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Evaluation of scrub typhus diagnosis in China: analysis of nationwide surveillance data from 2006 to 2016
Xin, Hua-Lei1,2; Yu, Jian-Xing2,3,4,5; Hu, Mao-Gui6; Jiang, Fa-Chun1; Li, Xiao-Jing1; Wang, Li-Ping2; Huang, Ji-Lei2,7; Wang, Jin-Feng6; Sun, Jun-Ling2; Li, Zhong-Jie2
2019-06-29
Source PublicationINFECTIOUS DISEASES OF POVERTY
ISSN2095-5162
Volume8Pages:12
Corresponding AuthorSun, Jun-Ling(sunjl@chinacdc.cn) ; Li, Zhong-Jie(lizhongjiecdc@163.com)
AbstractBackgroundScrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, and specific antimicrobial medicine is available. Early and accurate diagnosis is essential for reducing the risk of severe complications and death. In this study, we aimed to evaluate the case diagnosis situation among medical care institutions and geographical regions in China, and the results will benefit both clinical practice and the disease surveillance system.MethodsWe extracted individual scrub typhus case data2006-2016 from a national disease surveillance system in China. The diagnosis category and interval time from illness onset to diagnosis were compared among three levels of medical care institutions and provinces. The descriptive analysis method was performed in our study.ResultsDuring the 11-year study period, 93481 scrub typhus cases, including 57 deaths, were recorded in the nationwide surveillance system. The overall proportion of laboratory-confirmed cases was only 4.7%, and this proportion varied greatly among primary medical centres (2.8%), county level hospitals (4.2%), and city level hospitals (6.3%). Notably, the proportion of laboratory-confirmed cases has consistently decreased from 16.3% in 2006 to 2.6% in 2016, and the same decreasing trend was found among all three levels of medical care institutions. The interval from illness onset to case diagnosis (T-diag) for all cases was 5days (interquartile range [IQR]: 2-9days) and decreased from 7days (IQR: 3-11days) in 2006 to 5days (IQR: 2-8days) in 2016. The risk of death for patients with a T-diag of >7days was 2.2 times higher (OR=2.21, 95% CI: 1.05-5.21) than that of patients with a T-diag of <2days.ConclusionsThe interval time from illness onset to diagnosis for scrub typhus cases decreased greatly in China; however, the diagnosis rate of cases with laboratory-confirmed results must be increased among all levels of medical care institutions to reduce both the risk of death and the misuse of antibiotics associated with scrub typhus.
KeywordScrub typhus Diagnosis Evaluation China
DOI10.1186/s40249-019-0566-0
WOS KeywordRAPID TEST ; DISEASES ; FEVER ; TESTS
Indexed BySCI
Language英语
Funding ProjectNational Science and Technology Major Project[2018ZX10713-001-006] ; National Science and Technology Major Project[2018ZX10101002-003-002] ; Emergency Response Mechanism Operation Program, Chinese Center for Disease Control and Prevention[131031001000015001]
Funding OrganizationNational Science and Technology Major Project ; Emergency Response Mechanism Operation Program, Chinese Center for Disease Control and Prevention
WOS Research AreaInfectious Diseases
WOS SubjectInfectious Diseases
WOS IDWOS:000473212200001
PublisherBMC
Citation statistics
Document Type期刊论文
Identifierhttp://ir.igsnrr.ac.cn/handle/311030/58397
Collection中国科学院地理科学与资源研究所
Corresponding AuthorSun, Jun-Ling; Li, Zhong-Jie
Affiliation1.Qingdao City Ctr Dis Control & Prevent, Qingdao 266033, Shandong, Peoples R China
2.Chinese Ctr Dis Control & Prevent, Key Lab Surveillance & Early Warning Infect Dis, Div Infect Dis, Beijing 102206, Peoples R China
3.Acad Med Sci China, Minist Hlth, Key Lab Syst Biol Pathogens, Beijing 100000, Peoples R China
4.Acad Med Sci China, Dr Christophe Merieux Lab, CAMS Fdn Merieux, Inst Pathogen Biol, Beijing 100000, Peoples R China
5.Peking Union Med Coll, Beijing 100000, Peoples R China
6.Chinese Acad Sci, Inst Geog Sci & Nat Resources Res, State Key Lab Resources & Environm Informat Syst, Beijing 100000, Peoples R China
7.Chinese Ctr Dis Control & Prevent, Natl Inst Parasit Dis, Shanghai 200025, Peoples R China
Recommended Citation
GB/T 7714
Xin, Hua-Lei,Yu, Jian-Xing,Hu, Mao-Gui,et al. Evaluation of scrub typhus diagnosis in China: analysis of nationwide surveillance data from 2006 to 2016[J]. INFECTIOUS DISEASES OF POVERTY,2019,8:12.
APA Xin, Hua-Lei.,Yu, Jian-Xing.,Hu, Mao-Gui.,Jiang, Fa-Chun.,Li, Xiao-Jing.,...&Li, Zhong-Jie.(2019).Evaluation of scrub typhus diagnosis in China: analysis of nationwide surveillance data from 2006 to 2016.INFECTIOUS DISEASES OF POVERTY,8,12.
MLA Xin, Hua-Lei,et al."Evaluation of scrub typhus diagnosis in China: analysis of nationwide surveillance data from 2006 to 2016".INFECTIOUS DISEASES OF POVERTY 8(2019):12.
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