Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India.

• Автори: Vanramliana (Автор), Lalfakzuala Pautu (Автор), Pachuau Lalmalsawma (Автор), Gabriel Rosangkima (Автор), Devojit Kumar Sarma (Автор), Hunropuia Chinzah (Автор), Yogesh Malvi (Автор), Naveen Kumar Kodali (Автор), Christiana Amarthaluri (Автор), Karuppusamy Balasubramani (Автор), Praveen Balabaskaran Nina (Автор)
• Формат: Книга
• Опубліковано: Public Library of Science (PLoS), 2023-11-01T00:00:00Z.
• Предмети: article
• Онлайн доступ: Connect to this object online.
• Notes: 1935-2727; 1935-2735; 10.1371/journal.pntd.0011688
• Keywords: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270
• Source: PLoS Neglected Tropical Diseases, Vol 17, Iss 11, p e0011688 (2023)

<h4>Background</h4>In the past decade, scrub typhus cases have been reported across India, even in regions that had no previous history of the disease. In the North-East Indian state of Mizoram, scrub typhus cases were first recorded only in 2012. However, in the last five years, the state has seen a substantial increase in the scrub typhus and other rickettsial infections. As part of the public health response, the Mizoram Government has integrated screening and line listing of scrub typhus and other rickettsial infections across all its health settings, a first in India. Here we detail the epidemiology of scrub typhus and other rickettsial infections from 2018-2022, systematically recorded across the state of Mizoram.<h4>Methodology/principal findings</h4>The line-listed data positive for scrub typhus and other rickettsial infections identified by rapid immunochromatographic test and/or Weil-Felix test from 2018-22 was used for the analysis. During this period, 22,914 cases of rickettsial infections were recorded, out of which 19,651 were scrub typhus cases. Aizawl is the worst affected, with 10,580 cases (46.17%). The average incidence of rickettsial infections is 3.54 cases per 1000 persons-year, and the case fatality rate is 0.35. Only ∼2% of the reported scrub typhus cases had eschar. Multivariate logistic regression analysis indicate patients with eschar (aOR = 2.5, p<0.05), occupational workers [farmers (aOR:3.9), businessmen (aOR:1.8), construction workers (aOR:17.9); p<0.05], and children (≤10 years) (aOR = 5.4, p<0.05) have higher odds of death due to rickettsial infections.<h4>Conclusion</h4>The integration of systematic surveillance and recording of rickettsial diseases across Mizoram has shed important insights into their prevalence, morbidity, and mortality. This study underscores the importance of active surveillance of rickettsial infections across India, as the burden could be substantially higher, and is probably going undetected.