title: Leptospirosis among hospitalized febrile patients in northern Tanzania.
abstract: We enrolled consecutive febrile admissions to two hospitals in Moshi, Tanzania. Confirmed leptospirosis was defined as a ≥ 4-fold increase in microscopic agglutination test (MAT) titer; probable leptospirosis as reciprocal MAT titer ≥ 800; and exposure to pathogenic leptospires as titer ≥ 100. Among 870 patients enrolled in the study, 453 (52.1%) had paired sera available, and 40 (8.8%) of these met the definition for confirmed leptospirosis. Of 832 patients with ≥ 1 serum sample available, 30 (3.6%) had probable leptospirosis and an additional 277 (33.3%) had evidence of exposure to pathogenic leptospires. Among those with leptospirosis the most common clinical diagnoses were malaria in 31 (44.3%) and pneumonia in 18 (25.7%). Leptospirosis was associated with living in a rural area (odds ratio [OR] 3.4, P < 0.001). Among those with confirmed leptospirosis, the predominant reactive serogroups were Mini and Australis. Leptospirosis is a major yet underdiagnosed cause of febrile illness in northern Tanzania, where it appears to be endemic.
authors.affiliation: Department of Medicine and Department of Pathology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Holly M
authors.initials: HM
authors.lastname: Biggs
authors.forename: Duy M
authors.initials: DM
authors.lastname: Bui
authors.forename: Renee L
authors.initials: RL
authors.lastname: Galloway
authors.forename: Robyn A
authors.initials: RA
authors.lastname: Stoddard
authors.forename: Sean V
authors.initials: SV
authors.lastname: Shadomy
authors.forename: Anne B
authors.initials: AB
authors.lastname: Morrissey
authors.forename: John A
authors.initials: JA
authors.lastname: Bartlett
authors.forename: Jecinta J
authors.initials: JJ
authors.lastname: Onyango
authors.forename: Venance P
authors.initials: VP
authors.lastname: Maro
authors.forename: Grace D
authors.initials: GD
authors.lastname: Kinabo
authors.forename: Wilbrod
authors.initials: W
authors.lastname: Saganda
authors.forename: John A
authors.initials: JA
authors.lastname: Crump
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D007297:Inpatients; D007922:Leptospirosis / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D013636:Tanzania / Q000453:epidemiology*; D055815:Young Adult