Prevalence of anti-leptospiral IgM and detection of pathogenic Leptospira species DNA in neonates presenting with clinical sepsis in Southwestern Uganda

Abstract

Background Leptospirosis is an emerging neglected zoonotic disease that presents with nonspecific signs/symptoms and it can be mistaken for other diseases. Owing to limited diagnostic capacity and unawareness, the data on human leptospirosis particularly in neonates are scarce in many sub-Saharan countries. It has been underreported hindering preventive and control measures in place. The study aimed at determining prevalence of leptospirosis as a cause of febrile illness in neonates using IgM ELISA and a quantitative real-time PCR (qPCR). Methods This was a descriptive cross-sectional study that included 103 neonatal sepsis cases whose parents/legal guardians gave informed consent. The data on demographic and clinical characteristics were collected using structured data collection form. EDTA whole blood sample was collected from the neonates by trained study nurses. From the samples, IgM ELISA was done using automated analyzers, DNA extracted and qPCR was performed using primers for LipL32, specific for the pathogenic leptospires. Results The prevalence of anti-leptospiral IgM among the neonates as determined by ELISA was 4.3%, where all of them presented with lethargy and poor feeding. No pathogenic Leptospira species DNA was amplified by qPCR. Conclusions Evidence of leptospirosis was demonstrated in neonatal sepsis cases in this study. The findings suggest considerations of leptospirosis in the differential diagnosis of neonates with sepsis. More data are needed on the real epidemiology, clinical features, and burden of leptospirosis in neonates. There is need to include intermediate pathogenic species of Leptospira in the diagnostic qPCR assays.

Public health and research ethics education: the experience of developing a new cadre of bioethicists at a Ugandan institution

“…Research ethics education keeps evolving to adapt itself to contemporary ethical dilemmas. With the new challenges in public health like the double burden of malnutrition [ 33 ], the occasional outbreaks of health emergencies and emerging and re-emerging vector-borne zoonotic diseases [ 46 , 47 ], which necessitate having specific skills for One Health approaches, the complex multi-country clinical trials [ 34 ], and some unique ethical issues with sexual minorities in Uganda with implications for public health and bioethics [ 48 ], the MUREEP was started to build multi-level research ethics capacity at MUST and in three neighboring institutions (Bishop Stuart University, BSU in Mbarara district; Kampala International University-Western Campus, KIU-WC, Ishaka in Bushenyi district; and Kabale University, KAB in Kabale district, southwestern Uganda).…”