Socio-demographic, clinical, epidemiological and laboratory profile of cases of leptospirosis at tertiary care hospital: a two year study

Abstract

Background: Leptospirosis is a worldwide known and prevalent zoonotic disease associated with serious complications and morbidity as well as mortality. In India it should report 0.1-1.0 million cases/year but reported are always <10000. Human cases of leptospirosis in developing countries like India are usually underreported because of lack of awareness among the physicians, atypical presentations and lack of diagnostic facilities which presents a challenging task. The aim of the present study was to estimate the prevalence, epidemiological factors, risk factors, clinical profile and outcome of confirmed cases of leptospirosis in a tertiary care hospital for period of two years.Methods: A prospective cross sectional study was conducted at a tertiary care hospital of south India by department of community medicine in association with department of general medicine. The socio demographic data, clinical data, laboratory parameters and outcome of the confirmed cases were noted and analyzed. Modified faine’s score was used to confirm the cases of leptospirosis.Results: The prevalence of leptospirosis in our study was 15.75%, males outnumbered the females. Maximum number of cases was noted in the months of August-October and January. Poor drainage facilities, heavy rainfall were the major epidemiological factors associated with the disease. Majority was farmers and most of the cases were from rural areas. Fever was the most common symptom in all the cases followed by jaundice, vomiting and headache. Hyperbilirubinemia, altered liver enzymes were the most common altered laboratory parameters in the study. Renal failure was the most common complication in the study. Mortality was 6.25% and most commonly associated with acute myocarditis.Conclusions: Leptospirosis is seen mostly in monsoon season more among males. Fever and hepatic dysfunction are common signs with renal failure as the most common complication. Mortality is mostly due to myocarditis. Persons with high risk of exposure should be advised to seek early medical attention in case of febrile illnesses. Poor socio economic and environmental conditions and occupational habits are main determinants of the increased incidence of cases in our country.