{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:14:50Z","timestamp":1780344890313,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1151153"],"award-info":[{"award-number":["OPP1151153"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["220211"],"award-info":[{"award-number":["220211"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Rickettsioses are frequent causes of treatable febrile illness in Southeast Asia, including Myanmar. Accurate estimates of the incidence of rickettsioses are needed to inform investments in disease prevention and control. We sought to estimate the incidence of rickettsioses among adults and adolescents by combining sentinel hospital surveillance with a healthcare utilisation survey in Yangon, Myanmar.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a household\u2010based healthcare utilisation survey in the Yangon Region from 12 March through 5 April 2018. Multipliers derived from this survey were then applied to scrub typhus, murine typhus, and spotted fever group rickettsioses infections identified from a study of adolescent and adult community\u2010onset febrile illness done from 5 October 2015 through 4 October 2016 at Yangon General Hospital to estimate disease incidence. Acute serum was collected at enrolment and convalescent serum 14\u201330\u2009days after enrolment. Confirmed acute scrub typhus, murine typhus, and spotted fever group infections were diagnosed by a \u2265\u20094\u2010fold rise between acute and convalescent immunofluorescent antibody test titre to <jats:italic>Orientia tsutsugamushi<\/jats:italic> pooled Karp, Kato, and Gilliam antigens; <jats:italic>Rickettsia typhi<\/jats:italic> Wilmington strain; and <jats:italic>Rickettsia honei<\/jats:italic> and <jats:italic>Rickettsia conorii<\/jats:italic> antigens, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After applying multipliers, we estimated the overall annual incidence of acute scrub typhus among adolescents and adults in the Yangon Region at 211 cases per 100,000 persons, and the overall estimate of acute murine typhus among adults and adolescents was 44 cases per 100,000 persons per year for 2015\u20132016. There were no confirmed spotted fever group infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We provide the first estimates of scrub typhus and murine typhus community incidence in Myanmar. Similar research in children and from other parts of Myanmar, as well as studies of illness duration, complications, and deaths, is needed to estimate the disease burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.70010","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T12:39:52Z","timestamp":1753187992000},"page":"978-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Estimating scrub typhus and murine typhus incidence among adolescents and adults in Yangon, Myanmar"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6991-4180","authenticated-orcid":false,"given":"Win Thandar","family":"Oo","sequence":"first","affiliation":[{"name":"Department of Microbiology University of Medicine 1  Yangon Myanmar"},{"name":"Centre for International Health University of Otago  Dunedin New 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