A Community-based Case-control Study of Behavioral Factors Associated with Scrub Typhus during the Autumn Epidemic Season in South Korea

Sun-Seog Kweon Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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Jin-Su Choi Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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Hyun-Sul Lim Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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Jang-Rak Kim Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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Keon-Yeop Kim Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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So-Yeon Ryu Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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So-Dam Lee Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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Heung-Ku Im Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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Jun-Wook Kwon Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea; Department of Preventive Medicine, Chonnam National University College of Medicine, Gwangju, South Korea; Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, South Korea; Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, South Korea; Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea; Department of Preventive Medicine, Chosun University College of Medicine, Gwangju, South Korea; Department of Communicable Diseases Control, Korea Centers for Disease Control and Prevention, Seoul, South Korea

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A community-based, case-control study was carried out to investigate risk factors for scrub typhus in South Korea. Cases (n = 299) were defined as persons who were diagnosed serologically within the past two weeks. Two neighborhood control subjects were selected by matching for sex, age, and occupation. Taking a rest directly on the grass, working in short sleeves, working with bare hands, and squatting to defecate or urinate posed the highest risks, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of 1.7 (1.2–2.3), 1.6 (1.1–2.4), 1.7 (1.2–2.4), and 2.0 (1.4–2.9), respectively. Wearing a long-sleeved shirt while working, keeping work clothes off the grass, and always using a mat to rest outdoors showed protective associations, with aORs and 95% CIs of 0.5 (0.3–0.9), 0.6 (0.4–0.9), and 0.7 (0.5–0.9), respectively. These results might be useful in the establishment of a detailed control strategy for scrub typhus.

Author Notes

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