Table 4. Exposure characteristics of acute hepatitis E patients and age-matched controls.
| Conservative Case Definition | Liberal Case Definition | |||||
| Cases | Controls | Odds Ratio (CLR) | Cases | Controls | Odds Ratio (CLR) | |
| (N = 24) | (N = 68) | (95% CI) | (N = 46) | (N = 134) | (95% CI) | |
| Exposure Characteristics | No. (%) | No (%) | No. (%) | No (%) | ||
| Primary Employment Location | ||||||
| Indoors | 11 (45.8) | 40 (58.8) | 1.0 | 15 (32.6) | 69 (51.5) | 1.0 |
| Outdoors | 13 (54.2) | 28 (41.2) | 1.63 (0.57–4.62) | 31 (67.4) | 65 (48.5) | 3.17 (1.35–7.47) |
| Livestock Ownership * | ||||||
| Cows (Any) | 5 (20.8) | 27 (39.7) | 0.35 (0.10–1.15) | 13 (28.3) | 53 (39.6) | 0.62 (0.29–1.31) |
| Goats (Any) | 5 (20.8) | 19 (27.9) | 0.61 (0.18–2.12) | 13 (28.3) | 30 (22.4) | 1.42 (0.63–3.24) |
| Chickens (Any) | 11 (45.8) | 38 (55.9) | 0.52 (0.18–1.47) | 26 (56.5) | 72 (53.7) | 1.05 (0.53–2.07) |
| Ducks (Any) | 14 (58.3) | 34 (50.0) | 1.17 (0.45–3.05) | 29 (63.0) | 65 (48.5) | 1.58 (0.79–3.16) |
| Recent ** travel to town/city | ||||||
| None | 6 (25.0) | 45 (66.2) | 1.0 | 20 (43.5) | 90 (67.2) | 1.0 |
| Any § | 18 (75.0) | 23 (33.8) | 10.23 (2.17–48.15) | 26 (56.5) | 44 (32.8) | 2.37 (1.15–4.87) |
| “Eating Out” frequency † | ||||||
| Never | 17 (70.8) | 57 (83.8) | 1.0 | 28 (60.9) | 106 (79.1) | 1.0 |
| <7 times/wk | 5 (20.8) | 6 (8.8) | 2.98 (0.77–11.56) | 12 (26.1) | 18 (13.4) | 3.15 (1.16–8.52) |
| 7+ times/wk | 2 (8.3) | 5 (7.4) | 0.63 (0.07–5.51) | 6 (13.0) | 10 (7.5) | 1.80 (0.58–5.56) |
| Recent “Jaundice” contact **, ‡ | ||||||
| None | 17 (73.9) | 64 (97.0) | 1.0 | 34 (75.6) | 127 (97.0) | 1.0 |
| Any § | 6 (26.1) | 2 (3.0) | 10.83 (2.18–53.79) | 11 (24.4) | 4 (3.1) | 9.63 (3.06–30.37) |
| Recent Traditional Healer Visit ** | ||||||
| None | 5 (20.8) | 59 (86.8) | 1.0 | 12 (26.1) | 118 (88.1) | 1.0 |
| Any §, ‡‡ | 19 (79.2) | 9 (13.2) | 39.45 (5.18–300.24) | 34 (73.9) | 16 (11.9) | 35.55 (8.42–150.05) |
| Recent Injection ** | ||||||
| None | 16 (66.7) | 55 (80.9) | 1.0 | 29 (63.0) | 98 (73.1) | 1.0 |
| Any | 8 (33.3) | 13 (19.1) | 1.80 (0.55–5.87) | 17 (37.0) | 36 (26.9) | 1.86 (0.79–4.35) |
| Type of Household Latrine | ||||||
| Open/Hanging (Unsanitary) | 16 (66.7) | 30 (44.1) | 1.0 | 25 (54.4) | 56 (41.8) | 1.0 |
| Sealed/Slab (Sanitary) || | 8 (33.3) | 38 (55.9) | 0.28 (0.09–0.90) | 21 (45.7) | 78 (58.2) | 0.54 (0.26–1.13) |
| Drinking Water Source ‡ | ||||||
| Tubewell | 23 (100.0) | 58 (85.3) | - | 42 (93.3) | 121 (90.3) | 1.0 |
| Pond | 0 | 2 (2.9) | - | 1 (2.2) | 3 (2.2) | 1.22 (0.10–14.4) |
| River | 0 | 8 (11.8) | - | 9 (6.7) | 2 (4.4) | 0.69 (0.14–3.46) |
| Cooking Water Source | ||||||
| Tubewell | 2 (8.7) | 3 (4.4) | 1.0 | 3 (6.7) | 5 (3.7) | 1.0 |
| Pond | 17 (73.9) | 43 (63.2) | 0.56 (0.09–3.41) | 32 (71.1) | 88 (65.7) | 0.60 (0.14–2.53) |
| River | 4 (17.4) | 22 (32.4) | 0.23 (0.03–1.98) | 10 (22.2) | 41 (30.6) | 0.36 (0.07–1.89) |
| Average Water Consumption †† | ||||||
| ≤7 glasses per day | 7 (29.2) | 37 (54.4) | 1.0 | 14 (30.4) | 72 (53.7) | 1.0 |
| ≥8 glasses per day | 17 (70.8) | 31 (45.6) | 3.11 (0.92–10.55) | 32 (69.6) | 62 (46.3) | 2.83 (1.19–6.74) |
NB. Conservative case definition includes only individuals found to be anti-HEV IgM seropositive by the AFRIMS assay. The liberal case definition includes individuals found positive by either AFRIMS or the MBS assay.
“None” is not shown, comparison of livestock ownership uses “None” as the reference category (OR = 1.0).
Recent is defined as in the three months prior to the onset of illness/interview
Defined as the number of times eating food prepared outside the home in an average week.
p<0.005, Univariate conditional (fixed effects) logistic regression (CLR) comparing cases and controls.
“Don't know” (n<5) responses not shown/included in analysis.
p<0.05, Univariate conditional (fixed effects) logistic regression comparing cases and controls.
In an age category stratified analysis (≤15, 16–30,>30) only the≤15 group remained significantly at risk, likely due to low n's in each age category.
This association likely reflects a local practice of seeking initial care from traditional “faith” healers early during hepatitis-like illnesses.