{"id":"https://openalex.org/W158593145","doi":"https://doi.org/10.4269/ajtmh.1994.51.466","title":"Contrasting Roles of Rivers and Wells as Sources of Drinking Water on Attack and Fatality Rates in a Hepatitis E Epidemic in Somalia","display_name":"Contrasting Roles of Rivers and Wells as Sources of Drinking Water on Attack and Fatality Rates in a Hepatitis E Epidemic in Somalia","publication_year":1994,"publication_date":"1994-10-01","ids":{"openalex":"https://openalex.org/W158593145","doi":"https://doi.org/10.4269/ajtmh.1994.51.466","mag":"158593145","pmid":"https://pubmed.ncbi.nlm.nih.gov/7943574"},"language":"en","primary_location":{"id":"doi:10.4269/ajtmh.1994.51.466","doi":"https://doi.org/10.4269/ajtmh.1994.51.466","is_oa":false,"landing_page_url":"https://doi.org/10.4269/ajtmh.1994.51.466","pdf_url":null,"source":{"id":"https://openalex.org/S100045985","display_name":"American Journal of Tropical Medicine and Hygiene","issn_l":"0002-9637","issn":["0002-9637","1476-1645"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315658","host_organization_name":"American Society of Tropical Medicine and Hygiene","host_organization_lineage":["https://openalex.org/P4310315658"],"host_organization_lineage_names":["American Society of Tropical Medicine and Hygiene"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American Journal of Tropical Medicine and Hygiene","raw_type":"journal-article"},"parent_works":[],"lineage":["https://openalex.org/W158593145"],"child_works_count":0,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5090081129","display_name":"Khalif Mohamud Bile","orcid":"https://orcid.org/0000-0001-7723-2043","observed_orcids":["https://orcid.org/0000-0001-7723-2043"]},"institutions":[{"id":"https://openalex.org/I2801301251","display_name":"Somali National University","ror":"https://ror.org/03f3jde70","country_code":"SO","type":"education","lineage":["https://openalex.org/I2801301251"]}],"countries":["SO"],"is_corresponding":false,"raw_author_name":"Khalif Bile","raw_affiliation_strings":["Department of Medicine, Faculty of Medicine, Somali National University, Mogadishu"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Medicine, Faculty of Medicine, Somali National University, Mogadishu","institution_ids":["https://openalex.org/I2801301251"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061713400","display_name":"Abdullahi Isse","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Abdullahi Isse","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111462447","display_name":"Osman Mohamud","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Osman Mohamud","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110906605","display_name":"Peter Allebeck","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Peter Allebeck","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111400603","display_name":"Lars Nilsson","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lars Nilsson","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5075939124","display_name":"Hel\u00e9ne Norder","orcid":"https://orcid.org/0000-0002-7528-3872","observed_orcids":["https://orcid.org/0000-0002-7528-3872"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Helene Norder","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110215231","display_name":"Isa K. Mushahwar","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Isa K. Mushahwar","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5111524824","display_name":"Lars O. Magnius","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lars O. Magnius","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.8439,"has_fulltext":false,"cited_by_count":111,"citation_normalized_percentile":{"value":0.72987208,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":99},"biblio":{"volume":"51","issue":"4","first_page":"466","last_page":"474"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12025","display_name":"Hepatitis Viruses Studies and Epidemiology","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12025","display_name":"Hepatitis Viruses Studies and Epidemiology","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11331","display_name":"Fecal contamination and water quality","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2312","display_name":"Water Science and Technology"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11581","display_name":"Viral Infections and Outbreaks Research","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hepatitis-e","display_name":"hepatitis E","score":0.890999972820282},{"id":"https://openalex.org/keywords/hepatitis-e-virus","display_name":"hepatitis E virus","score":0.9100000262260437},{"id":"https://openalex.org/keywords/waterborne-diseases","display_name":"waterborne diseases","score":0.6790000200271606},{"id":"https://openalex.org/keywords/river-water-supply","display_name":"river water supply","score":0.699999988079071},{"id":"https://openalex.org/keywords/well-water","display_name":"well water","score":0.8040000200271606},{"id":"https://openalex.org/keywords/drinking-water-sources","display_name":"drinking water sources","score":0.8799999952316284},{"id":"https://openalex.org/keywords/somalia","display_name":"Somalia","score":0.6050000190734863},{"id":"https://openalex.org/keywords/case-fatality-rate","display_name":"case fatality rate","score":0.9860000014305115},{"id":"https://openalex.org/keywords/pregnancy","display_name":"pregnancy","score":0.37599998712539673},{"id":"https://openalex.org/keywords/age-distribution","display_name":"age distribution","score":0.578000009059906},{"id":"https://openalex.org/keywords/sex-distribution","display_name":"sex distribution","score":0.6230000257492065}],"concepts":[{"id":"https://openalex.org/C187316915","wikidata":"https://www.wikidata.org/wiki/Q92307203","display_name":"Case fatality rate","level":3,"score":0.6910820007324219},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.5819252729415894},{"id":"https://openalex.org/C2776029263","wikidata":"https://www.wikidata.org/wiki/Q131742","display_name":"Hepatitis","level":2,"score":0.4919566810131073},{"id":"https://openalex.org/C3019983190","wikidata":"https://www.wikidata.org/wiki/Q157661","display_name":"Hepatitis a virus","level":3,"score":0.48991507291793823},{"id":"https://openalex.org/C2775876817","wikidata":"https://www.wikidata.org/wiki/Q157661","display_name":"Hepatitis A","level":3,"score":0.48930665850639343},{"id":"https://openalex.org/C37701844","wikidata":"https://www.wikidata.org/wiki/Q3955915","display_name":"Attack rate","level":3,"score":0.4856678247451782},{"id":"https://openalex.org/C159047783","wikidata":"https://www.wikidata.org/wiki/Q7215","display_name":"Virology","level":1,"score":0.4184873402118683},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.3715830445289612},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3179517686367035},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.0736539363861084},{"id":"https://openalex.org/C2522874641","wikidata":"https://www.wikidata.org/wiki/Q808","display_name":"Virus","level":2,"score":0.06956654787063599}],"mesh":[{"descriptor_ui":"D000208","descriptor_name":"Acute Disease","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000367","descriptor_name":"Age Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002675","descriptor_name":"Child, Preschool","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004196","descriptor_name":"Disease Outbreaks","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005618","descriptor_name":"Fresh Water","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006508","descriptor_name":"Hepatitis Antibodies","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007223","descriptor_name":"Infant","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011247","descriptor_name":"Pregnancy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011251","descriptor_name":"Pregnancy Complications, Infectious","qualifier_ui":"Q000401","qualifier_name":"mortality","is_major_topic":false},{"descriptor_ui":"D011251","descriptor_name":"Pregnancy Complications, Infectious","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D011891","descriptor_name":"Rain","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012621","descriptor_name":"Seasons","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012737","descriptor_name":"Sex Factors","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012998","descriptor_name":"Somalia","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D014881","descriptor_name":"Water Supply","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D015994","descriptor_name":"Incidence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D016751","descriptor_name":"Hepatitis E","qualifier_ui":"Q000401","qualifier_name":"mortality","is_major_topic":false},{"descriptor_ui":"D016751","descriptor_name":"Hepatitis E","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D016752","descriptor_name":"Hepatitis E virus","qualifier_ui":"Q000276","qualifier_name":"immunology","is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.4269/ajtmh.1994.51.466","doi":"https://doi.org/10.4269/ajtmh.1994.51.466","is_oa":false,"landing_page_url":"https://doi.org/10.4269/ajtmh.1994.51.466","pdf_url":null,"source":{"id":"https://openalex.org/S100045985","display_name":"American Journal of Tropical Medicine and Hygiene","issn_l":"0002-9637","issn":["0002-9637","1476-1645"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315658","host_organization_name":"American Society of Tropical Medicine and Hygiene","host_organization_lineage":["https://openalex.org/P4310315658"],"host_organization_lineage_names":["American Society of Tropical Medicine and Hygiene"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American Journal of Tropical Medicine and Hygiene","raw_type":"journal-article"},{"id":"pmid:7943574","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/7943574","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American journal of tropical medicine and hygiene","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9940000176429749,"id":"https://metadata.un.org/sdg/3"},{"display_name":"Clean water and sanitation","score":0.6618000268936157,"id":"https://metadata.un.org/sdg/6"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2235824121","https://openalex.org/W2165902472","https://openalex.org/W1814294121","https://openalex.org/W2062763092","https://openalex.org/W2136522977","https://openalex.org/W7096897463","https://openalex.org/W2130321992","https://openalex.org/W2413984494","https://openalex.org/W1499886081","https://openalex.org/W2733803151"],"abstract_inverted_index":{"In":[0,36,102],"early":[1],"1988,":[2],"an":[3,59],"increased":[4],"incidence":[5],"of":[6,22,39,45,53,67,75,90,97,129,138,149,155,167,197],"acute":[7],"hepatitis":[8,76,172],"was":[9,25,83,110,115,160,163,176,206,211],"observed":[10],"in":[11,17,80,88,124,133,170,181,194,214,225],"villages":[12,41,215],"along":[13],"the":[14,18,112,125,134,157,192,195,198,204],"Shebeli":[15,20],"River":[16],"Lower":[19],"region":[21],"Somalia.":[23],"This":[24],"followed":[26],"by":[27,85],"a":[28,37,43,63,95,106,164,177],"large":[29],"epidemic":[30,82,189],"that":[31,203],"lasted":[32],"until":[33],"late":[34],"1989.":[35],"survey":[38],"142":[40],"with":[42,100,120,191,217],"population":[44],"245,312":[46],"individuals,":[47],"11,413":[48],"icteric":[49],"cases":[50,93,152,222],"were":[51,223],"recorded,":[52],"which":[54,162],"346":[55],"died,":[56],"corresponding":[57],"to":[58,117,131,141,185],"attack":[60,113,209],"rate":[61,66,114,180,210],"and":[62,69,140,237],"case":[64],"fatality":[65,179],"4.6%":[68],"3.0%,":[70],"respectively.":[71],"The":[72,188,208],"etiologic":[73],"role":[74],"E":[77,173],"virus":[78],"(HEV)":[79],"this":[81],"proven":[84],"demonstrating":[86],"anti-HEV":[87],"128":[89],"145":[91],"sampled":[92],"as":[94],"sign":[96],"recent":[98],"infection":[99],"HEV.":[101],"three":[103],"villages,":[104],"where":[105],"special":[107],"study":[108],"protocol":[109],"implemented,":[111],"found":[116],"increase":[118],"significantly":[119],"age":[121,130,139],"from":[122],"5%":[123],"group":[126,135],"1-4":[127],"years":[128,137,148,154],"13%":[132],"5-15":[136],"20%":[142],"for":[143,232],"persons":[144],"older":[145],"than":[146],"15":[147],"age.":[150],"Among":[151],"20-39":[153],"age,":[156],"female-to-male":[158],"ratio":[159],"1.5:1,":[161],"significant":[165],"predominance":[166],"females.":[168],"As":[169],"other":[171],"outbreaks,":[174],"there":[175],"high":[178],"pregnant":[182],"females,":[183],"estimated":[184],"be":[186],"13.8%.":[187],"peaked":[190],"rise":[193],"level":[196],"river":[199,218],"during":[200],"rainfall,":[201],"suggesting":[202],"disease":[205],"waterborne.":[207],"higher":[212],"(6.0%)":[213],"supplied":[216],"water,":[219],"while":[220],"fewer":[221],"recorded":[224],"those":[226],"relying":[227],"on":[228],"wells":[229],"or":[230],"ponds":[231],"their":[233],"water":[234],"supply,":[235],"1.7%":[236],"1.2%,":[238],"respectively.(ABSTRACT":[239],"TRUNCATED":[240],"AT":[241],"250":[242],"WORDS)":[243]},"counts_by_year":[{"year":2026,"cited_by_count":2},{"year":2025,"cited_by_count":3},{"year":2023,"cited_by_count":2},{"year":2022,"cited_by_count":1},{"year":2021,"cited_by_count":6},{"year":2020,"cited_by_count":2},{"year":2019,"cited_by_count":3},{"year":2018,"cited_by_count":5},{"year":2017,"cited_by_count":6},{"year":2016,"cited_by_count":5},{"year":2015,"cited_by_count":5},{"year":2014,"cited_by_count":11},{"year":2013,"cited_by_count":8},{"year":2012,"cited_by_count":5}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}