Seroprevalence of Scrub typhus at a tertiary care hospital in Andhra Pradesh

Ramyasree, A; Kalawat, Usha; Rani, N.B. Swaroop; Chaudhury, Abhijit

doi:10.4103/0255-0857.148381

Cited by 44 publications

(22 citation statements)

References 16 publications

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“…It has a high sensitivity (99 %), specificity (96 %) and serological agreement (97.5 %) with immunofluorescent assay [ 13 ]. A correlation of 97 %, between IgM ELISA and SD Bioline Tsutsugamushi rapid diagnostic test, was reported by Ramyasree A et al [ 14 ] among 100 suspected cases of scrub typhus in India.…”

Section: Methodsmentioning

confidence: 81%

“…Fever of >12 days, presence of eschar, ICU admission, shock needing ionotropes, CNS dysfunction etc. have also been proven to be predictors of mortality [ 5 , 14 , 35 ]. These give valuable hints to the impending fatal outcome and may help the clinicians to initiate the intensive management.…”

Section: Discussionmentioning

confidence: 99%

“…This study relied on rapid test for confirmation due to the cost and lack of wider availability of confirmatory tests. However, a correlation of 97 %, between IgM ELISA and SD Bioline Tsutsugamushi rapid test was reported in India [ 14 ] and it was more sensitive than standard IFA in acute phase from Thailand [ 55 ]. Moreover, a dramatic response to doxycycline strongly favors the scrub typhus diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India

et al. 2016

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BackgroundIndia is an integral component of “tsutsugamushi triangle” which depicts a part of the globe endemic to scrub typhus. Owing to frequent outbreaks witnessed in different parts of the country in the recent past, scrub typhus is described as a re-emerging infectious disease in India. The present study aimed to study the clinical and paraclinical profile, complications and predictors of outcome among 90 cases of scrub typhus diagnosed in a hospital of north-eastern India from Sept 2011 to Aug 2012.MethodsA longitudinal study was conducted in a hospital of Meghalaya, India between Sept 2011 and Aug 2012. Diagnosis of scrub typhus was arrived by SD BIOLINE tsutsugamushi (solid phase immunochromatographic assay) rapid diagnostic test for antibodies (IgM, IgG or IgA). Descriptive analyses of age, gender, geographic area, symptoms and signs, treatment, laboratory findings, complications, and outcome were conducted. Relative risk (RR) with 95 % confidence interval (CI) was computed for Multiple Organ Dysfunction Syndrome (MODS) and mortality. Binary logistic regression was applied to the significant correlates (P < 0.05) on univariate analysis to identify the predictors of MODS and mortality in scrub typhus.ResultsAs many as 662 clinically suspected scrub typhus patients were tested and 90 (13.6 %) were diagnosed to have scrub typhus. Out of 90 patients, 52.2 % (n = 47) were males and their mean (SD) age was 36.29 (13.38) years. Fever of <7 days (n = 75, 83.3 %), myalgia (n = 56, 62.2 %), pain abdomen (n = 24, 26.7 %), headache (n = 24, 26.7 %), nausea/vomiting (n = 21, 23.3 %), dry cough (n = 21, 23.3 %), hepatomegaly (n = 24, 26.7 %), splenomegaly (n = 22, 24.4 %), and lymphadenopathy (n = 20, 22.2 %) were the predominant clinical features. Eschar was seen in 10 patients (11.1 %). One third (n = 30) of the patients developed at least one systemic complication. Acute hepatitis (n = 15, 16.7 %), pneumonitis (n = 14, 15.6 %), and acute kidney injury (n = 11, 12.2 %) were the common complications. MODS was seen in 14.4 % (n = 13) and 38.5 % (n = 5) of the patients with MODS died. Overall, case fatality rate was 5.15 % (n = 5). On univariate analysis, platelets <100 000/mm3, serum creatinine >1.5 mg/dl, and transaminase (AST, ALT or both) >500 U/L were associated with MODS (P < 0.001) and mortality (P < 0.05). In addition, serum bilirubin >3 mg/dl was also associated with MODS (P < 0.001). On applying binary logistic regression, serum creatinine >1.5 mg/dl was a predictor of MODS (OR: 76.1, 95 % CI: 4.9–1175.6) and mortality (OR: 18.03, 95 % CI: 1.38–235.1).ConclusionIn this study setting, approximately one-seventh (13.6 %) of the acute undifferentiated febrile illness were due to scrub typhus. Systemic complications were common (33.3 %). Serum creatinine >1.5 mg/dl was a predictor of MODS and mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0186-x) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India

et al. 2016

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“…The reported seroprevalence of O . tsutsugamushi for each country is shown in Table 1 [ 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ]. The reports of outbreaks of scrub typhus are summarized in Table 2 [ 43 , 94 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , …”

Section: Methodsmentioning

confidence: 99%

A review of the global epidemiology of scrub typhus

et al. 2017

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Scrub typhus is a serious public health problem in the Asia-Pacific area. It threatens one billion people globally, and causes illness in one million people each year. Caused by Orientia tsutsugamushi, scrub typhus can result in severe multiorgan failure with a case fatality rate up to 70% without appropriate treatment. The antigenic heterogeneity of O. tsutsugamushi precludes generic immunity and allows reinfection. As a neglected disease, there is still a large gap in our knowledge of the disease, as evidenced by the sporadic epidemiologic data and other related public health information regarding scrub typhus in its endemic areas. Our objective is to provide a systematic analysis of current epidemiology, prevention and control of scrub typhus in its long-standing endemic areas and recently recognized foci of infection.

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“…In the present study the eschar was found in 7.69% of the patients which was very low in comparison to 41.7%, 46% from studies done by Dass et al at Meghalaya [12] and M. Vivekanandan et al [1] at Pondicherry, while most studies of the Oriental countries had eschar in 60-70% patients. Recent studies from northern India [17,18] and southern India [19,20,21] have also the similarly low level of prevalence of Eschar in their populations.…”

Section: Discussionmentioning

confidence: 96%

A single-centre experience of scrub typhus in a tertiary care centre - a re-emerging infection

Sahoo

Maikap

Mohanty³

et al. 2020

Int J Med Res Rev

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Background: Scrub typhus is a documented disease in Himachal Pradesh, but there have been few clinico-epidemiological studies in this area. The present study is done with IgM ELISA as a diagnostic test which has higher sensitivity and specificity as most of the previous studies had used Weil Felix test as a diagnostic test. Methodology: This was a prospective observational study. All the patients more than 18 years of age with positive IgM ELISA for scrub typhus with/without eschar were included. The clinical profile was observed. IgM scrub typhus was done by ELISA. Results: Total of 39 patients were observed between July 2016 to Dec 2016. Maximum patients were observed in August, September, and October. Fever with Headache was the most common presenting complaint. Eschar was present in 10 % patients. Complications were seen in 76.92 %. The mortality rate was 0%. Conclusion: The varied presentations and high rate of complications require a high index of suspicion for Scrub Typhus. The general physicians should be sensitized for the early diagnosis and treatment to reduce morbidity and mortality.

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Seroprevalence of Scrub typhus at a tertiary care hospital in Andhra Pradesh

Abstract: Scrub typhus should be included in the differential diagnosis of fever of unknown origin along with dengue, malaria and leptospirosis which are the other common endemic infections in this part of the country.

Cited by 44 publications

References 16 publications

Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India

Clinical and paraclinical profile, and predictors of outcome in 90 cases of scrub typhus, Meghalaya, India

A review of the global epidemiology of scrub typhus

A single-centre experience of scrub typhus in a tertiary care centre - a re-emerging infection

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