Diagnosis of scrub typhus: recent advancements and challenges
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REVIEW ARTICLE
Diagnosis of scrub typhus: recent advancements and challenges Deepak Kala1 · Shagun Gupta2 · Rupak Nagraik2 · Vivek Verma2 · Atul Thakur1 · Ankur Kaushal1 Received: 26 May 2020 / Accepted: 10 August 2020 © King Abdulaziz City for Science and Technology 2020
Abstract Scrub typhus is a mite-borne, acute febrile illness caused by the bacterium Orientia tsutsugamushi. It is a re-emerging infectious disease of the tsutsugamushi triangle. Scrub typhus is transmitted through bites of contaminated chiggers (larval stage). Diagnosis of scrub typhus is challenging as its symptoms mimic with other acute febrile illnesses. Several methods are effectual for diagnosis of scrub typhus that includes enzyme-linked immunosorbent assay (ELISA), immunofluorescence assay (IFA), immunochromatographic test (ICT), Weil–Felix, polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). Weil–Felix test was initially used for the diagnosis of scrub typhus in underdeveloped countries but not preferred due to a lack of both specificity and sensitivity. Other immuno-based methods like IFA and ELISA are most outrank for detection of scrub typhus due to their higher sensitivity and specificity, but not vigorous to lay bare the infection at early stages and need the convalescent sampling for verification of positive samples. On another deed, PCR based methods becoming acceptable over era due to its dexterity of early-stage diagnosis with higher specificity and sensitivity but lack its applicability in circumstances of scrub typhus due to the variegated genetic makeup of Orientia tsutsugamushi among its serotypes. The present review focused on various detection methods along with their advantages and disadvantages used in the diagnosis of scrub typhus. A comparison between available methods of diagnosis with challenges in the detection of scrub typhus is also summarized. Keywords Biosensor · Immunochromatographic test · Immunoflourescence assay · Polymerase chain reaction · Scrub typhus · Tsutsugamushi triangle
Introduction
* Ankur Kaushal [email protected]; [email protected] Deepak Kala [email protected] Shagun Gupta [email protected] Rupak Nagraik [email protected] Vivek Verma [email protected] Atul Thakur [email protected] 1
Amity Center of Nanotechnology, Amity University, Haryana 122413, India
Shoolini University, Solan 173229, India
2
Scrub typhus is a zoonotic infection that ensues in an acute febrile illness inherent to the ‘tsutsugamushi triangle’ and caused by intracytosolic, gram-negative bacterium Orientia tsutsugamushi (Paris et al. 2013; Prakash 2017). Humans are the fortuitous host of Leptotrombidium spp. and dead-end host of Orientia tsutsugamushi and it is transmitted to the community through bites of Leptotrombidium deliense (Shivalli 2016). Leptotrombidium deliense is a species of chigger mite and the principal vector of scrub typhus disease. This ailment is commonly endemic to the ‘tsutsugamushi tri
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