Risk factors for acquisition of scrub typhus in children admitted to a tertiary centre and its surrounding districts in South India: a case control study.
Adolescent
Animals
Case-Control Studies
Child
Child, Preschool
Disease Vectors
Female
Fever
Hospitalization
Humans
India
/ epidemiology
Male
Orientia tsutsugamushi
/ isolation & purification
Risk Factors
Rodentia
/ classification
Scrub Typhus
/ epidemiology
Tertiary Care Centers
/ statistics & numerical data
Trombiculidae
/ classification
Zoonoses
/ epidemiology
Children
Mites
Risk factors
Scrub typhus
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
26 Jul 2019
26 Jul 2019
Historique:
received:
12
12
2018
accepted:
18
07
2019
entrez:
28
7
2019
pubmed:
28
7
2019
medline:
8
10
2019
Statut:
epublish
Résumé
Scrub typhus is a mite borne zoonosis common in the tropics with no good preventive strategy. Children are also affected leading to considerable morbidity and mortality. We conducted a case control study and a vector survey to determine the risk factors for acquisition of scrub typhus. A case control study with a 1:2 case control ratio was conducted over a 2 year period at a tertiary care centre and its surrounding districts in South India. Cases were children < 15 years with confirmed scrub typhus. Controls were age and locality matched community controls without fever. Demographic, environmental and behavioural risk factors were obtained in cases and controls by an interview and an environmental survey. A vector survey was also undertaken in the immediate vicinity of the cases. Case Control study: 101 cases and 167 controls were analysed. On multivariate analysis, significant association was observed with environmental factors such as the presence of a water body within 100 m of the house (OR 3.56(1.36,9.75); p 0.011), cooking outside the house (OR 5.61 (1.51,23.01); p 0.011), owning pets (OR 3.33(1.16,9.09); p 0.031), and the presence of bushes within 5 m of the house (OR 2.78 (1.11,7.69); p 0.033). Of the behavioural factors, the child going to school by a vehicle (OR 3.12 (2.29,8.37); p 0.006) was associated with an increased risk. Drying clothes on a clothesline showed a trend towards protection from acquiring scrub typhus (OR 0.31 (0.08, 1.08); p 0.077). Vector survey:26 rodents were trapped in as many houses. Trombiculid mites were isolated in 24 houses with 9(34.6%) being able to transmit scrub typhus. 254 trombiculid mites belonging to four species and two genera were collected. Leptotrombidium deliense, (33.5%). Schoengastiella ligula, (11.0%) of the total mite specimens collected. S. ligula always co-existed with L. deliense. The estimated Chigger index for Leptotrombidium deliense and Schoengastiella ligula was 3.27and 1.08 per animal respectively. Our study highlights risk factors for scrub typhus, some of which may be modifiable. A clean peri-domestic environment free of vegetation, drying clothes on a clothesline and cooking indoors may decrease the risk of scrub typhus.
Sections du résumé
BACKGROUND
BACKGROUND
Scrub typhus is a mite borne zoonosis common in the tropics with no good preventive strategy. Children are also affected leading to considerable morbidity and mortality. We conducted a case control study and a vector survey to determine the risk factors for acquisition of scrub typhus.
METHODS
METHODS
A case control study with a 1:2 case control ratio was conducted over a 2 year period at a tertiary care centre and its surrounding districts in South India. Cases were children < 15 years with confirmed scrub typhus. Controls were age and locality matched community controls without fever. Demographic, environmental and behavioural risk factors were obtained in cases and controls by an interview and an environmental survey. A vector survey was also undertaken in the immediate vicinity of the cases.
RESULTS
RESULTS
Case Control study: 101 cases and 167 controls were analysed. On multivariate analysis, significant association was observed with environmental factors such as the presence of a water body within 100 m of the house (OR 3.56(1.36,9.75); p 0.011), cooking outside the house (OR 5.61 (1.51,23.01); p 0.011), owning pets (OR 3.33(1.16,9.09); p 0.031), and the presence of bushes within 5 m of the house (OR 2.78 (1.11,7.69); p 0.033). Of the behavioural factors, the child going to school by a vehicle (OR 3.12 (2.29,8.37); p 0.006) was associated with an increased risk. Drying clothes on a clothesline showed a trend towards protection from acquiring scrub typhus (OR 0.31 (0.08, 1.08); p 0.077). Vector survey:26 rodents were trapped in as many houses. Trombiculid mites were isolated in 24 houses with 9(34.6%) being able to transmit scrub typhus. 254 trombiculid mites belonging to four species and two genera were collected. Leptotrombidium deliense, (33.5%). Schoengastiella ligula, (11.0%) of the total mite specimens collected. S. ligula always co-existed with L. deliense. The estimated Chigger index for Leptotrombidium deliense and Schoengastiella ligula was 3.27and 1.08 per animal respectively.
CONCLUSIONS
CONCLUSIONS
Our study highlights risk factors for scrub typhus, some of which may be modifiable. A clean peri-domestic environment free of vegetation, drying clothes on a clothesline and cooking indoors may decrease the risk of scrub typhus.
Identifiants
pubmed: 31349809
doi: 10.1186/s12879-019-4299-2
pii: 10.1186/s12879-019-4299-2
pmc: PMC6660696
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
665Subventions
Organisme : Wellcome Trust
ID : 104021/Z/14/Z
Pays : United Kingdom
Références
Cochrane Database Syst Rev. 2000;(2):CD002150
pubmed: 10796680
Am J Trop Med Hyg. 2002 Aug;67(2):162-5
pubmed: 12389941
Ann N Y Acad Sci. 2003 Jun;990:25-35
pubmed: 12860596
Ann N Y Acad Sci. 2003 Jun;990:359-64
pubmed: 12860654
Curr Opin Infect Dis. 2003 Oct;16(5):429-36
pubmed: 14501995
Am J Clin Pathol. 2008 Oct;130(4):543-51
pubmed: 18794046
Am J Trop Med Hyg. 2009 Mar;80(3):442-6
pubmed: 19270296
J Clin Microbiol. 2010 Dec;48(12):4404-9
pubmed: 20926708
Indian J Public Health. 2011 Apr-Jun;55(2):92-9
pubmed: 21941043
Indian J Med Res. 2012 Apr;135(4):538-41
pubmed: 22664504
Korean J Parasitol. 2012 Dec;50(4):327-31
pubmed: 23230330
PLoS One. 2013 May 14;8(5):e63668
pubmed: 23691083
Vector Borne Zoonotic Dis. 2013 Aug;13(8):545-9
pubmed: 23930973
Int J Gynaecol Obstet. 2014 Nov;127(2):212
pubmed: 25109770
J Trop Pediatr. 2016 Oct;62(5):415-20
pubmed: 27122479
N Engl J Med. 2016 Sep 8;375(10):913-5
pubmed: 27602663
N Engl J Med. 2016 Sep 8;375(10):954-61
pubmed: 27602667
Indian J Med Res. 2016 Jul;144(1):76-81
pubmed: 27834329
PLoS Negl Trop Dis. 2017 Mar 8;11(3):e0005447
pubmed: 28273079
Indian J Med Res. 2016 Dec;144(6):893-900
pubmed: 28474626
Emerg Infect Dis. 2017 Aug;23(8):1414-1416
pubmed: 28726617
Infect Genet Evol. 2017 Oct;54:466-477
pubmed: 28803969
Indian Pediatr. 2017 Oct 15;54(10):867-870
pubmed: 29120335
Annu Rev Entomol. 1967;12:347-76
pubmed: 5340722
Trans R Soc Trop Med Hyg. 1982;76(1):85-8
pubmed: 7080163
Ann N Y Acad Sci. 1975;266:91-114
pubmed: 829479
Clin Infect Dis. 1997 Dec;25(6):1473-4
pubmed: 9431401