Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin

Leptospirosis is an important zoonotic disease in the world. The wet and warm climate in the Southeast Asia region provides a favourable condition for leptospires to survive in the environment and pathogenic leptospires have frequently been isolated from Malaysian waters and soils. A study was cond...

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Main Author:	Mohamed Nur Azim, Mazlan
Format:	Thesis
Language:	English
Published:	2014
Subjects:	QL Zoology
Online Access:	http://ir.unimas.my/id/eprint/9105/2/Nur%20Azim.pdf
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spelling	my-unimas-ir.91052023-03-28T07:40:38Z Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin 2014 Mohamed Nur Azim, Mazlan QL Zoology Leptospirosis is an important zoonotic disease in the world. The wet and warm climate in the Southeast Asia region provides a favourable condition for leptospires to survive in the environment and pathogenic leptospires have frequently been isolated from Malaysian waters and soils. A study was conducted in the Rejang basin of Sarawak from June 2009 to June 2012 to determine the seroprevalence of leptospirosis in the population and small mammals. The Rejang basin was chosen because leptospirosis cases had been previously found there. For human samples, all 508 sera were tested with Panbio® ELISA for leptospira IgM and the positive cases will be further examined by microscopic agglutination test (MAT) using 20 serovars obtained from the Institute of Medical Research (IMR), Kuala Lumpur. The seroprevalence of leptospirosis in human in the study area is 37.4% (190/508). The presumptive infecting serovars found were djasiman (22.1%), shermani (13.2%) and pomona (7.9%). For small mammals, 241 were trapped during the study and species that were trapped were Sundamys muelleri with 100 individuals (41.5%) (100/241), followed by Callosciurus notatus with 46 individuals (19.1%) (46/241), and Rattus exulans with 45 individuals (18.7%) (45/241). All blood extracted from small mammal samples were tested by MAT and ninety-eight (98) of sera samples tested (40.7%) (98/241) were positive for the antibody against Leptospira sp. with predominant presumptive serovars comprising of autumnalis (26.3%), tarassovi (23.2%) and bataviae (15.2%). The median age of seropositive cases was 42 years, many of whom were reliant on collected rain water and nearby river (74.7%) as their main water supply. More than half (56.3%) of the positive cases reported of having fever within the last 2-4 weeks before samples collection. Almost sixty percent (59.5%) of the seropositive respondent are females, whom are mostly housewives or farmers. Serovars australis, autumnalis, bataviae, canicola, iv celledoni, copenhageni, hebdomadis, tarassovi, pyrogenes, icterohaemorraghiae, ballum, shermani and panama can be correlated to both seropositive human and small mammals. Based on the result, Rejang Basin had the highest leptospirosis prevalence among human population and differences serovars compared to previous studies done in Malaysia. Logistic regression was used to identify factors associated with the leptospirosis infection. Factors that have significant association with the presence of leptospiral antibodies based on univariate analysis were: Primary education (OR= 0.654; 95% CI= 0.414-1.033), Secondary education (OR= 0.363; 95% CI= 0.219-0.602), presence of symptoms (OR=1.582; 95% CI=1.041-2.404), age groups of 11-20 years (OR= 0.291; 95% CI= 0.095-0.889), 21-30 ), 41-50 years (OR=0.323; 95% CI=0.115-0.911), 51-60 years (OR= 0.396; 95% CI= 0.137-1.141), Sarikei division (OR=0.360; CI= 0.169- 0.766) and contact with animal (OR= 0.511; 95% CI= 0.279-0.937). Based on multivariate analysis, the respondents’ educational level, age group and history of contact with animals remain to be significant. The respondents whom were defined as having the probable infection at time of survey were 5.3 times more likely to be symptomatic. The result also suggested that leptospirosis cases in Rejang Basin were most likely due to exposure to leptospires in the environment, possibly originating from the animal carriers. Due to the high prevalence of leptospirosis in the study area, appropriate public health and control strategies targeting this population should be implemented. Universiti Malaysia Sarawak, (UNIMAS) 2014 Thesis http://ir.unimas.my/id/eprint/9105/ http://ir.unimas.my/id/eprint/9105/2/Nur%20Azim.pdf text en validuser masters Universiti Malaysia Sarawak Faculty of Medicine and Human Sciences
institution	Universiti Malaysia Sarawak
collection	UNIMAS Institutional Repository
language	English
topic	QL Zoology
spellingShingle	QL Zoology Mohamed Nur Azim, Mazlan Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin
description	Leptospirosis is an important zoonotic disease in the world. The wet and warm climate in the Southeast Asia region provides a favourable condition for leptospires to survive in the environment and pathogenic leptospires have frequently been isolated from Malaysian waters and soils. A study was conducted in the Rejang basin of Sarawak from June 2009 to June 2012 to determine the seroprevalence of leptospirosis in the population and small mammals. The Rejang basin was chosen because leptospirosis cases had been previously found there. For human samples, all 508 sera were tested with Panbio® ELISA for leptospira IgM and the positive cases will be further examined by microscopic agglutination test (MAT) using 20 serovars obtained from the Institute of Medical Research (IMR), Kuala Lumpur. The seroprevalence of leptospirosis in human in the study area is 37.4% (190/508). The presumptive infecting serovars found were djasiman (22.1%), shermani (13.2%) and pomona (7.9%). For small mammals, 241 were trapped during the study and species that were trapped were Sundamys muelleri with 100 individuals (41.5%) (100/241), followed by Callosciurus notatus with 46 individuals (19.1%) (46/241), and Rattus exulans with 45 individuals (18.7%) (45/241). All blood extracted from small mammal samples were tested by MAT and ninety-eight (98) of sera samples tested (40.7%) (98/241) were positive for the antibody against Leptospira sp. with predominant presumptive serovars comprising of autumnalis (26.3%), tarassovi (23.2%) and bataviae (15.2%). The median age of seropositive cases was 42 years, many of whom were reliant on collected rain water and nearby river (74.7%) as their main water supply. More than half (56.3%) of the positive cases reported of having fever within the last 2-4 weeks before samples collection. Almost sixty percent (59.5%) of the seropositive respondent are females, whom are mostly housewives or farmers. Serovars australis, autumnalis, bataviae, canicola, iv celledoni, copenhageni, hebdomadis, tarassovi, pyrogenes, icterohaemorraghiae, ballum, shermani and panama can be correlated to both seropositive human and small mammals. Based on the result, Rejang Basin had the highest leptospirosis prevalence among human population and differences serovars compared to previous studies done in Malaysia. Logistic regression was used to identify factors associated with the leptospirosis infection. Factors that have significant association with the presence of leptospiral antibodies based on univariate analysis were: Primary education (OR= 0.654; 95% CI= 0.414-1.033), Secondary education (OR= 0.363; 95% CI= 0.219-0.602), presence of symptoms (OR=1.582; 95% CI=1.041-2.404), age groups of 11-20 years (OR= 0.291; 95% CI= 0.095-0.889), 21-30 ), 41-50 years (OR=0.323; 95% CI=0.115-0.911), 51-60 years (OR= 0.396; 95% CI= 0.137-1.141), Sarikei division (OR=0.360; CI= 0.169- 0.766) and contact with animal (OR= 0.511; 95% CI= 0.279-0.937). Based on multivariate analysis, the respondents’ educational level, age group and history of contact with animals remain to be significant. The respondents whom were defined as having the probable infection at time of survey were 5.3 times more likely to be symptomatic. The result also suggested that leptospirosis cases in Rejang Basin were most likely due to exposure to leptospires in the environment, possibly originating from the animal carriers. Due to the high prevalence of leptospirosis in the study area, appropriate public health and control strategies targeting this population should be implemented.
format	Thesis
qualification_level	Master's degree
author	Mohamed Nur Azim, Mazlan
author_facet	Mohamed Nur Azim, Mazlan
author_sort	Mohamed Nur Azim, Mazlan
title	Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin
title_short	Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin
title_full	Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin
title_fullStr	Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin
title_full_unstemmed	Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin
title_sort	seroprevalence and associated risk factors of leptospirosis in human and small mammals in the rejang basin
granting_institution	Universiti Malaysia Sarawak
granting_department	Faculty of Medicine and Human Sciences
publishDate	2014
url	http://ir.unimas.my/id/eprint/9105/2/Nur%20Azim.pdf
_version_	1783728031931564032

Seroprevalence and associated risk factors of leptospirosis in human and small mammals in the Rejang basin

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