Epidemiology of Human Leptospirosis in HIV Patients Attending Anti- Retro Viral Treatment in Public Hospitals and Clinics in Kabwe Urban
Abstract:
A
cross sectional study was carried out to assess the epidemiology of leptospirosis
in 282 participants, 150 were Human immune deficiency virus (HIV) positive patients
and 132 non-HIV patients (controls) attending ant retro viral treatment (ART) and
outpatient department in public hospitals and clinics in Kabwe, Zambia urban district
respectively. Demographic, disease history, co-morbidities and concomitant medication
history was captured using a structured 10-point close ended questionnaire. Plasma was tested
for the presence of leptospirosis using the enzyme linked immune sorbent assay (ELISA)
as screening test and the dark field microscopy technique (DFM) as confirmatory
test to determine disease distribution in the population. Plasma found positive
with ELISA and leptospires detected by dark field microscopy were considered to
have leptospirosis. Results revealed that 50 out of the 150 HIV positive
participants were positive for leptospirosis (33%). This was significantly higher (P=0.002)
than in the control group, where only 15 out of 132 participants were found to have leptospirosis
(11%). 5 tests were discordant as they gave positive results with ELSA yet leptospires
were not detected by the dark field microscopy. The leptospirosis confirmatory test was
found to have sensitivity of 94%, specificity of 97%, PPV 98%, NPV 92% and efficiency
of 95% which were significant parameters to warrant the adoption of the results
and determine the epidemiology of leptospirosis in the areas under study. It was
concluded that epidemiology of leptospirosis in Kabwe district is 21% after adjusting
for false positives.
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