title: Characteristics of rural leptospirosis patients admitted to referral hospitals during the 2008 leptospirosis outbreak in Sri Lanka: implications for developing public health control measures.
abstract: To determine the exposure risk factors of highly endemic rural leptospirosis in tropical setting, we conducted a prospective, hospital-based case control study in Sri Lanka. A conceptual hierarchy of variables was used to analyze the data. Case patients included 38 (34%) females and 73 (66%) males with a mean age of 36 yr (SD 12.7 yr). Using piped, chlorinated water for drinking/general purposes (odds ratio [OR] 0.33, 95% confidence interval [CI] 0.16-0.67), paddy fields in the vicinity of home (OR 1.77, 95% CI 1.06-2.97), sighting dogs at home yard/dog ownership (OR 1.79, 95% CI 1.11-2.91), sighting cattle at home yard/cattle ownership (OR 1.69, 95% CI 1.00-2.84), and work in a paddy field (OR 3.02, 95% CI 1.68, 5.41) were the main predictors of leptospirosis among febrile patients. In high endemic tropical settings with rural leptospirosis, risk factors in residential environments, rather than individual exposures, seemed to play a major role in leptospirosis disease transmission.
authors.affiliation: Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt" and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru sunethagampodi@yahoo.com.
authors.forename: Suneth B
authors.initials: SB
authors.lastname: Agampodi
authors.affiliation: Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt" and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Dhanaseela B
authors.initials: DB
authors.lastname: Nugegoda
authors.affiliation: Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt" and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Vasanthi
authors.initials: V
authors.lastname: Thevanesam
authors.affiliation: Department of Community Medicine, Tropical Disease Research Unit, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Landa; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka; Department of Medicine, University of California San Diego, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt" and Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Vinetz
mesh_terms: D016022:Case-Control Studies; D004196:Disease Outbreaks; D006761:Hospitals; D006801:Humans; D007922:Leptospirosis / Q000453:epidemiology* / Q000517:prevention & control; D011634:Public Health; D012017:Referral and Consultation; D012424:Rural Population; D013188:Sri Lanka / Q000453:epidemiology