Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.

Biggs, Holly M

Hertz, Julian T

Munishi, O Michael

Galloway, Renee L

Marks, Florian

Saganda, Wilbrod

Maro, Venance P

Crump, John A

United States

2017-03-02T19:15:03Z

2017-03-02T19:15:03Z

2013

BACKGROUND: The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75-102 cases per 100,000 persons annually. CONCLUSIONS/SIGNIFICANCE: We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings.

https://www.ncbi.nlm.nih.gov/pubmed/24340122

PNTD-D-13-00521

1935-2735

https://hdl.handle.net/10161/13782

eng

Public Library of Science (PLoS)

PLoS Negl Trop Dis

10.1371/journal.pntd.0002589

Adolescent

Adult

Aged

Aged, 80 and over

Child

Child, Preschool

Community Health Centers

Epidemiological Monitoring

Female

Health Services

Hospitals

Humans

Incidence

Infant

Leptospirosis

Male

Middle Aged

Surveys and Questionnaires

Tanzania

Young Adult

Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.

Journal article

Hertz, Julian T|0000-0002-7396-4789

https://www.ncbi.nlm.nih.gov/pubmed/24340122

e2589

12

Clinical Science Departments

Duke

Medicine

Medicine, Infectious Diseases

Pathology

School of Medicine

Surgery

Surgery, Emergency Medicine

Published online

7