An Observational Study of Human Leptospirosis in Seychelles

Autor: Biscornet, Leon, de Comarmond, Jeanine, Bibi, Jastin, Mavingui, Patrick, Dellagi, Koussay, Tortosa, Pablo, Pagès, Frédéric
Přispěvatelé: 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
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
Adolescent
Seychelles
[SDV.EE.ECO]Life Sciences [q-bio]/Ecology
environment/Ecosystems
Risk Factors
Agglutination Tests
Surveys and Questionnaires
[SDV.BID.EVO] Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE]
[SDV.EE.ECO] Life Sciences [q-bio]/Ecology
environment/Ecosystems
[SDV.EE.SANT] Life Sciences [q-bio]/Ecology
environment/Health
Animals
Humans
Leptospirosis
Prospective Studies
Aged
[SDV.EE.SANT]Life Sciences [q-bio]/Ecology
environment/Health
Leptospira
Farmers
[SDV.BID.EVO]Life Sciences [q-bio]/Biodiversity/Populations and Evolution [q-bio.PE]
Incidence
Articles
Middle Aged
[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Antibodies
Bacterial
Survival Analysis
Immunoglobulin M
Cats
Cattle
Female
[SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology
Zdroj: 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⟩
ISSN: 1476-1645
0002-9637
DOI: 10.4269/ajtmh.19-0228⟩
Popis: 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.
Databáze: OpenAIRE
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