Factors Contributing to the Occurrence of Leptospirosis, and the Impact on Public Health in Saint Lucia 2008-2019 (original) (raw)
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Epidemiology of human leptospirosis in Saint Lucia, 2010–2017
Revista Panamericana de Salud Pública
Objective. To describe the epidemiology of human leptospirosis cases in Saint Lucia from 2010 to 2017 and determine whether there was a relationship between cases and rainfall and temperature. Methods. A retrospective analytical study was undertaken to describe the seasonal patterns of human leptospirosis cases reported to the Ministry of Health of Saint Lucia between 2010 and 2017. Confirmed cases of leptospirosis were analyzed according to age, sex, seasonality, and geographical distribution. Disease incidence was calculated and the association of cases with geographical distribution, rainfall, and temperature was investigated. Results. A total of 353 leptospirosis cases were reported between 2010 and 2017 and of these, 145 (40.6%) were laboratory confirmed. Cases were aged 7 to 73 years (mean 34 years; median 30 years) with a male to female ratio of 4.2:1. Six deaths were reported during the period, with an overall case fatality rate of 4.1%. There was no relationship between loc...
A twelve-year study of leptospirosis on Barbados
European Journal of Epidemiology, 1995
cases of severe leptospirosis were confirmed on Barbados (range for 1980Barbados (range for -1991; mean 32.7; incidence 13.3/100,000/year). For the six-year periods 1980-1985 and 1986-1991 there was no significant change in incidence with time. Incidence is unlikely to change significantly in the next decade. Monthly average case numbers ranged from 1.4 (July) to 4.3 (November). The average (2.8) for June to December (the 7 wetter months) was not significantly higher than that (2.5) for January to May (the 5 drier months). The age range was 7-86. There were three times as many male cases (302) as female , and nearly 10 times as many in those <35. Although the highest number of cases (69) was in males aged 15-24, the highest incidence was in the older age groups, particularly the male 65-74 year-olds, and the female 55-64 year-olds. Leptospirosis was the proven cause of death in 55 (13.8%) hospital patients (annual range 0-13, mean Key words: Leptospires, Leptospirosis 4.5). Some of a further 39 fatalities might have been cases. Death from leptospirosis was nearly twice as common among the women as among the men. Only one patient under 20 years of age died. Leptospira were isolated and identified from 117 (29.4%) of the 398 sick patients. The infecting organisms were bim (serogroup Autumnalis -75), copenhageni (Icterohaemorrhagiae -26), arborea and bajan (Australis -2). These infecting serovars could not be distinguished clinically, but infection was milder in children than in adults. Despite its predominance in surveyed children, serogroup Panama was virtually absent in this study. Rainfall is the major factor affecting the distribution of cases; not surprisingly, sanitation workers and agricultural workers appear to be the groups at highest risk. The general lack of clear-cut risk factors reflects the ubiquity of leptospires in the environment and the fact that the disease is not entirely occupational.
Systematic Review on Socioeconomic and Environmental Factors of Leptospirosis
2021
Background: Leptospirosis is a Global emerging zoonotic tropical bacterial disease of the genus Leptospira, with high morbidity and mortality, especially in resource-limited communities. This study is a systematic review on the incidence of socioeconomic and environmental factors of human leptospirosis. Methods: The research involved published articles from PubMed, Scopus, and Google Scholar electronic databases for nine years. It also encompasses all cases analysed for the risk factors under study reported as numerical percentage incidences. The key terms searched in the database include "leptospirosis, Leptospira, human, patients, socioeconomic, environmental, risk factors, incidence, and prevalence." The search terms from the categories were linked with "OR" and those between categories with "AND." Retrieved articles were saved as comma-separated values (CVS) files and sorted out using the inclusion and exclusion criteria for the study, and then pres...
Risk Factors and Predictors of Severe Leptospirosis in New Caledonia
PLoS Neglected Tropical Diseases, 2013
Background: Leptospirosis is a major public health concern in New Caledonia (NC) and in other tropical countries. Severe manifestations of the disease are estimated to occur in 5-15% of all human infections worldwide and factors associated with these forms are poorly understood. Our objectives were to identify risk factors and predictors of severe forms of leptospirosis in adults.
Epidemiology of Human Leptospirosis in French Guiana (2007–2014): A Retrospective Study
The American Journal of Tropical Medicine and Hygiene, 2018
Leptospirosis is a worldwide zoonotic bacterial infection with a rising incidence. French Guiana is mostly covered by Amazonian rain forest. Despite a potentially favorable environment, leptospirosis has been barely studied in French Guiana. The objective of this study was to describe the current trends of leptospirosis epidemiology in French Guiana. A cross-sectional study was performed in the two main hospitals of French Guiana. Cases of leptospirosis from 2007 to 2014 were retrospectively identified with a systematic screening of serological and polymerase chain reaction results to classify them as confirmed, probable, or excluded cases. Medical files were reviewed to collect epidemiological data. Among the 72 included patients, 55 (76.4%) cases were confirmed and 17 (23.6%) were probable. The median age was 39 years (range: 16-82 years) and the M/F sex ratio 6.2. Sixty-two (86.1%) patients required hospitalization, including 12 (16.7%) in the intensive care unit. Three (4.2%) patients died. The monthly distribution of cases was correlated with rainfall (P = 0.004) and moisture (P = 0.038). Professional exposure was frequently identified (especially gold mining and construction). Among 16 different serogroups identified by microagglutination test, Icterohaemorrhagiae was the most frequent (38.0%). This study revealed an epidemiology close to that observed in Brazilian regions, and professional and climatic risk factors. The high diversity of serogroups may reveal a complex environmental reservoir requiring further investigations. Only 20% of leptospirosis patients were suspected as such on hospital admission, thus emphasizing the need to inform local physicians.
Leptospirosis in American Samoa – Estimating and Mapping Risk Using Environmental Data
PLoS Neglected Tropical Diseases, 2012
Background: The recent emergence of leptospirosis has been linked to many environmental drivers of disease transmission. Accurate epidemiological data are lacking because of under-diagnosis, poor laboratory capacity, and inadequate surveillance. Predictive risk maps have been produced for many diseases to identify high-risk areas for infection and guide allocation of public health resources, and are particularly useful where disease surveillance is poor. To date, no predictive risk maps have been produced for leptospirosis. The objectives of this study were to estimate leptospirosis seroprevalence at geographic locations based on environmental factors, produce a predictive disease risk map for American Samoa, and assess the accuracy of the maps in predicting infection risk.
An Observational Study of Human Leptospirosis in Seychelles
The American Journal of Tropical Medicine and Hygiene, 2020
A 1-year population-based prospective study was launched in Seychelles, a country with one of the highest human incidence of leptospirosis worldwide, to describe the characteristic features of the epidemiology of the disease and highlight the most prominent risk factors. Diagnosis was based on the IgM enzyme-linked immunosorbent assay, microscopic agglutination test, and real-time PCR. A standardized questionnaire was administered to 219 patients aged ³ 13 years consulting for acute febrile illness. The high incidence of leptospirosis in Seychelles was confirmed. The disease was particularly severe, as the case fatality rate was 11.8%. Leptospirosis was positively associated in univariate analysis with socio-professional and clinical variables including gardening/farming, oliguria, jaundice, conjunctivitis, history of hepatitis C virus infection, anemia, thrombocytopenia, and/or biological renal failure. Epidemiological analyses of the questionnaires highlighted a link of the disease with living in houses (versus apartment), the presence of animals around and in houses, gardening, and misuse of personal protective equipment. Multivariate analyses indicated that being a farmer/landscaper and having cattle and cats around the home are the most significant drivers of leptospirosis. Biological features most associated with leptospirosis were thrombocytopenia, leukocytosis, high values for renal function tests, and elevated total bilirubin. We report changes in behavior and exposure compared with data collected on leptospirosis 25 years ago, with indication that healthcare development has lowered case fatality. Continuous health education campaigns are recommended as well as further studies to clarify the epidemiology of human leptospirosis, especially the role of domestic animals.
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
Leptospirosis is an important zoonotic disease in the Pacific Islands. In Fiji, two successive cyclones and severe flooding in 2012 resulted in outbreaks with 576 reported cases and 7% case-fatality. We conducted a cross-sectional seroprevalence study and used an eco-epidemiological approach to characterize risk factors and drivers for human leptospirosis infection in Fiji, and aimed to provide an evidence base for improving the effectiveness of public health mitigation and intervention strategies. Antibodies indicative of previous or recent infection were found in 19.4% of 2152 participants (81 communities on the 3 main islands). Questionnaires and geographic information systems data were used to assess variables related to demographics, individual behaviour, contact with animals, socioeconomics, living conditions, land use, and the natural environment. On multivariable logistic regression analysis, variables associated with the presence of Leptospira antibodies included male gende...
American Journal of Tropical Medicine and Hygiene, 2014
To determine the exposure risk factors of highly endemic rural leptospirosis in tropical setting, we conducted a prospective, hospital-based case control study in Sri Lanka. A conceptual hierarchy of variables was used to analyze the data. Case patients included 38 (34%) females and 73 (66%) males with a mean age of 36 yr (SD 12.7 yr). Using piped, chlorinated water for drinking/general purposes (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.16-0.67), paddy fields in the vicinity of home (OR 1.77, 95% CI 1.06-2.97), sighting dogs at home yard/dog ownership (OR 1.79, 95% CI 1.11-2.91), sighting cattle at home yard/cattle ownership (OR 1.69, 95% CI 1.00-2.84), and work in a paddy field (OR 3.02, 95% CI 1.68, 5.41) were the main predictors of leptospirosis among febrile patients. In high endemic tropical settings with rural leptospirosis, risk factors in residential environments, rather than individual exposures, seemed to play a major role in leptospirosis disease transmission.