A Case-Control Study of Behavioural and Social Predictors of Severe Leptospirosis in a Tertiary Care Centre, Central Kerala

Abstract

Leptospirosis is a globally important zoonotic disease. The disease is caused by pathogenic Leptospira species. Infections result from direct or indirect exposure to infected reservoir animals that carry the pathogen in their renal tubules and shed pathogenic leptospirosis in the urine. This study was conducted to assess the social and behavioural predictors of severe Leptospirosis and to study the clinical profile and outcome of patients with severe leptospirosis .148 patients with leptospirosis were divided into severe and non-severe groups. The majority of our study population had risk factors like contact with soil or water through barefoot, farming, swimming, cattle rearing, contact with sewage and stagnant rainwater. Conditions such as inadequate access to safe drinking water and sanitation services, poor personal hygiene practices, low levels of literacy, and lack of access to health services, contribute to increased vulnerability to infection and work against prevention efforts. Severity predictor factors are Cut or injury prior to symptoms, NSAID intake for fever and Myalgia from the periphery, late referral and late initiation of antibiotics, acute kidney injury, pancreatitis, myocarditis, thrombocytopenia, ARDS, acute liver injury, platelet less than 50,000 and prolonged INR. Knowledge about risk factors for severe leptospirosis can improve prevention and control measures to mitigate the incidence of severe cases.