Prevalence and knowledge of scrub typhus in patients with acute febrile illness in teaching hospital, Chitwan, Nepal

Abstract

Background: Infection from scrub typhus has been documented in different areas of Nepal and Chitwan is one of the risk-prone areas. Objective: This study aimed to find out the prevalence of scrub typhus in patients suffering from an acute febrile illness (AFI) as well as their knowledge about it. Materials and Methods: Descriptive study was conducted in Chitwan Medical College (CMC), a tertiary care teaching hospital in Chitwan. A total of 301 patients with AFI admitted in different medical units and screened for scrub typhus by immunoglobulin M enzyme-linked immunosorbent assay method were selected purposively as a study sample. Face to face interview, record review, and blood reports were used to collect the required information. Data were collected from May 1, 2018, to December 2018. Before data collection, ethical approval was obtained from CMC Institutional Review Committee. Obtained data were entered into IBM-SPSS version 20 for window and analyzed using descriptive and inferential statistics. Results: The findings of the study revealed that 13.3% of patients with AFI were positive for scrub typhus. The most common symptoms among patients were fever (100%), headache (59.1%), vomiting (27.0%), and cough (26.7%). Out of 301 patients, only 70 (23.3%) had heard about scrub typhus. Among 70 patients, more than half 41 (58.6%) had a high level of knowledge on scrub typhus. On item wise knowledge, more than half of the patients knew that scrub typhus as infectious disease (52.9%), transmitted through the bite of mites (61.4%) but not transmitted through person to person (65.7%). However, only 38.6% knew that scrub typhus rapidly spread in the rainy season. Moreover, less than half of the patients knew that wearing closed footwear (41.4%), using insect repellents (48.6%), and avoiding traveling to mite infected areas (45.7%) are the preventive measures of scrub typhus. Conclusion: Our results highlight that scrub typhus infection is an important cause of AFI, and patients must be routinely screened for the proper diagnosis and timely treatment. Moreover, very few had heard about scrub typhus and its preventive measures, so awareness program on scrub typhus is needed for the risk groups to enhance their knowledge.