The rising health challenge of scrub typhus: a systematic review and meta-analysis

Scrub typhus, caused by Orientia tsutsugamushi, is an ignored re-emerging public health problem in India, affecting underprivileged rural communities unevenly. Transmitted by bites from Leptotrombidium mites, the disease presents with nonspecific fever symptoms, often resulting in severe complications and increased mortality if untreated. To obtain precise information, comprehensive research was performed utilizing relevant keywords on online sites such as Scopus, Google Scholar, PubMed, PMC, Research Gate, Science Direct, and conventional Google searches. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) approach was adopted for the current systematic review. Despite it being endemic, scrub typhus is frequently under-recognized due to limited reliable diagnostics, disjointed surveillance, and no clear treatment strategy. Climate change and ecological disturbances are expanding their transmission foci. This review underscores the current status of scrub typhus in India and the urgent need for a One Health approach, which involves human, animal, and environmental surveillance complemented with improved diagnostics, judicious use of antimicrobials, and a better-informed community. Policies must highlight scrub typhus in the national health priority list, accelerate vaccine research, and strengthen multi-sectoral collaboration. Addressing these serious issues will demand immediate action to mitigate this unappreciated scrub typhus growing burden and prevent further epidemics in a dynamic ecological world.