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Microhabitat Factors Influenced the Prevalence of Pathogenic Leptospira spp. in Small Mammal Host

Yusof MA, Mohd-Taib FS, Ishak SN, Md-Nor S, Md-Sah SA, Mohamed NZ, et al.

Ecohealth, 2019 06;16(2):260-274.
PMID: 31124020 DOI: 10.1007/s10393-019-01419-1

Leptospirosis, a widespread zoonotic disease, is a public health problem, especially in major urban centres, and is mainly reported to be associated with rats. In Malaysia, focus has been primarily given to the Leptospira prevalence in rodents per se, but there is lack of information on the microhabitat structure of the outbreak areas. We aimed to determine the diversity of small mammal species, microhabitat types, and their prevalence of pathogenic Leptospira spp. in the outbreak areas, which were categorized as urban, semi-urban, and recreational forests. Sampling involved deploying 100 to 300 live traps at each study site. Kidney samples were extracted from selected individuals, for screening of pathogenic Leptospira spp. by PCR. Out of 537 individuals from 15 small mammal species captured, 4 species were recorded from urban, 13 from semi-urban, and 11 from recreational forest sites. From 389 individuals screened, 58 were tested positive for pathogenic Leptospira. Recreational forests recorded the highest prevalence with 19.4% (n = 93), followed by urban, 16.6% (n = 163) and semi-urban sites with 9.8% (n = 133). Seven rodent species were tested positive for pathogenic Leptospira from all areas. R. norvegicus was found to harbour the highest prevalence (66.7%) in urban, R. rattus (53.8%) in semi-urban, whereby M. whiteheadi (44.4%) in recreational forest sites. Microhabitat analysis revealed that rubbish quantity contributed especially strongly to a high prevalence of Leptospira. This study contributes to understanding of the host and microhabitat preferences of Leptospira, which is important in controlling the spread of this disease in human's landscapes.

Matched MeSH terms: Leptospirosis/epidemiology
Fulltext Elevated levels of IL-8 in fatal leptospirosis

Wan Yusoff WSY, Abdullah M, Sekawi Z, Amran F, Yuhana MY, Mohd Taib N, et al.

Pathog Glob Health, 2020 03;114(2):99-103.
PMID: 32024441 DOI: 10.1080/20477724.2020.1724356

Leptospirosis causes a wide range of clinical outcomes, including organ failure and death. Early treatment significantly increases the chances of cure. Interleukin-8 (IL-8) is a chemoattractant cytokine for neutrophil and is associated with multiple organ failure. Research has indicated IL-8 to be raised in severe and fatal cases of leptospirosis, but its suitability as a prognostic biomarker has yet to be confirmed. This study aimed to evaluate the significance of IL-8 with the clinical outcomes of leptospirosis patients. Plasma IL-8 was measured in fifty-two samples from hospitalized patients and nineteen healthy controls. The comparisons were made between mild, severe-survived and fatal groups identified by clinical or laboratory findings. IL-8 was significantly higher in fatal (p = 0.01) compared to mild cases. IL-8 was also significantly higher in fatal (p = 0.02) when compared to survived cases of leptospirosis. IL-8 levels in the plasma of fatal leptospirosis cases were significantly elevated compared to survived cases and may serve as a potential prognostic biomarker in determining the possible outcome of leptospirosis patients.

Matched MeSH terms: Leptospirosis/epidemiology
Leptospira brings fresh challenge to adventure sports

Trubo R

Lancet Infect Dis, 2001 Sep;1(2):73.
PMID: 11871475
Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext Clinical aspect of leptospirosis in Malaya

Trimble AP

Proc. R. Soc. Med., 1957 Feb;50(2):125-8.
PMID: 13408224
Matched MeSH terms: Leptospirosis/epidemiology*
A preliminary study of the status of leptospirosis in the Malaysian Armed forces

Tan DS, Lopes DA

Southeast Asian J. Trop. Med. Public Health, 1972 Jun;3(2):208-11.
PMID: 5082848
Matched MeSH terms: Leptospirosis/epidemiology*
Occupational distribution of leptospiral (SEL) antibodies in West Malaysia

Tan DS

Med J Malaysia, 1973 Jun;27(4):253-7.
PMID: 4270781
Matched MeSH terms: Leptospirosis/epidemiology*
Leptospirosis in rural West Malaysia

Tan DS

Med J Malaya, 1970 Jun;24(4):261-6.
PMID: 4248346
Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext Leptospirosis in West Malaysia--epidemiology and laboratory diagnosis

Tan DS

Malays J Pathol, 1979 Aug;2:1-6.
PMID: 263416
Matched MeSH terms: Leptospirosis/epidemiology*
Acute febrile illnesses in Malaya: leptospirosis

TURNER LH, ELISBERG BL, SMITH CE, BROOM JC

Med J Malaya, 1959 Dec;14:83-98.
PMID: 13839948
Matched MeSH terms: Leptospirosis/epidemiology*
Serological Prevalence of Leptospirosis Among Rural Communities in the Rejang Basin, Sarawak, Malaysia

Suut L, Mazlan MN, Arif MT, Yusoff H, Abdul Rahim NA, Safii R, et al.

Asia Pac J Public Health, 2016 07;28(5):450-7.
PMID: 27183976 DOI: 10.1177/1010539516648003

Leptospirosis is an important zoonotic disease globally and is endemic in Malaysia. A study was conducted in the Rejang basin of Sarawak from June 2011 to May 2013 to determine the seroprevalence of leptospirosis among the communities and dominant infecting Leptospira serovars. A total of 508 human sera were analyzed using ELISA and the microscopic agglutination test (MAT). The seroprevalence of leptospirosis in the study area was 37.4%, with the highest prevalence in Kapit division. More women were positive for leptospirosis (59.5%), and the mean age of seropositive individuals was 42.2 (SD = 18.7) years. Antibody titers between 1:50 and 1:1600 were reported, and serovars djasiman (22.1%), shermani (13.2%), and pomona (7.9%) predominated, with varied distribution between geographical locations. This study highlighted the endemicity and diversity of existing Leptospira serovars within the community. This information should be communicated to local health personnel and communities at risk, and rapid diagnostic capability should be made available to local health facilities.

Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext Leptospirosis in the Malaysian army

Supramaniam V

Malays J Pathol, 1979 Aug;2:11-4.
PMID: 263417
Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever - a pilot study

Suppiah J, Chan SY, Ng MW, Khaw YS, Ching SM, Mat-Nor LA, et al.

J Biomed Sci, 2017 Jun 28;24(1):40.
PMID: 28659189 DOI: 10.1186/s12929-017-0344-x

BACKGROUND: Dengue and leptospirosis infections are currently two major endemics in Malaysia. Owing to the overlapping clinical symptoms between both the diseases, frequent misdiagnosis and confusion of treatment occurs. As a solution, the present work initiated a pilot study to investigate the incidence related to co-infection of leptospirosis among dengue patients. This enables the identification of more parameters to predict the occurrence of co-infection.
METHOD: Two hundred sixty eight serum specimens collected from patients that were diagnosed for dengue fever were confirmed for dengue virus serotyping by real-time polymerase chain reaction. Clinical, laboratory and demographic data were extracted from the hospital database to identify patients with confirmed leptospirosis infection among the dengue patients. Thus, frequency of co-infection was calculated and association of the dataset with dengue-leptospirosis co-infection was statistically determined.
RESULTS: The frequency of dengue co-infection with leptospirosis was 4.1%. Male has higher preponderance of developing the co-infection and end result of shock as clinical symptom is more likely present among co-infected cases. It is also noteworthy that, DENV 1 is the common dengue serotype among all cases identified as dengue-leptospirosis co-infection in this study.
CONCLUSION: The increasing incidence of leptospirosis among dengue infected patients has posed the need to precisely identify the presence of co-infection for the betterment of treatment without mistakenly ruling out either one of them. Thus, anticipating the possible clinical symptoms and laboratory results of dengue-leptospirosis co-infection is essential.

Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext A qualitative exploration of the misconceptions, knowledge gaps and constructs of leptospirosis among rural and urban communities in Malaysia

Sukeri S, Idris Z, Zahiruddin WM, Shafei MN, Idris N, Hamat RA, et al.

PLoS One, 2018;13(7):e0200871.
PMID: 30021013 DOI: 10.1371/journal.pone.0200871

This qualitative study aimed to explore the misconceptions, knowledge gaps and constructs of leptospirosis among 72 respondents from rural and urban districts in two states of Malaysia. We conducted focus group discussions and data were examined using thematic analyses. The layman term of 'rat urine disease' contributed the most to the misconceptions regarding leptospirosis. There were gaps in the knowledge among urban and rural respondents in the two states, with the majority of subjects demonstrating a poor understanding of the disease. Construction of knowledge about leptospirosis relied mostly on the information provided by mass and social media; reading materials; word-of-mouth publicity; observations; experiences; and knowledge sharing among families, friends, and communities. The study findings may provide the foundation for the development of educational materials that may reduce the gaps in knowledge, and thereby improve health literacy and enhance preventive health behaviours for avoiding leptospirosis.

Matched MeSH terms: Leptospirosis/epidemiology*
Update: Outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000

Stone SC, McNutt E

Ann Emerg Med, 2001 Jul;38(1):83-4.
PMID: 11423818
Matched MeSH terms: Leptospirosis/epidemiology*
Leptospirosis: Increasing importance in developing countries

Soo ZMP, Khan NA, Siddiqui R

Acta Trop, 2020 Jan;201:105183.
PMID: 31542372 DOI: 10.1016/j.actatropica.2019.105183

Leptospirosis is a zoonotic disease caused by the pathogenic helical spirochetes, Leptospira. Symptoms include sudden-onset fever, severe headaches, muscle pain, nausea and chills. Leptospirosis is endemic in developing countries such as Malaysia, India, Sri Lanka, and Brazil where thousands of cases are reported annually. The disease risk factors include the high population of reservoirs, environmental factors, recreational factors, and occupational factors. To end the endemicity of leptospirosis, these factors need to be tackled. The management of leptospirosis needs to be refined. Early diagnosis remains a challenge due to a lack of clinical suspicion among physicians, its non-specific symptoms and a limited availability of rapid point-of-care diagnostic tests. The purpose of this review is to provide insight into the status of leptospirosis in developing countries focusing on the risk factors and to propose methods for the improved management of the disease.

Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext Knowledge, Attitude, and Practices regarding Leptospirosis among Visitors to a Recreational Forest in Malaysia

Shafie NJ, Abdul Halim NS, Nor Zalipah M, Mohd Amin NAZ, Syed Esa SM, Md-Nor S, et al.

Am J Trop Med Hyg, 2021 Jan 18;104(4):1290-1296.
PMID: 33534768 DOI: 10.4269/ajtmh.20-0306

Leptospirosis is a zoonotic disease and a worldwide public health problem that affects mainly high-risk groups. Characterizing knowledge, attitude, and practice (KAP) among high-risk groups is important to develop appropriate prevention programs. Here, we performed a cross-sectional study among 300 visitors of a recreational forest in Malaysia to examine leptospirosis KAP and demographics. These variables were integrated to create knowledge and practice scores for each respondent. All respondents had heard about leptospirosis, and 87% of them correctly identified it as a disease. The majority of respondents had high knowledge (63%), positive attitude, and good practice (68%) toward prevention of the disease. However, there were gaps in knowledge, with 78% of the respondents indicating eating without washing hands as the major cause of leptospirosis transmission. Our final model identified that higher knowledge score was associated with higher practice score. Our results indicate that it is important to increase knowledge, especially on transmission routes of leptospirosis, among visitors in recreational areas. Moreover, more attention needs to be paid to promote good practice habits among visitors, targeting those at higher risk of being infected by leptospirosis to prevent potential outbreaks in the recreational areas.

Matched MeSH terms: Leptospirosis/epidemiology*
Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000

Sejvar J, Bancroft E, Winthrop K, Bettinger J, Bajani M, Bragg S, et al.

Emerg Infect Dis, 2003 Jun;9(6):702-7.
PMID: 12781010

Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.

Matched MeSH terms: Leptospirosis/epidemiology*
Seroprevalence of leptospiral antibodies among market workers and food handlers in the central state of Malaysia

Samsudin S, Sakinah SNS, Malina O, Norliza BA, Noh MA, Fairuz A, et al.

Trop Med Int Health, 2018 03;23(3):327-333.
PMID: 29356240 DOI: 10.1111/tmi.13033

OBJECTIVE: The high prevalence of leptospirosis in humans is of great public health concern, particularly in tropical and subtropical regions. This study aimed to determine the seroprevalence of leptospiral antibodies and distribution of serovars, and to assess the usefulness of enzyme-linked immunosorbent assay (ELISA) as a screening method for leptospiral antibodies in a high-risk healthy community.
METHODS: Cross-sectional study of 231 market workers and food handlers in wet markets and food premises from two localities in central Malaysia. Respondents' background information was obtained using a questionnaire. Serum samples were tested for leptospiral antibodies using ELISA and microscopic agglutination test (MAT).
RESULTS: Seroprevalence of leptospirosis among healthy workers was 46.3%. Detection of seropositivity was higher by MAT (46%) than ELISA (15%). We observed high seropositivity among local workers (49%), food handlers (49.5%), females (60.8%) and those aged 34 years and older (46.3%). Local strain LEP175 was the predominant serovar, followed by WHO strain Patoc.
CONCLUSION: Overall seroprevalence among healthy food handlers and market workers was high in this study. The workplace places susceptible individuals at risk of leptospirosis.

Matched MeSH terms: Leptospirosis/epidemiology
Fulltext Seroprevalence of Anti-Leptospira IgG and IgM Antibodies and Risk Assessment of Leptospirosis among Urban Poor Communities in Kuala Lumpur, Malaysia

Sahimin N, Sharif SA, Mohd Hanapi IR, Nai Chuan S, Lewis JW, Douadi B, et al.

Am J Trop Med Hyg, 2019 12;101(6):1265-1271.
PMID: 31628737 DOI: 10.4269/ajtmh.19-0003

Leptospirosis is a zoonotic bacterial disease caused by pathogenic species of the genus Leptospira. Disease incidence is known to be attributed to environmental and social conditions which promote the spread of reservoir hosts, primarily rodents. A well-being program was conducted to determine the seroprevalence and risk factors associated with leptospirosis in urban poor communities occupying low-cost flat accommodation and squatter settlements in the vicinity of Wilayah Persekutuan, Kuala Lumpur. Blood samples from a total of 532 volunteers were screened for the detection of IgG and IgM antibodies against leptospirosis using ELISA. Demographic data were collected for each participant through a questionnaire survey before blood collection. The overall seroprevalence was low (12.6%, n = 67/532; 95% CI: 9.9-15.7%), with 8.1% (n = 43/532) being seropositive for anti-Leptospira IgG, indicating previous infection, and 4.9% (n = 26/532) for anti-Leptospira IgM, indicating current infection. Two significant factors such as host age (P ≤ 0.01) and knowledge of disease transmission (P = 0.017) significantly influenced the presence of anti-Leptospira IgM, whereas the detection of anti-IgG indicated the presence of clean drinking water sources (P = 0.043). Despite the low prevalence, the transmission of leptospirosis does occur among urban poor communities, suggesting the need for undertaking public awareness programs.

Matched MeSH terms: Leptospirosis/epidemiology*
Fulltext A low molecular weight lipopolysaccharide antigen preparation reactive to acute leptospirosis heterologous sera

Riazi M, Abdul Rani B, Fairuz A, Zainul FZ

Trop Biomed, 2010 Aug;27(2):241-53.
PMID: 20962722 MyJurnal

There is a need for identification of new infection markers against common Leptospira isolates in Malaysia. To achieve this goal, seven-day-old cultures of Leptospira interrogans serogroup Icterohemorrhagiae (L44) and Leptospira interrogans serogroup Javanica (L55) were used for antigen preparation by sequential extraction method using 40 mM Tris, 8M Urea and 2M thiourea. Immunoblot analysis of the antigens were performed using serum samples from 46 local patients with confirmed acute leptospirosis, 28 patients with other infections and 14 healthy controls. The patients serum samples used in this study contained heterologous antibody against a number of different leptospira serovars. A strong IgM reactivity to a broad diffuse band of 10-15 kDa was observed. Combining results using L44 and L55 antigens showed sensitivity of 80.4% and specificity of 95.2% for detection of leptospirosis. Proteinase K and periodate treatment indicated that the band is likely to be lipopolysaccharide (LPS) in nature. This study showed that the 10-15 kDa antigen could potentially be useful for serodiagnosis of acute leptospirosis in Malaysia.

Matched MeSH terms: Leptospirosis/epidemiology

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