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Human leptospirosis in the Seychelles (Indian Ocean): a population-based study
The American Journal of Tropical Medicine and Hygiene
|January 14, 1999
Summary
Leptospirosis surveillance in Seychelles found 75 cases, primarily in middle-aged males. The Hurstbridge serogroup was linked to severe illness and death, indicating potential treatment inadequacy.
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 guiding public health interventions.
Purpose of the Study:
- To conduct a comprehensive 12-month surveillance of leptospirosis in the Seychelles population.
- To identify prevalent serogroups, risk factors, and clinical manifestations.
- To evaluate diagnostic methods and assess treatment effectiveness.
Main Methods:
- Population-based surveillance over 12 months.
- Diagnosis using microagglutination test and polymerase chain reaction (PCR).
- Analysis of demographic, clinical, and microbiological data.
Main Results:
- Confirmed 75 cases of leptospirosis (incidence 101/100,000) in a population of 74,331.
- Higher incidence observed in middle-aged males with environmental exposure.
- Icterohaemorrhagiae and Hurstbridge were the most frequent serogroups; Hurstbridge associated with severe outcomes.
- Common clinical forms included influenza-like illness (37%), jaundice (52%), acute renal failure (28%), and pulmonary hemorrhage (19%).
- Six deaths occurred, primarily due to pulmonary hemorrhage.
- Persistent PCR positivity post-treatment suggested potential penicillin treatment inadequacy.
Conclusions:
- Leptospirosis poses a considerable public health challenge in the Seychelles.
- The emergence of the Hurstbridge serogroup warrants further investigation due to its association with severe disease.
- Current penicillin treatment duration may be insufficient for complete bacterial eradication.