A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings.
Leptospirosis is a zoonotic infection with significant morbidity and mortality. The clinical presentation of leptospirosis is known to mimic the clinical profile of other prevalent tropical fevers. Laboratory confirmation of leptospirosis is based on the reference standard microscopic agglutination...
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ftdoajarticles:oai:doaj.org/article:dc3f58dfbefd49c8b8f863390d456d63 2023-05-15T15:12:45+02:00 A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. Senaka Rajapakse Praveen Weeratunga Roshan Niloofa Narmada Fernando Nipun Lakshitha de Silva Chaturaka Rodrigo Sachith Maduranga Nuwanthi Nandasiri Sunil Premawansa Lilani Karunanayake H Janaka de Silva Shiroma Handunnetti 2016-06-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0004513 https://doaj.org/article/dc3f58dfbefd49c8b8f863390d456d63 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4917116?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004513 https://doaj.org/article/dc3f58dfbefd49c8b8f863390d456d63 PLoS Neglected Tropical Diseases, Vol 10, Iss 6, p e0004513 (2016) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2016 ftdoajarticles https://doi.org/10.1371/journal.pntd.0004513 2022-12-31T12:25:42Z Leptospirosis is a zoonotic infection with significant morbidity and mortality. The clinical presentation of leptospirosis is known to mimic the clinical profile of other prevalent tropical fevers. Laboratory confirmation of leptospirosis is based on the reference standard microscopic agglutination test (MAT), direct demonstration of the organism, and isolation by culture and DNA detection by polymerase chain reaction (PCR) amplification. However these methods of confirmation are not widely available in resource limited settings where the infection is prevalent, and reliance is placed on clinical features for provisional diagnosis. In this prospective study, we attempted to develop a model for diagnosis of leptospirosis, based on clinical features and standard laboratory test results.The diagnostic score was developed based on data from a prospective multicentre study in two hospitals in the Western Province of Sri Lanka. All patients presenting to these hospitals with a suspected diagnosis of leptospirosis, based on the WHO surveillance criteria, were recruited. Confirmed disease was defined as positive genus specific MAT (Leptospira biflexa). A derivation cohort and a validation cohort were randomly selected from available data. Clinical and laboratory manifestations associated with confirmed leptospirosis in the derivation cohort were selected for construction of a multivariate regression model with correlation matrices, and adjusted odds ratios were extracted for significant variables. The odds ratios thus derived were subsequently utilized in the criteria model, and sensitivity and specificity examined with ROC curves.A total of 592 patients were included in the final analysis with 450 (180 confirmed leptospirosis) in the derivation cohort and 142 (52 confirmed leptospirosis) in the validation cohort. The variables in the final model were: history of exposure to a possible source of leptospirosis (adjusted OR = 2.827; 95% CI = 1.517-5.435; p = 0.001) serum creatinine > 150 micromol/l (adjusted OR = ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 10 6 e0004513 |
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language |
English |
topic |
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 Senaka Rajapakse Praveen Weeratunga Roshan Niloofa Narmada Fernando Nipun Lakshitha de Silva Chaturaka Rodrigo Sachith Maduranga Nuwanthi Nandasiri Sunil Premawansa Lilani Karunanayake H Janaka de Silva Shiroma Handunnetti A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Leptospirosis is a zoonotic infection with significant morbidity and mortality. The clinical presentation of leptospirosis is known to mimic the clinical profile of other prevalent tropical fevers. Laboratory confirmation of leptospirosis is based on the reference standard microscopic agglutination test (MAT), direct demonstration of the organism, and isolation by culture and DNA detection by polymerase chain reaction (PCR) amplification. However these methods of confirmation are not widely available in resource limited settings where the infection is prevalent, and reliance is placed on clinical features for provisional diagnosis. In this prospective study, we attempted to develop a model for diagnosis of leptospirosis, based on clinical features and standard laboratory test results.The diagnostic score was developed based on data from a prospective multicentre study in two hospitals in the Western Province of Sri Lanka. All patients presenting to these hospitals with a suspected diagnosis of leptospirosis, based on the WHO surveillance criteria, were recruited. Confirmed disease was defined as positive genus specific MAT (Leptospira biflexa). A derivation cohort and a validation cohort were randomly selected from available data. Clinical and laboratory manifestations associated with confirmed leptospirosis in the derivation cohort were selected for construction of a multivariate regression model with correlation matrices, and adjusted odds ratios were extracted for significant variables. The odds ratios thus derived were subsequently utilized in the criteria model, and sensitivity and specificity examined with ROC curves.A total of 592 patients were included in the final analysis with 450 (180 confirmed leptospirosis) in the derivation cohort and 142 (52 confirmed leptospirosis) in the validation cohort. The variables in the final model were: history of exposure to a possible source of leptospirosis (adjusted OR = 2.827; 95% CI = 1.517-5.435; p = 0.001) serum creatinine > 150 micromol/l (adjusted OR = ... |
format |
Article in Journal/Newspaper |
author |
Senaka Rajapakse Praveen Weeratunga Roshan Niloofa Narmada Fernando Nipun Lakshitha de Silva Chaturaka Rodrigo Sachith Maduranga Nuwanthi Nandasiri Sunil Premawansa Lilani Karunanayake H Janaka de Silva Shiroma Handunnetti |
author_facet |
Senaka Rajapakse Praveen Weeratunga Roshan Niloofa Narmada Fernando Nipun Lakshitha de Silva Chaturaka Rodrigo Sachith Maduranga Nuwanthi Nandasiri Sunil Premawansa Lilani Karunanayake H Janaka de Silva Shiroma Handunnetti |
author_sort |
Senaka Rajapakse |
title |
A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. |
title_short |
A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. |
title_full |
A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. |
title_fullStr |
A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. |
title_full_unstemmed |
A Diagnostic Scoring Model for Leptospirosis in Resource Limited Settings. |
title_sort |
diagnostic scoring model for leptospirosis in resource limited settings. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2016 |
url |
https://doi.org/10.1371/journal.pntd.0004513 https://doaj.org/article/dc3f58dfbefd49c8b8f863390d456d63 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 10, Iss 6, p e0004513 (2016) |
op_relation |
http://europepmc.org/articles/PMC4917116?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0004513 https://doaj.org/article/dc3f58dfbefd49c8b8f863390d456d63 |
op_doi |
https://doi.org/10.1371/journal.pntd.0004513 |
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PLOS Neglected Tropical Diseases |
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10 |
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6 |
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e0004513 |
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