Sero-epidemiology of scrub typhus among suspected cases in selected areas of Nepal

Introduction Scrub typhus is an acute, febrile, infectious disease which is caused by Orientia tsutsugamushi. In the current days of Nepal huge burden of scrub typhus have been found, mainly Southern Nepal. Methodology Blood samples were collected from the suspected patients of scrub typhus who is having acute febrile illness. Detection of Immunoglobulin M (IgM) antibody to Orientia tsutsugamushi was performed by using Scrub Typhus Detect™ kit, In Bios International USA. Results A total 1585 cases, 358 (22.58 %) were positive for IgM Antibodies to Orientia tsutsugamushi. Multivariate analysis demonstrated that the following factors were significantly associated with the scrub typhus. 1. Females (odd ratio [OR]= 2.037, P=< 0.001, confidence interval [CI]= 1.465 – 2.831) 2. Rural residential location (odd ratio [OR]= 0.431, P=0.001, confidence interval [CI]= 0.261 – 0.714), 3. House near grassland (odd ratio [OR]= 3.279, P=<0.001, confidence interval [CI]= 1.932 – 5.563), 4. Presence of mouse inside the house (odd ratio [OR]= 5.462, P=<0.001, confidence interval [CI]= 4.048 – 7.371), 5. Working in the field (odd ratio [OR]= 9.845, P=0.004, confidence interval [CI]= 2.068 – 46.954). Conclusion The study indicated that Scub typhus is a big burden of Nepal, where we have identified the prevalence rate was 23  % . Use of IgM ELISA test will help for early diagnosis and it is urgent to investigate to save the life of people who lives endemic areas of Scrub typhus in Nepal.