Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda
Loading...
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS Neglected Tropical Diseases
Abstract
The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence
of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for
seropositivity in humans in rural Western Uganda.
Methodology and Principal Findings
359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially
recruited during March and April 2014. A health history survey and serum were collected
from consented participants. Overall, 69% reported having fever in the past year,
with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0%
leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira
serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/
359; 95%CI 30.2–40.3%) defined as MAT titer 1:100 for any serovar. The highest prevalence
was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8%(71/359; 95%
CI 15.9–24.4%). The prevalence of probable recent leptospirosis (MAT titer 1:800) was
1.9% (95%CI 0.9–4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes).
Probable recent leptospirosis was associated with having self-reported malaria within the
past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher
odds (95%CI 1.4–108.6; p = 0.024) of Leptospira seropositivity compared with those who
had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds (95%CI 1.2–3.1; p = 0.009) of seropositivity compared with participants without monkeys
nearby.
Conclusions/Significance
The 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is
common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup). Leptospirosis
should be a diagnostic consideration in febrile illness and “smear-negative malaria” in
rural East Africa.
Description
Keywords
Leptospira Seroprevalence, Risk Factors, Health Centre Patients, Hoima District, Western Uganda
Citation
Dreyfus A, Dyal JW, Pearson R, Kankya C, Kajura C, Alinaitwe L, et al. (2016) Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda. PLoS Negl Trop Dis 10(8): e0004858. doi:10.1371/journal. pntd.0004858