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Seroprevalence & seroincidence of Orientia tsutsugamushi infection in Gorakhpur, Uttar Pradesh, India: A community-based serosurvey during lean (April-May) & epidemic (October-November) periods for acute encephalitis syndrome.
Indian J Med Res. 2020 Apr; 151(4):350-360.IJ

Abstract

Background & objectives

In India, acute encephalitis syndrome (AES) cases are frequently reported from Gorakhpur district in Uttar Pradesh. Scrub typhus is one of the predominant aetiological agents for these cases. In order to delineate the extent of the background of scrub typhus seroprevalence and the associated risk factors at community level, serosurveys during both lean and epidemic periods (phase 1 and phase 2, respectively) of AES outbreaks were conducted in this region.

Methods

Two community-based serosurveys were conducted during lean (April-May 2016) and epidemic AES (October-November 2016) periods. A total of 1085 and 906 individuals were enrolled during lean and epidemic AES periods, respectively, from different villages reporting recent AES cases. Scrub typhus-seronegative individuals (n=254) during the lean period were tested again during the epidemic period to estimate the incidence of scrub typhus.

Results

The seroprevalence of Orientia tsutsugamushi during AES epidemic period [immunoglobulin (Ig) IgG: 70.8%, IgM: 4.4%] was high as compared to that of lean AES period (IgG: 50.6%, P <0.001; IgM: 3.4%). The factors independently associated with O. tsutsugamushi positivity during lean AES period were female gender, illiteracy, not wearing footwear, not taking bath after work whereas increasing age, close contact with animals, source of drinking water and open-air defecation emerged as additional risk factors during the epidemic AES season. IgM positivity was significantly higher among febrile individuals compared to those without fever (7.7 vs. 3.5%, P=0.006). The seroincidence for O. tsutsugamushi was 19.7 per cent, and the subclinical infection rate was 54 per cent.

Interpretation & conclusions

The community-based surveys identified endemicity of O. tsutsugamushi and the associated risk factors in Gorakhpur region. The findings will be helpful for planning appropriate interventional strategies to control scrub typhus.

Authors+Show Affiliations

Division of Epidemiology & Biostatistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India.Division of Microbiology, ICMR-National AIDS Research Institute, Pune, Maharashtra, India.Division of Epidemiology & Biostatistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India.Division of Epidemiology & Biostatistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India.Division of Microbiology, ICMR-National AIDS Research Institute, Pune, Maharashtra, India.Department of Community Medicine, BRD Medical College, Gorakhpur, Uttar Pradesh, India.ICMR-National AIDS Research Institute, Pune, Maharashtra, India.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32461399

Citation

Kamble, Suchit, et al. "Seroprevalence & Seroincidence of Orientia Tsutsugamushi Infection in Gorakhpur, Uttar Pradesh, India: a Community-based Serosurvey During Lean (April-May) & Epidemic (October-November) Periods for Acute Encephalitis Syndrome." The Indian Journal of Medical Research, vol. 151, no. 4, 2020, pp. 350-360.
Kamble S, Mane A, Sane S, et al. Seroprevalence & seroincidence of Orientia tsutsugamushi infection in Gorakhpur, Uttar Pradesh, India: A community-based serosurvey during lean (April-May) & epidemic (October-November) periods for acute encephalitis syndrome. Indian J Med Res. 2020;151(4):350-360.
Kamble, S., Mane, A., Sane, S., Sonavale, S., Vidhate, P., Singh, M. K., Gangakhedkar, R., & Gupte, M. (2020). Seroprevalence & seroincidence of Orientia tsutsugamushi infection in Gorakhpur, Uttar Pradesh, India: A community-based serosurvey during lean (April-May) & epidemic (October-November) periods for acute encephalitis syndrome. The Indian Journal of Medical Research, 151(4), 350-360. https://doi.org/10.4103/ijmr.IJMR_1330_18
Kamble S, et al. Seroprevalence & Seroincidence of Orientia Tsutsugamushi Infection in Gorakhpur, Uttar Pradesh, India: a Community-based Serosurvey During Lean (April-May) & Epidemic (October-November) Periods for Acute Encephalitis Syndrome. Indian J Med Res. 2020;151(4):350-360. PubMed PMID: 32461399.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seroprevalence & seroincidence of Orientia tsutsugamushi infection in Gorakhpur, Uttar Pradesh, India: A community-based serosurvey during lean (April-May) & epidemic (October-November) periods for acute encephalitis syndrome. AU - Kamble,Suchit, AU - Mane,Arati, AU - Sane,Suvarna, AU - Sonavale,Suvarna, AU - Vidhate,Pallavi, AU - Singh,Manish Kumar, AU - Gangakhedkar,Raman, AU - Gupte,Mohan, PY - 2020/5/29/entrez KW - Acute encephalitis syndrome KW - Orientia tsutsugamushi KW - community-based KW - scrub typhus KW - seroincidence KW - seroprevalence KW - serosurvey SP - 350 EP - 360 JF - The Indian journal of medical research JO - Indian J. Med. Res. VL - 151 IS - 4 N2 - Background & objectives: In India, acute encephalitis syndrome (AES) cases are frequently reported from Gorakhpur district in Uttar Pradesh. Scrub typhus is one of the predominant aetiological agents for these cases. In order to delineate the extent of the background of scrub typhus seroprevalence and the associated risk factors at community level, serosurveys during both lean and epidemic periods (phase 1 and phase 2, respectively) of AES outbreaks were conducted in this region. Methods: Two community-based serosurveys were conducted during lean (April-May 2016) and epidemic AES (October-November 2016) periods. A total of 1085 and 906 individuals were enrolled during lean and epidemic AES periods, respectively, from different villages reporting recent AES cases. Scrub typhus-seronegative individuals (n=254) during the lean period were tested again during the epidemic period to estimate the incidence of scrub typhus. Results: The seroprevalence of Orientia tsutsugamushi during AES epidemic period [immunoglobulin (Ig) IgG: 70.8%, IgM: 4.4%] was high as compared to that of lean AES period (IgG: 50.6%, P <0.001; IgM: 3.4%). The factors independently associated with O. tsutsugamushi positivity during lean AES period were female gender, illiteracy, not wearing footwear, not taking bath after work whereas increasing age, close contact with animals, source of drinking water and open-air defecation emerged as additional risk factors during the epidemic AES season. IgM positivity was significantly higher among febrile individuals compared to those without fever (7.7 vs. 3.5%, P=0.006). The seroincidence for O. tsutsugamushi was 19.7 per cent, and the subclinical infection rate was 54 per cent. Interpretation & conclusions: The community-based surveys identified endemicity of O. tsutsugamushi and the associated risk factors in Gorakhpur region. The findings will be helpful for planning appropriate interventional strategies to control scrub typhus. SN - 0971-5916 UR - https://www.unboundmedicine.com/medline/citation/32461399/Seroprevalence_&_seroincidence_of_Orientia_tsutsugamushi_infection_in_Gorakhpur_Uttar_Pradesh_India:_A_community_based_serosurvey_during_lean__April_May__&_epidemic__October_November__periods_for_acute_encephalitis_syndrome_ L2 - http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2020;volume=151;issue=4;spage=350;epage=360;aulast=Kamble DB - PRIME DP - Unbound Medicine ER -
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