Post Flood Chemoprophylaxis with Doxycycline for Leptospirosis in an Endemic Area; Case Control Study

Abstract

Introduction: During the year 2019, Kerala state experienced flooding during August. Following this mass chemoprophylaxis with doxycycline was given in the flood in affected areas. In this context, the study was conducted with the objectives to identify the risk factors of leptospirosis and to know the usefulness of chemoprophylaxis with doxycycline in an endemic area.
 Methodology: It was conducted at a public sector tertiary care hospital setting. Cases were adult patients admitted in medical ward with confirmed diagnosis of leptospirosis and the controls were selected from the bystanders of the selected cases. Collected data were entered into MS Excel and analyzed using PASW’18 software.
 Results: Among cases (n=38), 84.2% were males and the age was 43.87 (15.5) years. Among controls (n=47), 85.1% were males with age of 45.83 (14.17) years. Out of this, occupational exposure (OR 4.22, 95% CI 1.61 – 11.09, p=0.003) and any wound during past one month (OR 27.6, 95% CI 3.49.17 – 217.75,p=0.001) were significantly associated with incidence of leptospirosis. Intake of doxycycline within 2 weeks of flood was found to be protective (95% OR 0.09, 95% CI 0.01-0.72, p=0.023).
 Conclusion: Our study found that occupational factors, and any wound or injury are important risk factors of leptospirosis and prophylaxis with doxycycline immediately after flood can reduce the risk of leptospirosis.