Leptospirosis and dengue fever are infectious diseases that co-occur during rainy seasons and both produce similar clinical signs. The purpose of this study was to assess the relative frequency of leptospirosis and dengue fever during a rainy season and the clinical difficulty to distinguish them. Blood samples from febrile patients in Guayaquil were obtained during the rainy season of 2008 and were analyzed by IgM ELISA for both diseases. Additionally, retrospective data (2003Additionally, retrospective data ( -2007 from febrile patients who attended one of largest public hospitals in Guayaquil were obtained. From 135 febrile patients samples, 15 (11.1%) were positive to leptospirosis; 36 (26,7%) to dengue fever; 3 (2.2%) to both pathogens and 81 (60%) were negative for both. Based on clinical diagnosis, cases were classified 68.1% as dengue fever; 20.7% as leptospirosis; 9.6% as malaria and 1.5% as other. However, 60% of patients clinically diagnosed as dengue had only antibodies against Leptospira and 25% patients diagnosed as leptospirosis had antibodies to dengue virus. The hospital archives indicated that 72.8% of patients clinically diagnosed as dengue fever had antibodies to Leptospira and not to dengue virus. The results suggest the two diseases are often misidentified which is a serious problem because both diseases require different medical treatment.Keywords. 5-6 Leptospirosis, Dengue, ELISA, MAT ResumenLa leptospirosis y dengue son enfermedades que presentan una sintomatología muy similar y ocurren durante las épocas lluviosas. El propósito del presente trabajo fue investigar la frecuencia de leptospirosis en la población de los barrios marginales de Guayaquil y el grado de dificultad que existe para distinguir clínicamente leptospirosis de dengue. Muestras de sangre de pacientes febriles provenientes de los barrios pobres de Guayaquil fueron colectadas durante la estación lluviosa del año 2008. Las muestras se sometieron a análisis de ELISA IgM para dengue y leptospirosis. Adicionalmente se obtuvieron datos retrospectivos (2003)(2004)(2005)(2006)(2007) de historias clínicas de pacientes que acudieron a uno de los hospitales públicos más grandes de Guayaquil. De un total de 135 pacientes febriles, 15 (11.1%) fueron positivos a leptospirosis por ELISA, 36 (26.7%) fueron positivos a dengue, 3 (2.2 %) fueron positivos a ambos patógenos y 81 (60%) fueron negativos para los dos. Sin embargo, 60% de los pacientes diagnosticados clínicamente como dengue tuvieron anticuerpos contra Leptospira y no para dengue y 25% pacientes diagnosticados como leptospirosis tuvieron anticuerpos contra el virus de dengue y no para Leptospira. Adicionalmente, los archivos hospitalarios (2003)(2004)(2005)(2006)(2007) indicaron que 72.8% de los pacientes diagnosticados clínicamente como dengue tuvieron anticuerpos contra Leptospira y carecían de anticuerpos contra virus de dengue. Los resultados sugieren que ambas enfermedades son frecuentemente identificadas erróneamente lo que representa un problema grave de salud pú...
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