title: Human leptospirosis in the Caribbean, 1997-2005: characteristics and serotyping of clinical samples from 14 countries.
abstract: OBJECTIVE
  To determine the frequency of human leptospirosis in the sera of suspected clinical cases sent by 14 Caribbean countries for diagnosis to a regional laboratory in 1997-2005.
  
  
  METHODS
  All serum samples were initially tested using the immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) for leptospirosis. Demographic data (such as age and sex), month of the year and clinical manifestations that had been observed by the attending physician were related to seropositivity. The microscopic agglutination test (MAT) was used to serotype sera using a panel of 23 international serovars.
  
  
  RESULTS
  Of 3 455 samples tested, 452 (13.1%) were seropositive for IgM antibodies to leptospirosis by the ELISA, with frequencies significantly (P < 0.05; χ2) different across countries and years. Among seropositive patients, the frequency of detection of leptospirosis (23.1%) was significantly higher in the age groups 1-20 years and 31-40 years combined compared with other age groups; and in male patients (72.1%) compared with female patients (19.7%) (P < 0.05; χ2). Chills, jaundice, vomiting, weakness, diarrhea, and kidney failure/problems were significantly (P < 0.05; χ2) exhibited at a higher frequency in seropositive, rather than seronegative patients. Using the MAT on 100 sera tested, 98 (98%) were seropositive, of which the serogroup Icterohaemorrhagiae was most prevalent with the detection of serovars Copenhageni (70%), Icterohaemorrhagiae (67%), and Mankarso (29%).
  
  
  CONCLUSIONS
  Since only 13.1% of the suspected cases of leptospirosis were seropositive for IgM ELISA antibodies, other clinical conditions may have been responsible for the clinical manifestations observed, or the patient may have had chronic leptospirosis (IgG). In the Caribbean, serovars of the serogroup Icterohaemorrhagiae were responsible for most infections in the cases tested.
authors.affiliation: School of Veterinary Medicine, Faculty of Medical Sciences, University of the West Indies, Trinidad and Tobago. Abiodun.Adesiyun@sta.uwi.edu
authors.forename: Abiodun Adewale
authors.initials: AA
authors.lastname: Adesiyun
authors.forename: Shirematee
authors.initials: S
authors.lastname: Baboolal
authors.forename: Sharianne
authors.initials: S
authors.lastname: Suepaul
authors.forename: Shakti
authors.initials: S
authors.lastname: Dookeran
authors.forename: Alva
authors.initials: A
authors.lastname: Stewart-Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D017691:Caribbean Region; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007919:Leptospira / Q000145:classification; D007922:Leptospirosis / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012703:Serotyping; D013997:Time Factors; D055815:Young Adult