Epidemiology of human leptospirosis in Malaysia
Abstract number: 1733_550
Fairuz A., Abdul Rani B., Ayu M., Hishamshah I.
Leptospirosis is endemic in Malaysia. The epidemiological data for the past decade is very limited and the true disease burden in Malaysia is unknown. A hospital based study was carried out to estimate the most recent incidence and prevalence rates of the disease and also to descibe some epidemiological characteristics of the disease in Malaysia.
All sera of patients suspected to have leptospirosis admitted to the hospitals in Malaysia were tested for presence of antibody to leptospira. Isolation of leptospires and Polymerase chain reactions were also carried out to augment the diagnotic sensitivity. The clinical data of patients confirmed to have leptospirosis were obtained from their clinical case notes.
A total number of 5652 sera were received throughout 2003 till 2005 and 1060 were confirmed positive leptospirosis. The annual incidence rates for 2003, 2004 and 2005 were 0.9, 1.18 and 2.13 per 100000 population respectively. The case fatality rate 10.2%. The cases occurred throughout the year but there were more cases during the intermonsoon period that is between June to September and December to January. The male to female ratio was 4:1. The mean age of patients was 40.1±19. Ninety five percent of the cases were those in the productive ages between 2060 years old. The disease was most common amongst the Malays, the largest ethnic group in Malaysia. The common clinical features were fever (98%), chills (64.2%), Jaundice (44%), Abdominal pain (42.9%), cough (56.5%) and hepatomegaly (40.5%). The most worrying trend is the increasing number of cases(50.8%) with severe pulmonary involvement which include pneumonia, pulmonary haemorrhage, ARDS, and pulmonary failure. Pulmonary failure was the major contributory factor causing death in 85% of the fatal cases.
In conclusion, leptospirosis still remain to be a significant cause of morbidity and mortality. There should be a concerted effort to assess the health as well as economic impact of leptospirosis in this country. A comprehensive database needs to be created in order to obtain more data on the current trend of leptospirosis in Malaysia. Research in this field should also be done via collaborative efforts between the human and veterinary health institutions to address major issues related to the disease and facilitate in designing of strategies for control and prevention of the disease in this country.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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