Prevalence of leptospirosis among patients attending renal and general outpatient units in Mulago Hospital, Kampala, Uganda

Abstract

Leptospirosis is a zoonotic bacterial infection caused by spirochetes, which belong to the genus Leptospira. It is the most widespread zoonosis in the world and is considered a global public health threat. The dynamics of Leptospirosis among renal patients is still unclear yet this coupled with poor diagnostic practices cripple the management of disease and other related febrile illnesses. Therefore, this study sought to establish the prevalence and associated factors of Leptospirosis among renal patients and general outpatients attending Mulago National Referral Hospital, Uganda. This cross-sectional study recruited and collected blood from a total of 254 patients attending Mulago hospital from July to October 2018. Additionally, the semi-structured questionnaires were administered to enrolled patients to collect data on socio-demographics and occupational practices that may be risks to getting infected with Leptospirosis. The blood samples were analyzed using the standard microscopic agglutination test (MAT) with a panel of 14 Leptospira-serovars belonging to 10 serogroups. Quantitative data were analyzed using R version 3.6.2 to ascertain the associated risk factors for the infection. This study found serovars Canicola and Ballum Kenya with the highest titres of ≥400 and ≥200 respectively. The overall prevalence of leptospirosis at 4.7% (CI = 2.6-8.3, P<0.05) among patients attending Renal and General Outpatient units in Mulago National Referral Hospital. There were five (5) positive reactive Leptospirosis cases in the general outpatient category, whereas the renal unit showed positive results for seven (7) cases of Leptospirosis. The patients in the general outpatient unit had the highest titres of ≥400 while renal was at ≥200. The patients who reported with signs of abdominal pain were 24.4 times more likely to be diagnosed with Leptospirosis (CI=2.42 – 267.89). The study also established a strong relationship between patients presenting with abdominal pain and leptospirosis. The study reveals that leptospirosis may be among the causative agents among renal patients and should be included among the differential diagnostic list to consider for further testing and diagnosis.