Different Patterns in a Cohort of Patients with Severe Leptospirosis (Weil Syndrome): Effects of an Educational Program in an Endemic Area

Elizabeth F. Daher Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Geraldo B. Silva Júnior Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Rafael S. A. Lima Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Rosa M. S. Mota Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Hermano A. L. Rocha Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Krasnalhia Lívia S. de Abreu Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Adller G. C. Barreto Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Eanes D. B. Pereira Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Sônia M. H. A. Araújo Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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Alexandre B. Libório Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Post-gradution Program in Public Health, University of Fortaleza, Fortaleza, Ceará, Brazil; Department of Internal Medicine, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Department of Statistics, Science Center, Federal University of Ceará, Fortaleza, Ceará, Brazil

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DOI:
https://doi.org/10.4269/ajtmh.2011.11-0080
Volume/Issue:
Volume 85: Issue 3
Page(s):
479–484
Restricted access
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The aim of this study is to investigate the changes in clinical pattern and therapeutic measures in leptospirosis-associated acute kidney injury; a retrospective study with 318 patients in Brazil. Patients were divided according to the time of admission: 1985–1996 (group I) and 1997–2010 (group II). Patients were younger in group I (36 ± 13 versus 41 ± 16 years, P = 0.005) and the numbers of oliguria increased (21% versus 41% in group II, P = 0.014). Higher frequency of lung manifestations was observed in group II (P < 0.0001). Although increased severity, there was a significant reduction in mortality (20% in group I versus 12% in group II, P = 0.03). Mortality was associated with advanced age, low diastolic blood pressure, oliguria, arrhythmia, and peritoneal dialysis, besides a trend to better mortality with penicillin administration. Leptospirosis is occurring in an older population, with a higher number of oliguria and lung manifestations. However, mortality is decreasing and can be the result of changes in treatment.

Author Notes

*Address correspondence to Alexandre B. Libório, Av. Abolição, 4043 ap 1203, Fortaleza, CE, Brazil – CEP: 60.165-082. E-mail: alexandreliborio@yahoo.com.br

Financial support: This research was supported by CNPq – Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian Research Council).

Authors' addresses: Elizabeth F. Daher, Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: ef.daher@uol.com.br. Geraldo B. Silva Junior, School of Medicine, University of Fortaleza, and Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: geraldobezerrajr@unifor.br. Rafael S. A. Lima, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil, E-mail: rafaelsiqueiraufc@gmail.com. Rosa M. S. Mota, Department of Statistics, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: rosa@ufc.br. Hermano A. L. Rocha, Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: hermanoalexandre@yahoo.com.br. Krasnalhia Livia S. Abreu, Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: kras_livinha@yahoo.com.br. Adller G. C. Barreto, Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: adller.md@gmail.com. Eanes D. B. Pereira, Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: eanes@fortalnet.com.br. Sônia M. H. A. Araújo, Department of Internal Medicine, Federal University of Ceara, Fortaleza, Ceara, Brazil, E-mail: sonia.holanda@gmail.com. Alexandre Braga Libório, Post-Graduation Program in Public Health, University of Fortaleza, Fortaleza, Ceara, Brazil, E-mail: alexandreliborio@yahoo.com.br.

Copyright:
©The American Society of Tropical Medicine and Hygiene 2011
Received:
07 Feb 2011
|
Accepted:
16 Jun 2011
|
Published Online:
01 Sep 2011
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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