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Objectives: This study aimed to describe the environmental and occupational risk factors associated with human leptospirosis in Si Sa Ket. Methods: Secondary data during the 2017-2021 from the 506-surveillance report of leptospirosis to the Sisaket Provincial Public Health Office and the National Disease Surveillance System at Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Thailand. We conducted a matched case-control study in Si Sa Ket from January 2021 to December 2021. 64 cases and 128 controls were included in this study. Risk factors were identified by multivariate logistic regression. Results: The incidence of leptospirosis during the 2017-2021 period was 28.75 per 100,000 population. Seasonal variation was observed, with the highest incidence during the rainy season from August to October. Adults aged 45-54 years had the highest incidence rate. There 73.2% of the cases worked in the agricultural sector. The outcome showed the risk factors of leptospirosis associated with working in the water area without wearing boots (adjOR=2.97, 95%CI=1.38-6.40), wounded (adjOR=3.94, 95%CI=1.26-12.30) and stay long times (adjOR=2.31, 95%CI=1.02-5.24). Conclusions: To reduce the leptospirosis burden and enhanced surveillance is required to understand the epidemiology and the risk factors of leptospirosis.

Leptospirosis is an emerging public health problem in Thailand especially Si Sa Ket. The aims of this study were to determine the leptospirosis incidence and factors of death among leptospirosis patients in Si Sa Ket. This study was performed during 2010-2019 from the 506-surveillance report of leptospirosis to the Sisaket Provincial Public Health Office and the National Disease Surveillance System, Bureau of Epidemiology, Ministry of Public Health, Thailand. The data was using the definition of leptospirosis patient for disease surveillance. Multiple logistic regression analysis was performed to evaluate factors of death. A total of 3,988 cases were reported from 22 districts, mainly in rural settings. The incidence rate for leptospirosis was 27.15 per 100,000 population. The dramatic phenomenal of epidemiological characteristics of leptospirosis in Si Sa Ket include a peak incidence in August and October in association with the rainy season. Seventy-four point eight percent of subjects were male, 24.5% were aged 45-54 years and 78.3% were agricultural workers. A total number of 86 deaths were registered in 19 districts. Mortality was higher in males (80.2%). The fatality rate was 2.16%. Significant factors of death found on multiple logistic regression analysis were agricultural workers (Adjusted OR=2.51, 95% CI: 1.15-5.49) and the duration of seeking for medical care >3 days after onset (Adjusted OR=2.45, 95% CI: 1.30-4.61). To reduce the burden disease, the promotion of preventive health behavior, early recognition and treatment of patients have been shown to reduce the severity of illness and death.