Characteristics of Rural Leptospirosis Patients Admitted to Referral Hospitals During the 2008 Leptospirosis Outbreak in Sri Lanka: Implications for Developing Public Health Control Measures

Suneth B. Agampodi Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical “Alexander von Humboldt” and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru

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Dhanaseela B. Nugegoda Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical “Alexander von Humboldt” and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru

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Vasanthi Thevanesam Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical “Alexander von Humboldt” and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru

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Joseph M. Vinetz Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical “Alexander von Humboldt” and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru

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To determine the exposure risk factors of highly endemic rural leptospirosis in tropical setting, we conducted a prospective, hospital-based case control study in Sri Lanka. A conceptual hierarchy of variables was used to analyze the data. Case patients included 38 (34%) females and 73 (66%) males with a mean age of 36 yr (SD 12.7 yr). Using piped, chlorinated water for drinking/general purposes (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.16–0.67), paddy fields in the vicinity of home (OR 1.77, 95% CI 1.06–2.97), sighting dogs at home yard/dog ownership (OR 1.79, 95% CI 1.11–2.91), sighting cattle at home yard/cattle ownership (OR 1.69, 95% CI 1.00–2.84), and work in a paddy field (OR 3.02, 95% CI 1.68, 5.41) were the main predictors of leptospirosis among febrile patients. In high endemic tropical settings with rural leptospirosis, risk factors in residential environments, rather than individual exposures, seemed to play a major role in leptospirosis disease transmission.

Author Notes

* Address correspondence to Suneth B. Agampodi, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Saliyapura, Sri Lanka, 50008. E-mail: sunethagampodi@yahoo.com

Financial support: This study was partially funded by a World Health Organization (WHO) country office grant through the Epidemiology unit of Sri Lanka and Mahidol Oxford Research Unit.

Authors' addresses: Suneth B. Agampodi and Dhanaseela B. Nugegoda, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, E-mails: sunethagampodi@yahoo.com and dbnug@yahoo.com. Vasanthi Thevanesam, Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka, E-mail: vasanthithevanesam@yahoo.com. Joseph M. Vinetz, Department of Medicine, University of California San Diego, La Jolla, CA, E-mail: jvinetz@ucsd.edu.

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