Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India

Rao, Pavitra N.; Eijk, Anna Maria van; Choubey, Sandhya; Ali, Syed Zeeshan; Dash, A. P.; Barla, Punam; Oraon, Rajshri Rani; Patel, Gautam; Nandini, Poojappa; Acharya, Subrata; Mohanty, Sanjib; Carlton, Jane M.; Satpathi, Sanghamitra

doi:10.1186/s12879-019-4161-6

Cited by 29 publications

(23 citation statements)

References 42 publications

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“…7,14 According to World health organisation "Scrub typhus is probably one of the most underdiagnosed and under reported febrile illness requiring hospitalization. In our study seropositivity of Scrub typhus was 20% which was higher than Rao et al 15 23 and Jhakaria et al 24 In our study Male affected more than female (60% vs 40%) Similar distribution was seen in Madhusmita et al 19 (61.7%), Palas Das et al 25 (58%), Raghunath et al 25 (61%) Lalrinkima et al 1 (56.6%) but female more than male distribution was seen in Saramma et al 21 (65% female), Rajendra et al 26 (64% female)). It may be due to fact that in this part of Odisha male are more involved in agricultural works than female.…”

Section: Discussioncontrasting

confidence: 68%

Seropositivity of Scrub Typhus Inpatients Attending a Tertiary Care Hospital in Western Odisha

Mukherjee¹,

Dash²,

Tiwari³

2020

jemds

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BACKGROUND Scrub typhus is a vector borne Rickettsial disease caused by Orientia tsutsugamushi and has been reported from tsutsugamushi triangle which includes India. It is a reemerging pathogen in India including the state of Odisha. This study was conducted to determine seropositivity of scrub typhus in patients attending a tertiary care hospital of Western Odisha. METHODS Fifty febrile patients who were negative for Malaria, Dengue and Leptospira attending a tertiary care hospital of Western Odisha were enrolled in the study. 3 ml of blood was collected, and serum was separated. IgM SD Bioline Tsutsugamushi lateral flow immunochromatography test was performed as per manufacturer instruction. Positive samples were confirmed by PCR method (Geno-Sen's ST Real Time PCR). RESULTS 20% of patients were positive for IgM SD Bioline Tsutsugamushi card test. 60% of positive patients were male. 20% of positive patients were having pathognomonic eschar. 60 % of infected patients were in the age group of 10-30. CONCLUSIONS In this study, 20% of febrile patients were positive for Scrub typhus infection. So, it should be included in the differential diagnosis of a febrile patient in Western Odisha.

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Section: Discussioncontrasting

confidence: 68%

Seropositivity of Scrub Typhus Inpatients Attending a Tertiary Care Hospital in Western Odisha

Mukherjee¹,

Dash²,

Tiwari³

2020

jemds

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“…The difficulty of correctly ascribing an etiology in this setting is so widely accepted that clinical cases caused by a variety of pathogens are often collated for surveillance purposes as "influenza-like illness" (18). Similar issues occur in malaria-endemic regions (16,19). One study in India found that only 5.7% of commonly diagnosed "malaria-infected" individuals actually had this etiology, while 25% had dengue instead (16).…”

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confidence: 86%

Co-circulation and misdiagnosis led to underestimation of the 2015-2017 Zika epidemic in the Americas

Oidtman

España

Perkins

2019

Preprint

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During the 2015-2017 Zika epidemic, dengue and chikungunya -two other viral diseases with the same vector as Zika -were also in circulation. Clinical presentation of these diseases can vary from person to person in terms of symptoms and severity, making it difficult to differentially diagnose them. Under these circumstances, it is possible that numerous cases of Zika could have been misdiagnosed as dengue or chikungunya, or vice versa. Given the importance of surveillance data for informing epidemiological analyses, our aim was to quantify the potential extent of misdiagnosis during this epidemic. Using basic principles of probability and empirical estimates of diagnostic sensitivity and specificity, we generated revised estimates of Zika incidence that accounted for the accuracy of diagnoses made on the basis of clinical presentation with or without molecular confirmation. Applying this method to weekly incidence data from 43 countries throughout Latin America and the Caribbean, we estimated that 1,062,821 (95% CrI: 1,014,428-1,104,794) Zika cases occurred during this epidemic, which is 56.4% (95% CrI: 49.3-62.6%) more than the 679,743 cases diagnosed as Zika. Our results imply that misdiagnosis was more common in countries with proportionally higher incidence of dengue and chikungunya, such as Brazil.. CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. not certified by peer review)

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“…The difficulty of correctly ascribing an etiology in this setting is so widely accepted that clinical cases caused by a variety of pathogens are often collated for surveillance purposes as "influenza-like illness" [21]. Similar issues occur in malaria-endemic regions [19,22]. One study in India found that only 5.7% of commonly diagnosed "malariainfected" individuals actually had this etiology, while 25% had dengue instead [19].…”

Section: Introductionmentioning

confidence: 99%

Co-circulation and misdiagnosis led to underestimation of the 2015–2017 Zika epidemic in the Americas

2021

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During the 2015–2017 Zika epidemic, dengue and chikungunya–two other viral diseases with the same vector as Zika–were also in circulation. Clinical presentation of these diseases can vary from person to person in terms of symptoms and severity, making it difficult to differentially diagnose them. Under these circumstances, it is possible that numerous cases of Zika could have been misdiagnosed as dengue or chikungunya, or vice versa. Given the importance of surveillance data for informing epidemiological analyses, our aim was to quantify the potential extent of misdiagnosis during this epidemic. Using basic principles of probability and empirical estimates of diagnostic sensitivity and specificity, we generated revised estimates of reported cases of Zika that accounted for the accuracy of diagnoses made on the basis of clinical presentation with or without laboratory confirmation. Applying this method to weekly reported case data from 43 countries throughout Latin America and the Caribbean, we estimated that 944,700 (95% CrI: 884,900–996,400) Zika cases occurred when assuming all confirmed cases were diagnosed using molecular methods versus 608,400 (95% CrI: 442,000–821,800) Zika cases that occurred when assuming all confirmed cases were diagnosed using serological methods. Our results imply that misdiagnosis was more common in countries with proportionally higher reported cases of dengue and chikungunya, such as Brazil. Given that Zika, dengue, and chikungunya appear likely to co-circulate in the Americas and elsewhere for years to come, our methodology has the potential to enhance the interpretation of passive surveillance data for these diseases going forward. Likewise, our methodology could also be used to help resolve transmission dynamics of other co-circulating diseases with similarities in symptomatology and potential for misdiagnosis.

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Dengue, chikungunya, and scrub typhus are important etiologies of non-malarial febrile illness in Rourkela, Odisha, India

Cited by 29 publications

References 42 publications

Seropositivity of Scrub Typhus Inpatients Attending a Tertiary Care Hospital in Western Odisha

Seropositivity of Scrub Typhus Inpatients Attending a Tertiary Care Hospital in Western Odisha

Co-circulation and misdiagnosis led to underestimation of the 2015-2017 Zika epidemic in the Americas

Co-circulation and misdiagnosis led to underestimation of the 2015–2017 Zika epidemic in the Americas

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