title: A NEW POSSIBILITY FOR SURVEILLANCE: DO WE IDENTIFY ALL CASES OF LEPTOSPIROSIS?
abstract: Leptospirosis is a febrile disease with a typically underestimated global incidence, especially in regions where dengue is endemic. Therefore, it is difficult to accurately determine the number of leptospirosis cases in these areas, which contributes to significant under-reporting this disease. In this study, we estimated the number of possible leptospirosis cases among dengue-like cases that were reported during 2008, 2010, and 2012 in the city of Fortaleza, northeast Brazil. Patients were evaluated for dengue and leptospirosis using immunoenzymatic tests for IgM antibodies that were specific to each pathogen. Among the suspected cases of dengue that resulted as negative in laboratory tests, 10.8% (2008), 19.2% (2010), and 30.8% (2012) were confirmed to be leptospirosis. Considering the cases reported by the surveillance authority as dengue that were subsequently discarded based on the laboratory test results, we estimate that the number of actual leptospirosis cases may be 26 to 49 times higher than those diagnosed and reported by the Health Services. Furthermore, we believe that approximately 20% of dengue-like cases may be leptospirosis cases in areas where the two diseases are endemic.
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Raissa Matos
authors.initials: RM
authors.lastname: Fontes
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Luciano Pamplona de Góes
authors.initials: LP
authors.lastname: Cavalcanti
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Augusto César Aragão
authors.initials: AC
authors.lastname: Oliveira
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Laiane Fernanda de Melo
authors.initials: LF
authors.lastname: Bezerra
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Almira Maria Monteiro
authors.initials: AM
authors.lastname: Gomes
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Jeová Keny Baima
authors.initials: JK
authors.lastname: Colares
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Danielle Malta
authors.initials: DM
authors.lastname: Lima
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D018563:Disease Notification; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007922:Leptospirosis / Q000175:diagnosis* / Q000453:epidemiology; D011159:Population Surveillance