Serological and molecular approaches for leptospirosis at a tertiary care centre in northern India
Keywords:ELISA, Leptospirosis, Microscopic Agglutination Test, PCR, Pyrexia of unknown origin
Background: Aims and objectives of the study was to determine prevalence rate of leptospirosis and recognition of common epidemiological situation and clinical manifestations of leptospirosis in patients with pyrexia of unknown origin at a tertiary care centre.
Methods: This was a hospital based prospective observational study. The duration of study was from August 2015 to July 2016. Patients with clinical symptoms of pyrexia of unknown origin attending Gandhi Memorial and Associated Hospital, King George’s Medical University Lucknow during the study period were enrolled in this study. We performed the IgM ELISA and PCR for the leptospirosis at our centre and for the Micro Agglutination Test (MAT), we sent the serum samples to regional medical research centre Department of Health Research Ministry of Health and Family Welfare, Govt. of India Port Blair.
Results: A Total of 104 symptomatic patients were recruited. Of total, IgM ELISA for leptospirosis were positive in 25 patients, PCR in 20 patients and MAT shows significant titres in 3 samples. The ROC curve analysis revealed significant diagnostic accuracy of IgM ELISA with 100.00% sensitivity and 78.22% specificity however showed less positive predictive value (12.0%) but high negative predictive value (100.0%). Most common presentation were fever, jaundice and rashes (40.4%) followed by fever and jaundice (29.8%).
Conclusions: Leptospirosis IgM ELISA and PCR showed good detection accuracy. Age, sex, occupation is not significantly associated to the leptospirosis.
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