Displaying publications 61 - 80 of 181 in total

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  1. Fulltext In Vitro Anti-Leptospiral Activity of Phyllanthus amarus Extracts and Their Combinations with Antibiotics
    Ismail CAM, Deris ZZ, Bakar RA, Ismail N
    Int J Environ Res Public Health, 2021 03 10;18(6).
    PMID: 33802184 DOI: 10.3390/ijerph18062834
    Despite modern medicine, there is an increasing trend for cases of the bacterial infection leptospirosis, and this has led to the exploration of alternative medicines from various sources including plants. The aim of this study was to investigate the in vitro anti-leptospiral activity of Phyllanthus amarus extracts alone and combined with penicillin G, ceftriaxone, and doxycycline. Antimicrobial susceptibility testing was performed using the microdilution broth technique upon methanol extract (ME), aqueous extract (AE), and antibiotics against the Leptospira interrogans serovars Australis, Bataviae, Canicola, and Javanica, to determine minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs). The results were analyzed using an ELISA microplate reader combined with microscopic analysis. Synergy testing using a checkerboard assay was performed to determine the fractional inhibitory concentration index values of extracts combined with antibiotics against leptospires. Scanning electron microscopy (SEM) was used to investigate morphological changes of leptospires caused by potential anti-leptospiral agents alone and combined with antibiotics. The MICs and MBCs for P. amarus extracts ranged from 100 to 400 µg/mL for AEs and from 400 to 800 µg/mL for MEs. Penicillin G was the most effective anti-leptospiral drug, with MICs and MBCs ranging from <0.01 to 0.78 and <0.01 to 3.13 µg/mL, respectively, followed by ceftriaxone, with both MICs and MBCs ranging from 0.05 to 0.78 µg/mL, and doxycycline, with MICs and MBCs ranging from 0.39 to 3.13 µg/mL and 12.5 to 25 µg/mL, respectively. Combinations of P. amarus extracts and antibiotics did not show synergistic effects on all tested Leptospira serovars, with some combinations demonstrating antagonistic effects. SEM analysis, however, showed distorted Leptospira surfaces. P. amarus AE performed better anti-leptospiral activity than P. amarus ME. The morphological effects of P. amarus extract alone and its combination with antibiotic on Leptospira cells revealed promising anti-leptospiral properties.
    Matched MeSH terms: Leptospirosis*
  2. Significant Clinical Presentation of Leptospirosis in Relation to Sociodemographic and Risk Factors in a Tertiary Hospital, Malaysia
    Mohd Taib N, Ahmad H, Soh KL, Md Shah A, Amin Nordin S, Than Thian Lung L, et al.
    Vector Borne Zoonotic Dis, 2020 04;20(4):268-274.
    PMID: 32013800 DOI: 10.1089/vbz.2018.2417
    Introduction:
    Incidence of leptospirosis has increased within the past few years in many countries. Its clinical presentations were generally nonspecific, making it difficult to assist in the diagnosis. Besides the determination of the common clinical features, the sociodemographic background is essential to identify high-risk populations to assist in prevention.
    Methods:
    Data for this study were obtained from electronic medical records among patients clinically diagnosed with leptospirosis at a tertiary hospital in Malaysia from the years 2011 to 2015 and were recorded using standard pro forma. Associations between clinical features and sociodemographics were performed using bivariate analysis and logistic regression.
    Results:
    Data were collected from 283 patients. Their mean age was 30.71 years old. Out of 283 patients, 206 (72.8%) were male. Involvement in outdoor events and water activities was the highest risk factor of acquiring leptospirosis in 64 (22.7%) patients followed by 59 (20.8%) patients who were staying in crowded housing areas with poor sanitation. Although fever was the main clinical presentation in 274 (96.8%) patients with leptospirosis, gastrointestinal (GIT) symptoms were the second most frequent in 159 (56.2%) patients followed by pulmonary symptoms, myalgia, headache, and jaundice. From the total number of 283 patients, only 21 (92.6%) presented with severe leptospirosis. GIT symptoms were a significant predictor for leptospirosis severity, while the age group was the significant sociodemographic factor toward GIT presentation in leptospirosis. The relationship between GIT symptoms and crowded housing areas with poor sanitation was also significant. Multivariable logistic regression showed that crowded housing areas with poor sanitation (odds ratio [OR] = 3.570, p 
    Matched MeSH terms: Leptospirosis/epidemiology*
  3. Evaluation of Leptospira biflexa antigens for screening human sera by the microscopic agglutination (MA) test in comparison with the sensitized-erythrocyte-lysis (SEL) test
    Tan DS, Welch QB
    Southeast Asian J. Trop. Med. Public Health, 1974 Mar;5(1):12-6.
    PMID: 4839075
    Matched MeSH terms: Leptospirosis/diagnosis*
  4. 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*
  5. 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*
  6. Molecular characterization of pathogenic Leptospira sp. in small mammals captured from the human leptospirosis suspected areas of Selangor state, Malaysia
    Azhari NN, Ramli SNA, Joseph N, Philip N, Mustapha NF, Ishak SN, et al.
    Acta Trop, 2018 Dec;188:68-77.
    PMID: 30145261 DOI: 10.1016/j.actatropica.2018.08.020
    Leptospirosis is caused by the spirochetal bacterium Leptospira of which rodents are considered the most important reservoir. This study aims to determine and characterize virulent Leptospira species among rodents and small mammals found in human settlements and recreational spots within the Hulu Langat and Gombak districts of Selangor, Malaysia; regions that frequently report probable human leptospirosis cases. Molecular analysis revealed an overall Leptospira detection rate of 14.3% among the 266 small mammals captured, and the human settlements were found to have the highest number of isolates (15.1%), followed by recreational sites (14.5%). The molecular characterization conducted based on the lipL32, secY genes and MLST revealed that the strains belonged to four different species, including; Leptospira interrogans (29; 76.3%; ST50, ST238, ST243), L. kirschneri (5; 13.15%; ST110), L. borgpetersenii (3; 8%; ST143) and L. weilii (1; 2.63%; ST242). The study revealed genotypes of circulating strains among small mammals in Malaysia, which include Leptospira locus ST110 L. kirschneri, ST 50 L. interrogans, ST143 L. borgpetersenii and ST242 L. weilii. Among the small mammals studied, 17/105 (16.2%) Rattus norvegicus, 7/59 (11.9%) of Rattus rattus, 5/24 (20.8%) of Maxomys whiteheadi, 4/18 (22.2%) of Sundamys muelleri, 2/22 (9%), Tupaia gliss, 2/16 (12.5%) Rattus tiomanicus and 1/4 (25%) of Suncus murinus carried pathogenic leptospires. The data from the present study may imply that, in addition to rodents, other small mammals also serve as maintenance hosts for Leptospira. Hence, much remains unknown about Leptospira maintenance hosts, and there is need for further investigation to ascertain the prevailing serovars of pathogenic Leptospira in Malaysia. This will assist in the development of efficient diagnostic assays with improved microscopic agglutination test (MAT) panels, and in the implementation of suitable prevention and control measures.
    Matched MeSH terms: Leptospirosis/microbiology*
  7. Fulltext Awareness, Knowledge, Attitude and Preventive Practice of Leptospirosis Among Healthy Malaysian and Non-Malaysian Wet Market Workers in Selected Urban Areas in Selangor, Malaysia
    Samsudin S, Saudi SNS, Masri NS, Ithnin NR, T Z M T J, Hamat RA, et al.
    Int J Environ Res Public Health, 2020 02 19;17(4).
    PMID: 32093098 DOI: 10.3390/ijerph17041346
    Leptospirosis has been reported as an endemic in most tropical countries. Among high risk occupations, leptospirosis includes workers in agriculture and domestic animal industries. Environmental hygiene in the wet market has established a link between the presence of rodents with probability of leptospirosis infection. This study was aimed to compare the level of knowledge, attitude and preventive practice against leptospirosis between healthy Malaysian and non-Malaysian wet market workers in selected wet markets in urban areas of Selangor. A cross-sectional study in the determined area was conducted with the participation of 147 respondents. The respondents were randomly chosen from the list provided by the state agency that regulates these markets. A self-administered bilingual validated questionnaire (English and Bahasa Melayu) was distributed to the selected respondents. There were 68 (48.3%) Malaysian respondents and 79 (53.7%) non-Malaysian respondents. The majority of them were males, who attained formal education and were less than 40 years old. Meanwhile, the respondents earned less than RM3000. Among the Malaysian respondents, 80.9% were aware of leptospirosis as compared to 17.7% of the non-Malaysian colleagues (p < 0.05). All items of knowledge showed that the Malaysian respondents scored higher as compared to non-Malaysian respondents. On attitude towards infection prevention, most Malaysian respondents had a positive attitude, while most non-Malaysian respondents had undecided perception on the majority of crucial attitude items. In practicing preventive measures, there was a marked significant difference in proportion between Malaysian and non-Malaysian respondents for items on "Specific Protection and Isolation at Source." There was a significant gap on knowledge, attitude and preventive practice among Malaysian workers as compared to non-Malaysian workers. Therefore, it was highly recommended the health promotion implementation should also provide specific focus on non-Malaysian workers.
    Matched MeSH terms: Leptospirosis*
  8. The importance of using a right test method in diagnosing leptospirosis
    Ilham NE, Joseph NSM, Bahtiar Affendy N, Mohd Taib N, Vasantha KN, Masri SN
    Trop Biomed, 2020 Jun 01;37(2):357-362.
    PMID: 33612804
    Leptospirosis is a common febrile illness in Malaysia. The disease is caused by pathogenic bacteria called leptospires that are transmitted directly or indirectly from animals to humans via contaminated water or soil. It is a potentially serious but treatable disease. Its symptoms may mimic those of other unrelated febrile illnesses such as dengue, influenza, meningitis, hepatitis or viral haemorrhagic fevers. The spectrum of the disease is extremely wide, ranging from subclinical infection to a severe syndrome of multiorgan infection with high mortality. The diagnosis requires high suspicion with history of exposure to water or environment possibly contaminated with infected animal urine. This is a case of a 13 year-oldgirl with no known medical illness, and a history of exposure to outdoor activities. However, paired sera for leptospirosis serology was not diagnostic. She then developed septic shock on day 14 of illness. But due to high suspicion of leptospirosis, antibiotic therapy was upgraded to ceftriaxone and samples were sent for further testing which revealed that leptospires were detected in the urine, using molecular technique. She improved after treated as leptospirosis.
    Matched MeSH terms: Leptospirosis/diagnosis*
  9. Fulltext Production and characterization of a polyclonal antibody of anti-rLipL21-IgG against leptospira for early detection of acute leptospirosis
    Seenichamy A, Bahaman AR, Mutalib AR, Khairani-Bejo S
    Biomed Res Int, 2014;2014:592858.
    PMID: 24860824 DOI: 10.1155/2014/592858
    Leptospirosis is one of the zoonotic diseases in animals and humans throughout the world. LipL21 is one of the important surface-exposed lipoproteins in leptospires and the most effective cross protective immunogenic antigen. It is widely considered as a diagnostic marker for leptospirosis. In this study, we evaluated the serodiagnostic potential of LipL21 protein of Leptospira interrogans serovar Pomona. We have successfully amplified, cloned, and expressed LipL21 in E. coli and evaluated its specificity by immunoblotting. Purified recombinant LipL21 (rLipL21) was inoculated into rabbits for the production of polyclonal antibody. Characterization of the purified IgG antibody against rLipL21 was performed by cross reactivity assay. Only sera from leptospirosis patients and rabbit hyperimmune sera recognized rLipL21 while the nonleptospirosis control sera showed no reaction in immunoblotting. We confirmed that anti-rLipL21-IgG antibody cross reacted with and detected only pathogenic leptospiral species and it did not react with nonpathogenic leptospires and other bacterial species. Results observed showed that anti-rLipL21-IgG antibody has high specificity and sensitivity to leptospires. The findings indicated that the antibody could be used in a diagnostic assay for detection of leptospires or their proteins in the early phase of infection.
    Matched MeSH terms: Leptospirosis/diagnosis*; Leptospirosis/immunology*; Leptospirosis/microbiology
  10. Acute renal failure after a holiday in the tropics
    Guron G, Holmdahl J, Dotevall L
    Clin. Nephrol., 2006 Dec;66(6):468-71.
    PMID: 17176921 DOI: 10.5414/cnp66468
    A 20-year-old, previously healthy woman, presented with high fever, headache and myalgia 3 days after her return from a holiday in Southeast Asia. Laboratory data on admission demonstrated a pronounced increase in plasma creatinine, marked thrombocytopenia and moderately elevated liver aminotransferases. After having ruled out malaria, dengue fever was primarily suspected and supportive intravenous fluid therapy was initiated. Still, 1 day after admission, platelet counts dropped even further and she became anuric although she did not appear hypovolemic. On day 2 after admission, urine production commenced spontaneously and the patient slowly recovered. All laboratory test results had returned to normal approximately 2 months later. Serological analysis for dengue fever was negative. It turned out that the patient had been trekking in the jungle while in Thailand and we, therefore, analyzed serology for Leptospira spirochetes which was clearly positive. The patient was diagnosed with leptospirosis which is a serious condition associated with a high mortality when complicated by acute renal failure. Differential diagnoses in patients with acute renal failure and tropical infections are reviewed. The importance of early recognition of leptospirosis, and prompt treatment with antibiotics in suspected cases, is emphasized.
    Matched MeSH terms: Leptospirosis/complications*; Leptospirosis/ethnology; Leptospirosis/microbiology
  11. Fulltext Antimicrobial prophylaxis for melioidosis and leptospirosis for at risk rescue workers
    Yew KL
    Med J Malaysia, 2013;68(1):88.
    PMID: 23466779
    Matched MeSH terms: Leptospirosis
  12. Prevalence of leptospiral DNA among wild rodents from a selected area in Beguk Dam Labis, Segamat, Johor, Malaysia
    Latifah I, Rahmat MS, Hayarti KB, Paramasvaran S, Azizah MR, Imran F, et al.
    Malays J Pathol, 2012 Dec;34(2):157-9.
    PMID: 23424779
    Leptospirosis is an emerging infectious disease. The differential diagnosis of leptospirosis is difficult due to the varied and often "flu like" symptoms which may result in a missed or delayed diagnosis. Leptospira is the aetiological agent of leptospirosis, a bacterial zoonosis with worldwide distribution. There are over 230 known serovars in the genus Leptospira. The true prevalence of leptospirosis in Malaysia is unknown or underestimated. Our goal was to determine the prevalence for Leptospira infection in rodents in a selected area in Beguk Dam Labis, Segamat, Johor. A study was carried out on 69 serum samples of trapped wild rodents. DNA was extracted from the sera using Leptospira PCR kit (Shanghai ZJ Bio-Tech Co., Ltd). Of 69 rodent serum samples tested by PCR, 9 (13%) showed positive results. In this study we found that (13%) of wild rodents caught in Beguk Dam Labis were infected by Leptospira.
    Matched MeSH terms: Leptospirosis/diagnosis; Leptospirosis/epidemiology; Leptospirosis/veterinary*
  13. Risk factors of leptospirosis among febrile hospital admissions in northeastern Malaysia
    Rafizah AA, Aziah BD, Azwany YN, Imran MK, Rusli AM, Nazri SM, et al.
    Prev Med, 2013;57 Suppl:S11-3.
    PMID: 23295174 DOI: 10.1016/j.ypmed.2012.12.017
    Leptospirosis is a worldwide zoonotic disease. Risk factors for the disease may vary among countries.
    Matched MeSH terms: Leptospirosis/diagnosis; Leptospirosis/etiology*; Leptospirosis/epidemiology
  14. Fulltext Molecular Characterization of Leptospira spp. in Environmental Samples from North-Eastern Malaysia Revealed a Pathogenic Strain, Leptospira alstonii
    Azali MA, Yean Yean C, Harun A, Aminuddin Baki NN, Ismail N
    J Trop Med, 2016;2016:2060241.
    PMID: 27127522 DOI: 10.1155/2016/2060241
    The presence of pathogenic Leptospira spp. in the environment poses threats to human health. The aim of this study was to detect and characterize Leptospira spp. from environmental samples. A total of 144 samples comprised of 72 soil and 72 water samples were collected from markets and recreational areas in a north-eastern state in Malaysia. Samples were cultured on Ellinghausen and McCullough modified by Johnson and Harris media. Leptospires were positive in 22.9% (n = 33) of the isolates. Based on partial sequences of 16S rRNA, a pathogenic leptospire, Leptospira alstonii (n = 1/33), was identified in 3% of the isolates followed by intermediate leptospire (L. wolffii, n = 1/33, and L. licerasiae, n = 7/33) and nonpathogenic leptospire, L. meyeri (n = 22/33) in 24.2% and 66.7%, respectively. This study demonstrates the presence of a clinically significant pathogenic L. alstonii in the environments which could pose health risks to the occupants and visitors.
    Matched MeSH terms: Leptospirosis
  15. Demographic, clinical and laboratory features of leptospirosis-malaria co-infections in Peninsular Malaysia
    Rao M, Atiqah N, Dasiman M, Amran F
    J Med Microbiol, 2020 Mar;69(3):451-456.
    PMID: 31846413 DOI: 10.1099/jmm.0.001127
    Introduction. Co-infection of leptospirosis-malaria is not uncommon due to their overlapping geographical distribution in the tropics.Aim. This study aimed to describe and compare the demographic, clinical and laboratory features of leptospirosis-malaria co-infection (LMCI) against leptospirosis mono-infection (LMI) in Peninsular Malaysia.Methodology. Data of patients admitted to various hospitals in Peninsular Malaysia from 2011 to 2014 diagnosed with leptospirosis in our laboratory were obtained from their admission records. Co-infections with malaria were identified via blood film for malaria parasites (BFMP). Description with inferential statistics analysis and multiple logistic regressions were used to distinguish features between dual and mono-infections.Results. Of 111 leptospirosis-positive patients, 26 (23.4 %) tested positive for malaria. Co-infections were predominant among male patients with a mean age of 33 years and were prevalent among immigrant populations who had settled in high-density suburban areas. Chills and rigor with splenomegaly were the only significant distinguishing clinical features of LMCI while leukocytosis and raised transaminases were significant laboratory parameters. Only chills and rigor demonstrated a predictive value for LMCI from analysis of multiple logistic regressions. No death was attributed to co-infection in this study, in contrast to LMI (11.8 %, n=10).Conclusion. The significant prevalence of LMCI found in this study with overlapping demographic, clinical and laboratory parameters makes diagnosis of co-infection challenging. It is essential to evaluate co-infection in endemic areas. Strengthened awareness of LMCI, comprehensive diagnostic services and further prospective studies are warranted.
    Matched MeSH terms: Leptospirosis/diagnosis; Leptospirosis/microbiology; Leptospirosis/epidemiology*
  16. 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/diagnosis*; Leptospirosis/microbiology; Leptospirosis/epidemiology*
  17. Fulltext Fatal pulmonary haemorrhage in co-infection with dengue and leptospirosis
    Zyneelia. H, Hashim E
    Medicine & Health, 2017;12(1):131-137.
    MyJurnal
    Leptospirosis is an emerging infectious disease with worldwide distribution. Its symptoms may mimic a number of other infections such as dengue, malaria, hepatitis and typhoid fever, particularly in tropical countries where these diseases are endemic. Similarly, dengue is an important infectious disease that poses as a public health emergency due to its rapid epidemic spread across the world. Here, we report a fatal case of dengue fever in a patient who was also serologically positive for leptospirosis. Co-infection of both dengue and leptospirosis can lead to an illness with overlapping symptoms and therefore present a clinical diagnostic dilemma to the treating physician. Hence, a high index of suspicion among clinicians is required, especially in high endemic areas. The optimal usage of antigen-based rapid diagnostic tests is essential to aid the clinicians to make timely and accurate diagnosis as well as to start appropriate treatment regimes.
    Keywords: co-infection, communicable diseases, dengue, leptospirosis
    Matched MeSH terms: Leptospirosis
  18. Draft Genome Sequence of Leptospira interrogans Serovar Bataviae Strain LepIMR 22 Isolated from a Rodent in Johor, Malaysia
    Amran F, Mohd Khalid MK, Mohamad S, Mat Ripen A, Ahmad N, Goris MG, et al.
    Genome Announc, 2016;4(5).
    PMID: 27609924 DOI: 10.1128/genomeA.00956-16
    Leptospira interrogans serovar Bataviae was recently identified as one of the persistent Leptospira serovars in Malaysia. Here, we report the draft genome sequence of the L. interrogans serovar Bataviae strain LepIMR 22 isolated from kidney of a rodent in Johor, Malaysia.
    Matched MeSH terms: Leptospirosis
  19. Leptospirosis: Molecular trial path and immunopathogenesis correlated with dengue, malaria and mimetic hemorrhagic infections
    Priya SP, Sakinah S, Sharmilah K, Hamat RA, Sekawi Z, Higuchi A, et al.
    Acta Trop, 2017 Dec;176:206-223.
    PMID: 28823908 DOI: 10.1016/j.actatropica.2017.08.007
    Immuno-pathogenesis of leptospirosis can be recounted well by following its trail path from entry to exit, while inducing disastrous damages in various tissues of the host. Dysregulated, inappropriate and excessive immune responses are unanimously blamed in fatal leptospirosis. The inherent abilities of the pathogen and inabilities of the host were debated targeting the severity of the disease. Hemorrhagic manifestation through various mechanisms leading to a fatal end is observed when this disease is unattended. The similar vascular destructions and hemorrhage manifestations are noted in infections with different microbes in endemic areas. The simultaneous infection in a host with more than one pathogen or parasite is referred as the coinfection. Notably, common endemic infections such as leptospirosis, dengue, chikungunya, and malaria, harbor favorable environments to flourish in similar climates, which is aggregated with stagnated water and aggravated with the poor personal and environmental hygiene of the inhabitants. These factors aid the spread of pathogens and parasites to humans and potential vectors, eventually leading to outbreaks of public health relevance. Malaria, dengue and chikungunya need mosquitoes as vectors, in contrast with leptospirosis, which directly invades human, although the environmental bacterial load is maintained through other mammals, such as rodents. The more complicating issue is that infections by different pathogens exhibiting similar symptoms but require different treatment management. The current review explores different pathogens expressing specific surface proteins and their ability to bind with array of host proteins with or without immune response to enter into the host tissues and their ability to evade the host immune responses to invade and their affinity to certain tissues leading to the common squeal of hemorrhage. Furthermore, at the host level, the increased susceptibility and inability of the host to arrest the pathogens' and parasites' spread in different tissues, various cytokines accumulated to eradicate the microorganisms and their cellular interactions, the antibody dependent defense and the susceptibility of individual organs bringing the manifestation of the diseases were explored. Lastly, we provided a discussion on the immune trail path of pathogenesis from entry to exit to narrate the similarities and dissimilarities among various hemorrhagic fevers mentioned above, in order to outline future possibilities of prevention, diagnosis, and treatment of coinfections, with special reference to endemic areas.
    Matched MeSH terms: Leptospirosis/immunology; Leptospirosis/epidemiology*; Leptospirosis/transmission
  20. Development and validation of pan-Leptospira Taqman qPCR for the detection of Leptospira spp. in clinical specimens
    Mohd Ali MR, Mohd Safee AW, Ismail NH, Abu Sapian R, Mat Hussin H, Ismail N, et al.
    Mol Cell Probes, 2018 04;38:1-6.
    PMID: 29524642 DOI: 10.1016/j.mcp.2018.03.001
    BACKGROUND: Early diagnosis of leptospirosis is important for ensuring better clinical management and achieving better outcomes. Currently, serological assays suffer from inconsistent performance and are less useful for early diagnosis of leptospirosis. As an alternative, qPCR is more sensitive, specific and able to detect the presence of leptospiral DNA during the acute phase of the infection. Meanwhile, most molecular assays do not detect the non-pathogenic group of Leptospira, even though these groups may also infect humans, although less frequently and less severely.

    METHODS: A set of primers and probe targeting rrs genes of 22 Leptospira spp. were designed and evaluated on 31 Leptospira isolates, 41 other organisms and 65 clinical samples from suspected patients.

    RESULTS: The developed assay was able to detect as low as 20 fg Leptospira DNA per reaction (equivalent to approximately 4 copies) and showed high specificity against the tested leptospiral strains. No cross amplification was observed with the other organisms. During the evaluation of the confirmed clinical specimens, the developed assay was able to correctly identify all positive samples (n = 10/10). One amplification was observed in a negative sample (n = 1/55). The sequencing of the PCR product of the discordant sample revealed that the sequences were similar to those of L. interrogans and L. kirschneri.

    CONCLUSION: The findings suggest that the developed Taqman qPCR assay is sensitive, specific and has potential to be applied in a larger subsequent study.

    Matched MeSH terms: Leptospirosis
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