Table 3.
Evaluation of potential risk factors for anthrax in case-control investigation participants in the 1 month prior to case onset date, Georgia, 2012
| Risk factor | Cases | Controls | OR*† | 95% CI | P value | ||
|---|---|---|---|---|---|---|---|
| n | % | n | % | ||||
| Livestock-related occupations‡ | 26 | 48 | 24 | 25 | 4·0 | 1·5–10·0 | 0·005 |
| Household animals | 53 | 79 | 67 | 51 | 7·2 | 2·7–19·1 | <0·001 |
| Cattle | 49 | 74 | 60 | 45 | 5·5 | 2·4–12·9 | <0·001 |
| Horse | 15 | 26 | 9 | 7 | 6·0 | 2·0–18·5 | 0·002 |
| Sheep | 17 | 28 | 20 | 16 | 2·2 | 1·0–5·2 | 0·06 |
| Goat | 9 | 16 | 7 | 6 | 3·3 | 1·1–10·0 | 0·03 |
| Dog | 35 | 59 | 39 | 31 | 4·6 | 2·0–10·4 | <0·001 |
| Livestock care | 47 | 70 | 61 | 47 | 3·8 | 1·8–8·2 | <0·001 |
| Herding | 31 | 48 | 43 | 34 | 3·2 | 1·4–7·2 | 0·004 |
| Cleaning§ | 37 | 61 | 54 | 43 | 3·0 | 1·4–6·4 | 0·005 |
| Milking | 15 | 25 | 29 | 23 | 1·5 | 0·6–3·8 | 0·4 |
| Shearing | 10 | 17 | 14 | 11 | 1·9 | 0·8–4·7 | 0·2 |
| Care for sick livestock | 16 | 25 | 6 | 5 | 24·6 | 3·2–188·1 | 0·002 |
| Sell sick livestock | 5 | 11 | 5 | 6 | 5·8 | 0·6–53·6 | 0·1 |
| Kill/dispose of carcass | 6 | 14 | 8 | 11 | 0·9 | 0·2–3·9 | 0·9 |
| Slaughter or skin livestock | 28 | 44 | 16 | 13 | 7·0 | 2·9–17·2 | <0·001 |
| Dispose of dead livestock | 11 | 17 | 3 | 2 | 18·1 | 2·3–142·0 | 0·006 |
| Exposed to livestock with suspected anthrax | 59 | 92 | 127 | 97 | 0·3 | 0·1–1·5 | 0·1 |
| How owner would treat sick livestock | |||||||
| Owner treated | 10 | 22 | 19 | 23 | 1·2 | 0·5–3·4 | 0·7 |
| Veterinarian treated | 29 | 63 | 54 | 66 | 0·9 | 0·4–2·2 | 0·9 |
| Slaughter own livestock | 27 | 42 | 29 | 25 | 2·9 | 1·3–6·6 | 0·01 |
| Activities during livestock slaughter | |||||||
| Holding animal down | 21 | 81 | 26 | 93 | 0·2 | 0·03–2·2 | 0·2 |
| Gutting | 24 | 96 | 25 | 89 | 2·6 | 0·3–25·2 | 0·4 |
| Killing | 23 | 88 | 27 | 96 | 1·0 | 0·06–16·0 | 1·0 |
| Skinning | 24 | 92 | 24 | 92 | 2·0 | 0·2–22·1 | 0·6 |
| Witnessing within a 10 m radius | 7 | 33 | 9 | 33 | 0·3 | 0·03–2·7 | 0·3 |
| Wear overalls or apron | 3 | 60 | 6 | 46 | Undefined | 1·0 | |
| Reason no protective equipment used | |||||||
| Not aware protective equipment needed | 13 | 76 | 22 | 81 | 0·7 | 0·1–5·2 | 0·7 |
| Normally does not use protective equipment | 15 | 65 | 10 | 38 | 0·3 | 0·03–2·5 | 0·3 |
| Meat handling activities | |||||||
| Cutting | 32 | 49 | 49 | 40 | 1·6 | 0·8–3·2 | 0·2 |
| Preparing for cooking | 21 | 34 | 45 | 37 | 0·8 | 0·4–1·7 | 0·6 |
| Moving | 29 | 45 | 40 | 33 | 2·1 | 1·0–4·2 | 0·05 |
| Cooking | 17 | 27 | 45 | 36 | 0·6 | 0·3–1·2 | 0·2 |
| Drying | 6 | 10 | 14 | 12 | 0·8 | 0·3–2·3 | 0·7 |
| Eating | 44 | 69 | 94 | 76 | 0·6 | 0·3–1·2 | 0·2 |
| Covered injury handling meat | 3 | 7 | 17 | 28 | 0·2 | 0·05–1·1 | 0·06 |
| Meat sources | |||||||
| Own farm | 21 | 36 | 24 | 21 | 3·5 | 1·3–9·4 | 0·01 |
| Butcher's shop | 31 | 52 | 82 | 67 | 0·4 | 0·2–0·9 | 0·03 |
| Grocery | 10 | 20 | 22 | 19 | 0·7 | 0·2–2·3 | 0·6 |
| Meat market | 25 | 47 | 61 | 52 | 0·8 | 0·4–1·7 | 0·5 |
| Neighbour | 13 | 28 | 18 | 17 | 2·5 | 0·7–8·4 | 0·2 |
| Mobile meat seller | 8 | 16 | 18 | 16 | 0·7 | 0·2–2·3 | 0·6 |
| Consumed raw or undercooked meat | |||||||
| Source of meat | |||||||
| Consumed cattle (beef) | 13 | 87 | 22 | 67 | 2·4 | 0·4–13·2 | 0·3 |
| Consumed sheep (mutton or lamb) | 5 | 33 | 15 | 47 | 0·3 | 0·03–2·6 | 0·3 |
| Where meat was consumed | |||||||
| At home | 12 | 67 | 21 | 75 | 0·3 | 0·03–3·2 | 0·3 |
| At restaurant | 4 | 25 | 9 | 32 | 0·9 | 0·2–4·6 | 0·9 |
| How meat was prepared | |||||||
| Pink in middle | 5 | 8 | 5 | 4 | 2·7 | 0·5–15·0 | 0·2 |
| Boiled | 48 | 76 | 84 | 67 | 1·8 | 0·8–4·0 | 0·2 |
| Grilled | 9 | 15 | 12 | 10 | 1·3 | 0·4–3·8 | 0·6 |
| Roasted | 17 | 28 | 46 | 38 | 0·6 | 0·3–1·2 | 0·1 |
| Kinkali (dumplings) | 29 | 47 | 69 | 54 | 0·7 | 0·4–1·5 | 0·4 |
| Shashlik (grilled barbecue) | 23 | 36 | 58 | 46 | 0·6 | 0·3–1·3 | 0·2 |
| Would eat meat from sick livestock | 59 | 92 | 113 | 88 | 2·0 | 0·6–7·3 | 0·3 |
| Would eat meat from livestock found dead | 60 | 95 | 112 | 88 | 5·0 | 1·0–24·8 | 0·05 |
| Travel|| | 13 | 20 | 17 | 13 | 1·7 | 0·7–4·1 | 0·3 |
| Handled livestock products | 33 | 51 | 27 | 22 | 4·0 | 1·9–8·4 | <0·001 |
| Bones/horn | 9 | 41 | 4 | 18 | 1·4 | 0·08–23·6 | 0·8 |
| Skin/hide | 16 | 62 | 4 | 17 | 3·0 | 0·3–28·8 | 0·3 |
| Leather | 12 | 55 | 7 | 30 | 2·6 | 0·3–25·2 | 0·4 |
| Insect bite | 53 | 88 | 127 | 97 | 0·2 | 0·03–0·8 | 0·02 |
| Work with soil | |||||||
| Near sick or dead livestock | 61 | 97 | 118 | 95 | 1·6 | 0·2–10·1 | 0·6 |
| Near livestock burial site | 15 | 94 | 36 | 95 | 0·7 | 0·04–11·8 | 0·8 |
| Near other earthworks | 42 | 65 | 75 | 58 | 1·5 | 0·6–3·4 | 0·4 |
| While gardening | 9 | 64 | 27 | 59 | 0·6 | 0·1–4·2 | 0·6 |
| Covered injury while working soil | 2 | 11 | 13 | 34 | 0·2 | 0·02–2·0 | 0·2 |
| Total | 67 | 100 | 134 | 100 | − | − | − |
OR, Odds ratio; CI, confidence interval.
*
All values shown in bold indicate a significant difference (P < 0·05).
†
All ORs and corresponding 95% CIs are calculated comparing cases to controls.
‡
Livestock-related occupations included herder/shepherd, farmer/rancher, livestock worker, and veterinarian.
§
Cleaning defined as removing animal waste and/or dirty bedding.
||
Participant travelled outside place of residence/village.