Govekar Siddhant, Puri Oshin, Bhatia Mohit
All India Institute of Medical Sciences, Rishikesh 249203, Uttarakhand, India.
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India.
Trans R Soc Trop Med Hyg. 2025 Feb 4;119(2):97-106. doi: 10.1093/trstmh/trae081.
Scrub typhus and leptospirosis are re-emerging zoonotic infections with significant morbidity and mortality rates in India. Overlapping aetiological and epidemiological patterns indicate a high possibility of their co-infection in India, which can be a diagnostic challenge due to non-specific clinical features. A systematic search of the PubMed/MEDLINE, Scopus and Embase databases was conducted to identify relevant studies published through 31 August 2023. Studies reporting co-infection of scrub typhus and leptospirosis among the Indian population were included. Data extraction, quality assessment and statistical analysis were performed in accordance with established guidelines. Six studies met the inclusion criteria, comprising a total of 58 co-infection cases. Pooled prevalence of scrub typhus-leptospirosis co-infection among acute undifferentiated febrile illness patients was 3.7% (95% confidence interval [CI] 0.00 to 0.126). Among scrub typhus patients, the prevalence of co-infection with leptospirosis was 13.7% (95% CI 0.027 to 0.304). Significant heterogeneity was observed among the included studies, highlighting the need for cautious interpretation of prevalence estimates. This meta-analysis underscores the clinical importance of scrub typhus-leptospirosis co-infection in India and emphasizes the need for enhanced clinical awareness, improved diagnostic strategies and targeted research efforts to address this emerging infectious disease threat.
恙虫病和钩端螺旋体病是在印度重新出现的人畜共患感染性疾病，具有较高的发病率和死亡率。病因学和流行病学模式的重叠表明，在印度它们合并感染的可能性很高，由于临床特征不具特异性，这可能是一个诊断难题。我们对PubMed/MEDLINE、Scopus和Embase数据库进行了系统检索，以识别截至2023年8月31日发表的相关研究。纳入了报告印度人群中恙虫病和钩端螺旋体病合并感染的研究。按照既定指南进行数据提取、质量评估和统计分析。六项研究符合纳入标准，共包括58例合并感染病例。急性未分化发热性疾病患者中恙虫病 - 钩端螺旋体病合并感染的合并患病率为3.7%（95%置信区间[CI]为0.00至0.126）。在恙虫病患者中，合并感染钩端螺旋体病的患病率为13.7%（95%CI为0.027至0.304）。在所纳入的研究中观察到显著的异质性，这突出了对患病率估计进行谨慎解释的必要性。这项荟萃分析强调了印度恙虫病 - 钩端螺旋体病合并感染的临床重要性，并强调需要提高临床意识、改进诊断策略以及开展针对性研究工作，以应对这一新兴传染病威胁。
