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Biomédica
Print version ISSN 0120-4157
Abstract
PEREZ-GARCIA, Janeth et al. Incidence and underreporting of leptospirosis comparing three diagnostic methods in the endemic region of Urabá, Colombia. Biomédica [online]. 2019, vol.39, suppl.1, pp.150-162. ISSN 0120-4157. https://doi.org/10.7705/biomedica.v39i0.4577.
Introduction:
Leptospirosis represents a public health problem and is a significant cause of morbidity and mortality in the region of Urabá. However, its notification reveals diagnostic limitations.
Objective:
To establish the incidence of leptospirosis in the municipalities of the so-called eje bananero in the Urabá region, to describe the magnitude of underreporting, and to propose guidelines for laboratory diagnosis by the public health network.
Materials and methods:
Two leptospirosis information sources were used: The national official surveillance system and a cross-sectional study of 479 acute-phase patients from April, 2010, to May, 2012. The diagnosis was made using three different tests: Indirect immunofluorescence, microagglutination test, and blood cultures. The exhaustiveness percentage of each information source was calculatedusing thecapture and recapture test.
Results:
From the total number of cases, 58% (278/479) were positive for leptospirosis at least by a test and 10.43% (29/278) of cases were positive by all three methods. The inclusion of a native strain in the microagglutination test panel increased the percentage of positivity by 15%. The cumulative incidence rate was 66.5/100,000 inhabitants and the case fatality ratio was 2.15%. The underreporting rates of leptospirosis in the Urabá region were 27.8% in morbidity and 66.6% in mortality.
Conclusion:
Under-registration of leptospirosis in the region highlights the necessity to use more than one diagnostic test to identify Leptospira in patients from endemic areas. Under-registration could be a common situation throughout the country.
Keywords : Leptospira/diagnosis; blood culture; agglutination tests; fluorescent antibody technique; indirect.