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01-09-2019 | Leptospirosis | Original Contribution

A Case–Control Study of Environmental and Occupational Risks of Leptospirosis in Sri Lanka

Authors: Marie Hellung Schønning, Matthew David Phelps, Janith Warnasekara, Suneth B. Agampodi, Peter Furu

Published in: EcoHealth | Issue 3/2019

Abstract

Sri Lanka has one of the highest incidences of human leptospirosis worldwide. Outbreaks of this zoonotic infection are related to the monsoons and flooding. The study investigates risk factors associated with environmental, animal and occupational exposure while acknowledging the potential bias due to hanta viral infections in the study samples. Data were obtained from structured interviews with 483 patients (276 cases and 207 controls). Risk exposures were studied for the entire population and for two stratified occupational groups: non-paddy workers and paddy workers. A higher odds ratio (OR) of leptospirosis transmission for paddy workers was observed compared to non-paddy workers (OR 1.905, 95% CI 1.274–2.856). Rat exposure was not associated with a significant higher risk for any of the groups. Instead, cattle and household animals seemed to be important for transmission of leptospirosis to humans, especially among non-paddy workers (OR 10.655, 95% CI 1.213–93.582). Leptospirosis in paddy workers was associated with environmental factors linked to contamination and wetness in paddy fields. Interestingly, abandoned paddy fields were found to have a protective effect against transmission to paddy workers (OR 0.421, 95% CI 0.237–0.748). Keeping animals on these dryer fields may act as a boundary for contamination of paddy fields with infectious animal urine. This finding may be considered as a public health intervention targeting leptospirosis among paddy workers.

Agampodi SB, Agampodi TC, Thalagala E, Perera S, Chandraratne S and Fernando S (2010a) Do People Know Adequately about Leptospirosis? A Knowledge Assessment Survey in Post-outbreak Situation in Sri Lanka, International Journal of Preventive Medicine. India: Medknow Publications, 1(3), pp. 158–163. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075525/

Agampodi SB, Peacock S, Thevanesam V et al. (2011) ‘Leptospirosis outbreak in Sri Lanka in 2008: lessons for assessing the global burden of disease’, The American Journal of Tropical Medicine and Hygiene, 85(3), pp. 471–478. https://doi.org/10.4269/ajtmh.2011.11-0276 CrossRefPubMedPubMedCentral

Agampodi SB. Matthias M, Moreno A et al. (2012) ‘Utility of Quantitative Polymerase Chain Reaction in Leptospirosis Diagnosis: Association of Level of Leptospiremia and Clinical Manifestations in Sri Lanka’, Clinical Infectious Diseases. Oxford University Press, 54(9), pp. 1249–1255. https://doi.org/10.1093/cid/cis035.CrossRef

Agampodi SB, Moreno A, Vinetz J et al. (2013) ‘Short report: Utility and limitations of direct multi-locus sequence typing on qPCR-positive blood to determine infecting Leptospira strain’, American Journal of Tropical Medicine and Hygiene, 88(1), pp. 184–185. https://doi.org/10.4269/ajtmh.2012.12-0526.CrossRefPubMed

Agampodi SB, Dahanayaka N, Bandaranayaka A et al. (2014) ‘Regional differences of leptospirosis in Sri Lanka: observations from a flood-associated outbreak in 2011’, PLoS neglected tropical diseases, 8(1), p. e2626. https://doi.org/10.1371/journal.pntd.0002626.CrossRefPubMedPubMedCentral

Agampodi SB, Nugegoda D, Thevanesam V et al. (2015) ‘Characteristics of rural leptospirosis patients admitted to referral hospitals during the 2008 leptospirosis outbreak in Sri Lanka: implications for developing public health control measures’, The American Journal of Tropical Medicine and Hygiene, 92(1), pp. 139–144. https://doi.org/10.4269/ajtmh.14-0465.CrossRefPubMedPubMedCentral

Agampodi SB, Dahanayaka N, Nöckler K et al. (2016) ‘Redefining gold standard testing for diagnosing leptospirosis: Further evidence from a well-characterized, flood-related outbreak in Sri Lanka’, American Journal of Tropical Medicine and Hygiene, 95(3), pp. 531–536. https://doi.org/10.4269/ajtmh.16-0033.CrossRefPubMed

Agampodi SB, Nugegoda DB and Thevanesam V (2010b) ‘Determinants of leptospirosis in Sri Lanka: Study Protocol’, BMC Infectious Diseases. BioMed Central, 10(1), p. 332. https://doi.org/10.1186/1471-2334-10-332.CrossRef

Alderman K, Turner LR and Tong S (2012) ‘Floods and human health: a systematic review’, Environment International, 47, pp. 37–47. https://doi.org/10.1016/j.envint.2012.06.003.CrossRefPubMed

Anonymous (2011) Second National Communication on Climate Change – Submission to UNFCCC Secretariat. Ministry of Environment. Available at: http://www.climatechange.lk/Publications.html (Accessed: 7 January 2018).

Chadsuthi S, Modchang C, Lenbury Y et al. (2012) ‘Modeling seasonal leptospirosis transmission and its association with rainfall and temperature in Thailand using time-series and ARIMAX analyses’, Asian Pacific Journal of Tropical Medicine, 5(7), pp. 539–546. https://doi.org/10.1016/s1995-7645(12)60095-9.CrossRefPubMed

Clement J, Nield G, Hinrichsen, SL et al. (1999) ‘Urban leptospirosis versus urban hantavirus infection in Brazil’, The Lancet, 354, 2003-2004.CrossRef

Clement J, Van Esbroeck M, Lagrou K et al. (2014) ‘Letter to the Editor: Leptospirosis versus hantavirus infections in the Netherlands and in Belgium, 2000 to 2014’, Eurosurveillance, 19(38), pp. 2–3. https://doi.org/10.2807/1560-7917.es2014.19.38.20912.CrossRef

Costa F, Hagan J, Calcagno J et al. (2015) ‘Global Morbidity and Mortality of Leptospirosis: A Systematic Review’, PLoS neglected tropical diseases, 9(9), p. e0003898. https://doi.org/10.1371/journal.pntd.0003898.CrossRefPubMedPubMedCentral

Dahanayaka NJ, Warnasekara Y, Rajapakse R et al. (2017) ‘Validity of Lateral Flow Immunochromatographic-Assays (LFIA) in diagnosis of leptospirosis’, Ceylon Medical Journal. The Sri Lanka Medical Association, 62(4), p. 248. https://doi.org/10.4038/cmj.v62i4.8579.CrossRef

Ellis WA (1994) ‘Leptospirosis as a cause of reproductive failure’, The Veterinary Clinics of North America. Food Animal Practice, 10(3), pp. 463–478.CrossRef

Finlayson CM and Horwitz P (2015) ‘Wetlands as Settings for Human Health—the Benefits and the Paradox’, in Finlayson CM, Horwitz P and Weinstein P (eds) Wetlands and Human Health. Dordrecht: Springer Netherlands, pp. 1–13.CrossRef

Gamage CD, Yasuda S, Nishio S et al. (2011) ‘Serological evidence of Thailand virus-related hantavirus infection among suspected leptospirosis patients in Kandy, Sri Lanka’, Japanese Journal of Infectious Diseases, 64(1), pp. 72–75.PubMed

Gamage CD, Koizumi N, Perera A et al. (2014) ‘Carrier status of leptospirosis among cattle in Sri Lanka: A zoonotic threat to public health’, Transboundary and Emerging Diseases, 61(1), pp. 91–96. https://doi.org/10.1111/tbed.12014.CrossRefPubMed

Haake DA and Levett PN (2015) ‘Leptospirosis in humans’, Current Topics in Microbiology and Immunology, 387, pp. 65–97. https://doi.org/10.1007/978-3-662-45059-8_5.CrossRefPubMedPubMedCentral

Lau CL, Smythe L, Craig S et al. (2010) ‘Climate change, flooding, urbanisation and leptospirosis: fuelling the fire?’, Transactions of the Royal Society of Tropical Medicine and Hygiene, 104(10), pp. 631–638. https://doi.org/10.1016/j.trstmh.2010.07.002.CrossRefPubMed

Mwachui MA, Crump L, Hartskeerl R et al. (2015) ‘Environmental and Behavioural Determinants of Leptospirosis Transmission: A Systematic Review’, PLoS neglected tropical diseases, 9(9), p. e0003843. https://doi.org/10.1371/journal.pntd.0003843.CrossRefPubMedPubMedCentral

Niloofa R, Fernando N, de Silva N et al (2015) Diagnosis of Leptospirosis: Comparison between Microscopic Agglutination Test, IgM-ELISA and IgM Rapid Immunochromatography Test. PloS one 10(6):e0129236. 10.1371/journal.pone.0129236.CrossRefPubMedPubMedCentral

Samarakoon YM and Gunawardena N (2013) ‘Knowledge and self-reported practices regarding leptospirosis among adolescent school children in a highly endemic rural area in Sri Lanka’, Rural and Remote Health, 13(4), p. 2360.PubMed

Sunil-Chandra NP, Clement J, Maes P et al. (2015) ‘Concomitant leptospirosis-hantavirus co-infection in acute patients hospitalized in Sri Lanka: Implications for a potentially worldwide underestimated problem’, Epidemiology and Infection, 143(10), pp. 2081–2093. https://doi.org/10.1017/s0950268814003707.CrossRefPubMed

Terpstra WJ (ed.) (2003) Human leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organization.

Torgerson PR, Hagan J, Costa F et al. (2015) ‘Global Burden of Leptospirosis: Estimated in Terms of Disability Adjusted Life Years’, PLoS neglected tropical diseases, 9(10), p. e0004122. https://doi.org/10.1371/journal.pntd.0004122.CrossRefPubMedPubMedCentral

Warnasekara JN and Agampodi SB (2017) Leptospirosis in Sri Lanka. Sri Lankan Journal of Infectious Diseases. 7 (2), 67-75 https://doi.org/10.4038/sljid.v7i2.8155.CrossRef

Warnasekara J, Koralegedara I and Agampodi S (2019) ‘Estimating the burden of leptospirosis in Sri Lanka; A systematic review’, BMC Infectious Diseases, 19 (1), 1–12. https://doi.org/10.1186/s12879-018-3655-y.CrossRef

Whitmee S, Haines A, Beyrer C et al. (2015) ‘Safeguarding human health in the Anthropocene epoch: Report of the Rockefeller Foundation-Lancet Commission on planetary health’, The Lancet. Elsevier Ltd, 386(10007), 1973–2028. https://doi.org/10.1016/s0140-6736(15)60901-1.CrossRef

Zhang C, Wang H and Yan J (2012) ‘Leptospirosis prevalence in Chinese populations in the last two decades’, Microbes and Infection, 14(4), pp. 317–323. https://doi.org/10.1016/j.micinf.2011.11.007.CrossRefPubMed

Title: A Case–Control Study of Environmental and Occupational Risks of Leptospirosis in Sri Lanka
Authors: Marie Hellung Schønning
Matthew David Phelps
Janith Warnasekara
Suneth B. Agampodi
Peter Furu
Publication date: 01-09-2019
Publisher: Springer US
Keywords: Leptospirosis
Leptospira
Published in: EcoHealth / Issue 3/2019
Print ISSN: 1612-9202
Electronic ISSN: 1612-9210
DOI: https://doi.org/10.1007/s10393-019-01448-w

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