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dc.contributor.authorTshokey, T
dc.contributor.authorStenos, J
dc.contributor.authorDurrheim, DN
dc.contributor.authorEastwood, K
dc.contributor.authorNguyen, C
dc.contributor.authorGraves, SR
dc.date.accessioned2020-12-18T02:43:56Z
dc.date.available2020-12-18T02:43:56Z
dc.date.issued2017-11-01
dc.identifierpii: PNTD-D-17-01459
dc.identifier.citationTshokey, T., Stenos, J., Durrheim, D. N., Eastwood, K., Nguyen, C. & Graves, S. R. (2017). Seroprevalence of rickettsial infections and Q fever in Bhutan. PLOS NEGLECTED TROPICAL DISEASES, 11 (11), https://doi.org/10.1371/journal.pntd.0006107.
dc.identifier.issn1935-2735
dc.identifier.urihttp://hdl.handle.net/11343/255473
dc.description.abstractBACKGROUND: With few studies conducted to date, very little is known about the epidemiology of rickettsioses in Bhutan. Due to two previous outbreaks and increasing clinical cases, scrub typhus is better recognized than other rickettsial infections and Q fever. METHODOLOGY: A descriptive cross-sectional serosurvey was conducted from January to March 2015 in eight districts of Bhutan. Participants were 864 healthy individuals from an urban (30%) and a rural (70%) sampling unit in each of the eight districts. Serum samples were tested by microimmunofluorescence assay for rickettsial antibodies at the Australian Rickettsial Reference Laboratory. RESULTS: Of the 864 participants, 345 (39.9%) were males and the mean age of participants was 41.1 (range 13-98) years. An overall seroprevalence of 49% against rickettsioses was detected. Seroprevalence was highest against scrub typhus group (STG) (22.6%) followed by spotted fever group (SFG) rickettsia (15.7%), Q fever (QF) (6.9%) and typhus group (TG) rickettsia (3.5%). Evidence of exposure to multiple agents was also noted; the commonest being dual exposure to STG and SFG at 5%. A person's likelihood of exposure to STG and SFG rickettsia significantly increased with age and farmers were twice as likely to have evidence of STG exposure as other occupations. Trongsa district appeared to be a hotspot for STG exposure while Punakha district had the lowest STG exposure risk. Zhemgang had the lowest exposure risk to SFG rickettsia compared to other districts. People living at altitudes above 2000 meters were relatively protected from STG infections but this was not observed for SFG, TG or QF exposure. CONCLUSION: This seroprevalence study highlights the endemicity of STG and SFG rickettsia in Bhutan. The high seroprevalence warrants appropriate public health interventions, such as diagnostic improvements and clinical treatment guidelines. Future studies should focus on vector profiles, geospatial, bio-social and environmental risk assessment and preventive and control strategies.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.titleSeroprevalence of rickettsial infections and Q fever in Bhutan
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pntd.0006107
melbourne.affiliation.departmentVeterinary Biosciences
melbourne.source.titlePLoS Neglected Tropical Diseases
melbourne.source.volume11
melbourne.source.issue11
dc.rights.licenseCC BY
melbourne.elementsid1283537
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720829
melbourne.contributor.authorStenos, John
dc.identifier.eissn1935-2735
melbourne.accessrightsOpen Access


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