Joel Navarrete Espinosa, Maribel Moreno Muñoz, Beatriz Rivas Sánchez, Oscar Velasco Castrejón
Coordinación de Vigilancia Epidemiológica y Apoyo en Contingencias, IMSS, México, DF, Mexico.
J Pathog. 2011;2011:408604. doi: 10.4061/2011/408604. Epub 2011 Nov 2.
Objective. To measure the prevalence of leptospirosis with two techniques in inhabitants of Izamal, Yucatan and to determine its relation with some exposure factors. Material and Methods. Transversal study in populations belonging to the HR62-IMSS-Opportunities working force in Izamal, Yucatan. Population, including 6 years of age or more, was randomly selected to participate in the study. A questionnaire was applied for personal ID and exposure factors; blood samples were taken for leptospirosis diagnosis. Simple frequencies, proportions, tendency and dispersion measures, prevalence and odd ratios and confidence intervals (CI) of 95%, and logistic regression model were obtained. Results. 204 patients, between 9 and 80 years old were included; 180 were positive (88.2%) with the dark-field technique; using MAT cutoff at 1 : 40, 178 patients (87.3%) were positive, while at 1 : 80 there were 103 positive (50.5%). The predominant serovar was Hardjo (94%). The highest prevalence was in women (96.3%) and in the >45-year-old group (95.7%); feminine gender (RM = 2.31 IC 95% 3.59-28.6), housewife (RM = 22.8 IC 95% 4.9-106.1), being in contact with stagnant water (RM = 5.2 IC 95% 1.7-15.9), and being in contact with domestic animal feces (RM = 5.1 IC 95% 1.9-13.1), these being the most significant variables in the final logistic regression model. Conclusions. The prevalence found was higher than the one nationally and internationally reported, representing an important finding, being in turn a local public health, maybe nationally. It is urgent to reinforce this research as well as to establish preventive and control measure to avoid exposure and health damages.
目的。采用两种技术测量尤卡坦州伊萨马尔居民钩端螺旋体病的患病率，并确定其与某些暴露因素的关系。材料与方法。对尤卡坦州伊萨马尔HR62-IMSS-机遇劳动力中的人群进行横断面研究。随机选择6岁及以上的人群参与研究。应用问卷收集个人身份信息和暴露因素；采集血样进行钩端螺旋体病诊断。得出简单频率、比例、趋势和离散度指标、患病率、比值比和95%置信区间（CI），以及逻辑回归模型。结果。纳入204例年龄在9至80岁之间的患者；暗视野技术检测180例呈阳性（88.2%）；采用微量凝集试验（MAT）截断值为1:40时，178例患者（87.3%）呈阳性，截断值为1:80时，103例呈阳性（50.5%）。主要血清型为哈德乔型（94%）。患病率最高的是女性（96.3%）和45岁以上组（95.7%）；女性（相对危险度=2.31，95%CI为3.59-28.6）、家庭主妇（相对危险度=22.8，95%CI为4.9-106.1）、接触积水（相对危险度=5.2，95%CI为1.7-15.9）以及接触家畜粪便（相对危险度=5.1，95%CI为1.9-13.1），这些是最终逻辑回归模型中最显著的变量。结论。所发现的患病率高于国内和国际报告的患病率，这是一项重要发现，进而可能成为地方乃至全国的公共卫生问题。迫切需要加强这项研究，并建立预防和控制措施以避免暴露和健康损害。
