Serological study of Leptospirosis in central Nepal

Abstract

<p><strong>Background: </strong>Leptospirosis, an infectious disease caused by spirochetes of the genus <em>Leptospira, </em>is the most wide-spread zoonosis in the world. Humans acquire infection through contact with the urine of infected or carrier animals, either directly or through contaminated water or soil. There are only few reports documenting the serological evidence of leptospirosis in Nepal. Thus, present study aims to determine the status of leptospirosis in central Nepal.</p><p> </p><p class="Default"><strong>Material and Methods: </strong>A descriptive cross sectional study was conducted in 1266 patients suspected of leptospirosis in Chitwan Medical College Teaching Hospital for a period of two years. Blood samples collected from the patients were processed for qualitative detection of leptospiral IgM antibody by ELISA (Enzyme linked immunosorbent assay).</p><p class="Default"><strong> </strong></p><p class="Default"><strong>Results: </strong>Of the 1266 samples subjected to ELISA, seropositivity was seen in 61 samples (4.8%) with the highest rate observed in the autumn season (63.9%) followed by summer season (21.3%). Majority (39.3%) of the seropositive individuals were agricultural workers. Leptospirosis was more common in males and in the people of 16-30 years.</p><p> </p><p><strong>Conclusion: </strong>Leptospirosis is common in central Nepal. Epidemiological surveillance and laboratory capacity across the region need strengthening to determine its true prevalence in the community.</p><p> </p><p><strong>Keywords</strong>: Leptospirosis, Central Nepal, Seropositivity<strong></strong></p

Sero-epidemiology study of leptospirosis in febrile patients from Terai region of Nepal

“…We show that a large proportion (21%) of febrile patients presenting to a Nepali hospital/clinics during summer season had serologic evidence of acute leptospirosis. A study conducted at Chitwan Medical College across 1266 patients suspected of leptospirosis revealed sero-positivity in 61 (4.8%) cases [ 21 ]. When restricted to analysis of patients presenting during the summer, their sero-positivity rate was 21.3%, which is in line with our findings.…”

“…The first report of a suspected leptospiral infection in Nepal was in a Nepali soldier in 1981 [ 17 ]. Since then, a number of serological studies have been carried out in Nepal, showing the presence of antibodies against Leptospira in a number of populations [ 18 – 21 ]. Leptospirosis is an under diagnosed disease in Nepal and easily mistaken for other febrile illnesses.…”

Persistent febrile illnesses in Nepal

“…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

“…According to review, of the 22,994 HIV patients with CD4 counts <350, but not on antiretrovirals, Fig. 6 Trend of Kala Azar cases and deaths in Nepal (2000Nepal ( -2013 [67] Pneumocystis pneumonia infections are estimated at 990 annually. Cases of oral and oesophageal candidiasis in HIV/AIDS patients were estimated at 10,347 and 2950, respectively.…”

“…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].…”