Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia

Introduction: Incidence of leptospirosis has increased within the past few years in many countries. Its clinical presentations were generally nonspecific, making it difficult to assist in the diagnosis. Besides the determination of the common clinical features, the sociodemographic background is ess...

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Main Authors: Mohd Taib, Niazlin, Ahmad, Hamidah, Soh, Kim Lam, Md Shah, Anim, Amin Nordin, Syafinaz, Lung, Leslie Than Thian, Abdullah, Maha, Chong, Chun Wie, Sekawi, Zamberi
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Published: Mary Ann Liebert 2020
Online Access:http://psasir.upm.edu.my/id/eprint/85815/
https://www.liebertpub.com/doi/10.1089/vbz.2018.2417
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spelling my.upm.eprints.858152023-09-20T03:52:17Z http://psasir.upm.edu.my/id/eprint/85815/ Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia Mohd Taib, Niazlin Ahmad, Hamidah Soh, Kim Lam Md Shah, Anim Amin Nordin, Syafinaz Lung, Leslie Than Thian Abdullah, Maha Chong, Chun Wie Sekawi, Zamberi Introduction: Incidence of leptospirosis has increased within the past few years in many countries. Its clinical presentations were generally nonspecific, making it difficult to assist in the diagnosis. Besides the determination of the common clinical features, the sociodemographic background is essential to identify high-risk populations to assist in prevention. Methods: Data for this study were obtained from electronic medical records among patients clinically diagnosed with leptospirosis at a tertiary hospital in Malaysia from the years 2011 to 2015 and were recorded using standard pro forma. Associations between clinical features and sociodemographics were performed using bivariate analysis and logistic regression. Results: Data were collected from 283 patients. Their mean age was 30.71 years old. Out of 283 patients, 206 (72.8%) were male. Involvement in outdoor events and water activities was the highest risk factor of acquiring leptospirosis in 64 (22.7%) patients followed by 59 (20.8%) patients who were staying in crowded housing areas with poor sanitation. Although fever was the main clinical presentation in 274 (96.8%) patients with leptospirosis, gastrointestinal (GIT) symptoms were the second most frequent in 159 (56.2%) patients followed by pulmonary symptoms, myalgia, headache, and jaundice. From the total number of 283 patients, only 21 (92.6%) presented with severe leptospirosis. GIT symptoms were a significant predictor for leptospirosis severity, while the age group was the significant sociodemographic factor toward GIT presentation in leptospirosis. The relationship between GIT symptoms and crowded housing areas with poor sanitation was also significant. Multivariable logistic regression showed that crowded housing areas with poor sanitation (odds ratio [OR] = 3.570, p < 0.001) and age between 20 and 40 years old (OR = 2.056, p = 0.014) were more likely to have GIT symptoms. Conclusions: Information regarding the clinical features of leptospirosis to the public is necessary, while targeted prevention by educational outreach among 20–40 year olds especially those participating in outdoor water activities are crucial to decrease the incidence and complications of leptospirosis. Mary Ann Liebert 2020 Article PeerReviewed Mohd Taib, Niazlin and Ahmad, Hamidah and Soh, Kim Lam and Md Shah, Anim and Amin Nordin, Syafinaz and Lung, Leslie Than Thian and Abdullah, Maha and Chong, Chun Wie and Sekawi, Zamberi (2020) Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia. Vector-Borne and Zoonotic Diseases, 20 (4). 268 - 274. ISSN 1557-7759; ESSN: 1530-3667 https://www.liebertpub.com/doi/10.1089/vbz.2018.2417 10.1089/vbz.2018.2417
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
description Introduction: Incidence of leptospirosis has increased within the past few years in many countries. Its clinical presentations were generally nonspecific, making it difficult to assist in the diagnosis. Besides the determination of the common clinical features, the sociodemographic background is essential to identify high-risk populations to assist in prevention. Methods: Data for this study were obtained from electronic medical records among patients clinically diagnosed with leptospirosis at a tertiary hospital in Malaysia from the years 2011 to 2015 and were recorded using standard pro forma. Associations between clinical features and sociodemographics were performed using bivariate analysis and logistic regression. Results: Data were collected from 283 patients. Their mean age was 30.71 years old. Out of 283 patients, 206 (72.8%) were male. Involvement in outdoor events and water activities was the highest risk factor of acquiring leptospirosis in 64 (22.7%) patients followed by 59 (20.8%) patients who were staying in crowded housing areas with poor sanitation. Although fever was the main clinical presentation in 274 (96.8%) patients with leptospirosis, gastrointestinal (GIT) symptoms were the second most frequent in 159 (56.2%) patients followed by pulmonary symptoms, myalgia, headache, and jaundice. From the total number of 283 patients, only 21 (92.6%) presented with severe leptospirosis. GIT symptoms were a significant predictor for leptospirosis severity, while the age group was the significant sociodemographic factor toward GIT presentation in leptospirosis. The relationship between GIT symptoms and crowded housing areas with poor sanitation was also significant. Multivariable logistic regression showed that crowded housing areas with poor sanitation (odds ratio [OR] = 3.570, p < 0.001) and age between 20 and 40 years old (OR = 2.056, p = 0.014) were more likely to have GIT symptoms. Conclusions: Information regarding the clinical features of leptospirosis to the public is necessary, while targeted prevention by educational outreach among 20–40 year olds especially those participating in outdoor water activities are crucial to decrease the incidence and complications of leptospirosis.
format Article
author Mohd Taib, Niazlin
Ahmad, Hamidah
Soh, Kim Lam
Md Shah, Anim
Amin Nordin, Syafinaz
Lung, Leslie Than Thian
Abdullah, Maha
Chong, Chun Wie
Sekawi, Zamberi
spellingShingle Mohd Taib, Niazlin
Ahmad, Hamidah
Soh, Kim Lam
Md Shah, Anim
Amin Nordin, Syafinaz
Lung, Leslie Than Thian
Abdullah, Maha
Chong, Chun Wie
Sekawi, Zamberi
Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia
author_facet Mohd Taib, Niazlin
Ahmad, Hamidah
Soh, Kim Lam
Md Shah, Anim
Amin Nordin, Syafinaz
Lung, Leslie Than Thian
Abdullah, Maha
Chong, Chun Wie
Sekawi, Zamberi
author_sort Mohd Taib, Niazlin
title Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia
title_short Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia
title_full Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia
title_fullStr Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia
title_full_unstemmed Significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, Malaysia
title_sort significant clinical presentation of leptospirosis in relation to socio-demographic and risk factors in a tertiary hospital, malaysia
publisher Mary Ann Liebert
publishDate 2020
url http://psasir.upm.edu.my/id/eprint/85815/
https://www.liebertpub.com/doi/10.1089/vbz.2018.2417
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score 13.160551