Epidemiological determinants of leptospirosis in rural and urban districts of Maharashtra, India

Abstract

Background: Leptospirosis is emerging as one of the growing public health problems in many parts of India. It can occur in both rural and urban areas with varied risk factors. This study was taken up in three districts of Maharashtra namely—Mumbai, Ratnagiri, and Sindhudurg to understand the determinants of leptospirosis in both the urban and rural areas and look for differences if any. Materials and Methods: This cross-sectional study was carried out during the year 2017. A pretested validated questionnaire was used to collect data. Field observations were made. Eighty-seven cases from Sindhudurg and 14 from Ratnagiri and 307 cases from Mumbai were included in the study. Results: A total of 408 cases were included in the study. A total of 63 (62.4%) were males and 38 (37.6%) were females. Most cases belonged to the 20–35 year age group (37%). In rural areas, 32.7% of them visited government facilities first, whereas, in the urban areas, it was 73.9% ( P = 0.006). Headache, myalgia, and prostration were more common in cases from rural areas ( P = <0.05). Skin rash was found to be associated with urban cases of leptospirosis. The presence of rodents, cattle sheds, pets, and working in paddy fields were common environmental risks in rural areas, and using water for recreational activities were common in urban areas ( P < 0.001). Conclusions: Context-specific risk factors were found significantly associated with the cases. No important difference was found in the epidemiology of leptospirosis in the urban and rural areas except the source of infection.

Clinico Epidemiological Study of Human Leptospirosis in Hilly Area of South India-A Population Based Case Control Study

“…In our study, majority of the patients belonged to the age group of 18-45 years indicating potential risk of occupational exposure among these working age group which is in concurrence with study findings by Patil DY[ 20 ] in Mumbai, wherein the majority of cases were in the age group of 25-50 years and studies done in northern and coastal part of India[ 21 - 23 ] and also in different parts of the world. [ 18 , 19 ] The gender-wise distribution of cases was almost equal in our study which is contrast to studies by Holla R et al ,[ 21 ] Kembhavi RS,[ 24 ] and by DebMandal M[ 25 ] reported prevalence was high among males. This might be due to factors like migration of male working population for better employment opportunities and female member of the family looking after the agricultural activities.…”

“…This temporal association could be due to animal and poultry waste which attracts rodents resulting in frequent transmission of the disease through contamination of soil with urine. These findings are in line with studies done in Maharashtra,[ 24 ] Middle Andaman,[ 27 ] and by Regmi L,[ 18 ] Esfandiari B et al ,[ 29 ] Suwanpakdee S,[ 34 ] and by Mwachui MA. [ 35 ] Our study also noted that rodent exposure factors like presence of rodents in the house and at the workplace and also presence of grain storage areas like godown had a higher risk for leptospirosis.…”

“…[ 35 ] Our study also noted that rodent exposure factors like presence of rodents in the house and at the workplace and also presence of grain storage areas like godown had a higher risk for leptospirosis. There is a high chance of soil contamination by infected urine of rodents which are present in the house and at the workplace resulting in disease transmission and these findings are in concurrence with studies by Kembhavi RS,[ 24 ] Desai KT,[ 26 ] Maze MJ,[ 10 ] Sahneh E,[ 9 ] and Dewi PS. [ 28 ]…”

Demographic and clinical risk factors associated with severity of lab-confirmed human leptospirosis in Colombia, 2015–2020

“…Studies in Puerto Rico [ 59 ], Thailand [ 52 ], and Nicaragua [ 38 ] did not find evidence that rash was an indicator of severe or fatal leptospirosis. In India, one study found that skin rash was significantly associated with leptospirosis in children [ 60 ], and another study found only suggestive evidence of such an association among urban leptospirosis cases [ 61 ], but not a sign of severity. However, previous evidence in Colombia suggested that rash is more common in other infections and may even be used, for example, to differentiate between dengue and leptospirosis [ 44 ].…”

An Overview of Anthropogenic Actions as Drivers for Emerging and Re-Emerging Zoonotic Diseases

“…Many studies show that leptospirosis is re-emerging, and it is becoming a public health problem, worldwide, with significant increases in its incidence and there being multiple outbreaks [176]. Recently, the disease has become widespread in Nicaragua, Brazil, India, Southeast Asia, the United States, and in several other countries [177][178][179][180][181][182][183][184]. Despite this, there are a few reports of leptospirosis in South and Southeast Asia, especially in the densely populated countries such as India and Indonesia, because the monitoring of it is very poor [171].…”