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Philip N, Ahmed K. Leptospirosis in Malaysia: current status, insights, and future prospects. J Physiol Anthropol 2023; 42:30. [PMID: 38087323 PMCID: PMC10714552 DOI: 10.1186/s40101-023-00347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Among zoonotic infections, leptospirosis has a worldwide distribution and high prevalence in tropical regions. It has a broad clinical presentation from mild to severe, life-threatening infection. Leptospires, the etiological agent of leptospirosis, are found in varied ecological niches and animal species, providing a significant source of human infection. This review aims to provide the current status of leptospirosis in Malaysia and the direction for future studies. The literature search for this review was performed using PubMed, Web of Sciences, and Google Scholar databases. The incidence of leptospirosis in Malaysia from 2004 to 2020 varied; however, a large number of cases occurred during floods. Leptospira has been isolated from wild and domestic animals as well as from the environment; among them, several novel species have been identified. In Malaysia, leptospirosis infection and death were mostly associated with recreational and non-recreational water activities. Despite the endemicity of leptospirosis, the public's knowledge, attitude, and practice level are relatively low in this country. More studies are needed in Malaysia to explore the extent of leptospirosis in different settings and locations.
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Affiliation(s)
- Noraini Philip
- School of Biological Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan.
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Limothai U, Tachaboon S, Dinhuzen J, Singh J, Jirawannaporn S, Leewongworasingh A, Thongpin M, Brameld S, Watanaboonyongcharoen P, Sitprija V, Tantawichien T, Thisyakorn U, Srisawat N. Seroprevalence of leptospirosis among blood donors in an endemic area. Sci Rep 2023; 13:12336. [PMID: 37524788 PMCID: PMC10390486 DOI: 10.1038/s41598-023-39461-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023] Open
Abstract
Thailand is known to be endemic for leptospirosis. This bacterium may pose a potential risk to transfusion safety. This study was a cross-sectional study examining the seroprevalence of leptospirosis among Thai blood donors. A total of 1053 serum specimens collected from blood donors residing in 5 regions of Thailand during March to September 2020 were included in this study. All samples were tested for the presence of antibodies to 22 leptospiral serovars using the microscopic agglutination test (MAT) and anti-Leptospira IgG antibodies using commercially available enzyme immunoassay. We found no evidence of recent exposure to Leptospira spp. in sera of healthy Thai blood donors by MAT, including those in higher-risk areas. However, in this same group, we did find small numbers of past exposure (1.7%) to Leptospira spp. by IgG ELISA. According to the findings of this study, there is currently no evidence for implementing new blood banking procedures to identify possible carriers in Thailand, however these should be continually monitored and revised according to the infectious disease burden in each country. It should be noted that there was a difference in the occupation rate between the general population reported in Thailand and blood donors in this study; it may not reflect the actual situation in the country.
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Affiliation(s)
- Umaporn Limothai
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Sasipha Tachaboon
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Janejira Dinhuzen
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Jasleen Singh
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thailand Public Health Research Fellowship, Health Education England, London, UK
| | - Sirawit Jirawannaporn
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Akarathep Leewongworasingh
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Phandee Watanaboonyongcharoen
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University and Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Visith Sitprija
- Thai Red Cross, Queen Saovabha Memorial Institute, Bangkok, Thailand
| | - Terapong Tantawichien
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Nattachai Srisawat
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand.
- Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
- Center for Critical Care Nephrology, The CRISMA Center, Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Academy of Science, Royal Society of Thailand, Bangkok, Thailand.
- Excellence Center for Critical Care Nephrology, Thai Red Cross Society, King Chulalongkorn Memorial Hospital, 1873, Rama 4 Rd., Lumphini, Pathumwan, Bangkok, 10330, Thailand.
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Arkell P, Angelina J, do Carmo Vieira A, Wapling J, Marr I, Monteiro M, Matthews A, Amaral S, da Conceicao V, Kim SH, Bailey D, Yan J, Fancourt's NSS, Vaz Nery S, Francis JR. Integrated serological surveillance of acute febrile illness in the context of a lymphatic filariasis survey in Timor-Leste: a pilot study using dried blood spots. Trans R Soc Trop Med Hyg 2021; 116:531-537. [PMID: 34850241 PMCID: PMC9157677 DOI: 10.1093/trstmh/trab164] [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: 09/03/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background Acute febrile illnesses (AFIs), including dengue, scrub typhus and leptospirosis, cause significant morbidity and mortality in Southeast Asia. Serological surveillance can be used to investigate the force and distribution of infections. Dried blood spot (DBS) samples are an attractive alternative to serum because they are easier to collect and transport and require less cold storage. We conducted a pilot study to determine the feasibility of integrating serological surveillance for dengue, scrub typhus and leptospirosis into a population-representative lymphatic filariasis seroprevalence survey in Timor-Leste using DBSs. Methods A total of 272 DBSs were collected from healthy community participants. DBSs were analysed at the National Health Laboratory using commercially available enzyme-linked immunosorbent assays. To validate assays for DBSs, 20 anonymised serum samples of unknown serostatus were used to create dried serum spots (DSSs). These were analysed with optical densities compared with those of serum. Where low variance was observed (dengue assay) the published kit cut-offs for serum were applied to the analysis of DBSs. For the other assays (scrub typhus and leptospirosis), index values (IVs) were calculated and cut-offs were determined to be at 2 standard deviations (SDs) above the mean. Results Of the 272 samples analysed, 19 (7.0% [95% confidence interval {CI} 4.3 to 10.7]) were positive for dengue immunoglobulin G (IgG), 11 (4.0% [95% CI 2.1 to 7.1]) were positive for scrub typhus IgG and 16 (5.9% [95% CI 3.4 to 9.4%]) were positive for leptospira IgG. Conclusions While dengue seroprevalence was lower than in nearby countries, results represent the first evidence of scrub typhus and leptospirosis transmission in Timor-Leste. Integrated programmes of serological surveillance could greatly improve our understanding of infectious disease epidemiology in remote areas and would incur minimal additional fieldwork costs. However, when planning such studies, the choice of assays, their validation for DBSs and the laboratory infrastructure and technical expertise at the proposed location of analysis must be considered.
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Affiliation(s)
- Paul Arkell
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Imperial College London, London, UK
| | | | | | - Johanna Wapling
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Ian Marr
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Merita Monteiro
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Ministry of Health, Dili, Timor-Leste
| | | | - Salvador Amaral
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Virginia da Conceicao
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,National Health Laboratory, Dili, Timor-Leste
| | | | - Daniel Bailey
- Rare and Imported Pathogens Laboratory, Porton Down, UK
| | - Jennifer Yan
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Royal Darwin Hospital, Darwin, NT, Australia
| | | | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Joshua R Francis
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Royal Darwin Hospital, Darwin, NT, Australia
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Mohd Hanapi IR, Sahimin N, Maackara MJB, Annisa AS, Abdul Mutalib RNS, Lewis JW, Behnke JM, Lau YL, Mohd Zain SN. Prevalence of anti-Leptospira antibodies and associated risk factors in the Malaysian refugee communities. BMC Infect Dis 2021; 21:1128. [PMID: 34724919 PMCID: PMC8561983 DOI: 10.1186/s12879-021-06830-0] [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: 07/02/2021] [Accepted: 10/28/2021] [Indexed: 12/03/2022] Open
Abstract
Background Refugees in Malaysia, who are afflicted by poverty, conflict and poor health, are vulnerable to a range of zoonotic infections in the deprived environmental and social conditions under which they live. Exposure to infections such as leptospirosis, for which rodents are primary hosts, is of particular concern. Methods A wellness program was conducted to determine the presence of antibodies against Leptospira (seroprevalence) in 11 refugee community schools and centers in the Klang Valley, Malaysia. A total of 433 samples were assessed for IgG and IgM antibodies against Leptospira, using enzyme-linked immunosorbent assays (ELISA). Results Overall Leptospira seroprevalence was 24.7%, with 3.0% being seropositive for anti-Leptospira IgG and 21.7% for anti-Leptospira IgM. Factors significantly associated with overall Leptospira seroprevalence included: age, ethnicity, pet ownership, knowledge of disease and awareness of disease fatality. For IgM seroprevalence, significant risk factors included sex, ethnicity, eating habits with hands, pet ownership, the presence of rats, walking in bare feet and water recreation visits. Conclusions These findings highlight the need for improvements in health and well-being among the refugee community through disease awareness programs and provision of healthy behavior programs, particularly in hygiene and sanitation through community engagement activities.
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Affiliation(s)
- Izzah Ruzana Mohd Hanapi
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norhidayu Sahimin
- Tropical Infectious Diseases Research and Education Centre (TIDREC), Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | | | - Aufa Shofia Annisa
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Raisya Nur Syazmeen Abdul Mutalib
- Department of Biomedical Science, Kulliyah of Allied Health Science, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - John W Lewis
- School of Biological Sciences, Royal Holloway, University of London, Egham, Surrey, TW20 OEX, UK
| | - Jerzy M Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Yee Ling Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Siti Nursheena Mohd Zain
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
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Chirathaworn C, Janwitthayanan W, Suputtamongkol Y, Poovorawan Y. Leptospira collagenase and LipL32 for antibody detection in leptospirosis. J Immunol Methods 2021; 499:113168. [PMID: 34673004 DOI: 10.1016/j.jim.2021.113168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 09/21/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Abstract
Various Leptospira components have been identified as candidate antigens for the detection of antibody to Leptospira. LipL32 is a Leptospira membrane protein which has been widely studied. The report of Leptospira whole-genome sequencing demonstrated that pathogenic Leptospira contained the nucleotide sequence (colA gene) coding for the collagenase. Expression of ColA protein and its enzymatic activity was demonstrated. In this study, cloned ColA protein, in comparison with LipL32, was used as an antigen for antibody detection. Thirty pairs of sera from human leptospirosis patients were tested. Sera from blood donors, and patients with scrub typhus and dengue virus infection (20 samples from each group) were tested for the specificity. All sera from leptospirosis patients tested in this study reacted with both ColA and LipL32 proteins. Sera from blood donors, patients with scrub typhus and dengue virus infection did not react with ColA protein. Data suggested that sensitivity and specificity of ColA protein for Leptospira antibody detection were 100%. In addition, ColA protein showed higher specificity than LipL32. Our data suggested that ColA protein could be another candidate antigen for antibody detection in leptospirosis diagnosis.
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Affiliation(s)
- Chintana Chirathaworn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand; Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Weena Janwitthayanan
- Master of Science Program in Medical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Dhewantara PW, Zhang W, Al Mamun A, Yin WW, Ding F, Guo D, Hu W, Soares Magalhães RJ. Spatial distribution of leptospirosis incidence in the Upper Yangtze and Pearl River Basin, China: Tools to support intervention and elimination. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 725:138251. [PMID: 32298905 DOI: 10.1016/j.scitotenv.2020.138251] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 03/14/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Since 2011 human leptospirosis incidence in China has remained steadily low with persistent pockets of notifications reported in communities within the Upper Yangtze River Basin (UYRB) and Pearl River Basin (PRB). To help guide health authorities within these residual areas to identify communities where interventions should be targeted, this study quantified the local effect of socioeconomic and environmental factors on the spatial distribution of leptospirosis incidence and developed predictive maps of leptospirosis incidence for UYRB and PRB. METHODS Data on all human leptospirosis cases reported during 2005-2016 across the UYRB and PRB regions were geolocated at the county-level and included in the analysis. Bayesian conditional autoregressive (CAR) models with zero-inflated Poisson link for leptospirosis incidence were developed after adjustment of environmental and socioeconomic factors such as precipitation, normalized difference vegetation index (NDVI), modified normalized difference water index (MNDWI), land surface temperature (LST), elevation, slope, land cover, crop production, livestock density, gross domestic product and population density. RESULTS The relationship of environmental and socioeconomic variables with human leptospirosis incidence varied between both regions. While across UYRB incidence of human leptospirosis was associated with MNDWI and elevation, in PRB human leptospirosis incidence was significantly associated with NDVI, livestock density and land cover. Precipitation was significantly and positively associated with the spatial variation of incidence of leptospirosis in both regions. After accounting for the effect of environmental and socioeconomic factors, the predicted distribution of residual high-incidence county is potentially more widespread both in the UYRB and PRB compared to the observed distribution. In the UYRB, the highest predicted incidence was found along the border of Chongqing and Guizhou towards Sichuan basin and northwest Yunnan. The highest predicted incidence was also identified in counties in the central and lower reaches of the PRB. CONCLUSIONS This study demonstrated significant geographical heterogeneity in leptospirosis incidence within UYRB and PRB, providing an evidence base for prioritising targeted interventions in counties identified with the highest predicted incidence. Furthermore, environmental drivers of leptospirosis incidence were highly specific to each of the regions, emphasizing the importance of localized control measures. The findings also suggested the need to expand interventional coverage and to support surveillance and diagnostic capacity on the predicted high-risk areas.
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Affiliation(s)
- Pandji Wibawa Dhewantara
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; Pangandaran Unit of Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, West Java 46396, Indonesia.
| | - Wenyi Zhang
- Center for Disease Control and Prevention of PLA, Beijing 100071, People's Republic of China.
| | - Abdullah Al Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD 4068, Australia.
| | - Wen-Wu Yin
- Chinese Center for Disease Control and Prevention, Beijing 102206, People's Republic of China.
| | - Fan Ding
- Chinese Center for Disease Control and Prevention, Beijing 102206, People's Republic of China.
| | - Danhuai Guo
- Scientific Data Center, Computer Network Information Center, Chinese Academy of Sciences, Beijing 100190, People's Republic of China.
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
| | - Ricardo J Soares Magalhães
- School of Veterinary Science, The University of Queensland, Gatton, Queensland 4343, Australia; Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD 4101, Australia.
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