ABSTRACT

Background: -Louse born Relapsing Fever is endemic in the mountains of Ethiopia and it accounts 27% of hospital admission. Most of the times, it occurs in the form of outbreak. In February 2017, a rise of louse-born Relapsing Fever cases was reported to Akaki Kality sub city from Akaki Kality woreda six districts.  The aim of this investigation was to identify the source of infection, risk factors and recommend preventive measures to challenge the problem.

Methods:  - We defined suspected cases as abrupt onset of rigors with remittent fever, headache, arthralgia and myalgia and compared each of them to two unmatched Controls randomly selected from health facilities based on screening result.  A total of 37 cases and 74 Controls (screened negative for Relapsing Fever clinically and by the laboratory) were interviewed. We run a Bivariate and Multivariate test to identify risk factors.  We assessed the residency place, living condition, environmental sanitation and personal hygiene of the participants.

Results: -We identified 70 total cases and interviewed 37 cases. The median age of cases was 20 (IQR=4).  The attack rate was 16/100,000 population.  Participant who was slept with greater six persons were 5.5 times more likely to develop relapsing fever than control (95% CI, 1.1, 28.0; P value 0.0379). Those individuals bathed at least weekly were 96% less likely to be affected, than those who do not take body both at all (AOR= 0.04(0.002,0.8).  No significant association was observed with monthly income, contact history, change cloth at night or not, washing clothes frequently or not, age groups and sex of the respondent.

Conclusion: We verified the existence of Relapsing fever outbreaks in Akaki  Kality  Sub  city Woreda six  which was  significantly associated  with mass  sleeping  and  poor  Hygiene.  Close follow up of disease trend is recommended to minimize the impact.