title: Diagnostic evaluation of rapid tests for scrub typhus in the Indian population is needed.
abstract: BACKGROUND
  Owing to frequent outbreaks witnessed in different parts of the country in the recent past, scrub typhus is being described as a re-emerging infectious disease in India. Differentiating scrub typhus from other endemic diseases like malaria, leptospirosis, dengue fever, typhoid, etc. is difficult due to overlapping clinical features and a lower positivity for eschars in Asian populations. Hence, the diagnosis heavily relies on laboratory tests.
  
  
  CONCLUSIONS
  Costs and the need of technical expertise limit the wide use of indirect immunoperoxidase or immunofluorescence assays, ELISA and PCR. The Weil-Felix test is the most commonly used and least expensive serological test, but lacks both sensitivity and specificity. Hence, the diagnosis of scrub typhus is often delayed or overlooked. With due consideration of the cost, rapidity, single test result and simplicity of interpretation, rapid diagnostic tests have come into vogue. However, evaluation of rapid diagnostic tests for scrub typhus in the Indian population is needed to justify or discourage their use.
  
  
  CONCLUSIONS
  Research studies are needed to find the most suitable test in terms of the rapidity of the result, simplicity of the procedure, ease of interpretation and cost to be used in the Indian populace.
authors.affiliation: Department of Community Medicine, Yenepoya Medical College, Yenepoya University, Mangalore-575018, Karnataka, India. shivalli.bhu@gmail.com.
authors.forename: Siddharudha
authors.initials: S
authors.lastname: Shivalli
mesh_terms: D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay / Q000191:economics / Q000379:methods; D019085:Fluorescent Antibody Technique, Direct / Q000191:economics / Q000379:methods; D006801:Humans; D007124:Immunoenzyme Techniques / Q000191:economics / Q000379:methods; D007194:India / Q000453:epidemiology; D012285:Orientia tsutsugamushi / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000191:economics / Q000379:methods; D012612:Scrub Typhus / Q000175:diagnosis* / Q000453:epidemiology; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000191:economics / Q000379:methods
keywords: India; Rapid test; Scrub typhus