The Predictive Factors for Severe Leptospirosis Cases in Kedah

Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to l...

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Main Authors: Rakesh Singh Sandhu, Halim Bin Ismail, Mohd Hasni Bin Ja’afar, Sanjay Rampal
Format: Article
Language:English
Published: MDPI AG 2020-05-01
Series:Tropical Medicine and Infectious Disease
Subjects:
Online Access:https://www.mdpi.com/2414-6366/5/2/79
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author Rakesh Singh Sandhu
Halim Bin Ismail
Mohd Hasni Bin Ja’afar
Sanjay Rampal
author_facet Rakesh Singh Sandhu
Halim Bin Ismail
Mohd Hasni Bin Ja’afar
Sanjay Rampal
author_sort Rakesh Singh Sandhu
collection DOAJ
description Over the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to leptospirosis requires monitoring, specific treatments, and intensive care admission, thus increasing the cost of treating severe leptospirosis cases. Currently, we have data on incident and mortality rates, but we do not have data on the number of patients with severe form of leptospirosis or how many patients have complications, and whether or not these complications were resolved. Therefore, we carried out this study to determine the predictive factors for severe leptospirosis cases in Kedah. We conducted a cross-sectional study. The data of patients diagnosed with leptospirosis were obtained from the surveillance unit, Kedah Health Department, through the e-notification system. These data were then sorted according to the hospitals where the patients were admitted. The patients’ medical records were collected, and their information was obtained using a checklist. A total of 456 confirmed leptospirosis cases were included in the study, with 199 patients classified as severe cases and 257 patients as mild cases, based on the Malaysian leptospirosis guidelines. Most patients were male (71.5%) with a mean SD age of 36.62 ± 20.75 years. The predictive factors for severe leptospirosis include abnormal lung sounds (OR: 3.07 [CI 1.58–6.00]), hepatomegaly (OR: 7.14 [1.10–45.98]), hypotension (OR: 2.16 [1.08–4.34]), leukocytosis (OR: 2.12 [1.37–3.29]), low hematocrit (OR: 2.33 [1.43–3.81]), and increased alanine aminotransferase (SGPT ALT) (OR: 2.12 [1.36–3.30]). In conclusion, knowing these predictive factors will help clinicians identify severe leptospirosis cases earlier and develop their treatment plans accordingly, to reduce the complications and death from severe leptospirosis.
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spelling doaj.art-b72b5e96edf74d988a93f3b6245102442023-11-20T00:24:26ZengMDPI AGTropical Medicine and Infectious Disease2414-63662020-05-01527910.3390/tropicalmed5020079The Predictive Factors for Severe Leptospirosis Cases in KedahRakesh Singh Sandhu0Halim Bin Ismail1Mohd Hasni Bin Ja’afar2Sanjay Rampal3Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, MalaysiaDepartment of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, MalaysiaDepartment of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, MalaysiaCentre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 56000, MalaysiaOver the past decade, increased awareness about leptospirosis disease in developing and industrialized countries has resulted in increased numbers of leptospirosis cases being reported worldwide. About 5% to 15% of leptospirosis patients end up with severe forms of the disease. Complication due to leptospirosis requires monitoring, specific treatments, and intensive care admission, thus increasing the cost of treating severe leptospirosis cases. Currently, we have data on incident and mortality rates, but we do not have data on the number of patients with severe form of leptospirosis or how many patients have complications, and whether or not these complications were resolved. Therefore, we carried out this study to determine the predictive factors for severe leptospirosis cases in Kedah. We conducted a cross-sectional study. The data of patients diagnosed with leptospirosis were obtained from the surveillance unit, Kedah Health Department, through the e-notification system. These data were then sorted according to the hospitals where the patients were admitted. The patients’ medical records were collected, and their information was obtained using a checklist. A total of 456 confirmed leptospirosis cases were included in the study, with 199 patients classified as severe cases and 257 patients as mild cases, based on the Malaysian leptospirosis guidelines. Most patients were male (71.5%) with a mean SD age of 36.62 ± 20.75 years. The predictive factors for severe leptospirosis include abnormal lung sounds (OR: 3.07 [CI 1.58–6.00]), hepatomegaly (OR: 7.14 [1.10–45.98]), hypotension (OR: 2.16 [1.08–4.34]), leukocytosis (OR: 2.12 [1.37–3.29]), low hematocrit (OR: 2.33 [1.43–3.81]), and increased alanine aminotransferase (SGPT ALT) (OR: 2.12 [1.36–3.30]). In conclusion, knowing these predictive factors will help clinicians identify severe leptospirosis cases earlier and develop their treatment plans accordingly, to reduce the complications and death from severe leptospirosis.https://www.mdpi.com/2414-6366/5/2/79leptospirosisseverepredictive factor
spellingShingle Rakesh Singh Sandhu
Halim Bin Ismail
Mohd Hasni Bin Ja’afar
Sanjay Rampal
The Predictive Factors for Severe Leptospirosis Cases in Kedah
Tropical Medicine and Infectious Disease
leptospirosis
severe
predictive factor
title The Predictive Factors for Severe Leptospirosis Cases in Kedah
title_full The Predictive Factors for Severe Leptospirosis Cases in Kedah
title_fullStr The Predictive Factors for Severe Leptospirosis Cases in Kedah
title_full_unstemmed The Predictive Factors for Severe Leptospirosis Cases in Kedah
title_short The Predictive Factors for Severe Leptospirosis Cases in Kedah
title_sort predictive factors for severe leptospirosis cases in kedah
topic leptospirosis
severe
predictive factor
url https://www.mdpi.com/2414-6366/5/2/79
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