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Title: Contrasting spatial distribution and risk factors for past infection with scrub typhus and murine typhus in Vientiane city, Lao PDR
Authors: Julie Vallé
Thaksinaporn Thaojaikong
Catrin E. Moore
Rattanaphone Phetsouvanh
Allen L. Richards
Marc Souris
Florence Fournet
Gérard Salem
Jean Paul J. Gonzalez
Paul N. Newton
Emergence des Pathologies Virales
Universite Paris Nanterre
Mahosot Hospital
Nuffield Department of Clinical Medicine
Naval Medical Research Center
Mahidol University
Asian Institute of Technology Thailand
Centre International de Recherches Medicales de Franceville
Keywords: Medicine
Issue Date: 1-Dec-2010
Citation: PLoS Neglected Tropical Diseases. Vol.4, No.12 (2010), 1-10
Abstract: Background: The aetiological diagnostic of fevers in Laos remains difficult due to limited laboratory diagnostic facilities. However, it has recently become apparent that both scrub and murine typhus are common causes of previous undiagnosed fever. Epidemiological data suggests that scrub typhus would be more common in rural areas and murine typhus in urban areas, but there is very little recent information on factors involved in scrub and murine typhus transmission, especially where they are sympatric - as is the case in Vientiane, the capital of the Lao PDR. Methodology and Principal Findings:We therefore determined the frequency of IgG seropositivity against scrub typhus (Orientia tsutsugamushi) and murine typhus (Rickettsia typhi), as indices of prior exposure to these pathogens, in randomly selected adults in urban and peri-urban Vientiane City (n=2,002, $35 years). Anti-scrub and murine typhus IgG were detected by ELISA assays using filter paper elutes. We validated the accuracy of ELISA of these elutes against ELISA using serum samples. The overall prevalence of scrub and murine typhus IgG antibodies was 20.3% and 20.6%, respectively. Scrub typhus seropositivity was significantly higher among adults living in the periphery (28.4%) than in the central zone (13.1%) of Vientiane. In contrast, seroprevalence of murine typhus IgG antibodies was significantly higher in the central zone (30.8%) as compared to the periphery (14.4%). In multivariate analysis, adults with a longer residence in Vientiane were at significant greater risk of past infection with murine typhus and at lower risk for scrub typhus. Those with no education, living on low incomes, living on plots of land with poor sanitary conditions, living in large households, and farmers were at higher risk of scrub typhus and those living in neighborhoods with high building density and close to markets were at greater risk for murine typhus and at lower risk of scrub typhus past infection. Conclusions: This study underscores the intense circulation of both scrub and murine typhus in Vientiane city and underlines difference in spatial distribution and risk factors involved in the transmission of these diseases.
Appears in Collections:Scopus 2006-2010

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