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da Rocha SMC, Pires RC, Monteiro DCS, Cronemberges TCR, de Souza NV, Colares JKB, Lima DM. Is there an overestimation of dengue compared with that of other acute febrile syndromes in childhood? PLoS Negl Trop Dis 2024; 18:e0012137. [PMID: 38848319 PMCID: PMC11161014 DOI: 10.1371/journal.pntd.0012137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 04/05/2024] [Indexed: 06/09/2024] Open
Abstract
A group of children with clinical suspicion of dengue were assessed to determine if there was an overestimation of dengue compared with that of leptospirosis and leishmaniasis. This descriptive and analytical cross-sectional study, based on the active search of participants with acute febrile illness, was conducted at two pediatric hospitals. The collection of clinical and epidemiological data was performed using questionnaires, and laboratory tests specific for dengue were performed using immunochromatographic, serological, and molecular methods. Dengue-negative samples were assessed for Leptospira and Leishmania spp. using molecular tests. Data were assessed using analysis of variance (ANOVA), the chi-square test, and Fisher's exact test. In total, 86 participants were evaluated, of whom 39 (45%) were positive for dengue fever, 4 (5%) for leptospirosis, and 1 (1%) for leishmaniasis. Forty-two participants (49%) presented dengue-like symptoms. The predominant age range for the virus was 3-10 years. Most clinical manifestations were nonspecific, with frequent concomitant gastrointestinal and respiratory symptoms. Furthermore, we found that the acute febrile syndrome in childhood persists as a challenge for health professionals, especially in the early days of the disease, due to a plurality of diagnostic hypotheses, associated with the difficulty of establishing well-defined symptoms in children, especially in infants. Dengue fever continues to be a frequent pathology with acute febrile infections in childhood; however, there is an overestimation of the disease, especially in endemic regions, when one considers only the clinical epidemiological diagnosis.
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Affiliation(s)
- Sônia Maria Cavalcante da Rocha
- University of Fortaleza (UNIFOR), Graduate Program in Medical Sciences, Fortaleza, Ceará, Brazil
- Hospital Infantil Albert Sabin, Fortaleza, Ceará, Brazil
| | | | - Daniela Cristina Sensato Monteiro
- University of Fortaleza (UNIFOR), Graduate Program in Medical Sciences, Fortaleza, Ceará, Brazil
- University of Fortaleza (UNIFOR/RENORBIO), Postgraduate Program in Biotechnology, Ceará State University, Fortaleza, Ceará, Brazil
| | | | - Natália Vasconcelos de Souza
- University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
- University of Fortaleza (UNIFOR/RENORBIO), Postgraduate Program in Biotechnology, Ceará State University, Fortaleza, Ceará, Brazil
| | - Jeová Keny Baima Colares
- University of Fortaleza (UNIFOR), Graduate Program in Medical Sciences, Fortaleza, Ceará, Brazil
- University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
| | - Danielle Malta Lima
- University of Fortaleza (UNIFOR), Graduate Program in Medical Sciences, Fortaleza, Ceará, Brazil
- University of Fortaleza (UNIFOR), Fortaleza, Ceará, Brazil
- University of Fortaleza (UNIFOR/RENORBIO), Postgraduate Program in Biotechnology, Ceará State University, Fortaleza, Ceará, Brazil
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Teles AJ, Bohm BC, Silva SCM, Bruhn FRP. Socio-geographical factors and vulnerability to leptospirosis in South Brazil. BMC Public Health 2023; 23:1311. [PMID: 37420253 PMCID: PMC10329394 DOI: 10.1186/s12889-023-16094-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 06/09/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Leptospirosis, caused by the Leptospira bacteria, is an acute infectious disease that is mainly transmitted by exposure to contaminated soil or water, thereby presenting a wide range of subsequent clinical conditions. This study aimed to assess the distribution of cases and deaths from leptospirosis and its association with social vulnerability in the state of Rio Grande do Sul, Brazil, between 2010 and 2019. METHODS The lethality rates and incidence of leptospirosis and their association with gender, age, education, and skin color were analyzed using chi-square tests. The spatial relationship between the environmental determinants, social vulnerability, and the incidence rate of leptospirosis in the different municipalities of Rio Grande do Sul was analyzed through spatial regression analysis. RESULTS During the study period, a total of 4,760 cases of leptospirosis, along with 238 deaths, were confirmed. The mean incidence rate was 4.06 cases/100,000 inhabitants, while the mean fatality rate was 5%. Although the entire population was susceptible, white-colored individuals, males, people of the working-age group, along with less-educated individuals, were more affected by the disease. Lethality was higher in people with dark skin, and the prime risk factor associated with death was the direct contact of the patients with rodents, sewage, and garbage. The social vulnerability was positively associated with the incidence of leptospirosis in the Rio Grande do Sul, especially in municipalities located in the center of the state. CONCLUSIONS It is evident that the incidence of the disease is significantly related to the vulnerability of the population. The use of the health vulnerability index showed great relevance in the evaluation of leptospirosis cases and can be used further as a tool to help municipalities identify disease-prone areas for intervention and resource allocation.
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Affiliation(s)
| | - Bianca Conrad Bohm
- Postgraduate Program in Veterinary, Federal University of Pelotas, Capão Do Leão, Rio Grande Do Sul, Brazil
| | - Suellen Caroline M Silva
- Postgraduate Program in Veterinary, Federal University of Pelotas, Capão Do Leão, Rio Grande Do Sul, Brazil.
| | - Fábio Raphael P Bruhn
- Department of Preventive Veterinary Medicine, Federal University of Pelotas, Capão Do Leão, Rio Grande Do Sul, Brazil
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Loong SK, Abd-Majid MA, Teoh BT, Cheh MJ, Khor CS, Chao CC, Khoo JJ, AbuBakar S. Leptospirosis among Dengue-Negative Febrile Patients in Selangor, Malaysia. Am J Trop Med Hyg 2022; 107:397-400. [PMID: 35895409 PMCID: PMC9393432 DOI: 10.4269/ajtmh.20-0656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 03/03/2022] [Indexed: 08/03/2023] Open
Abstract
In recent years, the number of leptospirosis cases, including the number of deaths, has exponentially increased in Malaysia. From June 2016 to February 2018, blood samples of 321 febrile patients with the presumptive diagnosis of dengue-like illness were examined for possible exposure to Leptospira. Two hundred fifty-five blood samples were tested as negative for dengue. Seminested polymerase chain reaction (PCR) and IgM ELISA for leptospirosis were performed. From the samples, an overall prevalence for leptospirosis based on PCR of 4.7% (12/255) was obtained. Eighteen percent (46/255) were positive for anti-Leptospira IgM antibodies. The genome sequences of six of 12 Leptospira PCR-positive samples showed > 97.0% similarity to Leptospira interrogans. One patient's sample consisted of Leptospira and chikungunya virus, suggesting a coinfection. Findings from the study suggest that leptospirosis is prevalent among dengue-negative febrile patients in Malaysia.
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Affiliation(s)
- Shih Keng Loong
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohamad Azlan Abd-Majid
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Boon Teong Teoh
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mi Jing Cheh
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chee Sieng Khor
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chien Chung Chao
- Naval Medical Research Center, Silver Spring, Maryland
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jing Jing Khoo
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sazaly AbuBakar
- Tropical Infectious Diseases Research & Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Calero ML, Monti G. Assessment of the Current Surveillance System for Human Leptospirosis in Ecuador by Decision Analytic Modeling. Front Public Health 2022; 10:711938. [PMID: 35309218 PMCID: PMC8927665 DOI: 10.3389/fpubh.2022.711938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Leptospirosis is a globally disseminated zoonotic disease with no national surveillance systems. On the other hand, surveillance is crucial for improving population health, and surveillance systems produce data that motivates action. Unfortunately, like many other countries, Ecuador put in place a monitoring system that has never been tested. The goal of this study was to use scenario tree modeling to assess the sensitivity of Ecuador's current national surveillance system to human leptospirosis as the basis for an economic assessment of the system. We created a decision-tree model to analyze the current system's sensitivity. The inputs were described as probabilities distributions, and the model assessed the program's sensitivity as an output. The model also considers the geographical and weather variations across Ecuador's three continental regions: Andean, Amazonia, and the Coast. Several data sources were used to create the model, including leptospirosis records from Ecuador's Ministry of Public Health, national and international literature, and expert elicitation, all of which were incorporated in a Bayesian framework. We were able to determine the most critical parameters influencing each scenario's output (CSU) sensitivity through sensitivity analysis. The Coast region had the best sensitivity scenario, with a median of 0.85% (IC 95% 0.41-0.99), followed by the Amazonia with a median of 0.54% (CI 95% 0.18-0.99) and the Andes with a median of 0.29% (CI 95% 0.02-0.89). As per the sensitivity study, the most influential criteria on the system's sensitivity were "Attendance or probability of going to a health center" and "probability of having symptoms," notably for the Coast and Amazonia Regions.
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Affiliation(s)
- María Laura Calero
- PhD Program in Veterinary Sciences, Faculty of Veterinary Sciences, Universidad Austral de Chile, Valdivia, Chile
| | - Gustavo Monti
- Faculty of Veterinary Sciences, Institute of Preventive Veterinary Medicine, Universidad Austral de Chile, Valdivia, Chile
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Shetty A, Kundu S, Gomes-Solecki M. Inflammatory Signatures of Pathogenic and Non-Pathogenic Leptospira Infection in Susceptible C3H-HeJ Mice. Front Cell Infect Microbiol 2021; 11:677999. [PMID: 34249775 PMCID: PMC8264587 DOI: 10.3389/fcimb.2021.677999] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/25/2021] [Indexed: 12/17/2022] Open
Abstract
The exact global impact of leptospirosis is unknown due to inadequate surveillance systems in place in most low-income countries. In this study, we analyzed the differences in mouse inflammatory signatures involved in pathogenic versus non-pathogenic Leptospira recognition at 24h and 72h post infection. Injection of C3H-HeJ mice with non-pathogenic L. biflexa increased circulation of a few chemokines (5/21, 24%) without secretion of cytokines in blood that resulted in engagement of resident macrophages, dendritic cells, neutrophils and NK cells without engagement of T cells. In contrast, pathogenic L. interrogans induced circulation of a much higher panel of chemokines (18/21, 86%) and pro- and anti-inflammatory cytokines (11/19, 58%) in blood with a resulting signaling cascade leading to engagement of macrophages, dendritic cells, monocytes, NK cells and T cells without engagement of neutrophils. Although neutrophils do not appear to be engaged, a considerable number of chemokines that recruit other granulocytes such as eosinophils and basophils were also increased at 72h post infection with L. interrogans. Overall, the data suggest that prevention of dissemination of L. biflexa is associated with an early engagement of the innate immune response characterized by upregulation of a few chemokines that results in an efficacious phagocytic response without an overwhelming increase of pro-inflammatory cytokines. However, when macrophages fail to clear a pathogenic serovar such as L. interrogans, the adaptive response (T cells) is engaged to help out, but the resulting chemo-cytokine storm mediates a robust but non-resolving inflammatory response to pathogenic Leptospira that results in dissemination, kidney colonization, pathology and disease.
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Affiliation(s)
- Advait Shetty
- Department of Pharmaceutical Sciences, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Suman Kundu
- Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Maria Gomes-Solecki
- Department of Pharmaceutical Sciences, The University of Tennessee Health Science Center, Memphis, TN, United States,Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science Center, Memphis, TN, United States,*Correspondence: Maria Gomes-Solecki,
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Del Valle-Mendoza J, Palomares-Reyes C, Carrillo-Ng H, Tarazona-Castro Y, Kym S, Aguilar-Luis MA, Del Valle LJ, Aquino-Ortega R, Martins-Luna J, Peña-Tuesta I, Verne E, Silva-Caso W. Leptospirosis in febrile patients with suspected diagnosis of dengue fever. BMC Res Notes 2021; 14:209. [PMID: 34051849 PMCID: PMC8164282 DOI: 10.1186/s13104-021-05627-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/20/2021] [Indexed: 12/23/2022] Open
Abstract
Objective This study was carried out to determine the prevalence of leptospirosis among febrile patients with a suspicious clinical diagnosis of dengue fever in northern Peru. Results A total of 276 serum samples from patients with acute febrile illness (AFI) and suspected diagnosis for dengue virus (DENV) were analyzed. We identified an etiological agent in 121 (47.5%) patients, DENV was detected in 30.4% of the cases, leptospirosis in 11.2% and co-infection by both pathogens was observed in 5.9% of the patients. In this study the most common clinical symptoms reported by the patients were: headache 89.1%, myalgias 86.9% and arthralgias 82.9%. No differences in symptomatology was observed among the different study groups.
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Affiliation(s)
- Juana Del Valle-Mendoza
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. .,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru.
| | - Carlos Palomares-Reyes
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Hugo Carrillo-Ng
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru.,Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Yordi Tarazona-Castro
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Sungmin Kym
- Division of Infectious Disease, Department of Internal Medicine, Chungnam National University School of Medicine , Daejeon, Korea
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Luis J Del Valle
- Barcelona Research Center for Multiscale Science and Engineering, Departament D'Enginyeria Química, EEBE, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Ronald Aquino-Ortega
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Johanna Martins-Luna
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Isaac Peña-Tuesta
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | | | - Wilmer Silva-Caso
- School of Medicine, Research and Innovation Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. .,Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru.
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Fornazari F, Richini-Pereira VB, Joaquim SF, Nachtigall PG, Langoni H. Leptospirosis diagnosis among patients suspected of dengue fever in Brazil. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20200118. [PMID: 33796136 PMCID: PMC7996315 DOI: 10.1590/1678-9199-jvatitd-2020-0118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: The early symptoms of leptospirosis and dengue fever are difficult to distinguish and can cause diagnostic confusion. Due to the large dengue epidemics that has occurred in Brazil in recent years, it is possible that cases of leptospirosis were unreported. Therefore, we performed a retrospective study to detect leptospirosis in patients who were tested for dengue, but whose laboratory diagnoses were negative. Methods: Sera samples from 2,017 patients from 48 cities located in the central region of São Paulo state, Brazil, were studied. All samples were subjected to the microscopic agglutination test (MAT), 305 of which were taken from patients five days or less since the onset of symptoms, and were additionally subjected to real-time polymerase chain reaction (PCR). Results: The overall prevalence of leptospirosis cases was 21 (1.04%), with 20 through MAT (18 for Icterohaemorrhagiae and two for the Cynopteri serogroup) and one through PCR (amplicon sequencing compatible with Leptospira interrogans). According to previously established criteria, eight cases of leptospirosis were classified as “confirmed” and 13 as “probable”. The Brazilian notification system for health surveillance had no records for 16 patients positive for leptospirosis and, thus, they were considered unreported cases. Statistical analyses revealed that the prevalence of leptospirosis was higher in men (1.56%) than in women (0.56%), and the mean age was higher in positive patients (43.7 years) than in negative ones (32.3 years). Conclusion: The results indicated that patients suspected of dengue fever had evidence of leptospirosis or Leptospira infection, and most of these cases were unreported in the Brazilian notification system. The high burden of dengue may contribute to the misdiagnosis of leptospirosis, and health professionals should increase their awareness of leptospirosis as an important differential diagnosis of patients with suspicion of dengue.
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Affiliation(s)
- Felipe Fornazari
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Husbandry, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | | | - Sâmea Fernandes Joaquim
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Husbandry, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | | | - Helio Langoni
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Husbandry, São Paulo State University (UNESP), Botucatu, SP, Brazil
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Monteiro DCS, de Souza NV, Amaral JC, de Lima KB, de Araújo FMC, Ramalho ILC, Martins VEP, Colares JKB, de Góes Cavalcanti LP, Lima DM. Dengue: 30 years of cases in an endemic area. Clinics (Sao Paulo) 2019; 74:e675. [PMID: 31508718 PMCID: PMC6724460 DOI: 10.6061/clinics/2019/e675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 04/10/2019] [Indexed: 11/18/2022] Open
Abstract
The present study aimed to review literature on studies of dengue cases conducted over 30 years in the state of Ceará. Between November 2015 and January 2016, articles published in Portuguese and English in 7 databases were searched using keywords and a Boolean operator. A total of 191 articles were identified in the databases; 133 were excluded according to the exclusion criteria, and 58 were included in the study. Of the 58 articles analyzed, 6 reported data from Brazil; including the Northeast region and the state of Ceará; 41 reported data for only the city of Fortaleza; 7 reported data for the state of Ceará; 4 reported data for cities in the interior of the state; and 3 included only children. The studies adopted different approaches and focused on different aspects of the disease. Study outcomes included the identification of serological, epidemiological, clinical, and laboratory characteristics; potential larvicides and biological predators of mosquitoes; potential antiviral agents; vector density characteristics; and educational dengue prevention and control strategies. Additionally, one vaccine trial was included. Although studies on dengue in the state of Ceará are scarce, they are encompassing, including several lines of research, and the number of studies and reports on dengue in the state of Ceará continues to increase.
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Affiliation(s)
| | - Natália Vasconcelos de Souza
- Programa de Pos Graduacao em Biotecnologia, Universidade Estadual do Ceara, Universidade de Fortaleza, Fortaleza, CE, BR
| | | | | | | | | | | | | | | | - Danielle Malta Lima
- Programa de Pos Graduacao em Biotecnologia, Universidade Estadual do Ceara, Universidade de Fortaleza, Fortaleza, CE, BR
- Universidade de Fortaleza, Fortaleza, CE, BR
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Gutiérrez JD, Martínez-Vega RA. Spatiotemporal dynamics of human leptospirosis and its relationship with rainfall anomalies in Colombia. Trans R Soc Trop Med Hyg 2019; 112:115-123. [PMID: 29635429 DOI: 10.1093/trstmh/try032] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 04/02/2018] [Indexed: 12/29/2022] Open
Abstract
Background In Colombia, human leptospirosis (HL) is a disease that has had a mandatory notification rule since 2007. Humans usually acquire the infection through water contaminated with animal urine that comes into direct contact with cutaneous lesions, eyes or mucous membranes. Objectives To analyze the spatiotemporal variability in the occurrence of HL cases in Colombia between 2007 and 2016, and its relation with the El Niño Southern Oscillation (ENSO) cycle and the consequent anomalies in rainfall in spatiotemporal clusters. Methods An ecological study of the HL cases, aggregated by municipality, and reported between 2007 and 2016, is presented. Findings During the period of study, 9928 cases of HL were reported, and 58.9% of the municipalities reported at least one case of leptospirosis. Six spatiotemporal clusters were identified-five were in the Andean region and one was in the Caribbean region. The assessment of the ENSO cycle and rainfall anomalies suggests the importance of La Niña episodes, and excess rainfall periods in the occurrence of cases of HL. Conclusions Our results demonstrate the importance of the ENSO cycle, rainfall periods and periods with excess rainfall in the occurrence of cases and outbreaks of HL in Colombia, and suggest the importance of the topography of valleys and flood zones as zones in which the risk of infection is elevated.
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Affiliation(s)
- J D Gutiérrez
- Universidad de Santander, Facultad de Ingeniería, Grupo Ambiental de Investigación Aplicada-GAIA
| | - R A Martínez-Vega
- Universidad de Santander, Facultad de Ciencias de la Salud, Escuela de Medicina, Grupo de investigación Salud-Comunid-UDES, Bucaramanga
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Leptospirosis in Wardha District, Central India—Analysis of hospital based surveillance data. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Gutiérrez JD, Martínez-Vega RA, Botello H, Ruiz-Herrera FJ, Arenas-López LC, Hernandez-Tellez KD. Environmental and socioeconomic determinants of leptospirosis incidence in Colombia. CAD SAUDE PUBLICA 2019; 35:e00118417. [DOI: 10.1590/0102-311x00118417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/02/2018] [Indexed: 01/12/2023] Open
Abstract
Human leptospirosis is an infection that most often affects tropical countries. Since 2007, Colombia requires the notification of disease cases, enabling the observation of an increase in cases in recent years. The objectives of this article were to analyze environmental and socioeconomic variables and to evaluate their relationship with human leptospirosis cases. This is an ecological study on human leptospirosis cases aggregated by municipality and reported between 2007 and 2016. Spatial aggregation assessment was made using the Getis-Ord Gi method, and negative binomial regression was used to evaluate the relationship between environmental and socioeconomic variables with human leptospirosis. During the study period, 9,928 cases of human leptospirosis were reported, and 58.9% of municipalities reported at least one case. Four hotspots of human leptospirosis, including 18 municipalities, were identified. The results of the negative binomial model confirmed the importance of the effects of education, poverty and some climatic variables on the decadal incidence rate of human leptospirosis. Our results confirm the importance of socioeconomic determinants such as social marginality associated with violence and education, as well as ecological variables such as rainfall, height above sea level and forest coverage on the incidence rate of human leptospirosis at municipal scale.
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Affiliation(s)
| | | | - Hector Botello
- Universidad Nacional, Colombia; Universidad Industrial de Santander, Colombia
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Martins MHDM, Spink MJP. Human leptospirosis as a doubly neglected disease in Brazil. CIENCIA & SAUDE COLETIVA 2018; 25:919-928. [PMID: 32159662 DOI: 10.1590/1413-81232020253.16442018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 06/25/2018] [Indexed: 12/20/2022] Open
Abstract
The aim of this article is to analyze discrepancies and informational gaps which produce a doubly neglected version of human leptospirosis in the Brazilian public health policy. To achieve this goal, we compared data on morbidity, mortality, hospital and social costs, population profiles, vector habits, social health determinants and diagnostic practices related to leptospirosis with another disease of higher recognition in Brazil: dengue fever. Our analysis shows that the arbitrariness of criteria for assigning health priorities, the invisibility of the population profile of human leptospirosis in official data and its mimetic character in clinic corroborate the production of a version of human leptospirosis that is invisible and, because of that, doubly neglected by the Brazilian public health policy. We conclude that these discrepancies and informational gaps are related to the fact that human leptospirosis affects a population which the State has no interest in keeping alive.
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Santos IDOC, Landi MFDA, Cruz LM, Bofill MIR, Santos DED, Lima EMMD, Castro MBD. Human leptospirosis in the Federal District, Brazil, 2011-2015: eco-epidemiological characterization. Rev Soc Bras Med Trop 2018; 50:777-782. [PMID: 29340454 DOI: 10.1590/0037-8682-0234-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/13/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Leptospirosis is an infectious disease that affects more than 5,000 people per year in Brazil. The Federal District (FD) lacks epidemiological studies of human leptospirosis and presents concerning rates of this disease, especially considering its lethality. METHODS Seventy-nine autochthonous human cases of leptospirosis between 2011 and 2015 were analyzed, with the probable infection location serving as a basis for the collection and analysis of the environmental and epidemiological variables. RESULTS The incidence of the disease ranged from 0.68-13.39 per 100,000 inhabitants in 21 of the 31 administrative regions that compose the FD. The local profile of human leptospirosis was predominantly associated with urban areas during the rainy season, population access to the sewage network, the treated water network, and the public garbage collection service. The vast majority of cases had a strong association with synanthropic rodents at the infection sites. CONCLUSIONS In order to prevent and control potentially lethal human leptospirosis infection, the eco-epidemiological characterization of this disease is a valuable tool for public policies of prevention, control, and surveillance. In addition to population awareness, the systematized control of synanthropic rodents could be the main health action to reduce the incidence of this disease in the FD.
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Affiliation(s)
| | | | - Laurício Monteiro Cruz
- Departamento de Vigilância Ambiental, Secretaria da Saúde, Administração do Distrito Federal, Brasília, DF, Brasil
| | - Maria Isabel Rao Bofill
- Departamento de Vigilância Ambiental, Secretaria da Saúde, Administração do Distrito Federal, Brasília, DF, Brasil
| | - Divino Eterno Dos Santos
- Departamento de Vigilância Ambiental, Secretaria da Saúde, Administração do Distrito Federal, Brasília, DF, Brasil
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