Evidence map›Paper›PMID 26274584›Full record

SynthesisPLoS neglected tropical diseases2015

A Systematic Review of Mortality from Untreated Scrub Typhus (Orientia tsutsugamushi).

Andrew J Taylor, Daniel H Paris, Paul N Newton

Registry-linked trialOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03847870 (Background Seroprevalence of Rickettsial Infections in Myanmar), which is not on this map. Cited by 219 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
219citing papers in PubMed, 13 pooled it
18.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03847870 completednot on this mapstarted 2019, after this paper: background citation

Background Seroprevalence of Rickettsial Infections in Myanmar

TypeobservationalSponsorMyanmar Oxford Clinical Research UnitRan2019 to 2019Enrolled700ConditionsRickettsiae InfectionsArmsMORU in-house ELISA test followed by IFA if positive
3 · Its place in the literature

Who cites it

219 citing papers in PubMed, 13 syntheses or guidelines pooled it, 354 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. The burden of scrub typhus in India: A systematic review.PLoS neglected tropical diseases · 2021
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. The double burden of diabetes and global infection in low and middle-income countries.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2019
    Pooled it
  12. Antibiotics for treating scrub typhus.The Cochrane database of systematic reviews · 2018
    Pooled it
  13. Pooled it
  14. Trial
  15. Trial
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  17. Article
  18. Article
  19. Imaging in scrub typhus - a pictorial review.Abdominal radiology (New York) · 2026
    Review
  20. Article

159 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 3 countries.

Andrew J TaylorLao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom.
Daniel H ParisLao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom; Mahidol-Oxford Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Paul N NewtonLao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom.
Mahosot Hospital · LALao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit · LA

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundScrub typhus, a bacterial infection caused by Orientia tsutsugamushi, is increasingly recognized as an important cause of fever in Asia, with an estimated one million infections occurring each year. Limited access to health care and the disease's non-specific symptoms mean that many patients are undiagnosed and untreated, but the mortality from untreated scrub typhus is unknown. This review systematically summarizes the literature on the untreated mortality from scrub typhus and disease outcomes. METHODOLOGY/PRINCIPAL

findingsA literature search was performed to identify patient series containing untreated patients. Patients were included if they were symptomatic and had a clinical or laboratory diagnosis of scrub typhus and excluded if they were treated with antibiotics. The primary outcome was mortality from untreated scrub typhus and secondary outcomes were total days of fever, clinical symptoms, and laboratory results. A total of 76 studies containing 89 patient series and 19,644 patients were included in the final analysis. The median mortality of all patient series was 6.0% with a wide range (min-max) of 0-70%. Many studies used clinical diagnosis alone and had incomplete data on secondary outcomes. Mortality varied by location and increased with age and in patients with myocarditis, delirium, pneumonitis, or signs of hemorrhage, but not according to sex or the presence of an eschar or meningitis. Duration of fever was shown to be long (median 14.4 days Range (9-19)).

conclusionsResults show that the untreated mortality from scrub typhus appears lower than previously reported estimates. More data are required to clarify mortality according to location and host factors, clinical syndromes including myocarditis and central nervous system disease, and in vulnerable mother-child populations. Increased surveillance and improved access to diagnostic tests are required to accurately estimate the untreated mortality of scrub typhus. This information would facilitate reliable quantification of DALYs and guide empirical treatment strategies.

Indexed as

Age FactorsHumansOrientia tsutsugamushiRisk FactorsScrub Typhus

Identifiers

PMID26274584
PMCPMC4537241
OpenAlexW1556311053

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.