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An Observational Study of Human Leptospirosis in Seychelles

Authors :
Biscornet, Leon
de Comarmond, Jeanine
Bibi, Jastin
Mavingui, Patrick
Dellagi, Koussay
Tortosa, Pablo
Pagès, Frédéric
Processus Infectieux en Milieu Insulaire Tropical (PIMIT)
Centre National de la Recherche Scientifique (CNRS)-IRD-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de La Réunion (UR)
Ministry of Health, Public Health Department, Victoria, Seychelles
Centre de Recherche et de Veille sur les Maladies Émergentes dans l'Océan Indien (CRVOI)
Université de La Réunion (UR)
Santé publique France - French National Public Health Agency [Saint-Maurice, France]
Université de La Réunion (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IRD-Centre National de la Recherche Scientifique (CNRS)
Tortosa, Pablo
Source :
The American Journal of Tropical Medicine and Hygiene, American Journal of Tropical Medicine and Hygiene, American Journal of Tropical Medicine and Hygiene, American Society of Tropical Medicine and Hygiene, 2020, 103 (3), pp.999-1008. ⟨10.4269/ajtmh.19-0228⟩, American Journal of Tropical Medicine and Hygiene, 2020, 103 (3), pp.999-1008. ⟨10.4269/ajtmh.19-0228⟩
Publication Year :
2020
Publisher :
The American Society of Tropical Medicine and Hygiene, 2020.

Abstract

International audience; 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 ³ 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.

Details

Language :
English
ISSN :
14761645 and 00029637
Volume :
103
Issue :
3
Database :
OpenAIRE
Journal :
The American Journal of Tropical Medicine and Hygiene
Accession number :
edsair.pmid.dedup....1f1e0c3081cc2c6fb291139108ff4694
Full Text :
https://doi.org/10.4269/ajtmh.19-0228⟩