Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India
Problem considered: Scrub typhus, a re-emerging zoonotic infection, often manifests as acute undifferentiated febrile illness (AUF), posing a significant epidemiological threat in tropical and subtropical regions. Its nonspecific clinical presentation complicates timely diagnosis, increasing the ris...
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Elsevier
2025-05-01
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| Series: | Clinical Epidemiology and Global Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213398425000892 |
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| author | Gayatri Sondhiya Prakash Tiwari HV Manjunathachar Vivek Chouksey Pradeep Tiwari Pradip V. Barde Chandrashekhar G. Raut Tapas Chakma Harpreet Kaur Pushpendra Singh |
| author_facet | Gayatri Sondhiya Prakash Tiwari HV Manjunathachar Vivek Chouksey Pradeep Tiwari Pradip V. Barde Chandrashekhar G. Raut Tapas Chakma Harpreet Kaur Pushpendra Singh |
| author_sort | Gayatri Sondhiya |
| collection | DOAJ |
| description | Problem considered: Scrub typhus, a re-emerging zoonotic infection, often manifests as acute undifferentiated febrile illness (AUF), posing a significant epidemiological threat in tropical and subtropical regions. Its nonspecific clinical presentation complicates timely diagnosis, increasing the risk of severe morbidity. Understanding its epidemiology and clinical characteristics is crucial for effective disease control, particularly in areas prone to outbreaks. Methods: This prospective cross-sectional study assessed the prevalence and clinical features of scrub typhus through detailed patient history, clinical examination, and commercial IgM ELISA, following DHR guidelines. Results: Among 911 AUF patients from tribal-dominated regions of Madhya Pradesh, India, 22.3% [95% CI: 19.6–25.1] were seropositive for anti- O. tsutsugamushi-specific IgM antibodies, indicating widespread transmission across 17 of 24 districts, particularly in tribal populations, between August 2018 and July 2020. Patient ages ranged from 9 months to 86 years, with 41.2% under 15 years and 35.5% in the working-age group (31–60 years). Notably, 16.7% of seropositive patients exhibited nervous system involvement alongside other clinical signs. Both genders showed similar susceptibility, and 32.3% of seropositive cases reported fever lasting 7–15 days. Peak seropositivity was observed during the monsoon at 38%, followed by the post-monsoon period at 20.4%. Conclusion: This study demonstrates the significant burden of scrub typhus in tribal regions of Madhya Pradesh, India, with high seropositivity during the monsoon and post-monsoon seasons. The association of prolonged fever with organ involvement emphasize the need for early detection, inclusion of scrub typhus in differential diagnoses, and region-specific preventive measures, particularly in endemic areas like Central India. |
| format | Article |
| id | doaj-art-c313441c089942acaa02d77ed02c4d0b |
| institution | OA Journals |
| issn | 2213-3984 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Epidemiology and Global Health |
| spelling | doaj-art-c313441c089942acaa02d77ed02c4d0b2025-08-20T02:10:53ZengElsevierClinical Epidemiology and Global Health2213-39842025-05-013310200010.1016/j.cegh.2025.102000Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, IndiaGayatri Sondhiya0Prakash Tiwari1HV Manjunathachar2Vivek Chouksey3Pradeep Tiwari4Pradip V. Barde5Chandrashekhar G. Raut6Tapas Chakma7Harpreet Kaur8Pushpendra Singh9ICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, India; ICMR-National Institute of Traditional Medicine, Belagavi, 590010, Karnataka, India; Faculty of Medical Research, Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201,002, India; Corresponding author.ICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, India; ICMR-National Institute of Virology, Central Zone, Jabalpur, 482003, Madhya Pradesh, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, India; Dr. DY Patil Medical College Hospital and Research Centre, Pimpri, Pune, 411018, Maharashtra, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, IndiaIndian Council of Medical Research, Headquarter, New Delhi, 110029, IndiaICMR- National Institute of Research in Tribal Health (NIRTH), Jabalpur, 482003, Madhya Pradesh, India; Faculty of Medical Research, Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201,002, India; Corresponding author.Problem considered: Scrub typhus, a re-emerging zoonotic infection, often manifests as acute undifferentiated febrile illness (AUF), posing a significant epidemiological threat in tropical and subtropical regions. Its nonspecific clinical presentation complicates timely diagnosis, increasing the risk of severe morbidity. Understanding its epidemiology and clinical characteristics is crucial for effective disease control, particularly in areas prone to outbreaks. Methods: This prospective cross-sectional study assessed the prevalence and clinical features of scrub typhus through detailed patient history, clinical examination, and commercial IgM ELISA, following DHR guidelines. Results: Among 911 AUF patients from tribal-dominated regions of Madhya Pradesh, India, 22.3% [95% CI: 19.6–25.1] were seropositive for anti- O. tsutsugamushi-specific IgM antibodies, indicating widespread transmission across 17 of 24 districts, particularly in tribal populations, between August 2018 and July 2020. Patient ages ranged from 9 months to 86 years, with 41.2% under 15 years and 35.5% in the working-age group (31–60 years). Notably, 16.7% of seropositive patients exhibited nervous system involvement alongside other clinical signs. Both genders showed similar susceptibility, and 32.3% of seropositive cases reported fever lasting 7–15 days. Peak seropositivity was observed during the monsoon at 38%, followed by the post-monsoon period at 20.4%. Conclusion: This study demonstrates the significant burden of scrub typhus in tribal regions of Madhya Pradesh, India, with high seropositivity during the monsoon and post-monsoon seasons. The association of prolonged fever with organ involvement emphasize the need for early detection, inclusion of scrub typhus in differential diagnoses, and region-specific preventive measures, particularly in endemic areas like Central India.http://www.sciencedirect.com/science/article/pii/S2213398425000892Scrub typhusOrientia tsutsugamushiSeroprevalenceCentral IndiaMadhya PradeshZoonoses |
| spellingShingle | Gayatri Sondhiya Prakash Tiwari HV Manjunathachar Vivek Chouksey Pradeep Tiwari Pradip V. Barde Chandrashekhar G. Raut Tapas Chakma Harpreet Kaur Pushpendra Singh Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India Clinical Epidemiology and Global Health Scrub typhus Orientia tsutsugamushi Seroprevalence Central India Madhya Pradesh Zoonoses |
| title | Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India |
| title_full | Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India |
| title_fullStr | Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India |
| title_full_unstemmed | Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India |
| title_short | Emergence of scrub typhus-associated neurological signs in central India: An unusual manifestation in febrile illness cases in Madhya Pradesh, India |
| title_sort | emergence of scrub typhus associated neurological signs in central india an unusual manifestation in febrile illness cases in madhya pradesh india |
| topic | Scrub typhus Orientia tsutsugamushi Seroprevalence Central India Madhya Pradesh Zoonoses |
| url | http://www.sciencedirect.com/science/article/pii/S2213398425000892 |
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