Background

In Indonesia, scrub typhus was first reported as pseudotyphus by Dr Schüffner in 1909. The history of scrub typhus in Indonesia entangles with colonial and world history. Early reports of cases showed distributions overlapping with the economic and military interests of the Dutch colonial government. These foci of attention by the colonial government give us awareness of the possibility of overlooked niches of infection through those earliest years of investigations.

Previous reports have documented scrub typhus cases and the existence of its vector and reservoir in Indonesia. It is likely that scrub typhus is causing considerable morbidity and mortality. However, we do not have a clear picture of how big the problem is as data remain scarce. Unrecognised and unmeasured harm cannot be acknowledged and mitigated, thus imposing potentially dangerous underestimation of harm.

Aims

The study aims:

1. to describe the history of scrub typhus in Indonesia,
2. to summarise the available evidence of scrub typhus transmission in Indonesia,
3. to perform a scrub typhus serosurvey of archived fever study samples as proxy of active transmission.

This project represents a crucial first step in identifying knowledge gaps, guiding future studies, and, ultimately, mitigating the morbidity and mortality caused by this fatal infection. This project is also a part of Kartika Saraswati’s DPhil with the University of Oxford.