Seroprevalence of Leptospirosis in Suspected High Risk Sudanese Patients; A Pilot Exploratory Study

Abstract

BackgroundThe extent of leptospirosis is unknown in Sudan and it might be mistaken for other more common febrile infectious diseases. Leptospirosis might also be associated with renal diseases that are common in Sudan. We intended to explore the existence of human leptospirosis in suspected high risk patients in Khartoum, Sudan, via sero-screening random febrile patients and those undergoing renal dialysis.MethodsThis is a pilot exploratory study that was conducted in 6 months period from April to September of 2013. Hospitals were selected conveniently following a non-random sampling approach. A total of 119 febrile patients (with or without definitive diagnosis) and patients under renal dialysis were included and their serum specimens, clinical and demographic data were collected. Sera were screened qualitatively for the existence of anti-leptospiral IgM antibodies using rapid lateral flow immunosorbent assay. Ethical clearance and official permissions were obtained.ResultsOut of the total 119 patients, 57 (47.9%) had end stage renal disease and were under dialysis at Renal Dialysis Unit in Asbab Charity Hospital in Bahri, 47 (39.5%), were febrile with unknown origin attending the Tropical Medicine Hospital in Omdurman, and 15 (12.6%) were febrile and were diagnosed as having malaria or typhoid and attended Yastabshiron Medical Centre and Bashauer Teaching Hospital. The overall prevalence of anti-leptospiral IgM antibodies among all 119 screened patients was 7%. The prevalence among the 57 with end stage renal disease was 9%, and among the 47 with fever of unknown origin was 6%. The prevalence among the 15 with fever of known origin (diagnosed as malaria or typhoid) was 0%. Almost all positive patients had recurring episodes of fever, are in close contact with livestock, were farmers and have natural untreated source for drinking water.ConclusionLeptospirosis is probably a common febrile condition and can be easily considered as one of the major causes of chronic kidney disease affecting people in this country. A national sero-screening for leptospirosis among those living in high risk geographical areas and those at occupational risk is highly recommended.