Abstract:
Scrub typhus is a mite-borne acute febrile illness caused by Orientia tsutsugamushi. It is
an emerging infectious disease in the northern region of Sri Lanka. Kilinochchi district
is predominantly an agriculture-based area, which is in the dry zone of Sri Lanka, most
of the area is considered as a rural area and scrub vegetation are plentiful, such nature
of these area is favorable to acquiring scrub typhus infections. Kilinochchi district in the
northern region was not included in the previous study. This study aims to determine
the prevalence, clinical and demographic features of scrub typhus among clinically
suspected typhus patients attending the District General Hospital Kilinochchi. Blood
samples were collected from all the clinically suspected typhus patients attending the
District General Hospital Kilinochchi from June 2021 to August 2021. All these patients
rapidly responded within 2-3 hours to doxycycline. Testing for anti-scrub typhus IgM
was performed in serum using an anti-scrub typhus IgM ELISA kit (AccuDiagTM, USA)
A total 39 patients were recruited for this study. Thirteen (33.3%) patients were positive
for anti-scrub typhus IgM, of whom 8 were males and 5 were females with a mean age
of 40.6 years. All the positive cases were from rural areas and 46.2% of them were
farmers. The major clinical presentations in these patients were fever (100%), chills
(69.2%), headache (69.2%), nausea (53.8%), vomiting (53.8%) and abdominal pain
(46.8%) while an eschar was found in only 23.1%. Nearly two thirds of the patients
had thrombocytopenia and a normal WBC count. Only 33.3% of acute febrile illnesses
in this study were attributed to scrub typhus. Patients with negative results must be
investigated for other possible infectious diseases, especially leptospirosis, which also
responds to doxycycline and is prevalent in the geographical area of Kilinochchi.
