Clinical characteristics and seroprevalence of leptospirosis in patients with acute undifferentiated fever: A cross-sectional study.

Abstract

Acute Febrile Illness (AFI) is common in developing countries and is often caused by various pathogens, including <i>Leptospira</i> spp., particularly in tropical regions with heavy rainfall. Leptospirosis is underreported in India, with seroprevalence ranging from 6.4% to 30.9%. This study aims to assess the clinical features and seroprevalence of leptospirosis among patients with acute undifferentiated fever in Ranchi, Jharkhand. This cross-sectional study was conducted at RIMS, Ranchi, from September 2022 to February 2024, involving 200 suspected leptospirosis patients. Ethical approval and informed consent were obtained. ELISA was used to detect IgM antibodies, and statistical analysis was performed using SPSS (<i>P</i> < 0.05). Out of 200 patients, 49 (24.5%) tested positive for leptospirosis. The seroprevalence was higher in males (69.38%) and farmers (38.77%), with a significant rural residence association (<i>P</i> = 0.001). Seasonal variation was significant with a peak in October (57.14%), and rodent exposure was strongly linked to positivity (69.38%, <i>P</i> = 0.001). Clinical symptoms such as cough, loose stools, vomiting, nausea, and jaundice were significantly associated with positive cases. Elevated serum bilirubin, SGPT, and SGOT also showed strong associations with ELISA positivity (<i>P</i> = 0.001). Leptospirosis is a significant cause of Acute Febrile Illness (AFI) in India, complicating diagnosis due to its non-specific symptoms. In resource-limited areas, ELISA is essential for seroprevalence estimation. Despite underreporting, the high seroprevalence found in this study highlights the need for targeted prevention and management programs in Jharkhand.