Objectives Scrub typhus, caused by Orientia tsutsugamushi, is a climate-sensitive vector-borne disease with high incidence in the Republic of Korea. This study examined long-term epidemiological trends and changing meteorological influences in the context of climate change.
Methods A retrospective time-series study was conducted using national surveillance data on 149,289 scrub typhus cases (2001–2024) across 4 surveillance phases. Temporal trends in age-standardized incidence rates were evaluated using Joinpoint regression. Associations between monthly meteorological variables and incidence were assessed with Spearman correlation analysis and time-series regression analysis using distributed lag non-linear models.
Results The national incidence increased until 2017 and has decreased since 2018, whereas the AAPC rebound to 4.32% during phase IV (2019–2024). The proportion of female cases decreased, while that of adults ≥70 years increased significantly. In phase IV, the average annual percent change increased in central and urban regions. The lag effect of meteorological factors lengthened from 4 to 6 months, with mean temperature (Tmean) and relative humidity (RH) representing the primary predictors. Phase III (2013–2018) displayed the highest cumulative relative risk (RR) for Tmean at 25.2 °C (RR, 5.86; 95% confidence interval [CI], 2.56–13.42), whereas in phase IV, only moderate RH (58%) remained significantly associated with incidence (RR, 1.68; 95% CI, 1.29–2.20).
Conclusion Over the past 2 decades, the influence of meteorological factors on scrub typhus has shifted, with recent years marked by greater uncertainty under increasing climate variability and instability. For timely risk prediction and targeted prevention, adaptive surveillance systems that integrate dynamic climate indicators—capturing the intensity, frequency, and variability of extreme weather events—are needed.
Objectives
The aims of this study were to analyze the characteristics of the 100 top-cited articles on scrub typhus (ST), and to assess the present research landscape and future research directions using bibliometric analysis.
Methods
Web of Science was used to conduct a bibliometric analysis of the 100 top-cited articles on ST. The articles were analyzed by publication year, number of citations, document type, journals, keywords, institutions, country of origin, and authorship.
Results
The top 100 articles on ST were published between 1945 to 2017. The number of citations ranges from 39 to 227 and the interquartile range was 35.5. The United States published the highest number (<italic>n</italic>=21) of articles. Mahidol University was the most prolific institution in terms of articles (<italic>n</italic>=14). The <italic>American Journal of Tropical Medicine and Hygiene</italic> was the journal with the most articles (<italic>n</italic>=14), and Paris DH was the most productive author in terms of the Hirsh-index, which was 10 for that author. The study revealed a significant correlation between the total number of citations and the number of authors (r=0.668, <italic>p</italic><0.001), number of institutions (r=0.692, <italic>p</italic><0.001), number of years since publication (r=0.869, <italic>p</italic><0.001), and number of countries involved (r=0.963, <italic>p</italic><0.001).
Conclusion
The findings of this study provide landmarks in the publication and citation frequency of the most influential articles on ST. In addition, this study provides useful information for readers and health policy-makers in evaluating the literature on ST.
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<sec>
<title>Objectives</title>
<p>Chigger mites are vectors for scrub typhus. This study evaluated the annual fluctuations in chigger mite populations and <italic>Orientia tsutsugamushi</italic> infections in South Korea.</p></sec>
<sec>
<title>Methods</title>
<p>During 2006 and 2007, chigger mites were collected monthly from wild rodents in 4 scrub typhus endemic regions of South Korea. The chigger mites were classified based on morphological characteristics, and analyzed using nested PCR for the detection of <italic>Orientia tsutsugamushi</italic>.</p></sec>
<sec>
<title>Results</title>
<p>During the surveillance period, the overall trapping rate for wild rodents was 10.8%. In total, 17,457 chigger mites (representing 5 genera and 15 species) were collected, and the average chigger index (representing the number of chigger mites per rodent), was 31.7. The monthly chigger index was consistently high (> 30) in Spring (March to April) and Autumn (October to November). The mite species included <italic>Leptotrombidium pallidum</italic> (43.5%), <italic>L. orientale</italic> (18.9%), <italic>L. scutellare</italic> (18.1%), <italic>L. palpale</italic> (10.6%), and <italic>L. zetum</italic> (3.6%). <italic>L. scutellare</italic> and <italic>L. palpale</italic> populations, were relatively higher in Autumn. Monthly <italic>O. tsutsugamushi</italic> infection rates in wild rodents (average: 4.8%) and chigger mites (average: 0.7%) peaked in Spring and Autumn.</p></sec>
<sec>
<title>Conclusion</title>
<p>The findings demonstrated a bimodal pattern of the incidence of <italic>O. tsutsugamushi</italic> infections. Higher infection rates were observed in both wild rodents and chigger mites, in Spring and Autumn. However, this did not reflect the unimodal incidence of scrub typhus in Autumn. Further studies are needed to identify factors, such as human behavior and harvesting in Autumn that may explain this discordance.</p></sec>
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Scrub typhus, also called tsutsugamushi disease, is classified as a Group 3 disease in Korea according to the National Notifiable Diseases Surveillance Systems. It is an infectious disease transmitted to humans through the bite of mites that are infected with an intracellular parasite called <i>Orientia tsutsugamushi</i> (Family: Rickettsiaceae). This study aims to identify the demographic characteristics of the infected cases according to profession, region, gender, and onset period and provide a basic data for prevention and control of the disease in the infected patients. Between 2001 and 2010, 16,741 men (36.3%) and 29,373 women (63.7%) were reported to have been infected with scrub typhus, with men being 1.6 times less infected than women. When classified according to age, it was found that 4421 persons (9.6%) were under 40 years of age; 6601 (13.1%) in their 40s; 9714 (21.1%) in their 50s; 13,067 (28.3%) in 60s; 10,128 (22.0%) in their 70s; and 2723 (5.9%) aged 80 or more. The elderly (60 years or older) represented more than half of the infected cases. When the infections were classified according to region, it was found that the county residents had the major share of infection, with a total of 1583 infected cases (59.85).
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Objectives
A hierarchical generalized linear model (HGLM) was applied to estimate the transmission pattern of scrub typhus from 2001 to 2011 in the Republic of Korea, based on spatial and temporal correlation. Methods
Based on the descriptive statistics of scrub typhus incidence from 2001 to 2011 reported to the Korean Centers for Disease Control and Prevention, the spatial and temporal correlations were estimated by HGLM. Incidences according to age, sex, and year were also estimated by the best-fit model out of nine HGLMs. A disease map was drawn to view the annual regional spread of the disease. Results
The total number of scrub typhus cases reported from 2001 to 2011 was 51,136: male, 18,628 (36.4%); female, 32,508 (63.6%). The best-fit model selected was a combination of the spatial model (Markov random-field model) and temporal model (first order autoregressive model) of scrub typhus transmission. The peak incidence was 28.80 per 100,000 persons in early October and the peak incidence was 40.17 per 100,000 persons in those aged 63.3 years old by the best-fit HGLM. The disease map showed the spread of disease from the southern central area to a nationwide area, excepting Gangwon-do (province), Gyeongsangbuk-do (province), and Seoul. Conclusion
In the transmission of scrub typhus in Korea, there was a correlation to the incidence of adjacent areas, as well as that of the previous year. According to the disease map, we are unlikely to see any decrease in the incidence in the near future, unless ongoing aggressive measures to prevent the exposure to the vector, chigger mites, in rural areas, are put into place.
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Objective
This study analyzes the spatial distribution of scrub typhus in Korea. Methods
A spatial distribution of <i>Orientia tsutsugamushi</i> occurrence using a geographic information system (GIS) is presented, and analyzed by means of spatial clustering and correlations. Results
The provinces of Gangwon-do and Gyeongsangbuk-do show a low incidence throughout the year. Some districts have almost identical environmental conditions of scrub typhus incidence. The land use change of districts does not directly affect the incidence rate. Conclusion
GIS analysis shows the spatial characteristics of scrub typhus. This research can be used to construct a spatial-temporal model to understand the epidemic tsutsugamushi.
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Objectives
Currently, the incidence of scrub typhus has increased in urban areas. In this study, we described the epidemiological characteristics of scrub typhus cases reported in the urban areas of Korea in 2009. Methods
We analysed the case investigation reports of scrub typhus cases that were collected in Korea in 2009. Specially, the different risk factors such as fieldwork and outdoor activity were compared to urban and rural areas, and six urban cities. Statistical analysis was performed using χ<sup>2</sup> test. Results
A total of 4,461 cases (including 1,663 suspected cases) were analysed in this study. Among these, the case reports of 4,254 cases had complete addresses. The cases with outdoor activities were 720 (85.2%) in urban areas. In Daegu and Daejeon, the number of cases participated in outdoor activities was 32 (34.4%) and 23 (31.5%), respectively. In other urban areas, cases with outdoor activities were more than 85%. Conclusion
The most common infection risk factor was outdoor activity in urban areas. However, the proportion and distribution of outdoor activities were different in urban areas. These results will be used to establish strategies for effective prevention and management in urban areas.
Citations
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