Abstract
Background
Scrub typhus (ST) is a life-threatening infectious disease if appropriate treatment is unavailable. Large discrepancy of clinical severity of ST patients was reported among age groups, and the underlying risk factors for severe disease are unclear.
Methods
Clinical and epidemiological data of ST patients were collected in 55 surveillance hospitals located in Guangzhou City, China, from 2012 to 2018. Severe prognosis and related factors were determined and compared between pediatric and elderly patients.
Results
A total of 2,074 ST patients including 209 pediatric patients and 1,865 elderly patients were included, with a comparable disease severity rate of 11.0% (95% CI 7.1%–16.1%) and 10.3% (95% CI 9.0%–11.8%). Different frequencies of clinical characteristics including lymphadenopathy, skin rash, enlarged tonsils, etc. were observed between pediatric and elderly patients. Presence of peripheral edema and decreased hemoglobin were the most important predictors of severe illness in pediatric patients with adjusted ORs by 38.99 (9.96–152.67, p<0.001) and 13.22 (1.54–113.50, p = 0.019), respectively, while presence of dyspnea and increased total bilirubin were the potential determinants of severe disease in elderly patients with adjusted ORs by 11.69 (7.33–18.64, p<0.001) and 3.17 (1.97–5.11, p<0.001), respectively. Compared with pediatric patients, elderly patients were more likely to receive doxycycline (64.8% v.s 9.9%, p<0.001), while less likely to receive azithromycin therapy (5.0% v.s 41.1%, p<0.001).
Conclusion
The disease severity rate is comparable between pediatric and elderly ST patients, while different clinical features and laboratory indicators were associated with development of severe complications for pediatric and elderly patients, which is helpful for diagnosis and progress assessment of disease for ST patients.
Funder
the Natural Science Foundation of China
the Science and Technology Plan Grant of Guangzhou
the Key Research and Development Program of China
Publisher
Public Library of Science (PLoS)
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health
Reference37 articles.
1. Scrub typhus—scientific neglect, ever-widening impact;DH Walker;New Engl J Med,2016
2. Endemic scrub typhus in South America;T Weitzel;New Engl J Med,2016
3. Q Fever, scrub typhus, and rickettsial diseases in children, Kenya, 2011–2012;AN Maina;Emerging Infect Dis,2016
4. Serologic evidence of scrub typhus in the Peruvian Amazon;C Kocher;Emerging Infect Dis,2017
5. Scrub typhus outbreak in a remote primary school, Bhutan, 2014;T Tshokey;Emerging Infect Dis,2017
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