Benacer Douadi, Thong Kwai Lin, Min Ng Choung, Bin Verasahib Khebir, Galloway Renee L, Hartskeerl Rudy A, Souris Marc, Mohd Zain Siti Nursheena
Institute of Biological Sciences, Faculty of Science, University of Malaya, Malaysia.
Institute of Mathematical Sciences, Faculty of Science, University of Malaya, Malaysia.
Acta Trop. 2016 May;157:162-8. doi: 10.1016/j.actatropica.2016.01.031. Epub 2016 Feb 1.
Leptospirosis is an emerging disease, especially in countries with a tropical climate such as Malaysia. A dramatic increase in the number of cases has been reported over the last decade; however, information on the epidemiological trends of this disease is lacking. The objective of this study is to provide an epidemiological description of human leptospirosis cases over a 9-year period (2004-2012) and disease relationship with meteorological, geographical, and demographical information. A retrospective study was undertaken to describe the patterns of human leptospirosis cases and their association with intrinsic (sex, age, and ethnicity) and extrinsic (location, rainfall, and temperature) factors. Data was grouped according to age, sex, ethnicity, seasonality and geographical distribution, and analyzed using statistical tools to understand the influence of all the different factors on disease incidence. A total of 12,325 cases of leptospirosis were reported between 2004 and 2012 with an upward trend in disease incidence, with the highest in 2012. Three hundred thirty-eight deaths were reported with an overall case fatality rate of 2.74%, with higher incidence in males (9696; 78.7%) compared with female patients (2629; 21.3%), and overall male to female ratio of 3.69:1. Patients aged cohorts between 30-39 years old (16.22 per 100,000 population) had the highest disease incidence while the lowest incidence occurred between <1 to 9 years old (3.44 per 100,000 population). The average incidence was highest amongst Malays (10.97 per 100,000 population), followed by Indians (7.95 per 100,000 population). Stratification according to geographical distribution showed that the state of Malacca had the highest average disease incidence (11.12 per 100,000 population) followed by Pahang (10.08 per 100,000 population). The states of Terengganu, Kelantan, and Perak recorded similar rates of incidence (≈8.00 per 100,000 population), while Johor with the least number of reported cases (1.80 per 100,000 population). Positive relationships were recorded between the number of reported cases with the number of raining days per month and monthly average temperature (p-value<0.05). However, no significant association was noted between rainfall volume and number of reported Leptospirosis cases. This collaborative efforts between medical, academic and governmental institutions has enabled the construction of this comprehensive database that is essential to understand the disease trends in Malaysia and add insights into the prevention and control of this disease.
钩端螺旋体病是一种新发疾病，在马来西亚等热带气候国家尤为如此。过去十年间报告的病例数急剧增加；然而，关于该疾病流行病学趋势的信息却很匮乏。本研究的目的是提供9年期间（2004 - 2012年）人类钩端螺旋体病病例的流行病学描述，以及疾病与气象、地理和人口统计学信息之间的关系。开展了一项回顾性研究，以描述人类钩端螺旋体病病例的模式及其与内在因素（性别、年龄和种族）和外在因素（地点、降雨量和温度）的关联。数据按年龄、性别、种族、季节性和地理分布进行分组，并使用统计工具进行分析，以了解所有不同因素对疾病发病率的影响。2004年至2012年间共报告了12325例钩端螺旋体病病例，疾病发病率呈上升趋势，2012年最高。报告了338例死亡，总体病死率为2.74%，男性发病率较高（9696例；78.7%），女性患者发病率较低（2629例；21.3%），总体男女比例为3.69:1。年龄在30 - 39岁的人群发病率最高（每10万人口中有16.22例），而1 - 9岁人群发病率最低（每10万人口中有3.44例）。马来西亚人的平均发病率最高（每10万人口中有10.97例），其次是印度人（每10万人口中有7.95例）。按地理分布分层显示，马六甲州的平均疾病发病率最高（每10万人口中有11.
