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印度泰米尔纳德邦北部立克次体感染的地理和流行情况:一项横断面研究。

Geography and prevalence of rickettsial infections in Northern Tamil Nadu, India: a cross-sectional study.

机构信息

Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.

Health Systems Research, ICMR-National Institute of Epidemiology (NIE), Chennai, Tamil Nadu, India.

出版信息

Sci Rep. 2022 Dec 2;12(1):20798. doi: 10.1038/s41598-022-21191-7.

Abstract

Rickettsial infections and Q fever are a common cause of acute febrile illness globally. Data on the role of climate and altitude on the prevalence of these infections in lacking from Southern India. In this study, we determined the sero-prevalence of scrub typhus (ST), spotted fever (SF), murine typhus (MT) and Q Fever (QF) in 8 eight geographical regions of North Tamil Nadu by detecting IgG antibodies using ELISA. Totally we tested 2565 people from 86 localities. Among the 27.3% positives, approximately 5% were IgG positive for two or more infections. Sero-prevalence to rickettsioses and Q fever was highest for individuals from rural areas and increased with age (> 30 years). Those in the Nilgiris highlands (wetter and cooler) and Erode, which has the most land under irrigation, demonstrated the least exposure to rickettsioses and Q fever. Lowland plains (AOR: 8.4-22.9; 95% CI 3.1-55.3) and highland areas up to 1000 m (AOR: 6.1-10.3; 95% CI 2.4-23.9) showed the highest risk of exposure to scrub typhus. For spotted fever, the risk of exposure was highest in Jawadhi (AOR:10.8; 95% CI 2.6-44.3) and Kalrayan (AOR:16.6; 95% CI 4.1-66.2). Q fever positivity was most likely to be encountered in Salem (AOR: 5.60; 95% CI 1.01-31.08) and Kalrayan hills (AOR:12.3; 95% CI 2.9-51.6). Murine typhus risk was significant only in Tiruvannamalai (AOR:24.2; 95% CI 3.3-178.6). Our study suggests that prevalence of rickettsial infections and Q fever is low in areas which receive rainfall of ≥ 150 cm/year, with average minimum and maximum temperatures between 15 and 25 °C and elevation in excess of 2000 m. It is also less in well irrigated lowlands with dry climate. These preliminary findings need confirmation by active surveillance in these areas.

摘要

立克次体感染和 Q 热是全球急性发热疾病的常见病因。印度南部缺乏关于气候和海拔对这些感染流行的影响的数据。在这项研究中,我们通过酶联免疫吸附试验(ELISA)检测 IgG 抗体,确定了北泰米尔纳德邦 8 个地理区域的恙虫病(ST)、斑疹热(SF)、鼠型斑疹伤寒(MT)和 Q 热(QF)的血清流行率。我们总共检测了来自 86 个地点的 2565 人。在 27.3%的阳性者中,大约有 5%的人 IgG 对两种或两种以上的感染呈阳性。农村地区人群的立克次体病和 Q 热血清阳性率最高,并随年龄增长而增加(>30 岁)。在尼拉甘吉高原(更潮湿和凉爽)和埃罗德(灌溉面积最大),人们接触立克次体病和 Q 热的几率最低。低地平原(优势比 [AOR]:8.4-22.9;95%置信区间 [CI]:3.1-55.3)和高达 1000 米的高地(AOR:6.1-10.3;95%CI:2.4-23.9)地区显示出接触恙虫病的最高风险。对于斑疹热,Jawadhi(AOR:10.8;95%CI:2.6-44.3)和 Kalrayan(AOR:16.6;95%CI:4.1-66.2)地区的暴露风险最高。在 Salem(AOR:5.60;95%CI:1.01-31.08)和 Kalrayan 山区(AOR:12.3;95%CI:2.9-51.6)最有可能检测到 Q 热阳性。鼠型斑疹伤寒的风险仅在 Tiruvannamalai(AOR:24.2;95%CI:3.3-178.6)显著。我们的研究表明,在降雨量≥150cm/年、平均最低和最高温度在 15 至 25°C 之间且海拔超过 2000 米的地区,立克次体感染和 Q 热的流行率较低。在气候干燥的灌溉良好的低地也较少。这些初步发现需要在这些地区进行主动监测来证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebbc/9718799/45d74b5eb614/41598_2022_21191_Fig1_HTML.jpg

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