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Paediatric leptospirosis: A population based case-control study from Chennai, India
R Narayanan, G Sumathi, S G Prabhakaran
1Department of Microbiology, Medical Microbiology Laboratory, Centre for Excellence in Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, India.
Insights
Leptospirosis surveillance in Chennai confirmed cases in children and adults. Paediatric leptospirosis showed more Weil's disease features and was strongly linked to rat infestation, with PCR aiding early diagnosis.
Area of Science:
- Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Leptospirosis is a significant zoonotic disease with diverse clinical presentations.
- Surveillance is crucial for understanding disease burden and risk factors, especially in tropical urban environments.
Purpose of the Study:
- To characterize clinical features and laboratory findings of leptospirosis in children and adults in Chennai.
- To evaluate the utility of Polymerase Chain Reaction (PCR) for diagnosing leptospirosis.
- To identify risk factors associated with paediatric leptospirosis.
Main Methods:
- Prospective surveillance of clinically suspected leptospirosis cases in Chennai.
- Laboratory confirmation using serological tests and Polymerase Chain Reaction (PCR).
- Clinical data collection and univariate analysis to identify associated factors.
Main Results:
- Confirmed leptospirosis in 26.1% of children and 26.6% of adults.
- Paediatric cases presented more frequently with classic Weil's disease features.
- Leptospira serovar Icterohaemorrhagiae was prevalent in both groups.
- PCR achieved 28.4% positivity and 96% specificity.
- Rat infestation showed a strong association with paediatric leptospirosis (OR 87.4).
Conclusions:
- Leptospirosis affects both children and adults in Chennai, with distinct clinical patterns in paediatric cases.
- Polymerase Chain Reaction (PCR) is a valuable tool for early and specific diagnosis of leptospirosis, particularly in children.
- Rat infestation is a significant risk factor for paediatric leptospirosis, highlighting the need for integrated vector control and public health interventions.
Abstract:
The surveillance in Chennai identified 134 children and 443 adults clinically suspected for leptospirosis. Of these, 35 (26.1%) children and 118 (26.6%) adults had laboratory confirmed diagnosis for leptospirosis. The paediatric leptospirosis exhibited a higher frequency of classic features of Weil's disease. The prevalent serovar encountered was Icterohaemorrhagiae with no difference in the pattern of infecting serovars between the two groups. Further, confirmation of diagnosis was achieved by polymerase chain reaction (PCR) with a positivity of 28.4% (specificity 96%). Univariate analysis showed significant association of paediatric leptospirosis with rat infestation (odds ratio 87.4). Thus, PCR facilitates early diagnosis of febrile illness among paediatric cases.
