2022
DOI: 10.1371/journal.pntd.0010331
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Diagnostic method-based underestimation of leptospirosis in clinical and research settings; an experience from a large prospective study in a high endemic setting

Abstract: Background Leptospirosis has globally significant human mortality and morbidity, yet estimating the clinical and public health burden of leptospirosis is challenging because timely diagnosis remains limited. The goal of the present study was to evaluate leptospirosis undercounting by current standard methods in both clinical and epidemiological study settings. Methodology/Principal findings A prospective hospital-based study was conducted in multiple hospitals in Sri Lanka from 2016 to 2019. Culture, whole b… Show more

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Cited by 15 publications
(17 citation statements)
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“…Leptospirosis has globally significant mortality and morbidity, yet the diagnosis is challenging because of the lack of ‘the diagnostic test’ which has high sensitivity and specificity [1 ▪▪ ,47 ▪▪ ].…”
Section: Challenges In the Laboratory Work Upmentioning
confidence: 99%
See 2 more Smart Citations
“…Leptospirosis has globally significant mortality and morbidity, yet the diagnosis is challenging because of the lack of ‘the diagnostic test’ which has high sensitivity and specificity [1 ▪▪ ,47 ▪▪ ].…”
Section: Challenges In the Laboratory Work Upmentioning
confidence: 99%
“…Cases missed by each method include; acute sample MAT, 80% (409/510); paired serum sample MAT, 58% (98/170); urine qPCR, 70% (153/220); and surveillance clinical case definition, 53% (265/496). Whole blood quantitative PCR (qPCR) missed 40% of cases [47 ▪▪ ]. Authors conclude that qPCR of multiple sample types should be used as a leading standard test for diagnosing acute leptospirosis [47 ▪▪ ] which is indeed not possible in primary care settings.…”
Section: Challenges In the Laboratory Work Upmentioning
confidence: 99%
See 1 more Smart Citation
“…Leptospirosis is one of the most common but potentially fatal zoonoses, caused by Leptospira species. As the clinical manifestations can be very diverse, the occurrence of this disease is underestimated [1,2], and is often misinterpreted as other causes of the febrile syndrome. Ninety percent of patients are asymptomatic or have mild symptoms, with sudden-onset fever being the most reported symptom [2].…”
Section: Introductionmentioning
confidence: 99%
“…As the clinical manifestations can be very diverse, the occurrence of this disease is underestimated [1,2], and is often misinterpreted as other causes of the febrile syndrome. Ninety percent of patients are asymptomatic or have mild symptoms, with sudden-onset fever being the most reported symptom [2]. Anicteric leptospirosis can also present with other manifestations, such as headache, myalgias, chills, abdominal pain, vomiting, diarrhea, conjunctival suffusion, and skin rash [3].…”
Section: Introductionmentioning
confidence: 99%