Clinical features of leptospirosis: a prospective descriptive study at the National Hospital of Sri Lanka (NHSL) in 2007

Gunawardhana, S A C U; Sellahewa, Kolitha H.

doi:10.4038/cmj.v53i4.293

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…Interestingly, pulmonary hemorrhage and other pulmonary complications were not observed among these confirmed cases. Previous studies in the National 30 and at Peradeniya Hospital (Central Province) at least 6-8 deaths because of pulmonary hemorrhage during this study period were attributed to leptospirosis. 32 This finding could be caused by varying virulence of infecting serovars in different studies.…”

Section: Discussionmentioning

confidence: 48%

“…In some studies, rates of renal complications are as high as 44-67% 27 whereas most studies report a range of renal complications ranging from 10% to 40%. 17,28,29 In previously reported studies in Sri Lanka, renal complication rates ranged from 25% 30 to 70%. 31 The most probable explanation for the low complication rates is that the present study involved active case finding, which resulted in detecting mildto-moderate cases, which could have missed in routine clinical practice.…”

Section: Discussionmentioning

confidence: 97%

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Leptospirosis Outbreak in Sri Lanka in 2008: Lessons for Assessing the Global Burden of Disease

Agampodi¹,

Peacock²,

Thevanesam³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. Global leptospirosis disease burden estimates are hampered by the lack of scientifically sound data from countries with probable high endemicity and limited diagnostic capacities. We describe the seroepidemiologic and clinical characteristics of the leptospirosis outbreak in 2008 in Sri Lanka. Definitive/presumptive case definitions proposed by the World Health Organization Leptospirosis Epidemiology Reference Group were used for case confirmation. Of the 404 possible cases, 155 were confirmed to have leptospirosis. Highest titers of patient seum samples reacted with serovars Pyrogenes (28.7%), Hardjo (18.8%), Javanica (11.5%), and Hebdomadis (11.5%). Sequencing of the 16S ribosomal DNA gene identified six infections: five with Leptospira interrogans and one with L. weilli . In this patient population, acute renal failure was the main complication (14.8%), followed by myocarditis (7.1%) and heart failure (3.9%). The case-fatality rate was 1.3%. This report strengthens the urgent need for increasing laboratory diagnostic capabilities to determine the causes of epidemic and endemic infectious diseases in Sri Lanka, a finding relevant to other tropical regions.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 97%

Leptospirosis Outbreak in Sri Lanka in 2008: Lessons for Assessing the Global Burden of Disease

Agampodi¹,

Peacock²,

Thevanesam³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…Leptospiruria coincides with the immune phase which begins with the appearance of IgM antibodies. 15 IgM based serology is of diagnostic value during this phase. Many rapid serodiagnostic assays are available, such as IgM based microplate enzyme-linked immunosorbant assay (ELISA), IgM dot ELISA test, IgM dipstick, latex agglutination test and haemagglutination assay.…”

Section: Evaluation Of Two Rapid Diagnostic Tests For Leptospirosismentioning

confidence: 99%

Leptospirosis: challenges in diagnosis, and predictors of severity

Rajapakse

Fernando

Niloofa

et al. 2017

J of Cey Coll of Phy

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“…Previously, we reviewed leptospirosis in Sri Lanka and explained the need for confirmation of this outbreak through laboratory confirmation and the importance of investigating this probable leptospirosis outbreak[12]. However, studies on the epidemiology and determinants of local disease transmission are lacking, whereas clinical manifestations are discussed in several papers[13-15]. …”

Section: Introductionmentioning

confidence: 99%

Determinants of leptospirosis in Sri Lanka: Study Protocol

2010

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BackgroundLeptospirosis is becoming a major public health threat in Sri Lanka as well as in other countries. We designed a case control study to determine the factors associated with local transmission of leptospirosis in Sri Lanka, in order to identify major modifiable determinants of leptospirosis. The purpose of this paper is to describe the study protocol in detail prior to the publishing of the study results, so that the readership will be able to understand and interpret the study results effectively.MethodsA hospital based partially matched case control design is proposed. The study will be conducted in three selected leptospirosis endemic districts in central Sri Lanka. Case selection will include screening all acute fever patients admitted to selected wards to select probable cases of leptospirosis and case confirmation using an array of standard laboratory criteria. Age and sex matched group of acute fever patients with other confirmed diagnosis will be used as controls. Case to control ratio will be 1:2. A minimum sample of 144 cases is required to detect 20% exposure with 95% two sided confidence level and 80% power. A pre tested interviewer administered structured questionnaire will be used to collect data from participants. Variables included in the proposed study will be evaluated using conceptual hierarch of variables in three levels; Exposure variables as proximal; reservoir and environmental variables as intermediate; socio-demographic variables as distal. This conceptual hierarch hypothesised that the distal and intermediate variables are mediated through the proximal variables but not directly. A logistic regression model will be used to analyse the probable determinants of leptospirosis. This model will evaluate the effect of same level and upper level variables on the outcome leptospirosis, using three blocks.DiscussionThe present national control programme of leptospirosis is hampered by lack of baseline data on leptospirosis disease transmission. The present study will be able to provide these essential information for formulation of better control strategies.

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Clinical features of leptospirosis: a prospective descriptive study at the National Hospital of Sri Lanka (NHSL) in 2007

Cited by 6 publications

References 2 publications

Leptospirosis Outbreak in Sri Lanka in 2008: Lessons for Assessing the Global Burden of Disease

Leptospirosis Outbreak in Sri Lanka in 2008: Lessons for Assessing the Global Burden of Disease

Leptospirosis: challenges in diagnosis, and predictors of severity

Determinants of leptospirosis in Sri Lanka: Study Protocol

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