Identification of Risk Factors for Plague in the West Nile Region of Uganda

The American journal of tropical medicine and hygiene (Impact Factor: 2.7). 03/2014; 90(6). DOI: 10.4269/ajtmh.14-0035
Source: PubMed


Plague is an often fatal, primarily flea-borne rodent-associated zoonosis caused by Yersinia pestis. We sought to identify risk factors for plague by comparing villages with and without a history of human plague cases within a model-defined plague focus in the West Nile Region of Uganda. Although rat (Rattus rattus) abundance was similar inside huts within case and control villages, contact rates between rats and humans (as measured by reported rat bites) and host-seeking flea loads were higher in case villages. In addition, compared with persons in control villages, persons in case villages more often reported sleeping on reed or straw mats, storing food in huts where persons sleep, owning dogs and allowing them into huts where persons sleep, storing garbage inside or near huts, and cooking in huts where persons sleep. Compared with persons in case villages, persons in control villages more commonly reported replacing thatch roofing, and growing coffee, tomatoes, onions, and melons in agricultural plots adjacent to their homesteads. Rodent and flea control practices, knowledge of plague, distance to clinics, and most care-seeking practices were similar between persons in case villages and persons in control villages. Our findings reinforce existing plague prevention recommendations and point to potentially advantageous local interventions.

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    ABSTRACT: Plague is a primarily flea-borne rodent-associated zoonosis that is often fatal in humans. Our study focused on the plague-endemic West Nile region of Uganda where affordable means for the prevention of human plague are currently lacking. Traditional hut construction and food storage practices hinder rodent exclusion efforts, and emphasize the need for an inexpensive but effective host-targeted approach for controlling fleas within the domestic environment. Here we demonstrate the ability of an insecticide delivery tube that is made from inexpensive locally available materials to reduce fleas on domestic rodents. Unbaited tubes were treated with either an insecticide alone (fipronil) or in conjunction with an insect growth regulator [(S)-methoprene], and placed along natural rodent runways within participant huts. Performance was similar for both treatments throughout the course of the study, and showed significant reductions in the proportion of infested rodents relative to controls for at least 100 d posttreatment. © 2014 Entomological Society of America.
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