Risk Factors of Streptococcus suis Infection in Vietnam. A Case-Control Study 英文参考文献.docVIP

RiskFactorsofStreptococcussuisInfectioninVietnam.A Case-ControlStudy DangTrungNghiaHo1,2,3,ThiPhuongTuLe1,MarcelWolbers1,QuangThaiCao1,VanMinhHoang Nguyen1,VuThieuNgaTran1,ThiPhuongThaoLe1,HoanPhuNguyen3,ThiHongChauTran3 ,Xuan SinhDinh3,SongDiepTo3,ThiThanhHangHoang1,2,TruongHoang2,JamesCampbell1,VanVinhChau Nguyen3,TranChinhNguyen3,VanDungNguyen4,ThiHoaNgo1,BrianG.Spratt6,TinhHienTran1,3, JeremyFarrar1,ConstanceSchultsz1,5* 1OxfordUniversityClinicalResearchUnit,WellcomeTrustMajorOverseasProgramme,HospitalforTropicalDiseases,HoChiMinhCity,Vietnam, 2PhamNgocThach UniversityofMedicine,HoChiMinhCity,Vietnam,3HospitalforTropicalDiseases,HoChiMinhCity,Vietnam,4Sub-DepartmentofAnimalHealthHoChiMinhCity,Ho Chi Minh City, Vietnam, 5Center for Poverty-related Communicable Diseases, Academic Medical Centre, Amsterdam Institute of Global Health and Development, UniversityofAmsterdam,Amsterdam,TheNetherlands,6DepartmentofInfectiousDiseaseEpidemiology,ImperialCollegeLondon,London,UnitedKingdom Abstract Background:Streptococcussuisinfection,anemergingzoonosis,isanincreasingpublichealthproblemacrossSouthEast Asia and the most common cause of acute bacterial meningitis in adults in Vietnam. Little is known of the risk factors underlyingthedisease. MethodsandFindings:Acase-controlstudywithappropriatehospitalandmatchedcommunitycontrolsforeachpatient wasconductedbetweenMay2006andJune2009.Potentialriskfactorswereassessedusingastandardizedquestionnaire andinvestigationofthroatandrectalS.suiscarriageincases,controlsandtheirpigs,usingreal-timePCRandcultureof swab samples. We recruited 101 cases of S. suis meningitis, 303 hospital controls and 300 community controls. By multivariateanalysis,riskfactorsidentifiedforS.suisinfectionascomparedtoeithercontrolgroupincludedeating‘‘high risk’’ dishes, including such dishes as undercooked pig blood and pig intestine (OR1=2.22; 95%CI=[1.15–4.28] and OR2=4.44;95%CI=[2.15–9.15]),occupationsrelatedtopigs(OR1=3.84;95%CI=[1.32–11.11]andOR2=5.