An Observational Study of Human Leptospirosis in Seychelles

Abstract

. 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 ≥ 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.

Clinical profile, management and outcome of patients with leptospirosis during the times of COVID-19 pandemic: A prospective study from a tertiary care centre in South India

“…This explains the high baseline severity in most cases. Similar to previous studies, cases were seen more commonly in men than women [10,12,13,[21][22][23][24][28][29][30][31][32][33][34][35]. This might be due to higher chances of exposure during outdoor activities.…”

“…Most patients present with fever, myalgias, and headache. Myalgia and headache have been described in 28-100% and 19-100% cases respectively in published literature [6,7,10,12,13,21,22,24,29,31,32,[34][35][36][37][38]. Conjunctival suffusion is characteristically seen in many patients with leptospirosis and may help to make a diagnosis.…”

“…In the study by Kuriakose et al, 20% had a decrease in urine output while only 16% were classified as renal failure [7]. Other studies have showed the prevalence of AKI and oliguria to be 1-81% and 1-56% respectively [10,12,13,21,22,24,29,31,32,[34][35][36]38]. Liver involvement is commonly described in patients with leptospirosis.…”

Effect of disinfection agents and quantification of potentially viable Leptospira in fresh water samples using a highly sensitive integrity-qPCR assay

“…This disease occurs worldwide but the incidence is the highest in tropical regions [ 1 – 3 ]. However, developed countries, including those in Europe [ 4 , 5 ], have also observed an increase in the number of reported cases.…”

“…Leptospirosis can take various forms, from a flu-like syndrome (fever, myalgia, or headache) to a multisystem disorder, with icteric and hemorrhagic syndrome accounting for 20% of cases, causing at least 60,000 deaths a year. This disease occurs worldwide but the incidence is the highest in tropical regions [1][2][3]. However, developed countries, including those in Europe [4,5], have also observed an increase in the number of reported cases.…”