Table 2.
Demographics, history, clinical manifestations, laboratory results, treatment, and outcomes of 484 scrub typhus, 67 murine typhus and 10 spotted fever patients.
| Characteristics | Scrub Typhus n = 484 |
Murine Typhus n = 67 |
Spotted Fever n = 10 |
Total n = 561 |
p Value § |
|---|---|---|---|---|---|
| Demographics | |||||
| Age, median (IQR) (n = 560) | 43 (24–58) | 43 (31–54) | 28 (18–37) | 42.5 (24–58) | 0.344 ¶ |
| Male, (n, (%)), n = 560) | 206 (42.6) | 42 (63.6) | 8 (80.0) | 256 (45.7) | 0.001 |
| Female (n, (%), n = 560) | 278 (57.4) | 24 (36.4) | 2 (20.0) | 304 (54.3) | |
| Farmer, n = 561 | 283 (58.5) | 18 (26.9) | 5 (50.0) | 306 (54.6) | 0.000 |
| Residence in rural area, n = 561 | 402 (83.1) | 36 (53.7) | 6 (60.0) | 444 (79.1) | 0.000 |
| History | |||||
| Admitted from community, n = 561 | 264 (54.5) | 37 (55.2) | 5 (50.0) | 398 (54.6) | 1.000 |
| Transferred from other hospital or clinic, n = 561 | 220 (45.6) | 30 (44.8) | 5 (50.0) | 255 (45.4) | |
| Received antimicrobial drugs before admission, n = 561 | 135 (27.9) | 20 (29.9) | 3 (30.0) | 158 (28.2) | 0.772 |
| Symptoms | |||||
| Headache, n = 561 | 448 (92.6) | 62 (92.5) | 10 (100) | 520 (92.7) | 1.000 |
| Myalgia, n = 561 | 250 (51.7) | 44 (65.7) | 9 (90.0) | 303 (54.0) | 0.036 |
| Retro-orbital pain, n = 560 | 105 (21.7) | 21 (31.3) | 2 (20.0) | 128 (22.9) | 0.088 |
| Sore throat, n = 561 | 117 (24.2) | 24 (35.8) | 3 (30.0) | 144 (25.7) | 0.098 |
| Cough, n = 560 | 220 (45.6) | 34 (50.8) | 5 (50.0) | 259 (46.3) | 0.435 |
| Nausea, n = 561 | 147 (30.4) | 23 (34.3) | 4 (40.0) | 174 (31.0) | 0.573 |
| Vomiting, n = 561 | 72 (14.9) | 11 (16.4) | 0 | 83 (14.8) | 0.717 |
| Abdominal pain, n = 561 | 95 (19.6) | 7 (10.5) | 0 | 102 (18.2) | 0.092 |
| Diarrhea, n = 560 | 59 (12.2) | 6 (9.0) | 0 | 65 (11.6) | 0.547 |
| Skin hyperemia, n = 560 | 124 (25.7) | 27 (40.3) | 0 | 151 (27.0) | 0.040 |
| Physical signs | |||||
| Congested skin, n = 561 | 273 (56.4) | 54 (80.6) | 4 (40.0) | 331 (59.0) | 0.000 |
| Conjunctivitis, n = 551 | 163 (33.7) | 36 (53.7) | 3 (10.0) | 202 (36.0) | 0.002 |
| Eschar, n = 561 | 368 (76.0) | 4 (6.0) | 1 (10.0) | 373 (66.5) | 0.000 |
| Rash, n = 561 | 118 (24.4) | 26 (38.8) | 0 | 144 (25.7) | 0.017 |
| Lymphadenopathy, n = 561 | 243 (50.2) | 7 (10.5) | 1 (10.0) | 251 (44.7) | 0.000 |
| Liver enlargement, n = 561 | 28 (5.8) | 0 | 2 (20.0) | 30 (5.4) | 0.037 |
| Spleen enlargement, n = 561 | 31 (6.4) | 0 | 1 (10.0) | 32 (5.7) | 0.024 |
| Subcutaneous hemorrhage, n = 560 | 13 (2.7) | 5 (7.5) | 0 | 18 (3.2) | 0.056 |
| Mucous membrane hemorrhage, n = 561 | 5 (1.0) | 2 (3.0) | 0 | 7 (1.3) | 0.205 |
| Rales, n = 561 | 64 (13.2) | 8 (11.9) | 0 | 72 (12.8) | 1.000 |
| Laboratory test results at admission | |||||
| Erythrocytes, T/L, median (IQR), n = 417 | 4.4 (3.9–4.7) | 4.5 (4.2–4.9) | 4.4 (4.1–4.8) | 4.4 (4.0–4.7) | 0.027 ¶ |
| Leukocytes, T/L, median (IQR), n = 417 | 7.5 (5.6–10.3) | 6.5 (5.0–8.7) | 6.2 (4.2–7.7) | 7.4 (5.5–10.0) | 0.049 ¶ |
| Platelets, G/L, median (IQR), n = 415 | 100 (66–144) | 87.5 (65–133) | 177.5 (75–269.5) | 100 (66–144) | 0.303 ¶ |
| Platelet < 100 G/L, n = 415 | 187 (51.5) | 20 (45.5) | 6 (75.0) | 213 (51.3) | 0.524 |
| Alanine aminotransferase > 40 IU/L, n = 376 | 282 (85.2) | 36 (97.3) | 7 (87.5) | 325 (86.4) | 0.042 |
| Aspartate aminotransferase ST > 37 IU/L, n = 375 | 316 (95.8) | 35 (94.6) | 8 (100) | 359 (95.7) | 0.670 |
| Total bilirubin > 17 µmol/L, n = 82 | 18 (23.4) | 2 (18.2) | 0 | 20 (24.4) | 1.000 |
| Albumin < 32 g/L, n =111 | 54 (54.6) | 1 (8.3) | 0 | 55 (49.6) | 0.004 |
| Creatinine > 120 µmol/L, n = 352 | 19 (6.1) | 1 (3.0) | 0 | 20 (5.7) | 0.706 |
| Treatment | |||||
| One of three protocol-specific antibiotics (Doxycycline, Chloramphenicol and Azithromycin), n = 661 | 478 (98.8) | 62 (92.5) | 8 (80.0) | 548 (97.7) | - |
| Non-protocol antibiotics, n = 561 | 4 (0.8) | 4 (6.0) | 1 (10.0) | 9 (1.6) | |
| Other therapies, (n = 561) | 2 (0.4) | 1 (1.5) | 1 (10.0) | 4 (0.7) | |
| Respiratory support, n = 561 | 31 (6.4) | 4 (6.0) | 0 | 35 (6.2) | 1.000 |
| Albumin transfusion, n = 557 | 23 (4.8) | 3 (4.6) | 0 | 26 (4.7) | 1.000 |
| Blood purification, n = 555 | 3 (0.6) | 0 | 0 | 3 (0.5) | 1.000 |
| Outcomes | |||||
| Death, n = 561 | 5 (1.0) | 1 (1.5) | 0 | 6 (1.1) | 0.542 |
| No. days in hospital, n = 555 | 6 (5–8) | 7 (5–8) | 7 (5–7) | 6 (5–8) | 0.128 ¶ |
| Suffering from shock, n = 549 | 6 (1.2) | 1 (1.5) | 0 | 7 (1.3) | 0.595 |
| Afebrile ≤ 72 h after treatment began, n = 545 | 418 (88.2) | 47 (77.1) | 9 (90.0) | 474 (87.0) | 0.024 |
§p value obtained when comparing between scrub and murine typhus groups, using Fisher’s exact test, except where noted. ¶ p value obtained when comparing between scrub and murine typhus groups using Mann-Whitney test.