Serological Investigation of Risk of Exposure to Scrub Typhus in Residence at Plantations in North Sumatra Relative to Urban Dwellers at Medan, North Sumatra (SEROSCRUB)

Funders
Mahidol-Oxford Tropical Medicine Research Unit
Nuffield Department of Medicine, University of Oxford

Principal Investigator
Kartika Saraswati

Location
North Sumatra, Indonesia

Outputs to date
Study preparations are currently ongoing. Data collection is expected to start in Q2 2023.

This study aims to compare the seroprevalence of, and factors associated with, exposure to scrub typhus in healthy adult residents of plantations and of urban Medan, North Sumatra. This study is a starting point in characterising scrub typhus epidemiology and its public health significance in Indonesia.

Background

Scrub typhus is a potentially fatal vector-borne illness caused by the obligate intracellular bacteria from the genus Orientia. It is a leading cause of nonmalarial fever in South and South East Asia. Previous reports have documented scrub typhus cases and the existence of its vector and reservoir in [1-3]. It is likely that scrub typhus is causing considerable morbidity and mortality. However, we do not have a clear picture of how big the problem is as data remain scarce. In the face of diagnostic challenges in resource-limited settings, understanding the distribution and risk of acquiring scrub typhus is essential in ensuring early diagnosis and prompt treatment. Scrub transmission is reportedly highly focal in nature, occurring within narrowly specific habitats and optimal climatic conditions [4]. Palm oil plantations in Southeast Asia have been identified as also likely foci of scrub typhus transmission [4-6]. On the other hand, there are also more and more data on the emergence of endemic scrub typhus in urban area [7-10].