Desai K T, Patel F, Patel P B, Nayak S, Patel N B, Bansal R K
Department of Community Medicine, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India.
J Postgrad Med. 2016 Oct-Dec;62(4):223-227. doi: 10.4103/0022-3859.188551.
The current study was planned to identify the epidemiological factors associated with leptospirosis in South Gujarat region using neighborhood controls.
A total of 100 cases of leptospirosis occurred in South Gujarat region during the year 2012 were selected using simple random sampling. Three neighbors of the selected cases formed the controls (n = 300). A pretested structured questionnaire was used for data collection and data were analyzed using Epi Info 2007.
There was significant association of illiteracy (odds ratio [OR] =1.82, 95% confidence interval [CI] =1.14-2.89), working in waterlogged fields during the reference season (OR = 4.6, 95% CI = 1.6-17.9), swimming/bathing in canals, open air defecation practices, storage of cow dung in or surrounding house, residence in the house made up of cow dung walls, households with access of food to rodents, injuries over hands/foot during the endemic season (OR = 3, 95% CI = 1.8-4.8), and history of skin disease during the endemic season (OR = 4.2, 95% CI = 2-8.5), with leptospirosis. Only 10% of individuals had gumboots for protection. A total of 83 (83%) cases and 240 (80%) controls had taken oral doxycycline chemoprophylaxis (P > 0.05). Cases had taken chemoprophylaxis for a median 4 weeks (range: 1-8) while controls had taken the same for median 8 weeks (range = 1-8) (P < 0.002).
Although the commonly established factors appear to be associated with leptospirosis, the role of host factors seems to play a more important role in determining susceptibility to leptospirosis in exposed individuals.
本研究旨在通过邻里对照确定古吉拉特邦南部地区钩端螺旋体病的流行病学相关因素。
2012年在古吉拉特邦南部地区共发生100例钩端螺旋体病病例,采用简单随机抽样法进行选取。所选病例的三名邻居作为对照(n = 300)。使用预先测试的结构化问卷收集数据,并使用Epi Info 2007进行数据分析。
文盲(优势比[OR]=1.82,95%置信区间[CI]=1.14 - 2.89)、在参考季节于涝渍田劳作(OR = 4.6,95% CI = 1.6 - 17.9)、在运河游泳/沐浴、露天排便习惯、在房屋内或周围储存牛粪、居住在牛粪墙房屋、家中有可供啮齿动物获取的食物、在流行季节手部/足部受伤(OR = 3,95% CI = 1.8 - 4.8)以及在流行季节有皮肤病史(OR = 4.2,95% CI = 2 - 8.5)与钩端螺旋体病显著相关。仅有10%的个体有胶靴用于防护。共有83例(83%)病例和240例(80%)对照接受了口服多西环素化学预防(P>0.05)。病例接受化学预防的中位时间为4周(范围:1 - 8周),而对照接受化学预防的中位时间为8周(范围 = 1 - 8周)(P<0.002)。
尽管常见的既定因素似乎与钩端螺旋体病相关,但宿主因素在决定暴露个体对钩端螺旋体病的易感性方面似乎发挥着更重要的作用。