Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo.
<h4>Background</h4>Fever with jaundice is a common symptom of some infectious diseases. In public health surveillance within the Democratic Republic of the Congo (DRC), yellow fever is the only recognized cause of fever with jaundice. However, only 5% of the surveillance cases are positi...
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2021
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oai:doaj.org-article:f2487c2c4e1f4091ac2628fc9216d23c2021-12-02T20:23:38ZLeptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo.1935-27271935-273510.1371/journal.pntd.0009670https://doaj.org/article/f2487c2c4e1f4091ac2628fc9216d23c2021-08-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009670https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Fever with jaundice is a common symptom of some infectious diseases. In public health surveillance within the Democratic Republic of the Congo (DRC), yellow fever is the only recognized cause of fever with jaundice. However, only 5% of the surveillance cases are positive for yellow fever and thus indicate the involvement of other pathogens. Leptospira spp. are the causative agents of leptospirosis, a widespread bacterial zoonosis, a known cause of fever with jaundice. This study aimed to determine the seropositivity of anti-Leptospira antibodies among suspected yellow fever cases and map the geographical distribution of possible leptospirosis in the DRC.<h4>Methods</h4>We conducted a retrospective study using 1,300 samples from yellow fever surveillance in the DRC from January 2017 to December 2018. Serum samples were screened for the presence of IgM against Leptospira spp. by a whole cell-based IgM ELISA (Patoc-IgM ELISA) at the Institut National de Recherche Biomedicale in Kinshasa (INRB) according to World Health Organization (WHO) guidance. Exploratory univariable and multivariable logistic regression analyses were undertaken to assess associations between socio-demographic factors and the presence of Leptospira IgM.<h4>Results</h4>Of the 1,300 serum samples screened, 88 (7%) showed evidence of IgM against Leptospira spp. Most positive cases (34%) were young adult males in the 20-29-year group. There were statistically significant associations between having Leptospira IgM antibodies, age, sex, and living area. Observed positive cases were mostly located in urban settings, and the majority lived in the province of Kinshasa. There was a statistically significant association between seasonality and IgM Leptospira spp. positivity amongst those living in Kinshasa, where most of the positive cases occurred during the rainy season.<h4>Conclusions</h4>This study showed that leptospirosis is likely an overlooked cause of unexplained cases of fever with jaundice in the DRC and highlights the need to consider leptospirosis in the differential diagnosis of fever with jaundice, particularly in young adult males. Further studies are needed to identify animal reservoirs, associated risk factors, and the burden of human leptospirosis in the DRC.Patrick Mukadi KakoniYannick Munyeku BazitamaJean Raphael NepomucenoElisabeth Pukuta-SimbuFrancois Kawhata MawikaGracia Kashitu MujingaLuigi PallaSteve Ahuka-MundekeJean-Jacques Muyembe TamfumNobuo KoizumiYoshinao KuboKoya AriyoshiChris SmithPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 8, p e0009670 (2021) |
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DOAJ |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Patrick Mukadi Kakoni Yannick Munyeku Bazitama Jean Raphael Nepomuceno Elisabeth Pukuta-Simbu Francois Kawhata Mawika Gracia Kashitu Mujinga Luigi Palla Steve Ahuka-Mundeke Jean-Jacques Muyembe Tamfum Nobuo Koizumi Yoshinao Kubo Koya Ariyoshi Chris Smith Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo. |
| description |
<h4>Background</h4>Fever with jaundice is a common symptom of some infectious diseases. In public health surveillance within the Democratic Republic of the Congo (DRC), yellow fever is the only recognized cause of fever with jaundice. However, only 5% of the surveillance cases are positive for yellow fever and thus indicate the involvement of other pathogens. Leptospira spp. are the causative agents of leptospirosis, a widespread bacterial zoonosis, a known cause of fever with jaundice. This study aimed to determine the seropositivity of anti-Leptospira antibodies among suspected yellow fever cases and map the geographical distribution of possible leptospirosis in the DRC.<h4>Methods</h4>We conducted a retrospective study using 1,300 samples from yellow fever surveillance in the DRC from January 2017 to December 2018. Serum samples were screened for the presence of IgM against Leptospira spp. by a whole cell-based IgM ELISA (Patoc-IgM ELISA) at the Institut National de Recherche Biomedicale in Kinshasa (INRB) according to World Health Organization (WHO) guidance. Exploratory univariable and multivariable logistic regression analyses were undertaken to assess associations between socio-demographic factors and the presence of Leptospira IgM.<h4>Results</h4>Of the 1,300 serum samples screened, 88 (7%) showed evidence of IgM against Leptospira spp. Most positive cases (34%) were young adult males in the 20-29-year group. There were statistically significant associations between having Leptospira IgM antibodies, age, sex, and living area. Observed positive cases were mostly located in urban settings, and the majority lived in the province of Kinshasa. There was a statistically significant association between seasonality and IgM Leptospira spp. positivity amongst those living in Kinshasa, where most of the positive cases occurred during the rainy season.<h4>Conclusions</h4>This study showed that leptospirosis is likely an overlooked cause of unexplained cases of fever with jaundice in the DRC and highlights the need to consider leptospirosis in the differential diagnosis of fever with jaundice, particularly in young adult males. Further studies are needed to identify animal reservoirs, associated risk factors, and the burden of human leptospirosis in the DRC. |
| format |
article |
| author |
Patrick Mukadi Kakoni Yannick Munyeku Bazitama Jean Raphael Nepomuceno Elisabeth Pukuta-Simbu Francois Kawhata Mawika Gracia Kashitu Mujinga Luigi Palla Steve Ahuka-Mundeke Jean-Jacques Muyembe Tamfum Nobuo Koizumi Yoshinao Kubo Koya Ariyoshi Chris Smith |
| author_facet |
Patrick Mukadi Kakoni Yannick Munyeku Bazitama Jean Raphael Nepomuceno Elisabeth Pukuta-Simbu Francois Kawhata Mawika Gracia Kashitu Mujinga Luigi Palla Steve Ahuka-Mundeke Jean-Jacques Muyembe Tamfum Nobuo Koizumi Yoshinao Kubo Koya Ariyoshi Chris Smith |
| author_sort |
Patrick Mukadi Kakoni |
| title |
Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo. |
| title_short |
Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo. |
| title_full |
Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo. |
| title_fullStr |
Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo. |
| title_full_unstemmed |
Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo. |
| title_sort |
leptospirosis as a cause of fever associated with jaundice in the democratic republic of the congo. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/f2487c2c4e1f4091ac2628fc9216d23c |
| work_keys_str_mv |
AT patrickmukadikakoni leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT yannickmunyekubazitama leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT jeanraphaelnepomuceno leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT elisabethpukutasimbu leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT francoiskawhatamawika leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT graciakashitumujinga leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT luigipalla leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT steveahukamundeke leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT jeanjacquesmuyembetamfum leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT nobuokoizumi leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT yoshinaokubo leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT koyaariyoshi leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo AT chrissmith leptospirosisasacauseoffeverassociatedwithjaundiceinthedemocraticrepublicofthecongo |
| _version_ |
1718374142037721088 |