Abstract
A nationwide prevention and control campaign for leptospirosis in Thailand has led to a decreased incidence rate, but the mortality and case fatality rates have remained stable. Regarding the limited knowledge of risk factors, a case-control study of the association between environmental and behavioral exposure with severe leptospirosis was implemented to identify the risk factors among adults in Thailand. The study was conducted in 12 hospital-based sites. Hospitalized patients with suspected clinical symptoms of leptospirosis were tested for leptospirosis by culture, loop mediated isothermal amplification (LAMP), real-time PCR, and the microscopic agglutination test (MAT). All participants answered a standardized questionnaire about potential risk factors. Risk factors were identified by univariable and multivariable logistic regression. Of the 44 confirmed cases, 33 (75.0%) presented with severe illness, as determined by clinical criteria, and were categorized as severe cases. Non-severe cases were defined as patients with non-severe symptoms of leptospirosis. Living nearby a rubber tree plantation (adjusted OR 11.65, 95% CI 1.08–125.53) and bathing in natural bodies of water (adjusted OR 10.45, 95% CI 1.17–93.35) were both significantly associated with an increased risk of severe leptospirosis. We recommend designating rubber plantations in Thailand as high-risk zones and closely monitoring hospitalized patients in those areas.
Highlights
Leptospirosis is a zoonotic disease with a worldwide distribution caused by spirochetes of the genus Leptospira
When exploring the behavioral and environmental risk factors for leptospirosis (Table 3), living nearby rubber tree plantations as well as bathing in natural bodies of water within two weeks before the illness were significantly associated with an increased risk of severe leptospirosis compared to non-severe leptospirosis after univariable analyses
This study is the first, to our knowledge, to investigate environmental and behavioral risk factors associated with severe leptospirosis in Thailand
Summary
Leptospirosis is a zoonotic disease with a worldwide distribution caused by spirochetes of the genus Leptospira. Two forms of disease are found in humans: icteric and anicteric. Anicteric leptospirosis is a mild disease and typically self-limited, while the icteric form is more severe. Campaigns for intensive and systematic rodent control, education of proper sanitation and hygiene practices, and promoting theuse of boots and gloves during farming work have been implemented [4] and repeatedly promoted by the Ministry of Public Health (MoPH) of Thailand led to an observed decrease in the incidence rate to 5.9 per 100,000 population [3]. Another study by Niwattayakul et al [6] from 1999 to 2000 showed the complicated clinical manifestations of severe leptospirosis in Thailand, revealing thatthe major causes of death included pulmonary complications, renal failure, and sepsis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
