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Clinical presentations and predictors of mortality for leptospirosis - A study from suburban area in Malaysia
R J Fann1, R R Vidya2, H E Chong2
1University Tunku Abdul Rahman, Faculty of Medicine and Health Sciences, Bandar Sungai Long, Cheras, Kajang, Selangor, Malaysia. fannrj@utar.edu.my.
Introduction:
Malaysia is endemic for leptospirosis with increasing incidence recorded over the years. Perak has recorded one of the highest incidence and mortality of leptospirosis since 2004.
Methods:
This is a retrospective study of confirmed leptospirosis cases in Larut, Matang and Selama (LMS) district in Perak reported in 2016. The demographic, clinical presentation, laboratory result and clinical outcomes data were analysed and presented.
Results:
Forty-two patients with confirmed diagnosis of leptospirosis were included into the study. Majority of patients were males and Malays. The case fatality rate was 14.3%. Patients with leptospirosis present with variable clinical presentations and are commonly seen with coinfection. Patients 70-year-old and older, have clinical presentations suggestive of organ dysfunction and require intensive care are associated with higher mortality.
Conclusion:
Leptospirosis is endemic in LMS district of Perak with high incidence and case fatality rate. The clinical presentation of leptospirosis is variable. Co-infection of leptospirosis with other acute febrile illness is common. Patients presenting with symptoms and signs of organ dysfunctions or require intensive care are associated with an increased odds of death.
Insights
Leptospirosis is a significant health concern in Perak, Malaysia, with a high incidence and mortality rate. Older patients and those with organ dysfunction or requiring intensive care face a higher risk of death from this infectious disease.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Leptospirosis is endemic in Malaysia, with Perak experiencing high and increasing rates of incidence and mortality.
- The Larut, Matang and Selama (LMS) district in Perak has consistently recorded high leptospirosis incidence and mortality since 2004.
Purpose of the Study:
- To analyze the demographic, clinical, laboratory, and outcome data of confirmed leptospirosis cases in the LMS district.
- To identify risk factors associated with mortality in leptospirosis patients within the study area.
Main Methods:
- A retrospective study design was employed.
- Data from confirmed leptospirosis cases reported in the LMS district in 2016 were analyzed.
Main Results:
- Forty-two confirmed leptospirosis cases were included; the majority were male and Malay.
- The case fatality rate was 14.3%. Common presentations included variable clinical signs and co-infections.
- Advanced age (≥70 years), organ dysfunction, and intensive care unit admission were associated with higher mortality.
Conclusions:
- Leptospirosis is endemic in the LMS district, characterized by high incidence and case fatality rates.
- Clinical presentations are diverse, and co-infections with other febrile illnesses are frequent.
- Organ dysfunction and intensive care needs significantly increase the risk of death in leptospirosis patients.
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