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Gómez-Martín MC, Rodríguez-Benjumeda LM, de Eguilior-Mestre MC, Lozano-Domínguez MC, Luque-Márquez R, Jódar-Sánchez F, Aznar-Martín J, Donaire-Granado JA, Luque-Romero LG. [Epidemiology of leptospirosis in the wetlands of Southern Spain]. GACETA SANITARIA 2023; 37:102288. [PMID: 36804781 DOI: 10.1016/j.gaceta.2023.102288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To find out whether the leptospirosis incidence rate among red swamp crayfish collectors in the harvesting season is higher than in the general population, and to identify risk factors and assess the direct and indirect health costs associated with leptospirosis seroconversion. METHOD This study was carried out between 1 July 2017 and 31 March 2018 in the municipality of Isla Mayor (Seville, Spain). It took the form of a prospective cohort study (exposed population: swamp crayfish collectors; non-exposed population: general population). The population was invited to take part in a prevalence study to be conducted using the ELISA qualitative technique, and informed consent was obtained from those who agreed. Negative serology cases were then included in the cohort study. Both cohorts were monitored clinically and symptomatic cases were serology tested. A second serum sample was taken from the swamp crayfish collectors at the end of the monitoring period to detect asymptomatic cases. Serovars were confirmed by microscopic agglutination testing. A bivariate descriptive analysis was carried out and cumulative incidence and relative risk were calculated, with positive serology being taken as the dependent variable. RESULTS A total of 278 people were included in the study, of whom 92 made up the swamp crayfish collectors cohort and 186 the general population cohort. Women made up 46.8% of the sample, but only 29.3% of the collectors cohort. The mean age was 45.1 (±16.4) years. Nine cases of seroconversion were detected: eight among swamp crayfish collectors and one in the general population. Overall cumulative incidence was therefore 3.2%: 8.7% in the exposed group and 0.5% in the non-exposed group. Relative risk was 16.2% (95% confidence interval: 2.1-127.4). The total cost of medical assistance and illness-related losses associated with leptospirosis was 1568€/case. CONCLUSIONS Leptospirosis in Isla Mayor is strongly associated with red swamp crayfish collecting. It's incidence here is much higher than that reported in studies published in other countries.
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Affiliation(s)
- María Carmen Gómez-Martín
- Unidad de Protección de la Salud, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Centro de Salud Ciudad Expo, Mairena del Aljarafe (Sevilla), España
| | - Luis Miguel Rodríguez-Benjumeda
- Unidad de Prevención, Promoción y Vigilancia de la Salud, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Centro de Salud Ciudad Expo, Mairena del Aljarafe (Sevilla), España
| | - María Carmen de Eguilior-Mestre
- Unidad de Gestión Clínica de Coria del Río, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Centro de Salud Blas Infante, Coria del Río (Sevilla), España
| | - María Carmen Lozano-Domínguez
- Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España
| | - Rafael Luque-Márquez
- Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España
| | - Francisco Jódar-Sánchez
- Departamento de Economía Aplicada (Estadística y Econometría), Facultad de Ciencias Económicas y Empresariales, Universidad de Málaga, Málaga, España
| | - Javier Aznar-Martín
- Unidad de Enfermedades Infecciosas, Microbiología Clínica y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Servicio Andaluz de Salud, Sevilla, España; Instituto de Investigaciones Biomédicas de Sevilla, IBIS (Universidad de Sevilla, Hospital Universitario Virgen del Rocío, Junta de Andalucía, Consejo Superior de Investigaciones Científicas), Sevilla, España; Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, España
| | | | - Luis Gabriel Luque-Romero
- Unidad de Investigación, Distrito Sanitario Aljarafe-Sevilla Norte, Servicio Andaluz de Salud, Sevilla, España; Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Sevilla, España.
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Evolution of Public Health Prevention of Leptospirosis in a One Health Perspective: The Example of Mahasarakham Province (Thailand). Trop Med Infect Dis 2021; 6:tropicalmed6030168. [PMID: 34564552 PMCID: PMC8482194 DOI: 10.3390/tropicalmed6030168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/27/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
Leptospirosis is an endemic disease with moderate to high incidence in Mahasarakham province, Thailand. The present study was designed to assess the policy implementation mission regarding leptospirosis prevention and control from the national level to the local administrative levels, through a One Health perspective. A qualitative study was conducted, using documentation review, individual in-depth interviews with public health officers, local government officers, livestock officers who developed policy implementation tools or have responsibilities in leptospirosis prevention and control. The results show that Thailand has progressively developed a leptospirosis prevention and control policy framework at the national level, transferring the responsibility of its implementation to the local level. The province of Mahasarakham has decided to foster cooperation in leptospirosis prevention and control at the local level. However, there are insufficient linkages between provincial, district and sub-district departments to ensure comprehensive disease prevention activities at the local level concerning leptospirosis patients and the whole population.
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Pérez-Cervera J, Vaello-Paños A, Dávila-Dávila E, Delgado-Expósito G, Morales-Martínez de Tejada Á, Aranda-López CA, Doncel-Vecino LJ, Sánchez-Sánchez M. Cardiac tamponade secondary to leptospirosis. A rare association: A case report. J Cardiol Cases 2021; 23:140-143. [PMID: 33717381 DOI: 10.1016/j.jccase.2020.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 09/16/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022] Open
Abstract
Herein is described the case of a 39-year-old female agronomist who was admitted to hospital after a syncopal episode. She had had fever, abdominal pain, nausea, and vomiting for the previous month. The patient showed signs of hypoperfusion, so a trans-thoracic echocardiography was done, demonstrating the presence of a cardiac tamponade. An emergency pericardiocentesis was performed, draining 500 ml of hematic content. Thoracic-abdominal computed tomography showed bilateral pleural effusion and also peritoneal effusion. Laboratory tests were compatible with an inflammatory situation with neutrophilic leukocytosis, alteration of hepatic function, and a plateau elevation of high-sensitivity troponin T. Colchicine was initiated but the evolution of the patient was torpid, making necessary the performance of a pericardial window due to an abrupt increase of pericardial effusion and echocardiographic signs of impending cardiac tamponade. Two chest tubes were inserted due to an increasing bilateral pleural effusion. Serology was positive for Leptospira spp. so doxycycline was initiated. She reported that she had inspected a rice-field the previous month. The patient presented a good response to the treatment, being discharged from hospital completely asymptomatic, with no pericardial effusion and practically resolved pleural effusions. She was evaluated again one month later, with no trace of effusions or symptoms. <Learning objective: Cardiac tamponade secondary to leptospirosis has never been described before. Leptospirosis is a global zoonosis that usually does not affect the heart or its associated structures. Myocarditis and arrhythmias are the most frequently associated cardiac manifestations. Presence of fever, nausea, abdominal pain, jaundice, or conjunctival suffusion in a patient in contact with an environment possibly contaminated by Leptospira should make this infection be considered as the cause of the clinical picture.>.
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Gómez-Martín M, Lozano C, Luque R, Luque-Romero L, Rodríguez-Benjumeda L, Aznar-Martin J. Red swamp crayfish collecting: a risk activity for leptospirosis. Clin Microbiol Infect 2020; 26:1103-1104. [DOI: 10.1016/j.cmi.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/02/2020] [Accepted: 03/10/2020] [Indexed: 10/24/2022]
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Pérez-García A, Tihista JÁ, Navascués A, Aguinaga A. Enfermedad de Weil autóctona: a propósito de un caso. Enferm Infecc Microbiol Clin 2019; 37:349-350. [DOI: 10.1016/j.eimc.2018.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 10/14/2022]
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Sociodemographic and clinical characteristics of patients infected with Leptospira spp. treated at four hospitals in Medellín, Colombia, 2008-2013. BIOMEDICA 2017; 37:62-67. [DOI: 10.7705/biomedica.v37i1.3280] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/31/2016] [Indexed: 11/21/2022]
Abstract
Introducción. La leptospirosis continúa siendo un problema significativo de salud en regiones tropicales, incluidos los países de Latinoamérica, donde es 100 veces más frecuente que en otras regiones del mundo. En los cuadros graves de la enfermedad, su mortalidad alcanza el 10 %. Su diagnóstico es un reto debido a que las manifestaciones clínicas en la fase inicial son inespecíficas y a la poca disponibilidad de pruebas diagnósticas.Objetivo. Describir las características sociodemográficas y clínicas, y el desenlace de la enfermedad en pacientes hospitalizados con leptospirosis.Materiales y métodos. Es un estudio retrospectivo que incluyó pacientes atendidos en cuatro instituciones de Medellín, entre enero de 2009 y diciembre de 2013, con un cuadro clínico sugestivo e IgM positiva para Leptospira spp.Resultados. Se incluyeron 119 pacientes, 80 % hombres y 58 % de procedencia rural. La duración promedio de los síntomas fue de 9,6 días (DE=9,6). El 89 % de los pacientes presentó fiebre; el 62 %, ictericia; el 74 %, mialgias; el 46 %, diarrea; el 41 %, hepatomegalia; el 13 %, esplenomegalia, y 13 %, enrojecimiento de los ojos. En 54 % de los pacientes hubo deterioro de la función renal, en 32 %, compromiso pulmonar y, en 13 %, falla hepática. El 16 % de los pacientes requirió atención en la unidad de cuidados intensivos, el 12 %, asistencia respiratoria mecánica, y el 11 %, administración de vasopresores. En 38,6 % de ellos la enfermedad cursó con síndrome de Weil y el 5 % falleció. La duración promedio de la hospitalización fue de 11 días (DE=9,6).Conclusiones. La leptospirosis en esta población tuvo manifestaciones clínicas y complicaciones similares a las reportadas en la literatura científica. Se observó una mortalidad general relativamente baja comparada con las estadísticas mundiales.
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Domingo I, Cuenca M, Gimeno F, Guerrero A. Incidence of leptospirosis in Spain, 2009-2012. Rev Clin Esp 2015; 216:51-3. [PMID: 26653048 DOI: 10.1016/j.rce.2015.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 10/02/2015] [Accepted: 10/25/2015] [Indexed: 10/22/2022]
Affiliation(s)
- I Domingo
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, España.
| | - M Cuenca
- Dirección de Investigación y Docencia, Hospital Universitario de La Ribera, Alzira, Valencia, España; Facultad de Enfermería, Universidad Católica de Valencia, Valencia, España
| | - F Gimeno
- Dirección de Investigación y Docencia, Hospital Universitario de La Ribera, Alzira, Valencia, España
| | - A Guerrero
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, España; Dirección de Investigación y Docencia, Hospital Universitario de La Ribera, Alzira, Valencia, España
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