title: Scrub Typhus: An Emerging Neglected Tropical Disease in Nepal.
abstract: BACKGROUND
  Scrub typhus is a neglected tropical disease and is under reported from Nepal. The objective of this study was to investigate the sero-epidemiology of scrub typhus in patients suffering from acute febrile illness.
  
  
  METHODS
  A total of 434 specimens collected from July to November 2015 at National Public Health Laboratory (NPHL) were investigated for detection of immunoglobulin M (IgM) antibody to Orientiatsutsugamushi.The Scrub Typhus Detect TM kit (InBios, USA) was used to detect the antibodies to O.tsutsugamushi in human serum. Randomly selected 10% positive specimens were used for confirmation by dot- enzyme-linked immunosorbent assay and indirect immunofluorescence assay.
  
  
  RESULTS
  Of the total, 175 (40.3%) were positive for IgM antibodies to O. tsutsugamushi. Positive results of scrub typhus were highest among female in 11-20 year followed by males in 41-50 years age group. The IgM antibodies to O. tsutusugamushi were positive in specimens of various geographical regions including 30 districts of Nepal. Positive cases were found in various ecological regions of Nepal.
  
  
  CONCLUSIONS
  Scrub typhus is one of the neglected tropical diseases in Nepal. Patients with acute febrile illness should be investigated for scrub typhus with high priority. There is an urgent need of reliable and affordable diagnostic tests at all level of health facilities of Nepal. Surveillance and public health awareness about the disease transmission and preventive measures needs to be initiated.
authors.affiliation: National Public Health Laboratory, Kathmandu, Nepal.
authors.forename: B P
authors.initials: BP
authors.lastname: Upadhyaya
authors.affiliation: National Public Health Laboratory, Kathmandu, Nepal.
authors.forename: G
authors.initials: G
authors.lastname: Shakya
authors.affiliation: National Public Health Laboratory, Kathmandu, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: National Public Health Laboratory, Kathmandu, Nepal.
authors.forename: N
authors.initials: N
authors.lastname: Rijal
authors.affiliation: National Public Health Laboratory, Kathmandu, Nepal.
authors.forename: J
authors.initials: J
authors.lastname: Acharya
authors.affiliation: National Public Health Laboratory, Kathmandu, Nepal.
authors.forename: L
authors.initials: L
authors.lastname: Maharjan
authors.affiliation: Epidemiology and Disease Control Division, Department of Health Services, Nepal.
authors.forename: B R
authors.initials: BR
authors.lastname: Marasini
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000907:Antibodies, Bacterial / Q000097:blood / Q000276:immunology; D002648:Child; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D008875:Middle Aged; D058069:Neglected Diseases / Q000175:diagnosis / Q000453:epidemiology*; D009390:Nepal / Q000453:epidemiology; D012285:Orientia tsutsugamushi / Q000276:immunology; D012612:Scrub Typhus / Q000175:diagnosis / Q000453:epidemiology*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: Epidemiology; Nepal; orientia tsutsugamushi; scrubtyphus.