title: Improvement of leptospirosis surveillance in remote Pacific islands using serum spotted on filter paper.
abstract: OBJECTIVE
  Leptospirosis is a serious neglected disease in the Pacific. Because sensitive and specific laboratory tests are largely unavailable, the burden of disease and epidemiological data are often unreliable and do not allow informed disease prioritization and efficient control. We report the use of serum spotted on filter paper to improve the surveillance of leptospirosis in remote and resource-limited settings.
  
  
  METHODS
  A total of 172 acute-phase serum samples collected from patients with suspected dengue at Yap State Hospital, Federated States of Micronesia, were spotted on filter paper and sent by regular mail to the Institut Louis Malardé, French Polynesia. Real-time PCR protocols for dengue and leptospirosis confirmation were performed on all specimens.
  
  
  RESULTS
  A total of five leptospirosis infections were detected amongst the patients with suspected dengue.
  
  
  CONCLUSIONS
  This study confirms the use of filter paper as a convenient tool to improve leptospirosis surveillance capacity in remote areas. New surveillance strategies, notably based on the regular use of this type of tool, are essential to more adequately describe the epidemiology and burden of neglected diseases.
authors.affiliation: Institut Louis Malardé, Tahiti, French Polynesia. Electronic address: dmusso@ilm.pf.
authors.forename: Didier
authors.initials: D
authors.lastname: Musso
authors.affiliation: Institut Louis Malardé, Tahiti, French Polynesia.
authors.forename: Claudine
authors.initials: C
authors.lastname: Roche
authors.affiliation: Yap State Hospital, Yap State, Federated States of Micronesia.
authors.forename: Maria
authors.initials: M
authors.lastname: Marfel
authors.affiliation: Waab Community Health Centers, Yap State, Federated States of Micronesia.
authors.forename: Martin
authors.initials: M
authors.lastname: Bel
authors.affiliation: World Health Organization, Fiji.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Nilles
authors.affiliation: Institut Louis Malardé, Tahiti, French Polynesia.
authors.forename: Van-Mai
authors.initials: VM
authors.lastname: Cao-Lormeau
mesh_terms: D003715:Dengue / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D059788:Dried Blood Spot Testing; D006801:Humans; D007922:Leptospirosis / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology*; D008849:Micronesia / Q000453:epidemiology; D011159:Population Surveillance; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Dengue; Filter paper; Leptospirosis; Neglected disease; PCR