Epidemiological Risk Factors of Urban Leptospirosis in North Chennai (Tamil Nadu) - A South India Study

Abstract

Background: On October 15, 2006, the China information system for disease control and prevention revealed typhoid fever (TF) cases increasing greatly from October 7, comparing with the same period of the previous year, in a coastal city, P.R. China.Objective: To identify its epidemiological cause, and develop its control measures.Methods: TF case was defined as any case involving onset of fever between October 7 and December 15, 2006, plus the following: high fever (>38.5 • C), headache, malaise, intestinal hemorrhaging, myalqia, or rose-colored spots on the skin, and with the laboratory result of the decreasing Eosinophil cell or Widal test (+) in Jiaojiang district. The first 25 cases from October 7 and 100 controls randomly chosen from neighborhood of each case, age referring to +5 year old, were selected to carry out a case-control study, through questionnaire. Well water was randomly selected to detect the total bacteria, Coliform group. The chi-square test and non-conditional logistic regression analysis was used for statistical analysis. Statistical significance was assessed by the two-sided test with the test level equaling 0.05.Results: Totally 58 typhoid cases, including 29 confirmed and 29 probable cases were identified between October 7 and December 15, 2006. The cases were mainly non-residents. Through non-conditional logistic regression analysis, the result showed that mode to use well water (Odds Ratio [OR] = 5.71, 95%. Confidence interval [95% CI] = 2.23-14.59) and eat outside (OR = 8.18, 95% CI = 1.51-44.26, AR = 0.27) was the main causation of this outbreak. In addition, through chi-square test, the result also shows that Xiama market (OR = 5.46, 95% CI = 1.61-20.37, AR = 0.23), cooked food taking (OR = 4.13, 95% CI = 1.44-11.92, AR = 0.27 may also the suspected risk factors of this outbreak. The number of total bacteria and Coliform group in well water both far outnumber the national drinking water standards. Further more, through field investigation, a public toilet was found 5 meters far from a well in the Xiama market.Conclusion: This TF outbreak was mainly caused by the inappropriate manner to use contaminated well water system, probably by septic tank seepage into storage well and unhealthy food habits. The epidemic was controlled by the effective measures.

Exploring Acute Febrile Illness in Children: Clinical Characteristics and Diagnostic Challenges

“…Malaria was diagnosed in nine patients, with the prevalence increasing with age. This is consistent with other studies, although the prevalence in this study was lower than in some others [15,16]. A total of 19 patients (9.74%) had dengue fever diagnoses, which was most likely due to an epidemic that existed during the study period.…”

Assessment of Serum Macrophage Migration Inhibitory Factor (MIF) as an Early Diagnostic Marker of Leptospirosis

“…It has been reported throughout the world, especially in tropical and subtropical regions. In India, leptospirosis is endemic in seven states, including Tamil Nadu, Kerala, Karnataka, Maharashtra, and Gujarat, and in one union territory, Andaman and Nicobar Islands, especially in North and South Andaman ( Loganathan and Shivakumar, 2008 ). Natural catastrophes such as flooding and cyclones can increase human exposure to leptospires, which leads to its outbreak ( Kobayashi, 2005 ).…”

“…Indeed, a noticeable outbreak in Kerala has been recently reported in 2018 ( James et al., 2018 ). Epidemics of leptospirosis are often reported in urban areas, such as Chennai and Mumbai ( Bharadwaj et al., 2002 ; Loganathan and Shivakumar, 2008 ; Loganathan et al., 2012 ).…”