Evaluation of scrub typhus surveillance, Alwar District, Rajasthan, India, July-August 2020

Introduction: Scrub typhus is one of the most underreported and fatal illnesses accounting for 23% of all febrile illness. Rajasthan reported cases during 2018-2019 in state reporting system but did not report any case to central Integrated Disease Surveillance Programme (IDSP) unit. We evaluated the Scrub typhus surveillance system in Alwar district, Rajasthan, with the objective of describing and evaluating the system and providing evidence-based recommendations to identify gaps. Material and Methods: In cross-sectional study, we reviewed records and conducted key informant interviews at district- and block-level health facilities. Using US Centers for Disease Control guidelines, we evaluated the system by framing indicators for selected attributes for a defined reference period. Overall performance was ranked as outstanding (90-100%), excellent (80-89%), very good (70-79%), good (60-69%), and poor (