title: Incidence of rickettsial infection in patients with acute fever in provincial Thai army hospitals.
abstract: Scrub typhus is common among patients with acute fever in rural areas of Thailand. The authors prospectively recruited patients with acute fever from provincial Thai army hospitals. Dot-ELISA test for scrub typhus was done in hospitals and then compared with standard immunofluorescent assay for diagnosis of scrub typhus. Among 178 patients, scrub typhus was diagnosed by immunofluorescent assay in 10 patients (5.61%). The incidence was high in the northeastern and northern regions. Dot-ELISA gave positive results in 4 of 115 patients, while immunofluorescent assay gave positive results in 6 patients (sensitivity = 66.7%). No false positive results of Dot-ELISA were found among 109 patients (specificity = 100%). All patients gave negative results for murine typhus and Thai tick typhus using immunofluorescent assay. Regarding this present study, Dot-ELISA for scrub typhus has a good sensitivity and specificity and can be used in rural hospitals. This test could be useful for diagnosis of scrub typhus in hospitals where immunofluorescent assay is not available.
authors.affiliation: Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.
authors.forename: Sataporn
authors.initials: S
authors.lastname: Thitivichianlert
authors.forename: Suthee
authors.initials: S
authors.lastname: Panichkul
authors.forename: Dharadhida
authors.initials: D
authors.lastname: Bodhidatta
authors.forename: Wuttikon
authors.initials: W
authors.lastname: Rodkvamtook
authors.forename: Suchitra
authors.initials: S
authors.lastname: Sukwit
authors.forename: Piyabutara
authors.initials: P
authors.lastname: Boonmee
authors.forename: Aphornpirom
authors.initials: A
authors.lastname: Ketupanya
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D005455:Fluorescent Antibody Technique; D006772:Hospitals, Military; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012285:Orientia tsutsugamushi / Q000276:immunology*; D011446:Prospective Studies; D012282:Rickettsia Infections / Q000150:complications / Q000453:epidemiology*; D012424:Rural Population; D012612:Scrub Typhus / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D012680:Sensitivity and Specificity; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial