Sero-epidemiology study of leptospirosis in febrile patients from Terai region of Nepal

BMC Infect Dis. 2017 Sep 18;17(1):628. doi: 10.1186/s12879-017-2733-x.

Abstract

Background: Leptospirosis is a re-emerging zoonotic disease caused by pathogenic strains of bacteria belonging to genus Leptospira whose symptoms can range from mild clinical manifestations to a severe life threatening illness. This disease may be under-recognized in resource poor settings like Nepal where many clinical laboratories lack appropriate equipment, technology and personnel for proper diagnosis.

Methods: We used IgM ELISA to estimate the sero-prevalence of leptospirosis in a group of febrile patients in a western region of Nepal. We also tested for possible co-infection with two other common febrile diseases endemic to Nepal including dengue and typhoid fever.

Results: Among samples from 144 febrile patients, 30 (21%) were positive for leptospiral IgM. In univariate analysis, leptospirosis was significantly associated with being of working age (p = 0.019), farming (p = 0.045) and water and animal contact (p = 0.0001). Widal and dengue serological study showed that the majority of leptospirosis infections did not have an alternative diagnosis.

Conclusion: As indicated by the study, regular surveillance of animal reservoirs in collaboration with veterinary department and inclusion of leptospirosis as a differential diagnosis of febrile illness is thus recommended based on the current findings.

Keywords: ELISA; Leptospira; Nepal.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Child
  • Coinfection / diagnosis
  • Dengue / diagnosis
  • Dengue / epidemiology
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay / methods
  • Female
  • Fever / diagnosis
  • Humans
  • Immunoglobulin M
  • Leptospira / pathogenicity
  • Leptospirosis / diagnosis*
  • Leptospirosis / epidemiology*
  • Leptospirosis / etiology
  • Male
  • Middle Aged
  • Nepal / epidemiology
  • Prevalence
  • Young Adult

Substances

  • Immunoglobulin M