Clinical Features, Laboratory Findings and Complications of Scrub Typhus in South Indian Children

Gopalakrisna, Manjunath Vaddambal; Hedda, Suryaprakash; Kumar, G. Shankarappa Vijay; Kumar, K. Jagadish; Murthy, D. S.

doi:10.3126/jnps.v37i1.16202

Cited by 3 publications

(6 citation statements)

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“…Fifteen studies were conducted on scrub typhus. Four studies were conducted in children [50, 51, 57, 59]. The remaining studies were mainly conducted in adults (Additional file 1: Table S10) [49, 52, 61, 63, 65–71].…”

Section: Resultsmentioning

confidence: 99%

“…Out of 40 studies, 25 (63%) studies [2, 16, 48, 50, 51, 53, 55, 57, 65, 68, 70, 71, 73–85] used a combination of pathogen-specific and nonspecific tests to evaluate aetiology of AFI (Additional file 1: Table S11). The remaining studies evaluated specific types of AFI (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…Four (16%) studies used < 5 specific tests [73, 74, 81, 84]. The remaining 14 (56%) studies used between 5 and 9 tests for etiological diagnosis of AFI [2, 48, 51, 53, 55, 57, 68, 71, 74, 79, 80, 82, 83, 85].…”

Section: Resultsmentioning

confidence: 99%

“…26 studies used malaria diagnostics [2, 16, 48, 50, 51, 53–55, 57, 60, 65, 68, 70, 71, 73, 74, 76–85] 14 studies (54%) used smear microscopy for parasite detection [2, 16, 48, 53, 54, 57, 73, 74, 76, 77, 79, 80, 84, 85]. and the remaining used RDT or quantitative buffy coat (QBC) alone or in combination for malaria diagnosis (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…17 out of 40 studies (43%) tested for typhoid. Among 17, three used blood culture [2, 16, 80], 14 used Widal [2, 48, 50, 51, 53, 57, 65, 70, 71, 74, 76, 79, 80, 83], while two used the Typhidot test to diagnose typhoid as a cause of AFI (Fig. 4e) [16, 78].…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic tools used in the evaluation of acute febrile illness in South India: a scoping review

Bhaskaran

Chadha²,

Sarin³

et al. 2019

BMC Infect Dis

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BackgroundAcute febrile illness (AFI) is characterized by malaise, myalgia and a raised temperature that is a nonspecific manifestation of infectious diseases in the tropics. The lack of appropriate diagnostics for the evaluation of AFI leads to increased morbidity and mortality in resource-limited settings, specifically low-income countries like India. The review aimed to identify the number, type and quality of diagnostics used for AFI evaluation during passive case detection at health care centres in South India.MethodsA scoping review of peer-reviewed English language original research articles published between 1946-July 2018 from four databases was undertaken to assess the type and number of diagnostics used in AFI evaluation in South India. Results were stratified according to types of pathogen-specific tests used in AFI management.ResultsThe review included a total of 40 studies, all conducted in tertiary care centres (80% in private settings). The studies demonstrated the use of 5–22 tests per patient for the evaluation of AFI. Among 25 studies evaluating possible causes of AFI, 96% tested for malaria followed by 80% for dengue, 72% for scrub typhus, 68% for typhoid and 60% for leptospirosis identifying these as commonly suspected causes of AFI. 54% studies diagnosed malaria with smear microscopy while others diagnosed dengue, scrub typhus, typhoid and leptospirosis using antibody or antigen detection assays. 39% studies used the Weil-Felix test (WFT) for scrub typhus diagnosis and 82% studies used the Widal test for diagnosing typhoid.ConclusionsThe review demonstrated the use of five or more pathogen-specific tests in evaluating AFI as well as described the widespread use of suboptimal tests like the WFT and Widal in fever evaluation. It identified the need for the development of better-quality tests for aetiological diagnosis and improved standardised testing guidelines for AFI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic tools used in the evaluation of acute febrile illness in South India: a scoping review

Bhaskaran

Chadha²,

Sarin³

et al. 2019

BMC Infect Dis

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Diagnostic Accuracy of Rapid Antibody Detection Test for Scrub Typhus

2023

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Systematic review of the scrub typhus treatment landscape: Assessing the feasibility of an individual participant-level data (IPD) platform

et al. 2021

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Background Scrub typhus is an acute febrile illness caused by intracellular bacteria from the genus Orientia. It is estimated that one billion people are at risk, with one million cases annually mainly affecting rural areas in Asia-Oceania. Relative to its burden, scrub typhus is understudied, and treatment recommendations vary with poor evidence base. These knowledge gaps could be addressed by establishing an individual participant-level data (IPD) platform, which would enable pooled, more detailed and statistically powered analyses to be conducted. This study aims to assess the characteristics of scrub typhus treatment studies and explore the feasibility and potential value of developing a scrub typhus IPD platform to address unanswered research questions. Methodology/principal findings We conducted a systematic literature review looking for prospective scrub typhus clinical treatment studies published from 1998 to 2020. Six electronic databases (Ovid Embase, Ovid Medline, Ovid Global Health, Cochrane Library, Scopus, Global Index Medicus), ClinicalTrials.gov, and WHO ICTRP were searched. We extracted data on study design, treatment tested, patient characteristics, diagnostic methods, geographical location, outcome measures, and statistical methodology. Among 3,100 articles screened, 127 were included in the analysis. 12,079 participants from 12 countries were enrolled in the identified studies. ELISA, PCR, and eschar presence were the most commonly used diagnostic methods. Doxycycline, azithromycin, and chloramphenicol were the most commonly administered antibiotics. Mortality, complications, adverse events, and clinical response were assessed in most studies. There was substantial heterogeneity in the diagnostic methods used, treatment administered (including dosing and duration), and outcome assessed across studies. There were few interventional studies and limited data collected on specific groups such as children and pregnant women. Conclusions/significance There were a limited number of interventional trials, highlighting that scrub typhus remains a neglected disease. The heterogeneous nature of the available data reflects the absence of consensus in treatment and research methodologies and poses a significant barrier to aggregating information across available published data without access to the underlying IPD. There is likely to be a substantial amount of data available to address knowledge gaps. Therefore, there is value for an IPD platform that will facilitate pooling and harmonisation of currently scattered data and enable in-depth investigation of priority research questions that can, ultimately, inform clinical practice and improve health outcomes for scrub typhus patients.

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Clinical Features, Laboratory Findings and Complications of Scrub Typhus in South Indian Children

Abstract: Introduction: Scrub typhus clinical features are non-specific

Cited by 3 publications

References 9 publications

Diagnostic tools used in the evaluation of acute febrile illness in South India: a scoping review

Diagnostic tools used in the evaluation of acute febrile illness in South India: a scoping review

Diagnostic Accuracy of Rapid Antibody Detection Test for Scrub Typhus

Systematic review of the scrub typhus treatment landscape: Assessing the feasibility of an individual participant-level data (IPD) platform

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