Leptospirosis Morbidity Research Articles

RETROSPECTIVE ANALYSIS OF LEPTOSPIROSIS MORBIDITY IN IVANO-FRANKIVSK REGION (EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS)

The aim: To perform a retrospective analysis of leptospirosis morbidity in Ivano-Frankivsk region, to give the etiological characteristics of leptospirosis according to clinicallaboratory parameters, to determine the peculiarities of the course, prognostic features. Materials and methods: Data of the State Enterprise "Ivano-Frankivsk Regional Laboratory Center of the Ministry of Health of Ukraine", reports and abstracts of medical records of the Regional Clinical Infectious Diseases Hospital for 2009-2018 were used. Clinical observation of patients, analysis of general-clinical, biochemical, and serological indices were carried out. Results: The leptospirosis morbidity in Ivano-Frankivsk region during 2009-2018 was higher than in general in Ukraine. Activation of foci of leptospirosis L. pomona and grippotyphosa in 2009-2013, decrease of L. grippotyphosa and increase of L. pomona foci and "new" L. autumnalis, australis, bataviae, cynopteri in 2014-2018 were noted. The emergence of leptospirosis L. autumnalis, which had a high virulence and caused a severe course, was noted. Conclusions: The leptospirosis morbidity in the Ivano-Frankivsk region over the past 10 years has exceeded the incidence in Ukraine and varied within 0.62-2.2 per 100,000. During the last 5 years, the serological structure has changed: L. pomona (27.7%) prevailed, L. grippotyphosa decreased (2.1%), L. bataviae and cynopteri, autumnalis increased (by 8.5%). Seasonality is shifted in the autumn-winter period (November-February) (L. grippotyphosa, australis, pomona, canicola). According to forecasts, leptospirosis induced by L. autumnalis was most adverse. Leptospiroses of serogroups L. australis, bataviae, cynopteri had a mild course, there were fewer complications.

Update on molecular diagnosis of human leptospirosis

Abstract Background Leptospirosis, caused by pathogenic Leptospira spp., is a widespread zoonotic disease worldwide. Early diagnosis is required for proper patient management and reducing leptospirosis morbidity and mortality. Objective To summarize current literature regarding commonly used and new promising molecular approaches to Leptospira detection and diagnostic tests of human leptospirosis. Method The relevant articles in Leptospira and leptospirosis were retrieved from MEDLINE (PubMed) and Scopus. Results Several molecular techniques have been developed for diagnosis of human leptospirosis. Polymerase chain reaction-based techniques targeting on either lipL32 or 16S rRNA (rrs) gene are most commonly used to detect leptospiral DNA in various clinical specimens. Whole blood and urine are recommended specimens for suspected cases in the first (acute) and the second (immune) phases, respectively. Isothermal amplification with less expensive instrument is an alternative DNA detection technique that may be suitable for resource-limited laboratories. Conclusion Detection of leptospiral DNA in clinical specimens using molecular techniques enhances sensitivity for diagnosis of leptospirosis. The efficient and robust molecular detection especially in the early leptospiremic phase may prompt early and appropriate treatment leading to reduced morbidity and mortality of patients with leptospirosis.

Seasonal epidemiologic peculiarities of leptospirosis in Lviv region

The aim of the research is to study seasonal epidemiologic peculiarities in hospitalized patients with the diagnosis “leptospirosis” on the territory of Lviv region.Material and methods. Сase histories of patients with leptospirosis, who were treated in Lviv regional clinical hospital of infectious diseases from 2002 to 2016, have been analyzed. Investigation of seasonal epidemiologic characteristics of this disease has been performed by retrospective analysis. A two-tailed Fischer’s test was used to compare relative values.Results. It has been established that leptospirosis morbidity was maximal in June-November with a peak in August. In summer, men suffered more often than women did. Death rate was the highest in winter and the lowest in summer. Duration of hospitalization was maximal in spring; it was the shortest in summer and autumn. Urban residents more often suffered in summer, rural residents – in winter. L. icterohaemorragiae was the cause of the disease more frequently and occurred with the same incidence throughout a year. L. grippotyphosa was much more common in summer-autumn period.Conclusion. It has been established that morbidity was the highest in summer-autumn period, and the death rate – in winter and spring months.

Evaluation of influence of factors of life-sustaining activity on the level from morbidity of leptospirosis in the example of the Chernivtsi region.

Evaluation of influence of factors of life-sustaining activity on the level from morbidity of leptospirosis in the example of the Chernivtsi region.

Spatiotemporal dynamics and risk factors for human Leptospirosis in Brazil

Leptospirosis is an emerging neglected tropical disease with a worldwide significant global health burden. Between 2000 and 2016, there were 63,302 cases of human leptospirosis and 6,064 deaths reported in Brazil. We modeled the spatiotemporal risk dynamics of human leptospirosis morbidity and lethality, and attributed an easily interpretable risk-based priority index (PI) for all Brazilian federative units to suggest improvements to the national surveillance system. We also developed a conceptual framework of causality and estimated the effects of environmental and socioeconomic determinants of morbidity and lethality. Spatiotemporal risk patterns of morbidity and lethality differed. For morbidity, the pattern was mainly spatial, whereas lethality was mainly explained by the spatiotemporal interaction. The hypothesized causal model explained a relevant fraction of the heterogeneity in the spatial and spatiotemporal interaction patterns. The increase in soil moisture, precipitation, poverty, and the decrease in the proportion of urban households, acted as risk factors. The increase in the proportion of households in which waste is directly collected and in temperature were preventive factors. The structured temporal trend was increasing for morbidity and decreasing for lethality. In terms of morbidity, it was clear that the prioritization should be focused in a couple of states, mainly Acre. In terms of lethality, the allocation of resources need not be as asymmetric, but there was nonetheless a prioritization order. The proposed approach can be used to characterize spatiotemporal dynamics of other diseases and to inform decision makers.

High incidence of leptospirosis in an observational study of hospital outpatients in Vanuatu highlights the need for improved awareness and diagnostic capacities.

BackgroundEstimates of leptospirosis morbidity identified Oceania as the region with highest burden. Besides Australia and New Zealand, Oceania is home of Pacific Island Countries and Territories, most of which are developing countries facing a number of challenges. Their archipelago geography notably affects health infrastructure and access to healthcare. Although human leptospirosis was formerly identified in Vanuatu, there is a lack of knowledge of this disease in the country. We aimed to identify leptospirosis in outpatients visiting the hospital.Methodology/Principal findingsWe conducted a clinical study to investigate leptospirosis as a cause of non-malarial acute febrile illness in Vanuatu. A total 161 outpatients visiting the outpatient clinics at Port Vila Central Hospital for internal medicine were recruited over 20 month. We showed that leptospirosis significantly affects humans in Vanuatu: 12 cases were confirmed by real-time PCR on acute blood samples (n = 5) or by high serology titers evidencing a recent infection (MAT titer ≥800 or ELISA≥18 Units, n = 7). A high rate of positive serology was also evidenced, by MAT (100<titer<800, 9 patients) or ELISA IgM (ELISA≥12 Units, 20 patients, including 6 also positive in MAT), showing frequent exposure to pathogenic leptospires, notably from serogroup Australis.Conclusions/SignificanceThe high numbers of both seropositive patients and acute leptospirosis cases observed in outpatients visiting Port Vila Central Hospital suggest a high exposure to pathogenic Leptospira in the population studied. The MAT serology pointing to serogroup Australis as well as exposure history suggest that livestock animals largely contribute to the burden of human leptospirosis in Vanuatu. The analysis of residential and travel data suggests that the risk might even be higher in other islands of the Vanuatu archipelago. Altogether, our study emphasizes the need to increase awareness and build laboratory capacity to improve the medical care of leptospirosis in Vanuatu.

The Epidemiological and Epizootiological Situation on Leptospirosis in the Territory of the Republic of Mordovia for 2002-2008

Presented are the results of retrospective analysis of leptospirosis morbidity in the Rrepublic of Mordovia for 2002-2008. Main directions of the epidemiologic surveillance in natural foci of this infection were shown.

Leptospirosis in children in Ciego de Avila Province, Cuba

The morbidity of leptospirosis among children from Ciego de Avila Province was investigated from 1982 to 1995, and 253 cases were diagnosed. Isolated cases prevailed over those occurring in outbreaks. The 10-14 age group was predominant, followed by the 5-9 age group. According to sex, it was more frequently found in males than in females. One death occurred during this period. There was an increase of cases from July to August and October, and November showed a higher incidence of cases. Fever, headache and myalgia were the symptoms and signs more frequently reported, and 92% of cases showed no icterus. Acute fever, leptospirosis and viral meningoencephalitis were the presumptive diagnoses most frequently made. Possible sources of infection involving a larger number of cases were contact with low terrains and bathing in rivers, ponds and lakes. Regarding diagnosis, 162 cases were diagnosed by the microagglutination test and 91 by the hemolytic test. Canicola, australis and pomona were the serogroups more frequently detected by the microagglutination test.