Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India.
Background 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 substa...
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ftdoajarticles:oai:doaj.org/article:6dd8d0375f4947bc8fc96e9b1e52dfd9 2024-01-14T10:05:02+01:00 Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. Vanramliana Lalfakzuala Pautu Pachuau Lalmalsawma Gabriel Rosangkima Devojit Kumar Sarma Hunropuia Chinzah Yogesh Malvi Naveen Kumar Kodali Christiana Amarthaluri Karuppusamy Balasubramani Praveen Balabaskaran Nina 2023-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0011688 https://doaj.org/article/6dd8d0375f4947bc8fc96e9b1e52dfd9 EN eng Public Library of Science (PLoS) https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011688&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011688 https://doaj.org/article/6dd8d0375f4947bc8fc96e9b1e52dfd9 PLoS Neglected Tropical Diseases, Vol 17, Iss 11, p e0011688 (2023) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2023 ftdoajarticles https://doi.org/10.1371/journal.pntd.0011688 2023-12-17T01:44:39Z Background 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. Methodology/principal findings 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. Conclusion 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Indian PLOS Neglected Tropical Diseases 17 11 e0011688 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Vanramliana Lalfakzuala Pautu Pachuau Lalmalsawma Gabriel Rosangkima Devojit Kumar Sarma Hunropuia Chinzah Yogesh Malvi Naveen Kumar Kodali Christiana Amarthaluri Karuppusamy Balasubramani Praveen Balabaskaran Nina Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background 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. Methodology/principal findings 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. Conclusion 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. |
format |
Article in Journal/Newspaper |
author |
Vanramliana Lalfakzuala Pautu Pachuau Lalmalsawma Gabriel Rosangkima Devojit Kumar Sarma Hunropuia Chinzah Yogesh Malvi Naveen Kumar Kodali Christiana Amarthaluri Karuppusamy Balasubramani Praveen Balabaskaran Nina |
author_facet |
Vanramliana Lalfakzuala Pautu Pachuau Lalmalsawma Gabriel Rosangkima Devojit Kumar Sarma Hunropuia Chinzah Yogesh Malvi Naveen Kumar Kodali Christiana Amarthaluri Karuppusamy Balasubramani Praveen Balabaskaran Nina |
author_sort |
Vanramliana |
title |
Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. |
title_short |
Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. |
title_full |
Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. |
title_fullStr |
Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. |
title_full_unstemmed |
Epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of Mizoram, North-East India. |
title_sort |
epidemiology of scrub typhus and other rickettsial infections (2018-22) in the hyper-endemic setting of mizoram, north-east india. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2023 |
url |
https://doi.org/10.1371/journal.pntd.0011688 https://doaj.org/article/6dd8d0375f4947bc8fc96e9b1e52dfd9 |
geographic |
Arctic Indian |
geographic_facet |
Arctic Indian |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 17, Iss 11, p e0011688 (2023) |
op_relation |
https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011688&type=printable https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0011688 https://doaj.org/article/6dd8d0375f4947bc8fc96e9b1e52dfd9 |
op_doi |
https://doi.org/10.1371/journal.pntd.0011688 |
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PLOS Neglected Tropical Diseases |
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