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Human leptospirosis in the Caribbean, 1997-2005: characteristics and serotyping of clinical samples from 14 countries

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Date
2011
Author
Adesiyun, Abiodun Adewale
Baboolal, Shirematee
Suepaul, Sharianne
Dookeran, Shakti
Stewart-Johnson, Alva
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Abstract
OBJECTIVE: To determine the frequency of human leptospirosis in the sera of suspected clinical cases sent by 14 Caribbean countries for diagnosis to a regional laboratory in 1997-2005. METHODS: All serum samples were initially tested using the immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) for leptospirosis. Demographic data (such as age and sex), month of the year and clinical manifestations that had been observed by the attending physician were related to seropositivity. The microscopic agglutination test (MAT) was used to serotype sera using a panel of 23 international serovars. RESULTS: Of 3 455 samples tested, 452 (13.1 percent) were seropositive for IgM antibodies to leptospirosis by the ELISA, with frequencies significantly (P 0.05; χ2) different across countries and years. Among seropositive patients, the frequency of detection of leptospirosis (23.1 percent) was significantly higher in the age groups 1-20 years and 31-40 years combined compared with other age groups; and in male patients (72.1 percent) compared with female patients (19.7 percent) (P 0.05; χ2). Chills, jaundice, vomiting, weakness, diarrhea, and kidney failure/problems were significantly (P 0.05; χ2) exhibited at a higher frequency in seropositive, rather than seronegative patients. Using the MAT on 100 sera tested, 98 (98 percent) were seropositive, of which the serogroup Icterohaemorrhagiae was most prevalent with the detection of serovars Copenhageni (70 percent), Icterohaemorrhagiae (67 percent), and Mankarso (29 percent). CONCLUSIONS: Since only 13.1 percent of the suspected cases of leptospirosis were seropositive for IgM ELISA antibodies, other clinical conditions may have been responsible for the clinical manifestations observed, or the patient may have had chronic leptospirosis (IgG). In the Caribbean, serovars of the serogroup Icterohaemorrhagiae were responsible for most infections in the cases tested.(AU)
 
OBJETIVO: Determinar la frecuencia de leptospirosis humana en el suero de presuntos casos clínicos enviados por 14 países del Caribe a un laboratorio regional para la confirmación del diagnóstico entre 1997 y 2005. MÉTODOS: Todas las muestras de suero se analizaron inicialmente mediante el ensayo inmunoenzimático de adsorción (ELISA) para detectar inmunoglobulina M (IgM) contra Leptospira. Se relacionó la seropositividad con datos demográficos (como la edad y el sexo), el mes del año y las manifestaciones clínicas observadas por el médico a cargo. Se usó la prueba de aglutinación microscópica para serotipificar los sueros con un grupo de 23 serovariedades internacionales. RESULTADOS: De las 3 455 muestras analizadas por ELISA, 452 (13,1 por ciento) fueron seropositivas para anticuerpos IgM contra Leptospira, con frecuencias significativamente diferentes (P 0,05; χ2) según el país y el año. En los pacientes seropositivos, la frecuencia de detección de leptospirosis (23,1 por ciento) fue significativamente mayor en los grupos etarios de 1 a 20 años y de 31 a 40 años combinados, en comparación con otros grupos de edad; y mayor en los varones (72,1 por ciento) en comparación con las mujeres (19,7 por ciento) (P 0,05; χ2). Los escalofríos, la ictericia, los vómitos, la debilidad, la diarrea y la insuficiencia o los trastornos renales fueron significativamente más frecuentes (P 0,05; χ2) en los pacientes seropositivos que en los seronegativos. De los 100 sueros que se analizaron con la prueba de aglutinación microscópica, 98 (98 por ciento) fueron seropositivos, y entre estos el serogrupo Icterohaemorrhagiae fue el más frecuente, con detección de las serovariedades Copenhageni (70 por ciento), Icterohaemorrhagiae (67 por ciento) y Mankarso (29 por ciento). CONCLUSIONES: Ya que solo 13,1 por ciento de los presuntos casos de leptospirosis fueron seropositivos por ELISA para anticuerpos IgM, las manifestaciones clínicas observadas pueden haberse debido a otras enfermedades, o el paciente puede haber tenido leptospirosis crónica (con anticuerpos IgG). En los casos analizados en el Caribe, las serovariedades del serogrupo Icterohaemorrhagiae causaron la mayoría de las infecciones.(AU)
 
Series
Rev Panam Salud Publica;29(5),may 2011
Subject
Leptospirosis; Laboratory Techniques and Procedures; Enzyme-Linked Immunosorbent Assay; Caribbean Epidemiology Centre; Caribbean Region; Leptospirosis; Técnicas y procedimientos de laboratorio; Prueba ELISA; Centro de Epidemiología del Caribe; Región del Caribe; Leptospirose; Região do Caribe; Leptospira; Leptospirose; Sorotipagem; Fatores de Tempo
URI
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011000500008
https://iris.paho.org/handle/10665.2/9529
Citation
Adesiyun, Abiodun Adewale,Baboolal, Shirematee,Suepaul, Sharianne,Dookeran, Shakti,Stewart-Johnson, Alva (2011) Human leptospirosis in the Caribbean, 1997-2005: characteristics and serotyping of clinical samples from 14 countries. Rev Panam Salud Publica;29(5) 350-357,may 2011. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892011000500008
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