Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Infection Control Department, Pao-Chien Hospital, Pingtung County, Taiwan.
Zoonoses Public Health. 2021 Dec;68(8):876-883. doi: 10.1111/zph.12876. Epub 2021 Jul 5.
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.
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 system software. The characteristics of confirmed ST cases and non-ST cases (cases with suspected ST but negative test findings) were compared.
Among the 38,127 reported cases, there were 6,791 (17.8%) confirmed ST cases. The overall incidence rate of ST in Taiwan was 1.49 per 100,000 residents per year. The trend of incidence rates increased over time. The Island region had the highest incidence rate (56.55 per 100,000 residents per year), followed by the Eastern region (15.13 per 100,000 residents per year). More confirmed ST cases were distributed in mountainous areas of Taiwan Main Island and Island region. Compared to non-ST cases, individuals with confirmed ST were younger (median [interquartile range] age: 44 [26-57] years versus 45 [30-60] years, p < .001) and more likely to engage in at-risk occupations (29.4% versus 13.3%, p < .001), including farming and animal husbandry (16.6% versus 9.0%, p < .001) and the armed forces (12.3% versus 3.5%, p < .001); however, they had a lower rate of animal contact (12.8% versus 20.1%, p < .001).
ST is an endemic disease in Taiwan, particularly in the Island region, Eastern region and mountainous areas. Patients engaged in at-risk occupations and presenting with acute febrile diseases should undergo investigations for ST.
恙虫病（ST）是亚太地区最易误诊、潜在致命的发热性疾病之一。我们利用全国性疾病监测数据库的数据，对过去 19 年来 ST 的危险因素进行了全面综述。
我们利用 1996 年至 2014 年台湾疾病管制署全国疾病监测数据库中的 ST 数据，分析了不同地区 ST 的发病率和相对风险。还评估了研究期间发病率的变化趋势。采用地理信息系统软件绘制了确诊 ST 病例的分布情况。比较了确诊 ST 病例和非 ST 病例（疑似 ST 但检测结果阴性的病例）的特征。
在报告的 38127 例病例中，确诊 ST 病例 6791 例（17.8%）。台湾 ST 的总发病率为每年每 10 万人 1.49 例。发病率呈上升趋势。岛屿地区发病率最高（每年每 10 万人 56.55 例），其次是东部地区（每年每 10 万人 15.13 例）。更多的确诊 ST 病例分布在台湾本岛和岛屿地区的山区。与非 ST 病例相比，确诊 ST 患者更年轻（中位数[四分位数范围]年龄：44[26-57]岁 vs 45[30-60]岁，P<0.001），从事高危职业的可能性更大（29.4% vs 13.3%，P<0.001），包括农业和畜牧业（16.6% vs 9.0%，P<0.001）和军队（12.3% vs 3.5%，P<0.001）；然而，他们接触动物的比例较低（12.8% vs 20.1%，P<0.001）。
ST 是台湾的地方性疾病，尤其是在岛屿地区、东部地区和山区。从事高危职业并出现急性发热性疾病的患者应接受 ST 检查。
