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Title: Environmental and behavioral risk factors for severe leptospirosis in Thailand
Authors: Soawapak Hinjoy
Somkid Kongyu
Pawinee Doung-Ngern
Galayanee Doungchawee
Soledad D. Colombe
Royce Tsukayama
Duangjai Suwancharoen
Thailand National Institute of Animal Health
University of California, Berkeley
Thailand Ministry of Public Health
Mahidol University
Weill Cornell Medical College
Keywords: Immunology and Microbiology;Medicine
Issue Date: 16-May-2019
Citation: Tropical Medicine and Infectious Disease. Vol.4, No.2 (2019)
Abstract: © 2019 by the authors. A nationwide prevention and control campaign for leptospirosis in Thailand has led to a decreased incidence rate, but the mortality and case fatality rates have remained stable. Regarding the limited knowledge of risk factors, a case-control study of the association between environmental and behavioral exposure with severe leptospirosis was implemented to identify the risk factors among adults in Thailand. The study was conducted in 12 hospital-based sites. Hospitalized patients with suspected clinical symptoms of leptospirosis were tested for leptospirosis by culture, loop mediated isothermal amplification (LAMP), real-time PCR, and the microscopic agglutination test (MAT). All participants answered a standardized questionnaire about potential risk factors. Risk factors were identified by univariable and multivariable logistic regression. Of the 44 confirmed cases, 33 (75.0%) presented with severe illness, as determined by clinical criteria, and were categorized as severe cases. Non-severe cases were defined as patients with non-severe symptoms of leptospirosis. Living nearby a rubber tree plantation (adjusted OR 11.65, 95% CI 1.08-125.53) and bathing in natural bodies of water (adjusted OR 10.45, 95% CI 1.17-93.35) were both significantly associated with an increased risk of severe leptospirosis. We recommend designating rubber plantations in Thailand as high-risk zones and closely monitoring hospitalized patients in those areas.
ISSN: 24146366
Appears in Collections:Scopus 2019

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