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Korean Journal of Epidemiology 1994;16(1): 41-53.
A Case-Control Study of Risk Factors for Hemorrhagic Fever with Renal Syndrome in Korean Soldiers.
Jung Han Park, Min Hae Yeh, Yeon Ja Hwang, Kenneth E Dixon
Abstract
A case-control study was conducted to identify the specific risk fatctors for hemorrhagic fever with renal syndrome(HFRS) in Korean soldiers. The case group consisted of 196 confirmed HFRS patients who were admitted to the Capital Armed Forces General Hospital between I November 1989 and 15 January 1992 and were 25 years old or younger. The control group consisted of 258 non-HFRS patients who were admitted to the same hospital and meeting following conditions; onset of symptom was within five days before or after the onset date of case, had regular military activities up to the onset of symptom, and no noticeable signs for the diagnosis. Most of the cases and controls came from the units located in Kyonggi province (61.7% of cases, 75.9% of controls) and Kangwon province (31.6% of cases, 15.5% of controls). The distribution of places where the cases and controls had moved into during 60 days period prior to admission was similar to that of the base units. Among 196 cases, 89.3% occurred in October through December and 46.9% in November. Significant risk factor was the field living condition. The odds ratio (OR) for sleeping in a tent vs not sleeping in a tent during 60 days period prior to admission was 1.55 (95% CI=1.07-2.25) and that for sleeping on the bare ground or in a vehicle was 3. 63 (95% CI=1.48-8.86). Other statistically significant risk factors were advanced tac tical training (OR=1.51, 95% CI=1.02-2.24), drinking surface water (OR=1.83, 95% CI=1.21-2.77), exposure to indoor dust (OR=1.58, 95% CI=1.05-2. 37), fixing trench (OR=1.63, 95% CI=1.12-2.37) and having seen Apodemus in the outdoors (OR=4. 61, 95% CI=2.12-10.02). Most of these risk factors were related with camping (field living condition) and thus the interaction between each risk factor and camping was examined by cross tabulation. None of the ORs for five risk factors was statistically significant for the cases who had no camping. However all of the ORs for the cases who had camping were increased and statistically significant ;2.27 for advanced tactical training, 2.64 for drinking surface water, 2.14 for exposure to indoor dust, 2.91 for fixing trench, and 7.58 for having seen Apodemus in outdoors. It was revealed in this study that the highest risk factor for HFRS is camping in the area where the Apodemus inhabits.


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