ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India.
ICMR-National Institute of Traditional Medicine, Belagavi, Karnataka, India.
Indian J Med Res. 2024 Jun;159(6):601-618. doi: 10.25259/ijmr_1442_23.
Background & objectives Scrub typhus is an emerging mite-borne zoonotic infection that has been overlooked, despite being one of the most widespread severe vector-borne diseases. With an estimated one billion people at risk worldwide and one million annual cases, it poses a significant public health concern. While various studies have investigated the prevalence of scrub typhus in different regions of India, a comprehensive regional systematic review and meta-analysis on the seropositivity of scrub typhus among acute febrile cases has been lacking. To address this gap, we conducted a systematic review and meta-analysis to compile information on the current seroprevalence of scrub typhus in acute febrile illness cases in India. Methods A literature search of multiple databases on prevalence of scrub typhus in acute febrile illness in India, 60 eligible studies out of 573 studies. The prevalence of individual studies was double arcsine transformed, and the pooled prevalence was calculated using inverse variance method. Results In total, these studies encompassed 34,492 febrile cases. The overall seroprevalence of scrub typhus among acute febrile illness cases in India was found to be 26.41 per cent [95% confidence interval (CI): 22.03-31.03]. Additionally, the pooled case fatality rate (based on data from six studies) among scrub typhus-positive cases yielded a case fatality rate of 7.69 per cent (95% CI: 4.37-11.72). Interpretation & conclusions This meta-analysis shows that scrub typhus is a significant health threat in India. Preventive measures to control scrub typhus need to be given priority.
恙虫病是一种新兴的螨媒动物传染病，尽管它是最广泛传播的严重媒介传播疾病之一，但仍被忽视。估计全世界有 10 亿人面临风险，每年有 100 万例病例，这对公共卫生构成了重大威胁。虽然有许多研究调查了印度不同地区恙虫病的流行情况，但缺乏对印度急性发热病例中恙虫病血清阳性率的全面区域系统评价和荟萃分析。为了解决这一差距，我们进行了一项系统评价和荟萃分析，以汇编有关印度急性发热病例中恙虫病当前血清流行率的信息。
对印度急性发热疾病中恙虫病流行率的多个数据库进行文献搜索，从 573 项研究中筛选出 60 项符合条件的研究。对个体研究的流行率进行双反正弦变换，使用倒数方差法计算汇总流行率。
这些研究共包括 34492 例发热病例。印度急性发热疾病中恙虫病的总体血清流行率为 26.41%（95%置信区间：22.03-31.03）。此外，从六项研究中获取的数据计算得出，恙虫病阳性病例的汇总病死率为 7.69%（95%置信区间：4.37-11.72）。
这项荟萃分析表明，恙虫病在印度是一个重大的健康威胁。需要优先采取预防措施来控制恙虫病。
