The Epidemiology of Scrub typhus in Thiruvarur, Tamil Nadu

National Vector-Borne Disease Control Programme (NVBDCP) under the National Center for Vector Borne Diseases Control (NCVBDC), Govt. of India, Delhi has put forth efforts to combat diseases transmitted by vectors, under the overarching umbrella of the National Health Mission (NHM). NCVBDC focuses mainly on six Vector Borne Diseases (VBD) but at the state and district level the VBD officials have to deal with all the VBDs covered under NCVBDC or outside the purview of NCVBDC. The advancement in modern technologies has increased attention to neglected tropical diseases, emphasizing their importance in public health discussions. Scrub typhus, a rickettsial infection with a harmless bite of infected chigger mite on humans, transmits the gram-negative bacteria Orientia tsutsugamushi causing the infection with rising mortality and morbidity rates across the globe. The living environment of the people plays a pivotal role in scrub typhus disease transmission. Rodents are the major reservoirs carrying the vector mites with additionally the environment, sanitation and hygiene as a crucial factor in the spread of scrub typhus. A study was conducted from December 2023-July 2024, in the delta district of Thiruvarur covering the household participants of 730 from both rural and urban households. The statistical analysis of both quantitative and categorical variables was done using the SPSS software Version 16.0. The spacio-temporal mapping of the household areas enhanced the study with the representation of the study participants who were exposed to the risk factors but were susceptible hosts to scrub typhus. The univariate analysis showed a significant association between scrub typhus exposure with the people working in the agricultural fields, location of toilets, kitchen, presence of animals in homes, barren land and paddy fields near living areas, lack of protective implements against rodents, drying clothes on bushes, walking barefoot with more chances of being bitten by insects, mites or ticks resulting in rashes or Eschars, hospitalization due to fever, sneezing and headache. The Multivariate regression analysis showed that the association between scrub typhus exposure to the kitchen located outdoors (aOR=3.768, CI: 1.036 - 13.699, p = 0.044), people living near paddy fields (aOR=2.140, CI: 1.019-4.492, p=0.044), the use of protective implements (aOR = 0.071 (CI: 0.034 - 0.147, p < 0.001), drying clothes on bushes (aOR = 3.012 CI: 1.579 - 5.745, p = 0.001) showed strong association to exposure to scrub typhus.