Clinico-Epidemiological Profile of Leptospirosis Among Patients Attending a Tertiary Care Center in Rajasthan

Background and objective Leptospirosis is a globally prevalent zoonotic disease with a differential diagnosis of acute febrile illness that is significantly underreported in Rajasthan, India. This study aimed to assess the seropositivity for Leptospira in patients attending a tertiary care center in Rajasthan and study their clinico-epidemiological profile. Material and methods A cross-sectional study was conducted between July 2019 and June 2022 at the Advanced Research Laboratory, Department of Microbiology, Sawai Man Singh (SMS) Medical College and Hospital, Jaipur, Rajasthan, India. Serum samples from 2,996 patients presenting with undifferentiated febrile illness/pyrexia of unknown origin (UFI/PUO) were tested for Leptospira IgM antibodies using an IgM capture enzyme-linked immunosorbent assay (ELISA). A total of 290 patients with a duration of illness of less than five days underwent Leptospira testing by polymerase chain reaction (PCR). Demographic characteristics, clinical features, exposure history, and duration of animal contact were obtained from the specimen requisition forms. Data were analyzed using appropriate statistical methods. Results A seropositivity of 5.01% (150/2,996) for Leptospira was found in the present study, with a male predominance of 58.67% (88/150) and 41.33% (62/150) female among positive cases. All samples (290) tested negative by PCR. The highest positivity was observed in the age group of 19-30 years. Highest positivity was observed during the monsoon and post-monsoon periods and winter (July-December, peak December) in Rajasthan. Seasonal analysis revealed that December consistently showed high positivity (10.70%), followed by July (8.53%), October (8.0%), and February (6.07%). However, the highest positivity was seen in November 2020 (36.36%) and December 2020 (20%). All 150 patients reported symptoms like fever and myalgia, whereas 76% (114/150) presented with headaches. Prolonged contact with animals and lack of awareness about zoonotic diseases were identified as major risk factors contributing to disease transmission in Rajasthan. Conclusion Leptospirosis is an underdiagnosed cause of acute febrile illness in Rajasthan, with animal exposure being a significant risk factor in our setting, particularly during the monsoon and post-monsoon seasons. Enhanced diagnostic facilities, increased awareness among clinicians, and targeted public health interventions are crucial to reducing associated morbidity and mortality.