Table 1.
Characteristics of confirmed leptospirosis cases according to initial clinical diagnoses at sites
| Clinical Diagnosis at Site | |||||||
|---|---|---|---|---|---|---|---|
| Dengue (n = 11) |
Typhoid fever (n = 4) |
UTI (n = 5) |
CAP (n = 3) |
Othera (n = 6) |
Leptospirosis (n = 22) |
Total (n = 51) |
|
| Demography | |||||||
| Gender (male: female) | 10:1 | 1:3 | 2:3 | 2:1 | 3:3 | 16:6 | 34:17 |
| Adult: Pediatricb | 9:2 | 4:0 | 4:1 | 3:0 | 4:2 | 22:0 | 46:5 |
| Age, median (range) | 29 (5.3–58.1) | 42.3 (19.2–60.4) | 27 (10–61.4) | 62.5 (59.7–64.4) | 47 (13–85) | 41.7 (20.8–62.1) | 41.2 (5.3–85) |
| Signs & Symptoms, N (%) | |||||||
| Anorexia | 3 (27.3) | 2 (50) | 0 | 1 (33.3) | 3 (50) | 7 (31.8) | 16 (31.4) |
| Chills | 4 (36.4) | 2 (50) | 3 (60) | 2 (66.7) | 1 (16.7) | 9 (40.9) | 21 (41.2) |
| Lethargy | 2 (18.2) | 1 (25) | 1 (20) | 0 | 1 (16.7) | 10 (45.5) | 15 (29.4) |
| Icterus | 2 (18.2) | 0 | 0 | 0 | 1 (16.7) | 6 (27.3) | 9 (17.6) |
| Decrease of consciousness | 0 | 0 | 0 | 0 | 1 (16.7) | 0 | 1 (1.9) |
| Headache | 5 (45.5) | 3 (75) | 3 (60) | 1 (33.3) | 3 (50) | 13 (59.1) | 28 (54.9) |
| Dizziness | 2 (18.2) | 1 (25) | 3 (60) | 2 (66.7) | 2 (33.3) | 6 (27.3) | 16 (31.4) |
| Cough | 2 (18.2) | 0 | 1 (20) | 1 (33.3) | 2 (33.3) | 9 (40.9) | 15 (29.4) |
| Shortness of breath | 0 | 0 | 0 | 0 | 0 | 4 (18.2) | 4 (7.8) |
| Epigastric pain | 0 | 2 (50) | 2 (40) | 1 (33.3) | 1 (16.7) | 8 (36.4) | 14 (27.5) |
| Abdominal pain | 2 (18.2) | 0 | 0 | 0 | 1 (16.7) | 5 (22.7) | 8 (15.7) |
| Nausea | 8 (72.7) | 4 (100) | 4 (80) | 3 | 4 (66.7) | 17 (77.3) | 40 (78.4) |
| Vomiting | 7 (63.6) | 3 (75) | 3 (60) | 2 (66.7) | 5 (83.3) | 12 (54.5) | 32 (62.7) |
| Constipation | 2 (18.2) | 2 (50) | 0 | 0 | 1 (16.7) | 0 | 5 (9.8) |
| Diarrhea | 5 (45.5) | 0 | 2 (40) | 2 (66.7) | 3 (50) | 9 (40.9) | 21 (41.2) |
| Arthralgia | 2 (18.2) | 0 | 4 (80) | 2 (66.7) | 0 | 12 (54.5) | 20 (39.2) |
| Myalgia | 1 (9.1) | 1 (25) | 3 (60) | 1 (33.3) | 1 (16.7) | 15 (68.2) | 22 (43.1) |
| Skin rash | 0 | 0 | 0 | 1 (33.3) | 0 | 1 (4.5) | 2 (3.9) |
| Conjunctival suffusion | 2 (18.2) | 0 | 0 | 0 | 1 (16.7) | 11 (50) | 14 (27.5) |
| Rhonchi | 0 | 0 | 0 | 2 (66.7) | 0 | 4 (18.2) | 6 (11.8) |
| Pruritus | 0 | 1 (25) | 0 | 0 | 0 | 0 | 1 (1.9) |
| Gastrocnemius pain | 1 (9.1) | 0 | 0 | 0 | 1 (16.7) | 6 (27.3) | 8 (15.7) |
| Oliguria | 1 (9.1) | 0 | 0 | 0 | 0 | 3 (13.6) | 4 (7.8) |
| Brown-coloured urine | 0 | 0 | 0 | 0 | 0 | 7 (31.8) | 7 (13.7) |
| Haematology & Chemistry Results, N (%) / N/tested (%) | |||||||
| Leukopenia | 0 | 0 | 1 (20) | 0 | 1 (16.7) | 0 | 2 (3.9) |
| Normal leucocyte count | 10 (90.9) | 3 (75) | 2 (40) | 2 (66.7) | 0 | 6 (27.3) | 23 (45.1) |
| Leukocytosis | 1 (9.1) | 1 (25) | 2 (40) | 1 (33.3) | 5 (83.3) | 16 (72.7) | 26 (50.9) |
| Platelet ≤150,000/mm3 | 8 (72.7) | 2 (50) | 1 (20) | 2 (66.7) | 1 (16.7) | 16 (72.7) | 30 (58.8) |
| Granulocytosis > 80% | 8/10 (80) | 2/3 (66.7) | 1/4 (25) | 2/2 (100) | 3/5 (60) | 10/12 (83.3) | 26/36 (72.2) |
| Lymphopenia < 20% | 9/10 (90) | 4/4 (100) | 2/4 (50) | 2/2 (100) | 5/5 (100) | 13/13 (100) | 35/38 (92.1) |
| Total bilirubin > 1 mg/dL | 3/11 (27.3) | 1/3 (33.3) | 0/4 | 1/3 (33.3) | 0/5 | 15/22 (68.2) | 20/48 (41.7) |
| Bilirubin direct > 0.65 mg/dL | 2/11 (18.2) | 1/3 (33.3) | 0/4 | 0/3 | 0/5 | 16/22 (72.7) | 19/48 (39.6) |
| ASTc > 100 | 1/11 (9.1) | 0/3 | 0/4 | 0/3 | 0/6 | 7/20 (35) | 8/47 (17) |
| ALTd > 100 | 0/11 | 0/3 | 0/4 | 0/3 | 0/6 | 3/22 (13.6) | 3/47 (6.4) |
| Creatinine > 1.4 mg/dL | 3/11 (27.3) | 0/3 | 2/4 (50) | 2/3 (66.7) | 0/5 | 15/22 (68.2) | 22/48 (45.8) |
| Diagnostic tests at sites, N/ tested (%) | |||||||
| Dengue IgM positive | 2/6 (33.3) | 2/4 (50) | 0/1 | 0/1 | 0/1 | 0/5 | 4/18 (22.2) |
| Tubex TF®e | 2/5 (40) | 4/4 (100) | 1/2 (50) | 0/1 | 1/3 (33.3) | 2/5 (40) | 10/20 (50) |
| Leptospira IgM positive | 0/1 | 0/4 | 0/1 | 0/1 | 0/1 | 18/22 (81.8) | 18/25 (72) |
| Reference Laboratory tests, N (%) | |||||||
| Dengue & S. typhi | 1 (9.1) | 0 | 0 | 0 | 0 | 0 | 1 (1.9) |
| Leptospira PCR & Serology | 6 (54.5) | 2 (50) | 2 (40) | 3 (100) | 3 (50) | 12 (54.5) | 28 (54.9) |
| Leptospira PCR only | 2 (18.2) | 0 | 0 | 0 | 1 (16.7) | 2 (9.1) | 5 (9.8) |
| Leptospira serology only | 3 (27.3) | 2 (50) | 3 (60) | 0 | 2 (33.3) | 8 (36.4) | 18 (35.3) |
| Outcome, N (%) | |||||||
| Death | 1 (9.1) | 1 (25) | 0 | 0 | 0 | 0 | 2 (4) |
adiarrhea (2), sepsis (1), pharyngitis (1), ulcus pedis (1), undifferentiated fever (1)
badult aged ≥18 year old; pediatric aged ≥1 - < 18 year old
Signs and symptoms in italics were not obtained from all patients as they were not included in the case report form. They were extracted from chart review
cAST: aspartate aminotransferase
dALT: alanine aminotransferase
eTUBEX TF® is a rapid diagnostic test to detect IgM antibodies against Salmonella typhi. Scores of 4–6 were considered positive