Scrub typhus and leptospirosis in rural and urban settings of central India: a preliminary evaluation

Vikram, Kumar; Agarwala, Pragya; Bhargava, Anudita; Jain, Yogesh; Jagzape, Tushar; Wasnik, Pritam

doi:10.1177/0049475519889712

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…We observed a higher sero-prevalence of ST in rural areas (15.3%) and lower in urban areas (10.8%). A similar pattern was reported by Vikram et al in 2020 with the sero-prevalence of 25% among rural and 18.1% among urban population 42 . Residing in the rural areas was found to be a potential risk factor for spotted fever and murine typhus as for scrub typhus in this study.…”

Section: Discussionsupporting

confidence: 89%

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: a cross-sectional study

D’Cruz

Perumalla

Jayaraman

et al. 2022

Sci Rep

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Rickettsial infections and Q fever are a common cause of acute febrile illness globally. Data on the role of climate and altitude on the prevalence of these infections in lacking from Southern India. In this study, we determined the sero-prevalence of scrub typhus (ST), spotted fever (SF), murine typhus (MT) and Q Fever (QF) in 8 eight geographical regions of North Tamil Nadu by detecting IgG antibodies using ELISA. Totally we tested 2565 people from 86 localities. Among the 27.3% positives, approximately 5% were IgG positive for two or more infections. Sero-prevalence to rickettsioses and Q fever was highest for individuals from rural areas and increased with age (> 30 years). Those in the Nilgiris highlands (wetter and cooler) and Erode, which has the most land under irrigation, demonstrated the least exposure to rickettsioses and Q fever. Lowland plains (AOR: 8.4–22.9; 95% CI 3.1–55.3) and highland areas up to 1000 m (AOR: 6.1–10.3; 95% CI 2.4–23.9) showed the highest risk of exposure to scrub typhus. For spotted fever, the risk of exposure was highest in Jawadhi (AOR:10.8; 95% CI 2.6–44.3) and Kalrayan (AOR:16.6; 95% CI 4.1–66.2). Q fever positivity was most likely to be encountered in Salem (AOR: 5.60; 95% CI 1.01–31.08) and Kalrayan hills (AOR:12.3; 95% CI 2.9–51.6). Murine typhus risk was significant only in Tiruvannamalai (AOR:24.2; 95% CI 3.3–178.6). Our study suggests that prevalence of rickettsial infections and Q fever is low in areas which receive rainfall of ≥ 150 cm/year, with average minimum and maximum temperatures between 15 and 25 °C and elevation in excess of 2000 m. It is also less in well irrigated lowlands with dry climate. These preliminary findings need confirmation by active surveillance in these areas.

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Section: Discussionsupporting

confidence: 89%

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: a cross-sectional study

D’Cruz

Perumalla

Jayaraman

et al. 2022

Sci Rep

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“…In this study, the sero-prevalence of ST was higher in rural areas (15.3%) and lower in urban areas (10.8%). A similar pattern was reported in 2020 from India where sero-prevalence was 25% among rural and 18.1% among urban population (Vikram et al, 2020). Residing in rural areas was also found to be a potential risk factor for spotted fever and murine typhus similar to scrub typhus in this study.…”

Section: Discussionsupporting

confidence: 91%

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: A cross-sectional study

Prakash

D’Cruz

Karunasree

et al. 2022

Preprint

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Rickettsial infections and Q fever are a common cause of acute febrile illness globally. Data on the role of climate and altitude on the prevalence of these infections in lacking from Southern India. In this study, we determined the sero-prevalence of scrub typhus (ST), spotted fever (SF), murine typhus (MT) and Q Fever (QF) in 8 eight geographical regions of North Tamil Nadu by detecting IgG antbodies using ELISA. Totally we tested 2565 people from 86 localities. Among the 27.3 % positives, approximately 5% were IgG positive for two or more infections. Seroprevalence to rickettsioses and Q fever was highest for individuals from rural areas and increased with age (>30 years). Those in the Nilgiris highlands (wetter and cooler) and Erode, which has the most land under irrigation, demonstrated the least exposure to rickettsioses and Q fever. Lowland plains (AOR: 8.4-22.9; 95% CI: 3.1-55.3) and highland areas upto 1000 metres (AOR: 6.1-10.3; 95% CI: 2.4-23.9) showed the highest risk of exposure to scrub typhus. For spotted fever, the risk of exposure was highest in Jawadhi (AOR:10.8; 95% CI: 2.6-44.3) and Kalrayan (AOR:16.6; 95% CI: 4.1–66.2). Q fever positivity was most likely to be encountered in Salem (AOR: 5.60; 95% CI: 1.01 – 31.08) and Kalrayan hills (AOR:12.3; 95% CI:2.9 – 51.6). Murine typhus risk was significant only in Thiruvannamalai (AOR:24.2; 95% CI: 3.3 – 178.6). Based on the data generated it seems that rickettsial infections and Q fever prevalence is low in areas which receive rainfall of ≥150 cm/yr, with average minimum and maximum temperatures between 15-25 C and elevation in excess of 2000 metres. It is also low in low land and irrigated lands with dry climate. These preliminary findings need to be validated by conducting active surveillance in these areas.

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“…Cases of leptospirosis with other infectious comorbidities, such as dengue ( Wijesinghe et al., 2015 ; Paul, 2022 ), malaria ( Wilairatana et al., 2021 ), chikungunya ( Nhan et al., 2016 ; Cardona-Ospina et al., 2018 ), and scrub typhus ( Watt et al., 2003 ; Borkakoty et al., 2016 ; Vikram et al., 2020 ), have been increasingly described in tropical and subtropical regions, especially in the overlapping endemic regions. Co-occurrences of leptospirosis and tuberculosis in humans, however, are less frequently reported ( Viswanathan and Iqbal, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

The diagnosis of leptospirosis complicated by pulmonary tuberculosis complemented by metagenomic next-generation sequencing: A case report

Shi

Wu²,

Kang³

et al. 2022

Front. Cell. Infect. Microbiol.

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Leptospirosis is a zoonotic infection caused by the pathogenic Leptospira. Leptospirosis is transmitted mainly through contact with contaminated rivers, lakes, or animals carrying Leptospira. Human leptospirosis has a wide range of non-specific clinical manifestations ranging from fever, hypotension, and myalgia to multi-organ dysfunction, which severely hampers the timely clinical diagnosis and treatment of leptospirosis. Therefore, there is an urgent clinical need for an efficient strategy/method that can be used for the accurate diagnosis of leptospirosis, especially in critically ill patients. Here, we report a case of a 75-year-old male patient with clinical presentation of fever, cough, and diarrhea. Initial laboratory tests and a computed tomography (CT) scan of the chest suggested only tuberculosis. The patient was finally diagnosed with pulmonary tuberculosis (PTB) combined with leptospirosis by sputum Xpert MTB RIF, epidemiological investigations, and delayed serological testing. Furthermore, through metagenomic next-generation sequencing (mNGS) of clinical samples of cerebrospinal fluid (CSF), urine, plasma and sputum, the causative pathogens were identified as Mycobacterium tuberculosis complex and Leptospira spp. With specific treatment for both leptospirosis and tuberculosis, and associated supportive care (e.g., hemodialysis), the patient showed a good prognosis. This case report suggests that mNGS can generate a useful complement to conventional pathogenic diagnostic methods through more detailed etiological screening (i.e., at the level of species or species complex).

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Scrub typhus and leptospirosis in rural and urban settings of central India: a preliminary evaluation

Cited by 8 publications

References 20 publications

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: a cross-sectional study

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: a cross-sectional study

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: A cross-sectional study

The diagnosis of leptospirosis complicated by pulmonary tuberculosis complemented by metagenomic next-generation sequencing: A case report

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