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Evaluation of a Rapid Kit for Detection of IgM against Leptospira in Human

Rao M, Amran F, Aqilla N

Can J Infect Dis Med Microbiol, 2019;2019:5763595.
PMID: 30881530 DOI: 10.1155/2019/5763595

Introduction: Leptospirosis is an acute febrile illness, known for its protean clinical manifestations and the challenge in differentiating from other infectious diseases. Standardized confirmatory test is antibody dependent and not accessible by the suburban community. This study measures efficiency of an immune-chromatographic assay, Leptocheck WB, in detecting acute leptospirosis.
Methods: A total of 142 sera were used for kit evaluation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated by comparing rapid kit results with gold standard laboratory, microscopic agglutination test (MAT).
Results: We found this rapid kit to have a sensitivity and specificity of 66.6% and 78.9%, respectively, whereas the PPV and NPV of the kit appeared to be 73.3% and 73.2%, respectively.
Discussion: Test efficiency of this rapid kit is reasonable. It is specific in detecting leptospiral antibody and assures clinician of accurate diagnosis by having higher PPV and NPV. It is prompt and efficient in comparison with conventional methods in assisting differential diagnosis. High sensitivity and specificity leptospirosis rapid test is indeed a crucial measure to assist the diagnosis of acute undifferentiated febrile illnesses.

Matched MeSH terms: Leptospira
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: Leptospira interrogans/immunology*
Role of 72 kDa protein of Leptospira interrogans as a diagnostic marker in acute leptospirosis

Riazi M, Zainul FZ, Bahaman AR, Amran F, Khalilpour A

Indian J Med Res, 2014 Feb;139(2):308-13.
PMID: 24718408

Leptospirosis is a widespread zoonotic disease and a public health problem, particularly in tropical and subtropical countries. Varied clinical manifestations of the disease frequently lead to misdiagnosis resulting in life-threatening multi-organ complications. Therefore, early laboratory investigation using an appropriate diagnostic approach is crucial. In the present study, a potential protein marker was identified and evaluated for its usefulness in the serodiagnosis of acute leptospirosis.

Matched MeSH terms: Leptospira interrogans serovar icterohaemorrhagiae/genetics*; Leptospira interrogans serovar icterohaemorrhagiae/immunology; Leptospira interrogans serovar icterohaemorrhagiae/pathogenicity
Fulltext Detection of pathogenic Leptospira from selected environment in Kelantan and Terengganu, Malaysia

Ridzlan FR, Bahaman AR, Khairani-Bejo S, Mutalib AR

Trop Biomed, 2010 Dec;27(3):632-8.
PMID: 21399605 MyJurnal

Leptospirosis is recognized as one of the important zoonotic diseases in the world including Malaysia. A total of 145 soil and water samples were collected from selected National Service Training Centres (NSTC) in Kelantan and Terengganu. The samples were inoculated into modified semisolid Ellinghausen McCullough Johnson Harris (EMJH) medium, incubated at room temperature for 1 month and examined under the dark-field microscope. Positive growth of the leptospiral isolates were then confirmed with 8-Azaguanine Test, Polymerase Chain Reaction (PCR) assay and Microscopic Agglutination Test (MAT). Fifteen cultures (10.34%) exhibited positive growths which were seen under dark field microscope whilst only 20% (3/15) were confirmed as pathogenic species. based on 8-Azaguanine Test and PCR. Serological identification of the isolates with MAT showed that hebdomadis was the dominant serovar in Terengganu. Pathogenic leptospires can be detected in Malaysian environment and this has the potential to cause an outbreak. Therefore, precautionary steps against leptospirosis should be taken by camp authorities to ensure the safety of trainees.

Matched MeSH terms: Leptospira/isolation & purification*
A Multi-landscape Assessment of Leptospira Prevalence on a Diversity of Small Mammals

Rosli MZ, Mohd-Taib FS, Khoo JJ, Chee HY, Wong YP, Shafie NJ, et al.

Ecohealth, 2023 Jun;20(2):208-224.
PMID: 37103759 DOI: 10.1007/s10393-023-01637-8

Leptospirosis is a major zoonotic disease, especially in the tropics, and rodents were known to be carriers of this bacterium. There was established information on Leptospira prevalence among animal reservoirs in human-dominated landscapes from previous literature. However, there was very little focus given comparing the prevalence of Leptospira in a wide range of habitats. An extensive sampling of small mammals from various landscapes was carried out, covering oil palm plantations, paddy fields, recreational forests, semi-urbans, and wet markets in Peninsular Malaysia. This study aims to determine the prevalence of pathogenic Leptospira in a diversity of small mammals across different landscapes. Cage-trapping was deployed for small mammals' trappings, and the kidneys of captured individuals were extracted, for screening of pathogenic Leptospira by polymerase chain reaction (PCR) using LipL32 primer. Eight microhabitat parameters were measured at each study site. Out of 357 individuals captured, 21 (5.9%) were positive for pathogenic Leptospira of which recreational forest had the highest prevalence (8.8%) for landscape types, whereas Sundamys muelleri shows the highest prevalence (50%) among small mammals' species. Microhabitat analysis reveals that rubbish quantity (p Leptospira prevalence among small mammals. Furthermore, nMDS analysis indicates that the presence of faeces, food waste, and exposure to humans in each landscape type also were linked with high prevalence of pathogenic Leptospira among the small mammals. This study supplements previous studies on pathogenic Leptospira prevalence across different landscape types, and the major microhabitat factors associated with Leptospira prevalence. This information is crucial for epidemiological surveillance and habitat management to curb the possibility of the disease outbreaks.

Matched MeSH terms: Leptospira*
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: Leptospira
Fulltext Leptospiral Infection, Pathogenesis and Its Diagnosis-A Review

Samrot AV, Sean TC, Bhavya KS, Sahithya CS, Chan-Drasekaran S, Palanisamy R, et al.

Pathogens, 2021 Feb 01;10(2).
PMID: 33535649 DOI: 10.3390/pathogens10020145

Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly existing as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil's disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.

Matched MeSH terms: Leptospira
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: Leptospira/isolation & purification*
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: Leptospira/immunology*
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: Leptospira/genetics; Leptospira/isolation & purification
Fulltext Leptospirosis in Kuala Lumpur and the comparative evaluation of two rapid commercial diagnostic kits against the MAT test for the detection of antibodies to leptospira interrogans

Sekhar WY, Soo EH, Gopalakrishnan V, Devi S

Singapore Med J, 2000 Aug;41(8):370-5.
PMID: 11256343

The aim of the study was to look into the epidemiology of serodiagnosed cases of leptospirosis at the University Hospital and compare two commercial ELISA Assays to the Microscopic Agglutination Test (MAT). Demographic data for all serodiagnosed cases for the years 1991-1997 were collected. From this data, 104 sera (n = 104) were selected as samples for comparative evaluation of the commercial ELISAs (INDX Dip-S-Ticks and PanBio ELISA) to the MAT test. Thirty two (n = 32) negative control sera were selected from serodiagnosed cases of other differential diagnosis of leptospira infection. The MAT test is a standard test that detects agglutination antibodies to leptospira biflexa, while the INDX Dip-S-Ticks is an ELISA dot test assaying for total anti-leptospira antibodies. The PanBio ELISA is a colorometric assay in test well strips to detect anti-leptospira IgM. The sensitivity, specificity, and efficiency of tests were calculated at a MAT cut-off value of 1:320. Demographic data showed that leptospirosis peaks during March-May and Aug-Nov coinciding with the inter-monsoon period with more men being infected than women and more adults than children. The sensitivity, specificity, and efficiency of test for the INDX Dip-S-Ticks were 83.3%, 93.8% and 87.5% while the values for the PanBio ELISA were 54.2%, 96.9% and 71.3%. The suboptimal PanBio result could be related to the blocking effect of high IgG titres or could be related to the diagnostic MAT cut-off values used in this study. The data hence reflects a pattern of transmission that is related to "wet" occupational risk factors. The commercial assays evaluated, are easier to perform but interpretation of results should be based on level of endemicity. The INDX Dip-S-Ticks allows this flexibility and is a practical alternative to the MAT test.

Matched MeSH terms: Leptospira interrogans/immunology*
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: Leptospira/pathogenicity
Fulltext In vitro antileptospiral activity of trigona thoracia propolis and its synergistic effects with commonly prescribed antibiotics

Siti Radziah Ismail

IIUM Medical Journal Malaysia, 2020;19(1):13-22.
MyJurnal

Introduction: Trigona thoracica propolis is known to have antimicrobial properties, however its
antileptospiral properties and its synergistic effects with commonly prescribed antibiotics are scarcely
documented. This study aimed to evaluate the antileptospiral properties of Trigona thoracica against
pathogenic Leptospira species (spp.) and to study its synergistic effects with commonly prescribed
antibiotics. Materials and Methods: The tested Leptospira serovars were Australis, Bataviae, Canicola and
Javanica. Aqueous extract propolis (AEP) and ethanolic extracts propolis (EEP) were used. Broth dilution
methods were used to determine the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal
Concentration (MBC) and the synergistic effects between the propolis and the tested antibiotics. The
synergistic effects was evaluated by using the fractional inhibitory concentration (FIC) index. Morphological
changes of the treated Leptospira were observed under a Scanning Electron Microscope (SEM). Results: The
AEP and EEP were found to have antileptospiral properties against the tested Leptospira spp. The synergy
result showed that only combination of AEP and penicillin G against serovar Australis has demonstrated
synergistic effect with the FIC index of 0.38. Morphological study using SEM showed significant structural
changes of the treated Leptospira spp. Conclusions: The result suggests that Trigona thoracica propolis could
potentially be used as either a complimentary or an alternative therapeutic agent against pathogenic
Leptospira spp.

Matched MeSH terms: Leptospira
Fulltext Serological prevalance of leptospiral infection in captive Malayan porcupiness (Hystrix brachyura)

Siti-Nurdyana, A.K., Bahaman, A.R., Sharma, R.S.K., Azlan, C.M., Abdul Razak, M.F.A.

Jurnal Veterinar Malaysia, 2016;28(2):1-3.
MyJurnal

Leptospirosis is recognised as one of the leading zoonotic diseases and rodents have been implicated as one of the natural reservoirs of the disease. The Malayan porcupines (Hystrix brachyura) which are also a rodent could possibly be a carrier of leptospiral organisms. This study was conducted to determine the serological prevalence of leptospiral infection among captive Malayan porcupines and to disclose the possibility of porcupines as a reservoir for leptospiral infection. Fifty serum samples were obtained from the Malayan porcupines kept in captivity at the Wildlife Conservation Centre, Sungai Dusun, Malaysia. The microscopic agglutination test (MAT) was performed on the serum samples to detect the presence of agglutinating antibodies to a panel of 16 Leptospira serovars (Australis, Autumnalis, Ballum, Bataviae, Canicola, Celledoni, Djasiman, Hardjobovis, Hardjopratjino, Hebdomadis, Hurstbridge, Icterohaemorrhagiae, Javanica, Pomona, Pyrogenes and Sejroe). From the serological test, 18% (n=9/50) of the Malayan porcupines tested had leptospiral antibodies to serovars Javanica (8%), Hurstbridge (4%), Ballum (2%), Celledoni (2%) and Hardjoprajitno (2%). It is seen that this study disclosed a high prevalence of leptospiral infection in the Malayan porcupines tested and indicated that the Malayan porcupines could possibly be a source of leptospirosis to other animals including humans and that they might play an important role in the epidemiology of leptospiral infection in the country.

Matched MeSH terms: Leptospira
Leptospira kmetyi sp. nov., isolated from an environmental source in Malaysia

Slack AT, Khairani-Bejo S, Symonds ML, Dohnt MF, Galloway RL, Steigerwalt AG, et al.

Int J Syst Evol Microbiol, 2009 Apr;59(Pt 4):705-8.
PMID: 19329592 DOI: 10.1099/ijs.0.002766-0

A single Leptospira strain (designated Bejo-Iso9(T)) was isolated from a soil sample taken in Johor, Malaysia. The isolate showed motility and morphology typical of the genus Leptospira under dark-field microscopy. Cells were found to be 10-13 microm in length and 0.2 microm in diameter, with a wavelength of 0.5 microm and an amplitude of approximately 0.2 microm. Phenotypically, strain Bejo-Iso9(T) grew in Ellinghausen-McCullough-Johnson-Harris medium at 13, 30 and 37 degrees C, and also in the presence of 8-azaguanine. Serologically, strain Bejo-Iso9(T) produced titres towards several members of the Tarassovi serogroup, but was found to be serologically unique by cross-agglutinin absorption test and thus represented a novel serovar. The proposed name for this serovar is Malaysia. Phylogenetic analysis of 16S rRNA gene sequences placed this novel strain within the radiation of the genus Leptospira, with sequence similarities within the range 90.4-99.5% with respect to recognized Leptospira species. DNA-DNA hybridization against the three most closely related Leptospira species was used to confirm the results of the 16S rRNA gene sequence analysis. The G+C content of the genome of strain Bejo-Iso9(T) was 36.2 mol%. On the basis of phenotypic, serological and phylogenetic data, strain Bejo-Iso9(T) represents a novel species of the genus Leptospira, for which the name Leptospira kmetyi sp. nov. is proposed. The type strain is Bejo-Iso9(T) (=WHO LT1101(T)=KIT Bejo-Iso9(T)).

Matched MeSH terms: Leptospira/classification*; Leptospira/genetics; Leptospira/isolation & purification*; Leptospira/physiology
Fulltext The effect of pH on the survival of leptospires in water

Smith CE, Turner LH

Bull World Health Organ, 1961;24(1):35-43.
PMID: 20604084

One of the factors on which the incidence of leptospirosis is dependent is the survival time of shed leptospires in surface water or soil water, and this time is in turn affected by the acidity or alkalinity of the water. The authors have therefore studied the survival of four leptospiral serotypes in buffered distilled water at pH's ranging from 5.3 to 8.0. All survived longer in alkaline than in acid water, and significant differences between the serotypes were found in response to pH. Survival at pH's under 7.0 ranged from 10 to 117 days and at pH's over 7.0 from 21 to 152 days. Survival was also studied in aqueous extracts of soil samples from different areas in Malaya; no correlation was found between pH and survival time.It was also noted that in a group of Malayan ricefields a low incidence of leptospirosis in man was accompanied by a high infection rate among rodents, and when it was found that this phenomenon could not be explained by pH or salinity, attention was turned to the soil. Bentonite clay, similar to the montmorrillonite clay of the ricefields, was found to adsorb about half the leptospires in suspension. The authors recommend that field study of this laboratory observation be undertaken.

Matched MeSH terms: Leptospira
Preventive medicine in relation to war conditions

Stringer CH

Journal of the Malaya Branch of the British Medical Association, 1939;3:286-93.

Matched MeSH terms: Leptospira
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: Leptospira/isolation & purification
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: Leptospira/genetics; Leptospira/immunology; Leptospira/isolation & purification*
Fulltext Sensitized-erythrocyte-lysis (SEL) test as an epidemiological tool for human leptospirosis serological surveys

Tan DS

Bull World Health Organ, 1969;40(6):899-902.
PMID: 5307602

Epidemiological studies of human leptospirosis have generally been limited to countries with specialized laboratories employing the microscopic-agglutination (MA) test. The sensitized-erythrocyte-lysis (SEL) test is much simpler for routine hospital laboratories to carry out and it has been found valuable in the diagnosis of human leptospirosis. This paper reports the results of studies of the SEL test as an epidemiological tool in serological surveys.The results showed that the significant SEL titre was 1:80 and that the sensitivity of the test depended possibly on the antigen preparation and the amount of complement used. Most of the SEL antibodies were found to persist at significant titres for about 1 year after active infection, but less than half persisted longer than that. The SEL test is therefore useful for detecting recent infections and for indicating that stability of leptospirosis in an area.The endemicity of leptospirosis in West Malaysia was confirmed by the SEL test, based on the employment of 1:80 as the significant titre.

Matched MeSH terms: Leptospira/immunology

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