Leptospirosis: An Emerging Infectious Disease in Nepal

Abstract

Introduction: The aim of this study was to determine prevalence of Leptospira spp in Japanese Encephalitis negative cases, as well as its demographic and geographical picture in Nepal.

Methods: The Nepal government along with World Health Organization (WHO) country office Nepal had approved this surveillance project, which conducted from 2007 to 2008 throughout 47 districts in Nepal. JE was confirmed from Cerebrospinal fluid (CSF) samples using ELIZA Method whereas Leptospiraspp was identified by using Latex Agglutination Test kit method in Nepal Public Health Laboratory (NPHL), Kathmandu, Nepal.

Results: Among 2690 Acute Encephalitis Surveillance, the lumber puncture (LP) was done in 2145 patients. Among those tested, JE positive was confirmed in 771 patients. LP was not done in 381 cases. Among 993 JE negative cases, positivity rate of Leptospira spp was reported 41.8% (416/993) . There was more male preponderance 63.5% (264/416) However, it was not statistically significant (p = 0.713) . In terms of age distribution, those above 15 years of age were 64.5% (268/416) while those below 15 years of age were 35.5% (148/416), (p = 0) In eco- region, the rate of infection was highest in Terai region at 53.2% (222/416) followed by Mountain region at 45.2% (188/416) and Himalayan at 1.4% (6/416), (p = 0.005) In terms of seasonal distribution, the rate of infection in autumn was at 44.2% (188/416) followed by summer at 40.1% (167/416), spring at 9.6% (40/416) and winter at 6.1% (25/416) (p = 0)

Conclusions: Nepal government cannot neglect the increasing possibility of outbreaks of Leptospira spp in different parts of the country, so this study recommends for surveillance of this infection to prevent future outbreaks in Nepal