Seroprevalence and Distribution of Leptospirosis Infection among Patients with Acute Febrile Illness in Central Uttar Pradesh: A Retrospective Observational Analysis

Abstract

Introduction: Leptospirosis is an anthropozoonotic disease. The wide spectrum of clinical manifestations of leptospirosis ranges from mild febrile illness without complications to severe disease with Multiorgan dysfunction. In the central and eastern parts of Uttar Pradesh, India, it is one of the major causes of acute febrile illness. Aim: To determine the seroprevalence, clinical features and geographical distribution of leptospirosis in Central Uttar Pradesh, India. Materials and Methods: This current retrospective observational study was conducted in the Serology Laboratory, Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Uttar Pradesh, India, from January 2022 to December 2022 and data were analysed from January 2023 to March 2023. A total of 625 patients with fever lasting >7 days attending the Outpatient Department (OPD) were included in the study. Serum samples of these patients were tested for Leptospira Immunoglobulin M (IgM) by Enzyme-linked Immunosorbent Assay (ELISA). Clinical, laboratory findings and demographic data were also collected from the hospital software. The patients were also tested for other infectious aetiologies such as malaria, typhoid, dengue and scrub typhus. Data were presented as percentages, and the Odds Ratio (OR), 95% CI, and p-value were used to test the level of significance. Results: Leptospirosis was found to be positive in 63 (10.08%) patients. The patients with leptospirosis belonged to the age group of 21-40 years with a male predominance. The maximum number of cases was from Lucknow district with 23.8% prevalence, followed by Prayagraj (11.11%). The common presenting symptoms were weakness, epigastric pain, myalgia and jaundice. Co-infection with scrub typhus was seen in 11 (17.4%) patients with leptospirosis. None of the other infections showed co-infection with leptospirosis. Coagulopathy and hepatic dysfunction were found in the majority of the patients with leptospirosis. Mortality was seen in five patients with Multiple Organ Dysfunction Syndrome (MODS). Conclusion: The seroprevalence of leptospirosis was found to be 10.08%. To reduce the morbidity and mortality linked to leptospirosis, it is necessary to improve diagnostic skills and the knowledge of physicians for screening the disease in patients with acute febrile illnesses, as it involves multiple systems and has overlapping common presenting symptoms.

Keywords

• anthropozoonotic
• coagulopathy
• hepatic dysfunction
• mortality