Abstract
BackgroundLeptospirosis is a neglected zoonosis affecting mainly tropical and subtropical regions worldwide, particularly South America and the Caribbean. As in many other countries, under-reporting of cases was suspected in the French West Indies because of inadequate access to diagnostic tests for the general population.Methodology/Principal findingsIn order to estimate the real incidence of leptospirosis in Guadeloupe and Martinique, a study was performed in 2011 using the three prevailing available biological tests for diagnosis: Microscopic Agglutination Test (MAT), IgM ELISA and PCR. The study investigated inpatients and outpatients and used active case ascertainment from data provided by a general practitioners’ sentinel network. The epidemiology of the disease was also described in terms of severity and demographic characteristics. Leptospirosis incidence was estimated at 69.4 (95%CI 47.6–91.1) and 60.6 (95%CI 36.3–85.0) annual cases per 100 000 inhabitants in Guadeloupe and Martinique, respectively, which was 3 and 4 times higher than previous estimations.Conclusion/SignificanceInclusion of PCR and IgM ELISA tests for diagnosis of leptospirosis resulted in improved sensitivity in comparison with MAT alone. Our results highlighted the substantial health burden of the disease in these two territories and the importance of access to appropriate laboratory tests. Based on our results, PCR and IgM ELISA tests have now been included in the list of tests reimbursed by the national system of social security insurance in France. Our results also underline the relevance of implementing an integrated strategy for the surveillance, prevention and control of leptospirosis in the French West Indies.
Highlights
Leptospirosis is a zoonotic bacterial disease which is widespread in tropical and subtropical regions
In 2011, we undertook a study to determine the incidence of leptospirosis in two territories (Guadeloupe and Martinique) in the French West Indies by establishing a surveillance network and implementing new diagnostic assays in order to ensure an exhaustive diagnostic analysis
We concluded that leptospirosis was previously significantly under-reported in the French West Indies and we recommended: 1- access to these new diagnostic tests for the entire population for a better detection of leptospirosis patients and, 2- the implementation of an integrated surveillance, alert and prevention system for the disease in this region
Summary
Leptospirosis is a zoonotic bacterial disease which is widespread in tropical and subtropical regions. It produces a wide array of clinical symptoms, ranging from an undifferentiated mild fever to severe multi-organ failure [1]. None of these symptoms is specific to the disease. The disease can usually be cured in humans within a few weeks without sequelae using appropriate antibiotic therapy [2]. It often requires hospitalization during the acute phase and complications related to the disease can be fatal. As in many other countries, under-reporting of cases was suspected in the French West Indies because of inadequate access to diagnostic tests for the general population
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.
