Risk factors associated with leptospirosis during an outbreak in Middle Andaman, India.
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Date
2009-07
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Abstract
Background & objectives: Leptospirosis outbreaks occur frequently in North and South Andaman
Islands but not in Middle Andaman. In 2002, an outbreak appeared in Middle Andaman for the first
time. Although a study on risk factors was conducted in North Andaman, it used seropositivity to define
leptospirosis. Since seropositivity might not indicate current leptospiral infection and as no study on risk
factors was conducted in Middle Andaman, we carried out this study to identify the risk factors during
the outbreak.
Methods: A suspected outbreak of leptospirosis occurred in Rangat of Middle Andaman during October
- November 2002. Suspected cases were screened for leptospirosis using microscopic agglutination
test (MAT). Fifty two patients confirmed to have leptospirosis based on rising titres in MAT on paired
sera, and 104 age, sex and neighbourhood seronegative matched controls, were included in the study. A
conditional multiple regression by backward elimination process was carried out with acute leptospirosis
as the dependent factor and various environmental, occupational and behavioural factors as independent
factors. A stratified analysis was also carried out.
Results: The presence of cattle in the house, drinking stream water, contact with garbage, walking barefoot
and standing in water while working were identified as significant factors associated with leptospirosis.
Stratified analysis showed a dose response relationship between number of cattle in the house and the
risk of leptospiral infection suugesting that cattle could be a source of infection.
Interpretation & conclusions: Identification of the potential risk factors would help understand the
transmission dynamics of the disease and formulate public health interventions.
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Keywords
Case control study, leptospirosis, logistic model, outbreak, risk factors
Citation
Sugunan A P, Vijayachari P, Sharma S, Roy Subarna, Manickam P, Natarajaseenivasan K, Gupte M D, Sehgal S C. Risk factors associated with leptospirosis during an outbreak in Middle Andaman, India. Indian Journal of Medical Research. 2009 Jul; 130(1): 67-73.