Patterns of Scrub Typhus tests prescribed among the three Hospitals in
Zhemgang District, 2019-2020: A record-based laboratory review study.
Abstract
Introduction: Scrub typhus is a neglected life threatening acute febrile
illness caused by bacteria Orientia tsutsugamushi and it is a
vector-borne zoonotic disease. In 2009, scrub typhus outbreak at Gedu
has awakened Bhutan on the awareness and testing of the
disease.Information and data of the study highlights the need for in
depth surveillance, awareness among prescribers and initiate preventive
measures in the country. Methods: We used retrospective descriptive
study through review of laboratory registers across three health centres
in Zhemgang district, south central Bhutan. The laboratories registers
have been transcribed into CSV file using Microsoft excel. Variables of
interest were collected from the registers and then analysed using open
statistical software R, (R Core Team (2020). R: A language and
environment for statistical computing. R Foundation for Statistical
Computing, Vienna, Austria.) And use of mStats package, (MyoMinnOo
(2020). mStats: Epidemiological DataAnalysis. R package version 3.4.0.)
Results: Of the total 922 tests prescribed for suspected scrub typhus in
the three health centers in Zhemgang, only 8.2 % (n=76) were tested
positive. Of these, Panbang Hospital had highest reported positive for
scrub typhus with 56.6 %( n=43) followed by Yebilaptsa Hospital 35.5
%( n=27) and Zhemgang Hospital with 7.9 %( n=6). The female gender is
comparably more affected as opposed to male with 57.9% (n=44) of the
positive cases being female. The prevalence of scrub typhus seems to be
affected by the seasonal variation as the months of Spring, Summer and
Autumn together accounts for 98.7%(n=75) of total positive cases. The
year 2019 noted significant scrub typhus cases accounting to 89.5
%(n=68) of the total positive cases over the two years. Conclusions:The
overall tests tested positive of the scrub typhus infection within two
years was 8.2%.