Seroprevalence of leptospirosis among blood donors in an endemic area

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Abstract

Thailand is known to be endemic for leptospirosis. This bacterium may pose a potential risk to transfusion safety. This study was a cross-sectional study examining the seroprevalence of leptospirosis among Thai blood donors. A total of 1053 serum specimens collected from blood donors residing in 5 regions of Thailand during March to September 2020 were included in this study. All samples were tested for the presence of antibodies to 22 leptospiral serovars using the microscopic agglutination test (MAT) and anti- Leptospira IgG antibodies using commercially available enzyme immunoassay. We found no evidence of recent exposure to Leptospira spp. in sera of healthy Thai blood donors by MAT, including those in higher-risk areas. However, in this same group, we did find small numbers of past exposure (1.7%) to Leptospira spp . by IgG ELISA. According to the findings of this study, there is currently no evidence for implementing new blood banking procedures to identify possible carriers in Thailand, however these should be continually monitored and revised according to the infectious disease burden in each country. It should be noted that there was a difference in the occupation rate between the general population reported in Thailand and blood donors in this study; it may not reflect the actual situation in the country.

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Global Morbidity and Mortality of Leptospirosis: A Systematic Review

Federico Costa, José E. Hagan, Juan Calcagno … (2016)

Background Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrome, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status. Methodology/Principal Findings We conducted a systematic review of published morbidity and mortality studies and databases to extract information on disease incidence and case fatality ratios. Linear regression and Monte Carlo modelling were used to obtain age and gender-adjusted estimates of disease morbidity for countries and Global Burden of Disease (GBD) and WHO regions. We estimated mortality using models that incorporated age and gender-adjusted disease morbidity and case fatality ratios. The review identified 80 studies on disease incidence from 34 countries that met quality criteria. In certain regions, such as Africa, few quality assured studies were identified. The regression model, which incorporated country-specific variables of population structure, life expectancy at birth, distance from the equator, tropical island, and urbanization, accounted for a significant proportion (R2 = 0.60) of the variation in observed disease incidence. We estimate that there were annually 1.03 million cases (95% CI 434,000–1,750,000) and 58,900 deaths (95% CI 23,800–95,900) due to leptospirosis worldwide. A large proportion of cases (48%, 95% CI 40–61%) and deaths (42%, 95% CI 34–53%) were estimated to occur in adult males with age of 20–49 years. Highest estimates of disease morbidity and mortality were observed in GBD regions of South and Southeast Asia, Oceania, Caribbean, Andean, Central, and Tropical Latin America, and East Sub-Saharan Africa. Conclusions/Significance Leptospirosis is among the leading zoonotic causes of morbidity worldwide and accounts for numbers of deaths, which approach or exceed those for other causes of haemorrhagic fever. Highest morbidity and mortality were estimated to occur in resource-poor countries, which include regions where the burden of leptospirosis has been underappreciated.

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Leptospirosis

Paul N. Levett, Joseph Vinetz (2001)

Leptospirosis is a worldwide zoonotic infection with a much greater incidence in tropical regions and has now been identified as one of the emerging infectious diseases. The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. The development of simpler, rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. In this review, the complex taxonomy of leptospires, previously based on serology and recently modified by a genotypic classification, is discussed, and the clinical and epidemiological value of molecular diagnosis and typing is also evaluated.

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Leptospirosis in humans.

David A. Haake, Paul N. Levett (2015)

Leptospirosis is a widespread and potentially fatal zoonosis that is endemic in many tropical regions and causes large epidemics after heavy rainfall and flooding. Infection results from direct or indirect exposure to infected reservoir host animals that carry the pathogen in their renal tubules and shed pathogenic leptospires in their urine. Although many wild and domestic animals can serve as reservoir hosts, the brown rat (Rattus norvegicus) is the most important source of human infections. Individuals living in urban slum environments characterized by inadequate sanitation and poor housing are at high risk of rat exposure and leptospirosis. The global burden of leptospirosis is expected to rise with demographic shifts that favor increases in the number of urban poor in tropical regions subject to worsening storms and urban flooding due to climate change. Data emerging from prospective surveillance studies suggest that most human leptospiral infections in endemic areas are mild or asymptomatic. Development of more severe outcomes likely depends on three factors: epidemiological conditions, host susceptibility, and pathogen virulence (Fig. 1). Mortality increases with age, particularly in patients older than 60 years of age. High levels of bacteremia are associated with poor clinical outcomes and, based on animal model and in vitro studies, are related in part to poor recognition of leptospiral LPS by human TLR4. Patients with severe leptospirosis experience a cytokine storm characterized by high levels of IL-6, TNF-alpha, and IL-10. Patients with the HLA DQ6 allele are at higher risk of disease, suggesting a role for lymphocyte stimulation by a leptospiral superantigen. Leptospirosis typically presents as a nonspecific, acute febrile illness characterized by fever, myalgia, and headache and may be confused with other entities such as influenza and dengue fever. Newer diagnostic methods facilitate early diagnosis and antibiotic treatment. Patients progressing to multisystem organ failure have widespread hematogenous dissemination of pathogens. Nonoliguric (high output) renal dysfunction should be supported with fluids and electrolytes. When oliguric renal failure occurs, prompt initiation of dialysis can be life saving. Elevated bilirubin levels are due to hepatocellular damage and disruption of intercellular junctions between hepatocytes, resulting in leaking of bilirubin out of bile caniliculi. Hemorrhagic complications are common and are associated with coagulation abnormalities. Severe pulmonary hemorrhage syndrome due to extensive alveolar hemorrhage has a fatality rate of >50 %. Readers are referred to earlier, excellent summaries related to this subject (Adler and de la Peña-Moctezuma 2010; Bharti et al. 2003; Hartskeerl et al. 2011; Ko et al. 2009; Levett 2001; McBride et al. 2005).

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Author and article information

Contributors

Nattachai Srisawat: drnattachai@yahoo.com

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 31 July 2023

Publication date PMC-release: 31 July 2023

Publication date Collection: 2023

Volume: 13

Electronic Location Identifier: 12336

Affiliations

[1 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Excellence Center for Critical Care Nephrology, , King Chulalongkorn Memorial Hospital, ; Bangkok, Thailand

[2 ]GRID grid.7922.e, ISNI 0000 0001 0244 7875, Center of Excellence in Critical Care Nephrology, Faculty of Medicine, , Chulalongkorn University, ; Bangkok, Thailand

[3 ]GRID grid.7922.e, ISNI 0000 0001 0244 7875, Tropical Medicine Cluster, , Chulalongkorn University, ; Bangkok, Thailand

[4 ]GRID grid.7922.e, ISNI 0000 0001 0244 7875, School of Global Health, Faculty of Medicine, , Chulalongkorn University, ; Bangkok, Thailand

[5 ]GRID grid.508398.f, ISNI 0000 0004 1782 4954, Thailand Public Health Research Fellowship, Health Education England, ; London, UK

[6 ]GRID grid.416757.6, National Institute of Health of Thailand, ; Nonthaburi, Thailand

[7 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Department of Laboratory Medicine, Faculty of Medicine, , Chulalongkorn University and Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, ; Bangkok, Thailand

[8 ]GRID grid.418828.f, Thai Red Cross, Queen Saovabha Memorial Institute, ; Bangkok, Thailand

[9 ]GRID grid.7922.e, ISNI 0000 0001 0244 7875, Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, , Chulalongkorn University, ; Bangkok, Thailand

[10 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Division of Nephrology, Department of Medicine, Faculty of Medicine, , King Chulalongkorn Memorial Hospital, ; Bangkok, Thailand

[11 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Center for Critical Care Nephrology, The CRISMA Center, Department of Critical Care Medicine, School of Medicine, , University of Pittsburgh, ; Pittsburgh, PA USA

[12 ]GRID grid.512985.2, Academy of Science, Royal Society of Thailand, ; Bangkok, Thailand

[13 ]GRID grid.411628.8, ISNI 0000 0000 9758 8584, Excellence Center for Critical Care Nephrology, Thai Red Cross Society, , King Chulalongkorn Memorial Hospital, ; 1873, Rama 4 Rd., Lumphini, Pathumwan, Bangkok, 10330 Thailand

Article

Publisher ID: 39461

DOI: 10.1038/s41598-023-39461-3

PMC ID: 10390486

PubMed ID: 37524788

SO-VID: 4c02eb52-c009-4ab4-a7d2-5606315394a5

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Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 22 March 2023

Date accepted : 25 July 2023

Funding

Funded by: The Second Century Fund (C2F), Chulalongkorn University

Funded by: Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University

Award ID: GA64/05

Funded by: Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University

Funded by: Tropical Medicine Cluster, Chulalongkorn University

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ScienceOpen disciplines: Uncategorized

Keywords: infectious-disease epidemiology,health policy,epidemiology,population screening

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ScienceOpen disciplines: Uncategorized

Keywords: infectious-disease epidemiology, health policy, epidemiology, population screening

Seroprevalence of leptospirosis among blood donors in an endemic area

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Most cited references 41

Global Morbidity and Mortality of Leptospirosis: A Systematic Review

Leptospirosis

Leptospirosis in humans.

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