Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study

Introduction: Dengue and Leptospirosis are emerging important public health problems in India. While Dengue is a vector borne viral infection transmitted by Aedes mosquitoes, Leptospirosis is a zoonosis caused by pathogenic Leptospira. The incidence of both these infections increases during the rain...

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Main Authors: Anitha Ravindar, Priyadarshini Shanmugam
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2018-06-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/11570/36112_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PB(AG_OM)_PN(SS).pdf
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author Anitha Ravindar
Priyadarshini Shanmugam
author_facet Anitha Ravindar
Priyadarshini Shanmugam
author_sort Anitha Ravindar
collection DOAJ
description Introduction: Dengue and Leptospirosis are emerging important public health problems in India. While Dengue is a vector borne viral infection transmitted by Aedes mosquitoes, Leptospirosis is a zoonosis caused by pathogenic Leptospira. The incidence of both these infections increases during the rainy season. Due to simultaneous transmission of both these infections during rainy season, co-infections can occur. These mixed infections can change the clinical spectrum of disease to more fulminant course and presents a diagnostic and therapeutic challenge to the treating physicians. Aim: To determine the prevalence of Dengue and Leptospira co-infection by Dengue NS1 antigen, IgM and IgG ELISA, Leptospira PCR and Leptospira IgM ELISA. Materials and Methods: This was a cross-sectional study done over a period of one year at Chettinad Hospital and Research Institute. Symptomatic patients belonging to all age groups with fever of 7 days duration were included in the study. Blood (10mL) was collected from 100 febrile patients by using aseptic techniques, serum separated by centrifugation and then screened for both infections. Results: Dengue infection was found to be positive in 29 patients (29%) and Leptospirosis was found to be positive in 18 patients (18%). Four (4%) patients had a co-infection of dengue and leptospirosis. Among the 29 dengue positive patients, NS1 antigen was positive in 22 (75.86%), anti-dengue IgM was positive in 15 (51.72%) and anti-dengue IgG was positive in 8 (27.58%) patients. Dengue RT-PCR was found to be positive in 20 patients (68.96%). Among the 18 Leptospira positive patients, Leptospira IgM and Leptospira PCR were positive in 8 (44.44%) & 10 (55.55%) patients respectively. Of the co-infected patients, 75% were found to be positive for Dengue NS1, RTPCR and Leptospira PCR and 25% was found to be positive for anti-dengue IgM and Leptospira IgM antibodies. Conclusion: Co-infections may result in illness with overlapping signs and symptoms and enhanced ability to diagnose it early in illness with robust diagnostic methods which will help guide the physicians.
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spelling doaj.art-13979d7ca95044f49fead3471bf6df9b2022-12-22T01:27:50ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-06-01126DC05DC0910.7860/JCDR/2018/36112.11570Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional StudyAnitha Ravindar0Priyadarshini Shanmugam1Post Graduate Tutor, Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamilnadu, India.Professor and Head, Department of Microbiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamilnadu, India.Introduction: Dengue and Leptospirosis are emerging important public health problems in India. While Dengue is a vector borne viral infection transmitted by Aedes mosquitoes, Leptospirosis is a zoonosis caused by pathogenic Leptospira. The incidence of both these infections increases during the rainy season. Due to simultaneous transmission of both these infections during rainy season, co-infections can occur. These mixed infections can change the clinical spectrum of disease to more fulminant course and presents a diagnostic and therapeutic challenge to the treating physicians. Aim: To determine the prevalence of Dengue and Leptospira co-infection by Dengue NS1 antigen, IgM and IgG ELISA, Leptospira PCR and Leptospira IgM ELISA. Materials and Methods: This was a cross-sectional study done over a period of one year at Chettinad Hospital and Research Institute. Symptomatic patients belonging to all age groups with fever of 7 days duration were included in the study. Blood (10mL) was collected from 100 febrile patients by using aseptic techniques, serum separated by centrifugation and then screened for both infections. Results: Dengue infection was found to be positive in 29 patients (29%) and Leptospirosis was found to be positive in 18 patients (18%). Four (4%) patients had a co-infection of dengue and leptospirosis. Among the 29 dengue positive patients, NS1 antigen was positive in 22 (75.86%), anti-dengue IgM was positive in 15 (51.72%) and anti-dengue IgG was positive in 8 (27.58%) patients. Dengue RT-PCR was found to be positive in 20 patients (68.96%). Among the 18 Leptospira positive patients, Leptospira IgM and Leptospira PCR were positive in 8 (44.44%) & 10 (55.55%) patients respectively. Of the co-infected patients, 75% were found to be positive for Dengue NS1, RTPCR and Leptospira PCR and 25% was found to be positive for anti-dengue IgM and Leptospira IgM antibodies. Conclusion: Co-infections may result in illness with overlapping signs and symptoms and enhanced ability to diagnose it early in illness with robust diagnostic methods which will help guide the physicians.https://jcdr.net/articles/PDF/11570/36112_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PB(AG_OM)_PN(SS).pdflaboratory diagnosismolecular methodstropical fevers
spellingShingle Anitha Ravindar
Priyadarshini Shanmugam
Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study
Journal of Clinical and Diagnostic Research
laboratory diagnosis
molecular methods
tropical fevers
title Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study
title_full Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study
title_fullStr Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study
title_full_unstemmed Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study
title_short Co-infection of Dengue and Leptospirosis in Patients Presenting to a Tertiary Care Hospital with Acute Febrile Illness: A Cross-sectional Study
title_sort co infection of dengue and leptospirosis in patients presenting to a tertiary care hospital with acute febrile illness a cross sectional study
topic laboratory diagnosis
molecular methods
tropical fevers
url https://jcdr.net/articles/PDF/11570/36112_CE(RA1)_F(T)_PF1(AGAK)_PFA(AK)_PB(AG_OM)_PN(SS).pdf
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