Seroprevalence and Clinicoepidemiological Profile of Leptospirosis in Acute Febrile Illness Cases at a Medical College in Amritsar, Punjab, India

Abstract

Introduction: Leptospirosis is an anthropozoonotic disease; it occurs worldwide but is most common in tropical and subtropical countries. It is usually underreported due to a lack of awareness, atypical presentations and lack of diagnostic facilities, especially in a resource-limited setting like India. Knowing the local prevalence of such infections is of utmost importance for appropriate control and management. Aim: To estimate the seroprevalence of leptospirosis among suspected Acute Febrile Illness (AFI) cases and to assess the clinicoepidemiological profile of leptospirosis cases presented at Government Medical College, Amritsar, Punjab, India. Materials and Methods: This hospital-based cross-sectional study was conducted at Government Medical College, Amritsar, Punjab, India. A total of 360 clinically suspected AFI cases were enrolled in the study. The demographic and clinical profile of the cases was taken on a semistructured predesigned proforma. Blood sample was collected from the patients, and an Immunoglobulin M (IgM) Enzyme-linked Immunosorbent Assay (ELISA) was done for diagnosis. Data analysis was done using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) statistical package for windows. Results: Out of 360 AFI cases suspected of leptospirosis, 62 (17.2%) were positive for leptospirosis IgM ELISA. The majority of AFI cases and leptospirosis cases belonged to the 21-40 years age group followed by the 41-60 years age group. Seroprevalence was found to be higher in males (20.8%) as compared to females (12.7%). Maximum seroprevalence (20.1%) was seen during the monsoon season followed by the autumn, summer and winter season. The association between risk exposure to risk factors and leptospirosis seroprevalence was found to be statistically significant (p=0.034). Fever, myalgia, headache, nausea/vomiting, icterus and hepatomegaly were common clinical features observed in leptospirosis cases. Conclusion: Leptospirosis has rapidly emerged to become the major cause of AFI in many parts of India. High seroprevalence of leptospirosis was reported among undifferentiated AFI cases in the present study. A programmatic approach towards the prevention, control and management of these emerging diseases in Punjab is highly recommended.