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Volume 31, Number 6—June 2025

CME ACTIVITY - Synopsis

Clinical Manifestations, Risk Factors, and Disease Burden of Rickettsiosis, Cambodia, 2007–2020

Gerard C. Kelly, Agus Rachmat, Long Khanh Tran, Chonthida Supaprom, Hip Phireak, Satharath Prom, Heng Sopheab, Nora Cleary, Michael von Fricken, Christina M. Farris, and Andrew G. LetiziaComments to Author 
Author affiliation: Culmen International, LLC, Alexandria, Virginia, USA (G.C. Kelly, L.K. Tran); AC Investment Co, contractor for NAMRU INDO PACIFIC, Phnom Penh, Cambodia (A. Rachmat, C. Supaprom, H. Phireak); Oxford University Clinical Research Unit, Jakarta, Indonesia (A. Rachmat); Cambodia Ministry of National Defense Department of Health, Phnom Penh (S. Prom); Cambodia National Institute of Public Health, Phnom Penh (H. Sopheab); University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA (N. Cleary, M. von Fricken); US Naval Medical Research Command Viral and Rickettsial Diseases Department, Silver Spring, Maryland, USA (C.M Farris); US Naval Medical Research Unit INDO PACIFIC, Singapore (A.G. Letizia)

Main Article

Table 3

Association between key participant characteristics and rickettsial infection among patients with acute undifferentiated febrile illness who tested positive for rickettsioses as part of study of rickettsiosis in Cambodia, 2007–2020*

Characteristic OR (95% CI) p value
Year
 1.04 (1.02–1.07)
 0.001
Age group, y
<15 Referent
16–25 3.68 (2.79–4.86) <0.001
26–35 3.06 (2.30–4.06) <0.001
36–45 4.17 (3.14–5.54) <0.001
>46
 4.02 (3.07–5.26)
 <0.001
Sex
F Referent
M
 1.16 (0.99–1.36)
 0.072
Education
Lower primary school Referent
Primary school 0.77 (0.63–0.95) 0.014
Lower secondary school 0.70 (0.52–0.94) 0.019
High school 0.56 (0.39–0.77) <0.001
Diploma or university
 0.23 (0.04–0.77)
 0.047
Employment status
Unemployed Referent
Employed
 0.69 (0.50–0.94)
 0.022
Season
Dry, Nov–Apr Referent
Wet, May–Oct
 0.97 (0.84–1.13)
 0.7
Area
Rural Referent
Urban
 1.95 (1.29–2.99)
 0.002
Terrestrial ecosystem
Southeastern Indochina dry evergreen forests Referent
Cardamom Mountains rain forests 0.90 (0.30–2.21) 0.8
Central Indochina dry forests 3.68 (2.51–5.60) <0.001
Tonle Sap-Mekong peat swamp forests
 1.74 (1.03–2.98)
 0.041
Influence of rural/urban setting within terrestrial ecosystem†
Urban/Cardamom Mountains rain forests
Urban/Central Indochina dry forests 0.52 (0.32–0.85) 0.009
Urban/Tonle Sap-Mekong peat swamp forests
Had traveled
No Referent
Yes
 0.79 (0.62–1.01)
 0.061
Traveled to forest
No Referent
Yes
 1.87 (1.52–2.30)
 <0.001
Antibiotic use in past 30 d
No Referent
Yes 1.02 (0.72–1.41) >0.9

*Determined by generalized linear model for binomial regression. OR, odds ratio. †Reference group is rural location (data not listed) for respective urban ecosystems.

Main Article

Page created: March 18, 2025
Page updated: May 27, 2025
Page reviewed: May 27, 2025
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