Seropositivity of Leptospira spp. Antibodies among Febrile Patients Attending Outpatient Clinics in Mwanza, Tanzania: Should It Be Included in Routine Diagnosis? (original) (raw)
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Seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island
Journal of Ideas in Health
Background: Leptospirosis is one of the neglected causes of febrile illness and death in developing countries, including Tanzania. The study aims to determine the seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island. Methods: A cross-sectional study was carried out in the three selected hospitals in Unguja Island between January and March 2022. A total of 402 participants with febrile illness were enrolled in the study, and blood samples were collected for sera preparation. Microscopic agglutination test (MAT) was used to detect antibodies against five Leptospira serovars, including Sokoine, Lora, Pomona, Grippotyphosa, and Hebdomadis. All sera samples reacted with MAT titers≥1:160 were counted as positive, MAT titers ranging from 1:20 to 1:80 were counted as exposed to Leptospira bacteria while the absence of agglutination was regarded as negative. The data was analyzed using SPSS version 26, 2019. Descriptive and logistic regression was performed, ...
2020
IntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptosp...
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2017
Leptospirosis, is one of most widespread zoonosis in the world and is caused by spirochetes of the genus Leptospira. In Mozambique, the disease is heavily ignored and its epidemiology is unknown. The objective of this study was to investigate occurrence of leptospirosis in febrile patients. A cross-sectional study was conducted among febrile patients between June 2012 and September 2015. A total of 373 paired samples were drawn from febrile patients, of whom 208 were from Caia District Hospital (rural setting) in Sofala province and 165 were from Polana Caniço General Hospital (suburban setting) in Maputo city. Samples were initially screened using an in-house ELISA for IgM and IgG antibodies. Double positive samples were confirmed using MAT. Of the 373 febrile patients, 5 (1.3%) had acute leptospirosis (MAT ≥400) and 38 (10.2%) had presumptive infection [IgM(+)/MAT≥100&MAT <400]. While most of the patients with presumptive infection (84.2%; 32/38) lived in rural settings, 60% (3...
PLOS Neglected Tropical Diseases, 2016
Background The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda. Methodology and Principal Findings 359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/ 359; 95%CI 30.2-40.3%) defined as MAT titer 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8% (71/359; 95% CI 15.9-24.4%). The prevalence of probable recent leptospirosis (MAT titer 1:800) was 1.9% (95%CI 0.9-4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes). Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher odds (95%CI 1.4-108.6; p = 0.024) of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds
The Trend of Prevalence for Leptospira Specific Antibodies among the Acute Febrile Patients in Peru
2018
Leptospirosis is endemic in Peru, posing a medical threat to US Forces military personnel currently deployed in Peru. There are no reports of leptospirosis available for Peru in recent years. This study is aimed to identify the trend of prevalence for Leptospira-specific antibodies among the acute febrile patients in Peru using serological assays. The hypothesis is that the presence of detectable Leptospira-specific antibodies in these acute febrile patients should suggest an active or recent Leptospira infection. Seven hundred and fifty samples (two hundred and fifty samples each for the year 2005, 2010 and 2015) were arbitrarily selected from individuals enrolled in an acute febrile illness surveillance study in Peru that were negative for malaria and arbovirus isolation. The overall positive for Leptospira-specific antibodies among those acute febrile patients which were negative for malaria and arbovirus isolation was 32%, 24% and 16% for years 2005, 2010 and 2015 respectively. Although, there was a decreasing trend of prevalence for Leptospira-specific antibodies among acute febrile patients which were negative for malaria and arbovirus isolation during the past 10 years, the 16% prevalence Leptospira-specific antibodies in 2015 was still quite high, indicating the potential high level of risk due to Leptospira-infection.
PLoS Negl Trop Dis, 2022
Leptospirosis is among the most important zoonotic diseases in (sub-)tropical countries. The research objective was to evaluate the accuracy of the Serion IgM ELISA EST125M against the Microscopic Agglutination Test (MAT = imperfect reference test); to assess its ability to diagnose acute leptospirosis infections and to detect previous exposure to leptospires in an endemic setting. In addition, to estimate the overall Leptospira spp. seroprevalence in the Wiwa indigenous population in North-East Colombia. We analysed serum samples from confirmed leptospirosis patients from the Netherlands (N = 14), blood donor sera from Switzerland (N = 20), and sera from a cross-sectional study in Colombia (N = 321). All leptospirosis ELISA-positive, and a random of negative samples from Colombia were tested by the MAT for confirmation. The ELISA performed with a sensitivity of 100% (95% CI 77% - 100%) and a specificity of 100% (95% CI 83% - 100%) based on MAT confirmed Leptospira spp. positive and negative samples. In the cross-sectional study in Colombia, the ELISA performed with a sensitivity of 100% (95% CI 2-100%) and a specificity of 21% (95% CI 15-28%). Assuming a 5% Leptospira spp. seroprevalence in this population, the positive predictive value was 6% and the negative predictive value 100%. The Leptospira spp. seroprevalence in the Wiwas tested by the ELISA was 39%; however, by MAT only 0.3%. The ELISA is suitable to diagnose leptospirosis in acutely ill patients in Europe several days after onset of disease. For cross-sectional studies it is not recommended due to its low specificity. Despite the evidence of a high leptospirosis prevalence in other study areas and populations in Colombia, the Wiwa do not seem to be highly exposed to Leptospira spp.. Nevertheless, leptospirosis should be considered and tested in patients presenting with febrile illness.
BMC Infectious Diseases, 2018
Background: In spite of a local favorable environment, leptospirosis has never been described in Central African Republic so far mainly because of the weakness of diagnostic tests and differential diagnostic strategy for febrile jaundice cases negative for yellow fever virus. Here we bring a complementary insight to conclusions of Gadia CLB et al. regarding the presence of leptospirosis in Central African Republic in YFV-negative febrile icteric patients. Methods: Our study included 497 individuals presenting with fever and jaundice but negative for yellow fever infection, retrospectively selected from the national surveillance biobank for yellow fever in Institut Pasteur de Bangui, Central African Republic. A combination of serological (ELISA, agglutination) and molecular biology techniques (quantitative real-time polymerase chain reaction) was used to identify Leptospira or the patient's immune response to the bacteria. Statistical analyses were done using the non parametric Mann-Withney U test with a 5% statistical threshold. Results: ELISA test results showed 46 positive serum samples while 445 were negative and 6 remains equivocal. In addition, the reference microscopic agglutination test for leptospirosis diagnostic confirmed that 7 out of 32 samples tested were positive. Unfortunately, all 497 serum samples tested for leptospirosis were negative using the molecular techniques. Conclusions: Unlike Gadia et al., we confirmed that leptospirosis is circulating in Central African Republic and therefore may be responsible for some of the unexplained cases of febrile jaundice in the country. Thus, leptospirosis needs to be investigated to improve identification of aetiological pathogens. Our study also suggests a need to improve sample transportation and storage conditions.
Leptospira Seropositivity in Humans, Livestock and Wild Animals in a Semi-Arid Area of Tanzania
Pathogens, 2021
Background: Leptospirosis is among the major neglected zoonoses in developing countries. The prevalence of leptospirosis remains underestimated in many African countries because of limited diagnostic facilities. We studied Leptospira seropositivity prevalence in humans, sheep, goats and rodents in a semi-arid region of central Tanzania and compared findings with reports from humid tropical areas. The aims were to establish the disease burden in different settings; understand circulating Leptospira serovars and potential major reservoirs for establishing appropriate control measures. Methods: Humans, sheep, goats, rodents and shrews (insectivores) were sampled from Bahi district, a semi-arid area in central Tanzania. Samples were tested for leptospiral antibodies using microscopic agglutination test (MAT) consisting of Leptospira serovars mainly reported in Tanzania and reference strains. Findings were compared with previous data to determine the disease epidemiological patterns. Res...
Geographic distribution of anti-Leptospira antibodies in humans in Côte d’Ivoire, West Africa
European Journal of Clinical Microbiology & Infectious Diseases, 2018
Blood samples were collected from each patient who matches the clinical WHO's case definition for 43 notifiable disease. Samples were sent, at +4°C, to the National Reference Centre at the Institut Pasteur 44 de Côte d'Ivoire for analysis. Anti-Leptospira antibody testing was carried out at Institut Pasteur de 45 Côte d'Ivoire (IPCI) and Institut Pasteur in Paris (IP). We used as screening methods the ELISA 46 against type IgG anti-Leptospira antibodies previously describe by Bourhy et al. (2013) in IPCI [7]. 47 Confirmation was carried out by MAT in IP with a threshold of 1:50. As antigens, 16 serogroups were 48 used (table 1). 49 Socio-demographic and clinical data from the National Reference Centre, which manage the samples 50 and results for analysis performed on studied samples, were used to build a database using Epi Info 51 software (CDC, Atlanta, Georgia). Data analyses were done using R software 3.2.0 [8].