Evidence map›Paper›PMID 41628250›Full record

ArticlePLoS neglected tropical diseases2026

Cost of illness of scrub typhus in South India - a population-based, mixed-methods study.

Carol Devamani, Adam Biran, Koya Ariyoshi, K R John, Ian Ross, Yoshinao Kubo, Daniel Chandramohan, Kundavaram Paul Prabhakar Abhilash, Wolf-Peter Schmidt

Erratum issuedAbstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Carol DevamaniDepartment of Child Health-3, Christian Medical College Vellore, Vellore, India.ORCID https://orcid.org/0009-0009-3446-7753
Adam BiranPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
Koya AriyoshiDepartment of Infectious Disease Epidemiology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
K R JohnDepartment of Community Medicine, AIMSR, Chittoor, India.
Ian RossDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Yoshinao KuboDepartment of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
Daniel ChandramohanDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Kundavaram Paul Prabhakar AbhilashDepartment of Emergency Medicine, Christian Medical College Vellore, Vellore, India.
Wolf-Peter SchmidtDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundScrub typhus is a potentially life-threatening acute febrile illness found in many parts of Asia. This study aimed to estimate the cost of illness among scrub typhus cases in Tamil Nadu, South India and explore treatment-seeking behaviour. METHODS/PRINCIPAL

findingsCases were enrolled from a population-based cohort study on scrub typhus in 32,279 individuals living in rural villages. Data on direct and indirect costs were collected using structured questionnaires from 311 scrub typhus cases of which 26 were severe. Thirteen cases with severe infections (or their relatives) underwent in-depth interviews to understand treatment-seeking pathways. The mean age of cases was 41.1 years, and 64% were female. The average monthly household income was USD 236 (standard deviation, SD 155). The average number of workdays missed in severe infection was 18 days per episode (SD 22.2) compared to 4 days (SD 11.6) in non-severe illness. The mean overall cost of illness was USD 189 (SD 495), disaggregating to USD 1,321 (SD 1045) for severe cases and USD 86 (SD 209) for non-severe. In both severe and non-severe cases, hospital admission was common (69/311) and was associated with a cost increase of over USD 400. Costs were almost twice as high in males compared to females. Catastrophic health expenditure exceeding 25% of annual income occurred in 10% of cases. Treatment by traditional healers, untrained practitioners, pharmacies and local clinics was sought even for mild fever of short duration. In-depth interviews revealed that patients preferred to have a one-off treatment enabling them to return to daily routines with little demand for fever diagnostics. There was demand for higher level of care and diagnostic procedures only when symptoms became severe or the case was a child or a pregnant woman. CONCLUSIONS/SIGNIFICANCE: Hospitalisation, common in both severe and non-severe patients, was the driving factor for high costs. Early case recognition may reduce hospitalisations and health expenditure in highly endemic settings.

Indexed as

Cost of IllnessScrub TyphusAdolescentAdultAgedCohort StudiesFemaleHumansIndiaMaleMiddle AgedPatient Acceptance of Health CareRural PopulationSurveys and QuestionnairesYoung Adult

Identifiers

PMID41628250
PMCPMC12890111

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.