• 1.

    Costa F et al.2015. Global morbidity and mortality of leptospirosis: a systematic review. PLoS Negl Trop Dis 9: e0003898.

  • 2.

    Goarant C et al.2009. Outbreak of leptospirosis in New Caledonia: diagnosis issues and burden of disease. Trop Med Int Health 14: 926929.

  • 3.

    Faine S , World Health Organization , 1982. Guidelines for the Control of Leptospirosis. Available at: https://apps.who.int/iris/handle/10665/37219. Accessed October 11, 2021.

  • 4.

    Katz AR, Ansdell VE, Effler PV, Middleton CR, Sasaki DM , 2001. Assessment of the clinical presentation and treatment of 353 cases of laboratory‐confirmed leptospirosis in Hawaii, 1974–1998. Clin Infect Dis 33: 18341841.

    • Search Google Scholar
    • Export Citation
  • 5.

    van Samkar A, van de Beek D, Stijnis C, Goris M, Brouwer MC , 2015. Suspected leptospiral meningitis in adults: report of four cases and review of the literature. Neth J Med 73: 464470.

    • Search Google Scholar
    • Export Citation
  • 6.

    Dolhnikoff M, Mauad T, Bethlem EP, Carvalho CRR , 2007. Pathology and pathophysiology of pulmonary manifestations in leptospirosis. Braz J Infect Dis 11: 142148.

    • Search Google Scholar
    • Export Citation
  • 7.

    Daher EDF, de Abreu KLS, da Silva Jr. GB , 2010. Leptospirosis-associated acute kidney injury. Braz. J. Nephrol. 32: 408415.

  • 8.

    Musso D, La Scola B , 2013. Laboratory diagnosis of leptospirosis: a challenge. J Microbiol Immunol Infect 46: 245252.

  • 9.

    Shivakurma S, 2013. Indian Guidelines for the Diagnosis of Human Leptospirosis. Medicine Update. Mumbai, India: The Association of Physicians of India, 23–29.

  • 10.

    Sukmark T et al.2018. Thai-Lepto-on-admission probability (THAI-LEPTO) score as an early tool for initial diagnosis of leptospirosis: result from Thai-Lepto AKI study group. PLoS Negl Trop Dis 12: e0006319.

    • Search Google Scholar
    • Export Citation
  • 11.

    Temeiam N, Jareinpituk S, Phinyo P, Patumanond J, Srisawat N , 2020. Development and validation of a simple score for diagnosis of leptospirosis at outpatient departments. PLoS Negl Trop Dis 14: e0007977.

    • Search Google Scholar
    • Export Citation
  • 12.

    Rajapakse S et al.2016. A diagnostic scoring model for leptospirosis in resource limited settings. PLoS Negl Trop Dis 10: e0004513.

  • 13.

    Stoddard RA, Gee JE, Wilkins PP, McCaustland K, Hoffmaster AR , 2009. Detection of pathogenic Leptospira spp. through TaqMan polymerase chain reaction targeting the lipL32 gene. Diagn Microbiol Infect Dis 64: 247255.

    • Search Google Scholar
    • Export Citation
  • 14.

    Bharti AR et al.2003. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis 3: 757771.

  • 15.

    Bandara K, Weerasekera MM, Gunasekara C, Ranasinghe N, Marasinghe C, Fernando N, 2016. Utility of modified Faine’s criteria in diagnosis of leptospirosis. BMC Infect Dis 16: 446.

  • 16.

    Le Turnier P, Bonifay T, Mosnier E, Blanchet D, Jolivet A, Demar M, Picardeau M, Djossou F, Epelboin L, 2018. Leptospirose versus dengue: et si la CRP suffisait pour guider l’antibiothérapie devant une fièvre au retour ou en zone d’endémie? Une étude cas-témoin appariée, Médecine et Maladies Infectieuses 48 (Suppl): S18.

  • 17.

    Institut de la statistique et des études économiques Nouvelle-Calédonie , n.d. Structure de la Population et Évolutions. Available at: http://www.isee.nc/population/recensement/structure-de-la-population-et-evolutions. Accessed October 11, 2021.

  • 18.

    Weinberger D, Baroux N, Grangeon J-P, Ko AI, Goarant C , 2014. El Niño southern oscillation and leptospirosis outbreaks in New Caledonia. PLoS Negl Trop Dis 8: e2798.

    • Search Google Scholar
    • Export Citation
  • 19.

    WHO, 2014. Severe malaria. Trop Med Int Health 19 (Suppl 1): 7–131.





Clinical Evaluation of the Modified Faine Criteria in Patients Admitted with Suspected Leptospirosis to the Territorial Hospital, New Caledonia, 2018 to 2019

View More View Less
  • 1 Centre Hospitalier Territorial de Nouvelle Calédonie, Service des Maladies Infectieuses et Médecine Iinterne, Dumbéa, New Caledonia;
  • | 2 Institut Pasteur de Nouvelle Calédonie, Nouméa, New Caledonia


Leptospirosis is endemic in New Caledonia. Clinical diagnosis is often difficult and its evolution can be fatal. Leptospirosis requires specific management before biological confirmation. Modified Faine criteria (Faine Score) have been suggested to diagnose leptospirosis on epidemiological (parts A and B) and biological (part C) criteria. The main objective of our study was to assess the relevance of the epidemiological–clinical modified Faine score, parts A and B (MF A + B), in patients with suspected leptospirosis in New Caledonia. A monocentric case–control study was conducted in suspect patients for whom a Leptospira polymerase chain reaction (PCR) test was done within the first 7 days of signs onset at the tertiary hospital from January 2018 to January 2019. Cases and control subjects were matched 1:2 in the gender and age categories. Bivariate, and then multivariable, analyses studied the association between the MF A + B score and a positive Leptospira PCR test, adjusted on the variables retained. In all, 35 cases and 70 control subjects matched for age and gender were analyzed. Multivariable analysis by logistic regression found a significant association between an MF A + B score taken from the categories “possible leptospirosis” (score, 20–25) and “presumed leptospirosis” (score, > 26), and the case or control subject status (P < 0.0001). Model performance was high, with an area under the curve value of 99.27%, 93.55% sensitivity, and 96.36% specificity, which classified subjects correctly in 95.35% of cases. Our study suggests using the MF A + B score to identify possible cases of leptospirosis and initiate antibiotic therapy before biological confirmation in New Caledonia. This score should be evaluated in areas where more differential diagnoses exist and where PCR is not widely available.

    • Supplemental Materials (PDF 17 KB)

Author Notes

Address correspondence to Arnaud Tarantola, Lyssavirus Epidemiology and Neuropathology Unit & WHO Collaborating Centre for Research on Rabies, Global Health Department, Institut Pasteur, 28 rue du Docteur Roux, 75724, Paris Cedex 15, France. E-mail: atarantola@hotmail.com

Authors’ addresses: Hélène Guibreteau, Shirley Gervolino, and Ann-Claire Gourinat, Centre Hospitalier Territorial de Nouvelle Calédonie, Service des Maladies Infectieuses et Médecine Iinterne, Dumbéa, New Caledonia, E-mails: hguibret@gmail.com, shirley.gervolino@cht.nc, and ann-claire.gourinat@cht.nc. Arnaud Tarantola and Cyrille Goarant, Institut Pasteur de Nouvelle Calédonie, Nouméa, New Caledonia, E-mails: atarantola@hotmail.com and cgoarant@pasteur.nc. Julien Colot, Cécile Cazorla, and Elise Klement-Frutos, Centre Hospitalier Territorial de Nouvelle Calédonie, Service des Maladies Infectieuses et Médecine Iinterne, Dumbéa, New Caledonia, and Institut Pasteur de Nouvelle Calédonie, Nouméa, New Caledonia, E-mails: jcolot@pasteur.nc, cecile.cazorla@cht.nc, and elisemma@hotmail.com.