morvet Ltd, Masterton, New Zealand (R. Morris)

Main Article

Table 3

Variables that had a χ2 p value <0.2 in unconditional univariable analysis that were considered for the final multivariable model in a study of risk factors for clinical scrub typhus, Bhutan, 2015

Variable* Odds ratio Wald p value χ2 p value Multivariable model
Demographic variables
Age (continuous)
 0.98
 0.032
 0.028
 †
Occupation (reference: farmer) 0.036
Housewife 0.31 0.066
Civil servant/military 0.19 0.043
Corporate/private business 0.64 0.582
Preschool/student 1.48 0.387
Other (monk/nun, construction)
 2.57
 0.424
Rural location (reference: urban)
 7.23
 <0.001
 <0.001
House-related variables
Traditional house (reference: modern) 3.75 0.001 <0.001
2‒3 floors in house (reference: 1 floor) 0.40 0.017 0.015
Traditional toilet‡ (reference: modern) 2.18 0.046 0.043 †
Toilet located outside house§ (reference: inside)
 11.23
 <0.001
 <0.001
Toilet type (reference: modern inside) <0.001
Modern outside 11.57 0.002
Traditional outside
 16.20
 <0.001
Kept piles of wood (firewood, logs/timber, brush, and twigs) against the house wall (reference: no) 1.88 0.078 0.076
Kept firewood against house wall (reference: no) 1.85 0.100 0.098 †
Kept logs/timber against house wall (reference: no) 2.07 0.151 0.143
Kept wood in the yard (reference: no)
 0.48
 0.047
 0.045
Animal ownership
Possessed cattle (reference: no) 0.44 0.023 0.021
Possessed poultry (reference: no)
 0.48
 0.037
 0.035
Protective measures
Worked outdoors in short sleeves (reference: never) 0.035
Occasionally 0.94 0.912
Most of the time 0.59 0.299
Always
 2.71
 0.091
Worked in garden/fields with bare hands (reference: never) 0.108 †
Occasionally 3.26 0.040
Most of the time 1.47 0.575
Always
 0.95
 0.911
Changed working clothes to sleep (reference: never) 0.119
Occasionally 0.62 0.536
Most of the time 0.25 0.080
Always
 0.60
 0.499
Frequency of showers (reference: never and weekly) 0.120
2–3 times/week 0.47 0.069
Every day
 0.48
 0.104
Cultivation-related exposures
Harvested cardamom (reference: no) 7.11 0.013 0.003 †
Worked in an orchard (reference: no) 1.86 0.180 0.174
Cleared bushes for others as a job (reference: no)
 2.13
 0.056
 0.053
 †
Forest-related variables
Visited forest (Reference: no) 2.26 0.023 0.022
Collected timber in the forest (reference: no) 4.19 0.205 0.157
Collected nonwood products in forest (reference: no)
 2.90
 0.129
 0.109
Other outdoor exposures
Sat or slept on grass (reference: never) 0.059 †
1– 6 times 1.43 0.436
7–10 times 1.67 0.392
>10 times 3.47 0.009

*Exposure variables related to a period of 1 mo before patients’ recruitment at healthcare center. †Significant (p<0.05) in the multivariable model. ‡Traditional toilets are a pit latrine with wattle and daub walls or planks without continuous water supply. Modern toilets have an Indian or western pot type toilet with concrete or tiled walls and floor with a continuous water supply. Toilet type was considered regardless of location inside or outside the house. §Considered location only, regardless of modern or traditional toilet type.

Main Article

Page created: February 24, 2023
Page updated: April 18, 2023
Page reviewed: April 18, 2023
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