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Construction and validation of a predictive model for meningoencephalitis in pediatric scrub typhus based on machine learning algorithms.

To retrospectively analyze the clinical characteristics of pediatric scrub typhus (ST) with meningoencephalitis (STME) and to construct and validate predictive models using machine learning.Clinical data were collected from 100 cases of pediatric STME and matched with data from 100 ST cases without meningitis using propensity-score matching. Risk factors for STME in pediatrics were identified through the least absolute shrinkage and selection operator (LASSO) regression analysis. Six predictive models-Logistic Regression, K-Nearest Neighbors, Naive Bayes, Multi-layer Perceptron(MLP), Random Fo…

Analysis of the Spatiotemporal Distribution and Evolutionary Trends of Scrub Typhus in Jiangsu Province from 2006 to 2023.

OBJECTIVE: This study aims to analyze the epidemiological characteristics, spatial and temporal distribution patterns, and trends in the evolution of scrub typhus (ST) in Jiangsu Province from 2006 to 2023. Scrub typhus was chosen for this study due to its increasing incidence in Jiangsu Province, its substantial health burden on rural populations, and its relevance as a vector-borne disease influenced by environmental and seasonal factors. METHODS: Data on ST cases in Jiangsu Province from 2006 to 2023 were obtained from the China Disease Control and Prevention Information System. Descriptiv…

Seasonal dynamics and niches of three vector chigger species at a focus of scrub typhus in southwest China.

OBJECTIVE: The present study aims to investigate the seasonal dynamics of main vectors of scrub typhus, and thereby provide scientific information for the surveillance and control of the disease. METHODS: A field investigation lasting for 12 consecutive months was conducted at a fixed survey site (Waxi Village) in Binchuan County (a focus of scrub typhus), Yunnan Province of southwest China between 2019 and 2020. Based on the taxonomic identification of all collected chigger mites, the three vector chigger species of scrub typhus (Leptotrombidium deliense, L. scutellare and L. imphalum) were …

A case of acute pulmonary edema in scrub typhus: a rare complication with normal cardiac and renal function.

BACKGROUND: Scrub typhus is a mite-borne rickettsial infection endemic to parts of Asia, including Sri Lanka, with a wide range of clinical manifestations. CASE PRESENTATION: We report a rare case of a 16-year-old male who presented with a seven-day febrile illness complicated by hypoxemia and pulmonary congestion. Clinical examination revealed an eschar and inguinal lymphadenopathy, raising strong suspicion of scrub typhus, which was subsequently confirmed by a Weil-Felix OXK titer of 1:1280. Despite initial suspicion of myocarditis, cardiac and renal evaluations were normal, and the patient …

Разоблачение невидимого: обобщенное состояние миоклонуса и MODS в скруб тифах, доклад о деле и обзор литературы.

ОКРУЖАЮЩАЯ СРЕДА: < < Ориентия цуцугамуши > > , побудительный агент скруба тифа, представляет собой серьезную угрозу для здоровья населения во всем Азиатско-Тихоокеанском регионе. Клинические проявления скруба тифа сильно различаются, задержки в лечении связаны с высокой смертностью, в то время как быстрая и соответствующая антимикробная терапия, как правило, с использованием доксициклина или подходящих альтернатив, может значительно снизить смертность. Таким образом, ранняя диагностика и эффективное лечение имеют решающее значение для исхода пациента. Здесь мы представляем редкий

Совпадение в аннотации оригинала
BACKGROUND: Orientia tsutsugamushi, the causative agent of scrub typhus, poses a significant public health threat across the Asia-Pacific region. Clinical manifestations of scrub typhus vary widely, delays in treatment are associated with high mortality, whereas prompt and appropriate antimicrobial therapy, typically with doxycycline or suitable alternatives…

A Clinico-Epidemiological Study of Scrub Typhus Cases in a Tertiary Care Center of a Non-endemic Area.

Background Scrub typhus is a re-emerging mite-borne rickettsial infection, traditionally endemic to hilly regions with scrub vegetation, with an emerging spread into non-endemic areas. Given its common presentation as acute undifferentiated febrile illness (AUFI), it often remains underdiagnosed in these areas, even by astute physicians. The study was undertaken to evaluate the socio-epidemiological and clinical characteristics, including complications and mortality, of scrub typhus in a non-endemic region. Methodology This retrospective study included 64 patients diagnosed with scrub typhus u…

Epidemiologic changes of a longitudinal surveillance study spanning 51 years of scrub typhus in mainland China.

Scrub typhus may be one of the world's most prevalent, neglected and serious, but easily treatable, febrile diseases. It has become a significant potential threat to public health in China. In this study we used national disease surveillance data to analyze the incidence and spatial-temporal distribution of scrub typhus in mainland China during 1952-1989 and 2006-2018. Descriptive epidemiological methods and spatial-temporal epidemiological methods were used to investigate the epidemiological trends and identify high-risk regions of scrub typhus infection. Over the 51-year period, a total of 1…

Development and implementation of a strategy for early diagnosis and management of scrub typhus: an emerging public health threat.

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging zoonotic disease in the tropics with considerable morbidity and mortality rates. This disease, which is mostly prevalent in rural areas, remains underdiagnosed and underreported because of the low index of suspicion and non-specific clinical presentation. Limited access to healthcare, diagnostics, and treatment in rural settings further makes it challenging to distinguish it from other febrile illnesses. While easily treatable, improper treatment leads to severe forms of the disease and even death. As there is no existing public …

Frequency and distribution of eschar in patients with scrub typhus in India: systematic review of literature and meta-analysis.

INTRODUCTION: Scrub typhus is a mite-borne tropical febrile illness with high mortality if untreated. The presence of eschar is pathognomonic, but a wide range of frequencies of eschar positivity has been reported in Indian patients. Therefore, this systematic review and meta-analysis aimed to ascertain the frequency (overall and geographic region-wise) and anatomical distribution of eschar in scrub typhus in India. METHODOLOGY: We searched articles in two databases using: [(scrub OR typhus OR Orientia) AND (eschar) AND (India)]. The articles were independently screened and critically apprais…

"Is it time to initiate scrub typhus surveillance in Karnataka?"-Lessons from a seroprevalence survey in a rural district.

BACKGROUND: Scrub typhus, caused by Orientia tsutsugamushi, is a commonly occurring, but underdiagnosed rickettsial infection in India. Considering the high incidence of scrub typhus among patients with acute febrile illness in the hospital setting and the paucity of community seroprevalence studies, we aimed to estimate the prevalence of scrub typhus in the community in the Bengaluru Rural District. METHODS: A pilot cross-sectional survey was conducted between October and December 2022 among eligible asymptomatic adults from five randomly selected villages of the Bangalore Rural District aft…

Deciphering the genotypic diversity and epidemiology of scrub typhus genotypes in India: A systematic review and meta-analysis.

BACKGROUND: Scrub typhus is a significant cause of Acute Febrile Illness in India and presents a range of clinical manifestations influenced by the genotypes of the causative agent, Orientia tsutsugamushi. Understanding the distribution of these genotypes is crucial for public health planning, diagnostic accuracy, and vaccine development. METHODS: In this systematic review, we analyzed 18 studies from an initial pool of 2013 records identified through database searches following PRISMA guidelines. The relevance of the findings to the genotype prevalence of Scrub typhus in India was taken into…

Predictors of severity factors associated with severe scrub typhus among children in a tertiary care hospital.

BACKGROUND OBJECTIVES: Scrub typhus is an acute febrile zoonotic disease caused by the obligate intracellular gram-negative bacteria Orientia tsutsugamushi. Growing data over the last few years from the Indian subcontinent suggest that it is one of the most widespread but under-reported diseases. This study aimed to document the clinical and paraclinical profiles and evaluate complications of scrub typhus in severe and non-severe pediatric age groups. METHODS: A prospective observational study was conducted in pediatric patients. Frequency, mean, percentage and standard deviation were include…

Using ecological niche modeling to predict the potential distribution of scrub typhus in Fujian Province, China.

BACKGROUND: Despite the increasing number of cases of scrub typhus and its expanding geographical distribution in China, its potential distribution in Fujian Province, which is endemic for the disease, has yet to be investigated. METHODS: A negative binomial regression model for panel data mainly comprising meteorological, socioeconomic and land cover variables was used to determine the risk factors for the occurrence of scrub typhus. Maximum entropy modeling was used to identify the key predictive variables of scrub typhus and their ranges, map the suitability of different environments for t…

Oral Azithromycin Versus Doxycycline in the Treatment of Children With Uncomplicated Scrub Typhus: A Randomized Controlled Trial.

OBJECTIVES: To compare the efficacy of azithromycin versus doxycycline in treatment of children with uncomplicated scrub typhus in terms of percentage of children who attained remission of fever after 72 hours of administration of first dose of the study drug, mean time taken to attain fever defervescence, normalization of laboratory parameters, resolution of hepatosplenomegaly and lymphadenopathy. DESIGN: Interventional, open-labeled randomized controlled trial. STUDY METHODS: Patients admitted with undifferentiated fever in the In-Patient Department (IPD), Department of Paediatrics, All In…

Socio-demographic and Clinico-epidemiological Study of Scrub Typhus in A Tertiary Care Hospital of Mymensingh, Bangladesh.

Scrub typhus is one of the leading causes of undifferentiated treatable febrile illness in Asia pacific region. It is grossly under diagnosed in many tropical countries of South Asia including Bangladesh, due to wide range of non-specific clinical presentations, low index of suspicion among clinicians, limited awareness and lack of accurate diagnostic facilities. This cross sectional observational study was conducted at department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh from March 2019 to February 2020 enrolling 113 diagnosed cases of scrub typhus by Immunochromatog…

Mild Encephalitis/Encephalopathy with Reversible Splenial Lesion Associated with Scrub Typhus in a Child: A Case Report.

Background: Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a rare clinicoradiological syndrome characterized by transient mild encephalopathy and magnetic resonance imaging (MRI) findings of a reversible lesion in the splenium of the corpus callosum (SCC). Multiple causes have been proposed for the pathogenesis of MERS, with infection as the most pre-eminent. Case Presentation: We report the case of a 10-year-old girl with MERS due to scrub typhus. Her clinical manifestations of headache and drowsiness, together with lesions involving the SCC, as shown by MRI, and…

Epidemiology and risk factors of scrub typhus in Taiwan: A nationwide database study from 1996 to 2014.

BACKGROUND: Scrub typhus (ST) is one of the most underdiagnosed, potentially fatal febrile diseases in the Asia-Pacific region. We conducted a comprehensive review of the risk factors of ST over 19 years using data from a nationwide database. METHODS: We used data on ST from the nationwide database of the Taiwan Centers for Disease Control from 1996 to 2014 to analyse the incidence rates and relative risks of ST according to different regions. The trends of incidence rates over the study period were also evaluated. The distribution of confirmed ST cases was mapped using geographic information…

Association of leptospirosis and scrub typhus in acute encephalitis syndrome in a tertiary care hospital in Odisha, India.

BACKGROUND: Acute encephalitis syndrome (AES) is a major public health concern in India, causing febrile illness principally associated with viral infection. Bacteria-like scrub typhus and leptospirosis also cause acute febrile illness. Therefore, this study was conceived to address the possible etiological agents contributing to sporadic AES in a tertiary care center in Odisha, India. METHOD: This was a prospective hospital-based study that enrolled 92 consecutive patients with clinically diagnosed AES whose blood/cerebrospinal fluid samples were tested for IgM antibodies to dengue, Japanese…

Clinical Profile and Outcome of Adult Patients with Scrub Typhus in a Tertiary Care Centre of Eastern Nepal.

INTRODUCTION: Scrub typhus is an under-diagnosed and undertreated zoonotic human infection. There are no data related to profile of adult patients in Nepal. We conducted this study to report socio-demographic, clinical profile and complications of scrub typhus in our scenario. METHODS: This was a descriptive cross-sectional study carried out in Nobel Medical College Teaching Hospital, eastern Nepal. The sample enrollment process was consecutively who were admitted under medical ward and intensive care unit. Diagnosis was established serologically with positive test of IgM antibodies against s…

Ideal Criteria for Accurate Mouse Models of Vector-Borne Diseases with Emphasis on Scrub Typhus and Dengue.

Nine criteria regarding the infectious agent, mode of transmission, portal of entry, route of spread, target organs, target cells, pathologic lesions, incubation period, and modifiable spectrum of disease and outcomes appropriate to the intended experimental purpose are described. To provide context for each criterion, mouse models of two vector-borne zoonotic infectious diseases, scrub typhus and dengue, are summarized. Application of the criteria indicates that intravenous inoculation of Orientia tsutsugamushi into inbred mice is the best current model for life-threatening scrub typhus, and …