Leptospirosis y rickettsiosis, reto diagnóstico para el síndrome febril en zonas endémicas

García, René Ramírez; Quintero, Juan Carlos; Rosado, Aixa Paola; Arboleda, Margarita; González, Víctor Alejandro; Agudelo‐Flórez, Piedad

doi:10.7705/biomedica.5598

Cited by 6 publications

(7 citation statements)

References 20 publications

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“…The concomitant seroprevalent and seroincident findings provide evidence of individuals in Urabá, Colombia, who have been exposed to both microorganisms without developing overt clinical disease or being diagnosed. Our result carries important public health implications, as clinical case reports have indicated that individuals susceptible to concurrent infections by rickettsioses and leptospirosis may experience more severe clinical manifestations and potentially fatal outcomes( 18 , 22 ).…”

Section: Discussionmentioning

confidence: 80%

Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia.

Torres-Bustamante,

Cantillo-Barraza,

et al. 2024

Preprint

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Rickettsioses and leptospirosis are infectious diseases that are often underdiagnosed due to a lack of knowledge about their epidemiology, pathophysiology, diagnosis, management, among others. Objetive: to characterize the seroprevalence and seroincidence of both Rickettsia and Leptospira agents and determine the risk factors for these outcomes in rural areas of Urabá, Antioquia. Methods: a secondary data analysis using information on Rickettsia and Leptospira exposure from a prior prospective study that explored sociocultural and ecological aspects of Rickettsia infection in rural Urabá, Colombia. A multinomial mixed logistic regression model was employed to analyze factors linked to seroprevalent cases of Rickettsia, Leptospira and both, along with descriptive analyses of seroincident cases. Results: the concomitant seroprevalence against Rickettsiaand Leptospira was 9.38% [95%CI 6.08%-13.37%] (56/597). The factors associated with this seroprevalence were age (ORa= 1.02 [95%CI 1.007–1.03]), male gender (ORa= 3.06 [95%CI 1.75–5.37]), fever history (ORa= 1.71 [95%CI 1.06–2.77]) the presence of breeding pigs (ORa= 2.29 [95%CI 1.36–3.88]), peridomicile yucca crops(ORa= 2.5 [95%CI 1.1–5.62]), and deforestation practices(ORa= 1.74 [95%CI 1.06–2.87]). The concomitant seroincidence against Rickettsia and Leptospira was 1.09% (3/274) [95%CI 0.29%-4.05%], three cases were female, with a median age of 31.83 years-old (IQR 8.69–56.99). At the household level, all the seroincident cases had households built partially or totally with soil floors, wooden walls, and zinc roofs. Two seroincident cases described the presence of equines, canines, and domestic chickens in intra or peri-domicile. Finally, two cases were exposed to synanthropic rodents, and one case to tick infestation. Conclusion: there is evidence of seroprevalent and seroincident cases of seropositivity against both Rickettsia and Leptospira in rural areas of Urabá, Colombia. These findings can help improve public health surveillance systems in preventing, detecting, and attending to the different clinical cases caused by these pathogens.

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Section: Discussionmentioning

confidence: 80%

Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia.

Torres-Bustamante,

Cantillo-Barraza,

et al. 2024

Preprint

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“…Cardona-Ospina et al ., presented cases indicating that concurrent viral co-infections with leptospirosis might have contributed to fatal outcomes [ 68 ]. Similarly, Ramírez-García R et al [ 67 ] reported a case of concurrent leptospirosis and rickettsiosis infection in a patient with a high-risk occupational history in an endemic area for tropical diseases. The patient exhibited progressive and ultimately fatal clinical symptoms [ 67 ].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, Ramírez-García R et al [ 67 ] reported a case of concurrent leptospirosis and rickettsiosis infection in a patient with a high-risk occupational history in an endemic area for tropical diseases. The patient exhibited progressive and ultimately fatal clinical symptoms [ 67 ]. Consequently, leptospirosis should be considered as a potential cause of the febrile syndrome, not only as an isolated agent but also as a possible co-infection that can have serious implications for patient health and may be associated with increased mortality rates [ 30 , 65 , 67 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

“…The patient exhibited progressive and ultimately fatal clinical symptoms [ 67 ]. Consequently, leptospirosis should be considered as a potential cause of the febrile syndrome, not only as an isolated agent but also as a possible co-infection that can have serious implications for patient health and may be associated with increased mortality rates [ 30 , 65 , 67 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

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Fatal acute undifferentiated febrile illness among clinically suspected leptospirosis cases in Colombia, 2016–2019

Parra Barrera,

Reales-González,

Salas

et al. 2023

PLoS Negl Trop Dis

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Background Acute undifferentiated febrile illness is a common challenge for clinicians, especially in tropical and subtropical countries. Incorrect or delayed diagnosis of febrile patients may result in medical complications or preventable deaths. Common causes of acute undifferentiated febrile illness in Colombia include leptospirosis, rickettsioses, dengue fever, malaria, chikungunya, and Zika virus infection. In this study, we described the acute undifferentiated febrile illness in postmortem patients reported as suspected cases of leptospirosis through the national leptospirosis surveillance in Colombia, 2016–2019. Methodology/principal findings We retrospectively analyze human fresh and formalin-fixed tissue samples from fatal suspected leptospirosis cases reported by the Public Health Laboratories in Colombia. Leptospirosis confirmation was made by immunohistochemistry, real-time polymerase chain reaction (PCR) in the tissue samples. In some cases, the serum sample was used for confirmation by Microagglutination test (MAT). Simultaneously, tissue samples were tested by PCR for the most common viral (dengue, Zika, and chikungunya), bacterial (Brucella spp., and Rickettsia spp.), and parasitic (malaria). Fresh tissue samples from 92 fatal suspected leptospirosis cases were reported to the National Reference Laboratory from 22/32 departments in Colombia. We confirmed leptospirosis in 27% (25/92) of cases. Other pathogens identified by real-time PCR were Brucella spp. (10.9%), Rickettsia spp. (14.1%), and dengue (2.2%). Dengue (6.9%), hepatitis (3.5%), and Yellow Fever cases (2.2%) were detected by the pathology. All patients were negative for chikungunya and Plasmodium spp. Most cases were classified as undifferentiated febrile illnesses (45.7%; 42/92). Conclusions/Significance This study underscores the importance of early and accurate recognition of leptospirosis to prevent mortalities. Moreover, it draws attention to the existence of other febrile syndromes in Colombia, including rickettsiosis and brucellosis, that currently lack sufficient human surveillance and regular reporting. Expanding laboratory surveillance to include viruses such as Hantavirus, Mayaro virus, Oropouche virus, and West Nile virus is crucial.

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“…Globally, tropical infectious diseases lead to melancholy of more than one billion people’s lives with one-half of deaths annually. Children are more prone to tropical infections and every year, one-third of the infected children die due to malaria [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence in differentiating tropical infections: A step ahead

et al. 2022

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Background and objective Differentiating tropical infections are difficult due to its homogenous nature of clinical and laboratorial presentations among them. Sophisticated differential tests and prediction tools are better ways to tackle this issue. Here, we aimed to develop a clinician assisted decision making tool to differentiate the common tropical infections. Methodology A cross sectional study through 9 item self-administered questionnaire were performed to understand the need of developing a decision making tool and its parameters. The most significant differential parameters among the identified infections were measured through a retrospective study and decision tree was developed. Based on the parameters identified, a multinomial logistic regression model and a machine learning model were developed which could better differentiate the infection. Results A total of 40 physicians involved in the management of tropical infections were included for need analysis. Dengue, malaria, leptospirosis and scrub typhus were the common tropical infections in our settings. Sodium, total bilirubin, albumin, lymphocytes and platelets were the laboratory parameters; and abdominal pain, arthralgia, myalgia and urine output were the clinical presentation identified as better predictors. In multinomial logistic regression analysis with dengue as a reference revealed a predictability of 60.7%, 62.5% and 66% for dengue, malaria and leptospirosis, respectively, whereas, scrub typhus showed only 38% of predictability. The multi classification machine learning model observed to have an overall predictability of 55–60%, whereas a binary classification machine learning algorithms showed an average of 79–84% for one vs other and 69–88% for one vs one disease category. Conclusion This is a first of its kind study where both statistical and machine learning approaches were explored simultaneously for differentiating tropical infections. Machine learning techniques in healthcare sectors will aid in early detection and better patient care.

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Leptospirosis y rickettsiosis, reto diagnóstico para el síndrome febril en zonas endémicas

Cited by 6 publications

References 20 publications

Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia.

Eco-epidemiological study of seropositivity against Rickettsia and Leptospira agents in rural areas of Urabá, Colombia.

Fatal acute undifferentiated febrile illness among clinically suspected leptospirosis cases in Colombia, 2016–2019

Artificial intelligence in differentiating tropical infections: A step ahead

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