Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, UK.
Vet Rec. 2022 Mar;190(6):e512. doi: 10.1002/vetr.512. Epub 2021 May 31.
To estimate the annual incidence risk of leptospirosis diagnosis in practice-attending dogs in the UK during 2016 and identify risk factors for diagnosis.
Incidence of leptospirosis diagnosis in dogs during 2016 was estimated from dogs in primary-care practices from the VetCompass Programme (n = 905,543). A case-control study of laboratory cases (n = 362) versus VetCompass controls explored factors (age, sex, neutering, breed, Kennel Club group, urban-rural location, indices of deprivation) associated with leptospirosis diagnosis through multivariable logistic regression.
Annual incidence risk of leptospirosis in the VetCompass population was 0.8 cases per 100,000 dogs (0.0008%, 95% CI 9.1 × 10 -5.2 × 10 ). Adult dogs, especially 1- < 5 years olds (odds ratio [OR] = 0.38, 95% CI 0.27-0.54), and dogs attending urban clinics (OR = 0.26, 95% CI 0.19-0.35) had reduced odds of leptospirosis versus dogs < 1 year old and rural dogs, respectively. Dogs attending clinics in less deprived areas had increased odds of diagnosis (OR = 3.63, 95% CI 2.28-5.78) compared to crossbreds, Cocker Spaniels (OR = 4.25, 95% CI 2.65-6.84), Collies (OR = 3.53, 95% CI 2.22-5.62) and Lurchers (OR = 3.49, 95% CI 1.50-8.11) had increased odds of diagnosis.
Leptospirosis is rarely diagnosed in clinical practice, suggesting that many true cases may be missed. Demographic risk factors identified here may inform the index of suspicion and encourage increased use of confirmatory diagnostic testing.
估计 2016 年英国临床就诊犬感染钩端螺旋体病的年发病率,并确定诊断的相关风险因素。
从 VetCompass 计划(n=905543)中的基层医疗实践中的犬只中估算 2016 年犬感染钩端螺旋体病的发病率。通过多变量逻辑回归,对实验室病例(n=362)与 VetCompass 对照的病例对照研究,探索与钩端螺旋体病诊断相关的因素(年龄、性别、绝育、品种、英国养犬俱乐部分组、城乡位置、贫困指数)。
VetCompass 人群中钩端螺旋体病的年发病率为每 10 万只犬 0.8 例(0.0008%,95%CI 9.1×10 -5.2×10 -6 )。成年犬,尤其是 1-<5 岁的犬(比值比[OR] 0.38,95%CI 0.27-0.54)和城市诊所就诊的犬(OR 0.26,95%CI 0.19-0.35)感染钩端螺旋体病的几率低于 1 岁以下的犬和农村犬。与混血犬、可卡犬(OR 4.25,95%CI 2.65-6.84)、牧羊犬(OR 3.53,95%CI 2.22-5.62)和猎狐犬(OR 3.49,95%CI 1.50-8.11)相比,就诊于贫困程度较低地区的犬感染钩端螺旋体病的几率增加。
在临床实践中很少诊断出钩端螺旋体病,这表明可能遗漏了许多真实病例。本研究确定的人口统计学风险因素可能有助于提高警惕指数,并鼓励更多地使用确认性诊断检测。