Sero-prevalence of anti-Leptospira antibodies and associated risk factors in rural Rwanda: A cross-sectional study.
Adult
Aged
Agglutination Tests
Animals
Antibodies, Bacterial
/ blood
Asymptomatic Diseases
/ epidemiology
Cross-Sectional Studies
Female
Humans
Leptospira
/ classification
Leptospirosis
/ blood
Male
Middle Aged
Prevalence
Rodentia
/ microbiology
Rwanda
/ epidemiology
Seroepidemiologic Studies
Young Adult
Zoonoses
/ blood
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
02
02
2020
accepted:
05
08
2021
revised:
17
12
2021
pubmed:
8
12
2021
medline:
19
2
2022
entrez:
7
12
2021
Statut:
epublish
Résumé
Leptospirosis is a zoonotic disease transmitted through the urine of wild and domestic animals, and is responsible for over 50,000 deaths each year. In East Africa, prevalence varies greatly, from as low as 7% in Kenya to 37% in Somalia. Transmission epidemiology also varies around the world, with research in Nicaragua showing that rodents are the most clinically important, while studies in Egypt and Chile suggest that dogs may play a more important role. There are no published studies of leptospirosis in Rwanda. We performed a cross-sectional survey of asymptomatic adults recruited from five occupational categories. Serum samples were tested using ELISA and Microscopic Agglutination Test (MAT). We found that 40.1% (151/377) of asymptomatic adults had been exposed to Leptospira spp. Almost 36.3% of positive subjects reported contact with rats (137/377) which represent 90.7% among positive leptospira serology compared with 48.2% of negative subjects (182/377) which represent 80.5% among negative leptospira serology (OR 2.37, CI 1.25-4.49) and 1.7 fold on prevalence ratio and 2.37 of odd ratio. Furthermore, being a crop farmer was significantly associated with leptospirosis (OR 2.06, CI 1.29-3.28). We identified 6 asymptomatic subjects (1.6%) who met criteria for acute infection. This study demonstrates a high prevalence of leptospiral antibodies infection among asymptomatic adults in rural Rwanda, particularly relative to neighboring countries. Although positive subjects were more likely to report rat contact, we found no independent association between rats and leptospirosis infection. Nonetheless, exposure was high among crop farmers, which is supportive of the hypothesis that rats together with domestic livestock might contribute to the transmission. Further studies are needed to understand infecting Leptospira servers and elucidate the transmission epidemiology in Rwanda and identify means of host transmitters.
Sections du résumé
BACKGROUND
Leptospirosis is a zoonotic disease transmitted through the urine of wild and domestic animals, and is responsible for over 50,000 deaths each year. In East Africa, prevalence varies greatly, from as low as 7% in Kenya to 37% in Somalia. Transmission epidemiology also varies around the world, with research in Nicaragua showing that rodents are the most clinically important, while studies in Egypt and Chile suggest that dogs may play a more important role. There are no published studies of leptospirosis in Rwanda.
METHODS & FINDINGS
We performed a cross-sectional survey of asymptomatic adults recruited from five occupational categories. Serum samples were tested using ELISA and Microscopic Agglutination Test (MAT). We found that 40.1% (151/377) of asymptomatic adults had been exposed to Leptospira spp. Almost 36.3% of positive subjects reported contact with rats (137/377) which represent 90.7% among positive leptospira serology compared with 48.2% of negative subjects (182/377) which represent 80.5% among negative leptospira serology (OR 2.37, CI 1.25-4.49) and 1.7 fold on prevalence ratio and 2.37 of odd ratio. Furthermore, being a crop farmer was significantly associated with leptospirosis (OR 2.06, CI 1.29-3.28). We identified 6 asymptomatic subjects (1.6%) who met criteria for acute infection.
CONCLUSIONS
This study demonstrates a high prevalence of leptospiral antibodies infection among asymptomatic adults in rural Rwanda, particularly relative to neighboring countries. Although positive subjects were more likely to report rat contact, we found no independent association between rats and leptospirosis infection. Nonetheless, exposure was high among crop farmers, which is supportive of the hypothesis that rats together with domestic livestock might contribute to the transmission. Further studies are needed to understand infecting Leptospira servers and elucidate the transmission epidemiology in Rwanda and identify means of host transmitters.
Identifiants
pubmed: 34874936
doi: 10.1371/journal.pntd.0009708
pii: PNTD-D-19-01548
pmc: PMC8683035
doi:
Substances chimiques
Antibodies, Bacterial
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0009708Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NIAID NIH HHS
ID : R01 AI121207
Pays : United States
Organisme : FIC NIH HHS
ID : R01 TW009504
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Travel Med Infect Dis. 2010 Jan;8(1):33-9
pubmed: 20188303
Ann Trop Med Parasitol. 2009 Dec;103(8):711-8
pubmed: 20030995
Trans R Soc Trop Med Hyg. 1982;76(2):178-82
pubmed: 6980503
PLoS Negl Trop Dis. 2019 May 31;13(5):e0007225
pubmed: 31150391
PLoS Negl Trop Dis. 2015 Dec 01;9(12):e0004251
pubmed: 26624890
PLoS Negl Trop Dis. 2015 Sep 17;9(9):e0003843
pubmed: 26379035
J Trop Med. 2012;2012:519701
pubmed: 22685476
Clin Microbiol Rev. 2001 Apr;14(2):296-326
pubmed: 11292640
Lancet Infect Dis. 2003 Dec;3(12):757-71
pubmed: 14652202
Int J Environ Health Res. 2003 Jun;13 Suppl 1:S47-56
pubmed: 12775379
PLoS Negl Trop Dis. 2018 Jun 25;12(6):e0006600
pubmed: 29939991
Am J Trop Med Hyg. 2000 Nov-Dec;63(5-6):249-54
pubmed: 11421372
Int J Infect Dis. 2014 Nov;28:47-64
pubmed: 25197035
PLoS Negl Trop Dis. 2015 Mar 25;9(3):e0003607
pubmed: 25806825
PLoS Negl Trop Dis. 2015 Sep 17;9(9):e0003898
pubmed: 26379143
East Afr Med J. 1987 Jan;64(1):49-54
pubmed: 3622331
Am J Trop Med Hyg. 2011 Mar;84(3):420-5
pubmed: 21363980
Int J Environ Res Public Health. 2014 Jun 26;11(7):6666-80
pubmed: 24972030
PLoS Negl Trop Dis. 2014 Jul 24;8(7):e2941
pubmed: 25058149
Vet Rec. 1999 Mar 13;144(11):287-91
pubmed: 10204224
Acta Trop. 2016 May;157:162-8
pubmed: 26844370
Am J Trop Med Hyg. 2020 Dec;103(6):2552-2560
pubmed: 33069266