Leptospirosis in Luanda (Angola): Contribution for a differential diagnosis of patients with febrile illnesses: Contribuição para o diagnóstico diferencial de doentes com doença febril

Maria Luísa Vieira, Elsa Fortes-Gabriel

Research output: Contribution to conferencePosterpeer-review

Abstract

E_urolept f 2012 Poster presentations
II PP 131
LEPTOSPIROSIS IN LUANDA (ANGOLA): CONTRIBUTION FOR
A DIFFERENTIAL DIAGNOSIS OF PATIENTS WITH FEBRILE
ILLNESSES
Fortes-Gabriel E. M. V., Vieira M. L.
Unidade de Ensino e Investiga9cio de Microbiologia Medica, Grupo de Leptospirose e Borreliose de Lyme, Instituto deHigiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal
Leptospirosis is an important zoonosis of worldwide distribution, particularly in tropical countries.
The nonspecific clinical presentation of the infection can lead to a misdiagnosis in these regions, where similar febrile diseases are common and can be confused with other disorders such as malaria. In Angola, the leptospirosis diagnosis is done only by the patient history and medical suspicion, which can
lead to misdiagnosis contributing the increase in antibiotic treatment and resistance in the population.
The aim of this work was to know the seroprevalence of the leptospirosis in patients that presents febrile symptoms and an initial diagnosis of malaria ( after not confirmed), and to evaluate the Leptospira infection rate from rodents living close to human communities and their role as major spirochete reservoirs.
Serum samples were obtained from 250 patients (109 children and 141 adults) attended at Pediatric and Military Hospitals, both localized in Luanda. A clinical and epidemiological questionnaire was applied to all patients, according to Ethics Committee of Angola Health authorization. A total of 40 rodents (rats and mice) were live-trapped and necropsied to extract the kidney. The serological evaluation was performed by Microscopic Agglutination Test (MAT), and the renal carrier }tatus was studied. ",
by two PCR one specific of genus Leptospira 16S gene, the other specific of pathogenic leptospires
(hapl). The last PCR was performed on patient serum samples. The laboratorlal wo,rkwas developed at the Leptospirosis Lab., (IHMT, UNL), Lisbon, Portugal. The analysis of the epidemiological data suggests that the population has high exposure to risk factors such as the contact with rodents and poor
sanitation. Of the 250 sera analyzed, 11 (4.4%) showed agglutinins anti-L interr6gans s.l. with titers (2: 1: 100) and about 20% ( 50/250) showed borderline reactivity. DNA of Leptospifciwas not detecfe1Lin the studied sera. So far, leptospiral DNA was found 3/40 (7.5%) in rodent kidney(sa'mples. The1kidrtey cultures are still ongoing. Our preliminary results showed that: i) about 25% of feBr~ ~t~ie~l_~atients had contact with the etiologic agent of leptospirosis; ii) the significant number of borderline sera may be due to the indiscriminate use of antibiotics and other drugs by the population (self-medication), early in the febrile syndrome; iii) therefore, it is necessary to enhance the parameters of the clinical epidemiological survey for the history of symptoms and therapeutic evolution in these patients; and iv) it is important to increase the population sampling, including patients from other provinces and in
particular, those living in rural areas in order to understand the true incidence of leptospirosis and the potential co-infection with malaria or other febrile diseases.
Original languageEnglish
Pages90
Number of pages91
Publication statusPublished - 31 May 2012
EventEuropean Meeting of Leptospirosis organised by ELS (european Leptospirosis Society: Eurolept 2012 - Dubrovnik, Croatia
Duration: 31 May 20122 Jun 2012

Conference

ConferenceEuropean Meeting of Leptospirosis organised by ELS (european Leptospirosis Society
Abbreviated titleELS
Country/TerritoryCroatia
CityDubrovnik
Period31/05/122/06/12

Keywords

  • Leptospirosis; Diagnosis; Angola; ; Angola ;
  • Angola

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