Comparison of the Estimated Incidence of Acute Leptospirosis in the Kilimanjaro Region of Tanzania between 2007-08 and 2012-14.
Journal Article (Journal Article)
Background
The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of this estimate over time, we estimated the incidence of acute leptospirosis in Kilimanjaro Region, northern Tanzania for the time period 2012-2014.Methodology and principal findings
Leptospirosis cases were identified among febrile patients at two sentinel hospitals in the Kilimanjaro Region. Leptospirosis was diagnosed by serum microscopic agglutination testing using a panel of 20 Leptospira serovars belonging to 17 separate serogroups. Serum was taken at enrolment and patients were asked to return 4-6 weeks later to provide convalescent serum. Confirmed cases required a 4-fold rise in titre and probable cases required a single titre of ≥800. Findings from a healthcare utilisation survey were used to estimate multipliers to adjust for cases not seen at sentinel hospitals. We identified 19 (1.7%) confirmed or probable cases among 1,115 patients who presented with a febrile illness. Of cases, the predominant reactive serogroups were Australis 8 (42.1%), Sejroe 3 (15.8%), Grippotyphosa 2 (10.5%), Icterohaemorrhagiae 2 (10.5%), Pyrogenes 2 (10.5%), Djasiman 1 (5.3%), Tarassovi 1 (5.3%). We estimated that the annual incidence of leptospirosis was 11-18 cases per 100,000 population. This was a significantly lower incidence than 2007-08 (p<0.001).Conclusions
We estimated a much lower incidence of acute leptospirosis than previously, with a notable absence of cases due to the previously predominant serogroup Mini. Our findings indicate a dynamic epidemiology of leptospirosis in this area and highlight the value of multi-year surveillance to understand leptospirosis epidemiology.Full Text
Duke Authors
Cited Authors
- Maze, MJ; Biggs, HM; Rubach, MP; Galloway, RL; Cash-Goldwasser, S; Allan, KJ; Halliday, JEB; Hertz, JT; Saganda, W; Lwezaula, BF; Cleaveland, S; Mmbaga, BT; Maro, VP; Crump, JA
Published Date
- December 2016
Published In
Volume / Issue
- 10 / 12
Start / End Page
- e0005165 -
PubMed ID
- 27911902
Pubmed Central ID
- PMC5135036
Electronic International Standard Serial Number (EISSN)
- 1935-2735
International Standard Serial Number (ISSN)
- 1935-2727
Digital Object Identifier (DOI)
- 10.1371/journal.pntd.0005165
Language
- eng