Detection of Anti-LeptospiraIgM Antibody in Serum Samples of Suspected Patients Visiting National Public Health Laboratory, Teku, Kathmandu

Abstract

Leptospirosis is a globally distributed zoonosis with varied clinical outcomes and multiorgan involvement in humans. In this study conducted from July 2011 to December 2011, 178 serum samples from patients suspected of leptospirosis were tested by Panbio IgM ELISA at National Public Health Laboratory, Kathmandu, out of which 51 (28.65%) were positive for anti-Leptospira IgM antibody. Leptospirosis was more common in people in their 2nd and 3rd decades of their life which together comprised 56.86% of the total positive cases. Most of those tested positive were farmers followed by students and housewives. Both animal contact and water contact seemed to play significant roles in disease transmission. Symptoms were vague with the most common being fever, headache, myalgia, abdominal pain, vomiting, jaundice, and diarrhoea. Life style heavily dominated by agronomical and farming activities in Nepal is conducive to leptospirosis transmission. Leptospirosis seems to be a significant public health problem in Nepal but is underestimated. In resource poor countries like Nepal where laboratories performing MAT or maintaining cultures are rarely available, serological test like ELISA could well depict the scenario of the disease prevalence.

Seroprevalence of leptospiral antibodies among market workers and food handlers in the central state of Malaysia

“…However, current infections may not necessarily be associated with the presence of a specific IgM antibody [29]. Nonetheless, previous studies on leptospiral antibody detection in healthy populations mostly focused on detection of IgG, whereas IgM detection was mainly carried out in patients [21,23,[30][31][32][33][34][35].…”

Persistent febrile illnesses in Nepal

“…There are a few serological studies carried out in Nepal showing the presence of antibodies against major Leptospira spp. prevalent in Asia9111217181920232427 and underlining that the infection is largely underreported9. An annual incidence of 6.1 cases per 1000 population was found in a cohort of healthy volunteers17.…”

“…An annual incidence of 6.1 cases per 1000 population was found in a cohort of healthy volunteers17. Among febrile patients, seroprevalence reported in various studies ranged from 0.5 to 37 per cent (Table)9111217181920232427.…”

“…The extracted information was synthesized using narrative description. The Table shows the frequency of target conditions among febrile patients in Nepal giving overviews of available information per target condition9101112131415161718192021222324252627 and Figs 2 and 3 shows numbers of reported cases of malaria and visceral leishmaniasis over time.…”

Changing Trend of Infectious Diseases in Nepal

“…In 2000, Rai et al reported Leptospira seroprevalence rate of 32.0% among apparently healthy people with equal positive rate among males and females, and Tibeto-Burman and Indo-Aryan ethnic groups [117]. Seropositive rate among the suspected cases of leptospirosis in central Terai and in Kathmandu has been reported at 4.8% and 28.6% [118,119], respectively. However, in western Terai, among the 144 febrile cases, 21% have been reported to be positive for leptospiral antibodies (IgM) indicating the acute leptospirosis [120].…”