Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

Filho, Alfredo Pereira Leite de Albuquerque; Araújo, Jéssica Guido de; Souza, Inacelli Queiroz de; Martins, Luciana; Oliveira, Marta Iglis de; Silva, Maria Jesuíta Bezerra da; Montarroyos, Ulísses Ramos; Filho, Demócrito de Barros Miranda

doi:10.1590/s0037-86822011000600016

Cited by 7 publications

(12 citation statements)

References 11 publications

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“…Moreover, not all cases were reported, many cases are unnoticed and may be confused with a bad flu and laboratory tests can not always detect the classical bacilli Leptospira . The time for diagnosis of the disease is very important and laboratory techniques currently developed assist in achieving a more rapid, accurate and makes the treatment more effective [13-16]. …”

Section: Discussionmentioning

confidence: 99%

Incidence of Leptospirosis infection in the East Zone of Sao Paulo City, Brazil

Miyazato¹,

Fonseca²,

Caputto³

et al. 2013

Int Arch Med

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BackgroundLeptospirosis is a zoonosis which is spread through contamined running water. This contaminations is seriously affected by the flooding which occurs in the area surrounding the Aricanduva river. The transmission of the disease results mainly from the contact of water with soil contaminated by the urine of infected animals. We aimed to conduct an epidemiological survey on Leptospirosis cases in Sao Paulo East Zone area.MethodThe analysis conducted in this study was based on data collected from the health authorities of that region close the Aricanduva river between 2007 and 2008 years, which give the rates of confirmed cases, mortality and death from human Leptospirosis. Other information concerned with the relationships among rainfall index, points of flooding and incidence of Leptospirosis.ResultsWe observed a direct and important water contamination. Records of flooding points and dates of the reported cases in the region showed a direct relationship from which the period of higher rainfall also recorded an increase in cases. The annual record of the city and the region and rainfall regions also presented correlation.ConclusionThe association between the indices of flooding and Leptospirosis cases indicates that preventive measures are necessary to avoid exposing the community.

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Section: Discussionmentioning

confidence: 99%

Incidence of Leptospirosis infection in the East Zone of Sao Paulo City, Brazil

Miyazato¹,

Fonseca²,

Caputto³

et al. 2013

Int Arch Med

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“…Infected humans exhibit a wide spectrum of clinical responses to infection ranging from subclinical, acute flu-like symptoms, pyrexia of unknown origin, haemoptysis, acute renal disease, CNS involvement, to acute haemorrhagic fever [11, 12] none of which are pathognomonic for leptospirosis.…”

Section: Introductionmentioning

confidence: 99%

‘Leptorapide’ – a one-step assay for rapid diagnosis of human leptospirosis

Brownlow¹,

Kavanagh²,

Logan³

et al. 2013

Epidemiol. Infect.

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Leptospirosis is a globally important zoonotic infection caused by spirochaetes of the genus Leptospira. It is transmitted to humans by direct contact with infected animals or indirectly via contaminated water. It is mainly a problem of the resource-poor developing countries of the tropical and sub-tropical regions of the world but outbreaks due to an increase in travel and recreational activities have been reported in developed and more industrialized areas of the world. Current methods of diagnosis are costly, time-consuming and require the use of specialized laboratory equipment and personnel. The purpose of this paper is to report the validation of the 'Leptorapide®' test (Linnodee Ltd, Northern Ireland) for the diagnosis of human leptospirosis. It is a simple one-step latex agglutination assay performed using equal volumes of serum sample and antigen-bound latex beads. Evidence of leptospiral antibodies is determined within minutes. Agglutination is scored on a scale of 1-5 and the results interpreted using a score card provided with the kit. Validation has been performed with a large sample size obtained from individuals originating from various parts of the world including Brazil and India. The test has shown sensitivity and specificity values of 97·1% and 94·0%, respectively, relative to the microscopic agglutination test. The results demonstrate that Leptorapide offers a cost-effective and accurate alternative to the more historical methods of antibody detection.

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“…Of these, 15 (25.9%) met our selection criteria and were included [ 25 – 39 ]; 12 (80%) [ 25 – 36 ] tested samples from endemic countries and three (20%) [ 37 – 39 ] from non-endemic countries. Of the 12 studies in endemic countries, nine studies (75%) [ 25 – 30 , 35 , 36 ] reported data from single acute-phase samples and ten studies (83,3%) [ 25 – 29 , 31 – 34 ] reported data from paired samples. Of the three studies in non-endemic countries, two (66.6%) [ 37 , 38 ] reported data from single acute-phase samples and two (66.6%) [ 38 , 39 ] from paired samples.…”

Section: Resultsmentioning

confidence: 99%

“…Of these studies, 14 (93%) of 15 [ 25 – 38 ] included participants with suspected leptospirosis and one (7%) of 15 [ 39 ] included participants with fever. Of studies from endemic regions, recruitment occurred in Brazil [ 28 , 29 ]; Japan [ 34 ]; Pacific Island Countries and Territories such as Marquesas Islands, Society Islands, Wallis and Futuna, and New Caledonia [ 27 ]; India [ 32 , 33 ]; Laos [ 25 , 28 ]; Malaysia [ 30 , 35 ]; and Thailand [ 31 , 36 ]. In non-endemic countries, recruitment occurred in New Zealand [ 39 ] and Slovenia [ 37 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge

Valente,

Bramugy,

Keddie

et al. 2024

BMC Infect Dis

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Background Leptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum samples. However, reported estimates of MAT’s sensitivity vary. We evaluated the accuracy of four index tests, MAT on paired samples as well as alternative standards for leptospirosis diagnosis: MAT on single acute-phase samples, polymerase chain reaction (PCR) with the target gene Lfb1, and ELISA IgM with Leptospira fainei serovar Hurstbridge as an antigen. Methods We performed a systematic review of studies reporting results of leptospirosis diagnostic tests. We searched eight electronic databases and selected studies that tested human blood samples and compared index tests with blood culture and/or PCR and/or MAT (comparator tests). For MAT selection criteria we defined a threshold for single acute-phase samples according to a national classification of leptospirosis endemicity. We used a Bayesian random-effect meta-analysis to estimate the sensitivity and specificity of MAT in single acute-phase and paired samples separately, and assessed risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy Approach- 2 (QUADAS-2) tool. Results For the MAT accuracy evaluation, 15 studies were included, 11 with single acute-phase serum, and 12 with paired sera. Two included studies used PCR targeting the Lfb1 gene, and one included study used IgM ELISA with Leptospira fainei serovar Hurstbridge as antigen. For MAT in single acute-phase samples, the pooled sensitivity and specificity were 14% (95% credible interval [CrI] 3–38%) and 86% (95% CrI 59–96%), respectively, and the predicted sensitivity and specificity were 14% (95% CrI 0–90%) and 86% (95% CrI 9–100%). Among paired MAT samples, the pooled sensitivity and specificity were 68% (95% CrI 32–92%) and 75% (95% CrI 45–93%) respectively, and the predicted sensitivity and specificity were 69% (95% CrI 2–100%) and 75% (2–100%). Conclusions Based on our analysis, the accuracy of MAT in paired samples was not high, but it remains the reference standard until a more accurate diagnostic test is developed. Future studies that include larger numbers of participants with paired samples will improve the certainty of accuracy estimates.

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Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil

Cited by 7 publications

References 11 publications

Incidence of Leptospirosis infection in the East Zone of Sao Paulo City, Brazil

Incidence of Leptospirosis infection in the East Zone of Sao Paulo City, Brazil

‘Leptorapide’ – a one-step assay for rapid diagnosis of human leptospirosis

Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge

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