Operative Definitions for Prevention and Control of Leptospirosis in Costa Rica
Versión traducida del artículo "Definiciones operativas para la prevención y control de la leptospirosis en Costa Rica" DOI: https://doi.org/10.51481/amc.v52i4.680
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https://doi.org/10.51481/amc.v52i4.749Palabras clave:
Leptospirosis, epidemiologic surveillance, Costa RicaResumen
Aim: Leptospirosis is the most frequent zoonotic disease worldwide and it requires an efficient epidemiologic surveillance. This study evaluated the operative definitions of the Costa Rican Protocol for the prevention and control of leptospirosis.
Methods: this work is a two-stage (descriptive, analytic) cross-sectional study using a clinical-predictive model by means of logistic regression. Data were obtained from the National Reference Center for Virology and Leptospirosis, Costa Rican Institute for Research and Education in Nutrition and Health (January 2001 to June 2003).
Results: Five hundred and sixty-eight records were initially found. One hundred and fifty-four were eliminated for not having the correct information for the classification of the leptospirosis protocol. The other 414 records were analyzed and none of them complied with the criteria for a confirmed case. For this reason, a broader definition taken from the literature was used (confirmed case = serology of 1:800). Consequently, 52 cases were confirmed and 368 were classified as suspicious. Only cefalalgia (OR=0.5; CI 95% 0.2 -1.1) and male gender (OR=3,01; CI 95% 1.2-8.1) showed a significant association with the diagnosis of leptospirosis. When clinical and epidemiologic variables were grouped, the combinations of cephalalgia+myalgia+epidemiologic history(OR=3,8; CI 95% 1.1-14.9) and systemic symptoms+epidemiologic history (OR=0.01; CI 95% 1.2-18.9) showed significant association with the diagnosis, although with a high correlation between them (Kappa > 0.8).
Conclusion: with the existing data and by means of the methodology used for the analysis it was not possible to validate the definitions established by the protocol or to generate operative definitions that could be applied on a national scale. It was also impossible to establish a definition of a probable case.
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Levet P.N. Leptospirosis. Clin Microbiol Rev 2001; 14: 296-325.
Smits H, Van der Hoorn M, Goris M, Gussenhoven G, Yersin C, Sasaky D. et al. Simple Latex Agglutination Assay for Rapid Serodiagnosis of Human Leptospirosis. J Clin Microbiol 2000; 38: 1272-1275.
Smits H, Eapen C.K, Sugathan S, Kuriakose M, Gasem M, Yersin C, et al. Lateral Flow Assay for Rapid Serodiagnosis of Human Leptospirosis. Clin Diagn Lab Immunol 2001; 8: 166-169.
Eapen C.K, Sugathan S, Kuriakose M, Abdoel T, Smits H.L. Evaluation of the clinical utility of a rapid blood test for human leptospirosis. Diagn Microbiol Infect Dis 2002; 42: 221-225.
Bajani M, Ashford D, Bragg S, Woods C, Aye T, Spiegel R. et al. Evaluation of four commercially available rapid serologic tests for diagnosis of leptospirosis. J Clin Microbiol 2003; 41: 803-809.
World Health Organization (WHO) – International Leptospirosis Society (ILS). Human Leptospirosis: guidance for diagnosis, surveillance and control. 2003.
Katz A, Effler P. “Probable” versus “confirmed” leptospirosis: an epidemiologic and clinical comparison utilizing a surveillance case classification. Ann Epidemiol 2003; 13: 196-203.
Ministerio de Salud de Costa Rica. Protocolo para la prevención y control de la leptospirosis. Tercera edición. 2002.
Thrusfield M, Ortega C, de Blas I, Noordhuizen J.P, Frankena K. WIN EPISCOPE 2.0: improved epidemiological software for veterinary medicine. Vet Rec 2001; 148: 567-572.
Sanders E, Rigau-Pérez J, Smits H, Deseda C, Vorndam V, Aye T, et al. Increase of Leptospirosis in dengue – negative patients after a Hurricane in Puerto Rico in 1966. Am J Trop Med Hyg 1999; 61: 399404.
Dupont H, Dupont-Perdrizet D, Perie J.L., Zehner-Hansen S, Jarrige B., Daijardin, J.B. Leptospirosis: prognostic factors associated with mortality. Clin Infect Dis 1997; 25: 720-724.
Ministerio de Salud. Normas técnicas para el control del dengue y dengue hemorrágico. San José, Costa Rica: Ministerio de Salud; Comisión Técnica Interinstitucional de Dengue, 2000.
Sáenz E, Maranda L, González L. Adecuación de la definición de casos sospechosos de dengue, basado en la asociación de síntomas y signos según los registros médicos, Costa Rica, 1998. Rev Costarric Cienc Méd 2001; 22: 131-140.
Boletín Epidemiológico. Sistema Nacional de Vigilancia de la Salud. Ministerio de Salud de Costa Rica. 2001.
Boletín Epidemiológico. Sistema Nacional de Vigilancia de la Salud. Ministerio de Salud de Costa Rica. 2002.
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