Laboratory diagnosis and epidemiological features of leptospirosis cases in a tribal region of Western Maharashtra, India: A retrospective study.

PURPOSE: Palghar district, located in the coastal region of the Konkan division of Maharashtra, has a predominantly tribal population. Leptospirosis is a major neglected public health problem and is highly underreported in Palghar district. The study aimed to evaluate the seropositivity of Leptospira infection and its associated epidemiological factors in tribal areas of the Palghar district of Maharashtra. METHODS: The present retrospective study included 94 samples of patients clinically suspected of leptospirosis during a period of one year (2021-2022) tested at Model Rural Health Research Unit (MRHRU) Dahanu. The serum sample testing was done for the presence of specific Leptospira IgM antibodies using the Panbio™ Leptospira IgM ELISA kit. Leptospirosis seropositivity was correlated with various epidemiological risk factors. RESULTS: A total of 12 samples of patients tested positive for specific IgM antibodies by ELISA method, indicating an overall positivity of 12.8%. Among those who tested positive, fever (83.3%), headache (58.3%), myalgia (50%), redness of the eyes (50%), and calf tenderness (16.7%) were the common symptoms observed. Subjects with redness of the eyes were significantly associated with leptospirosis (p = 0.018). The highest positivity (50%) was reported from the Ganjad area of Dahanu taluka. Farmers and animal handlers were most affected by leptospirosis. CONCLUSION: The high proportion of Leptospirosis cases reflects the endemic nature of the disease in the Palghar district. This study shows seasonal trends in leptospirosis incidence over the year. The clinical presentation of leptospirosis may vary from sub-clinical to mild illness to severe and potentially fatal. The findings of this study will be important for achieving the overarching goal of One Health.

TruenatTM - micro real-time-polymerase chain reaction for rapid diagnosis of leptospirosis at minimal resource settings.

Background & objectives: The biological spectrum of leptospirosis ranges from acute undifferentiated febrile illness to severe fatal syndrome or a combination of syndromes. Diagnosis on clinical grounds alone is difficult and depends on laboratory support. However, no confirmatory tests are available, which is rapid and can be performed with minimum facilities available. The objectives of this study were to evaluate the diagnostic utility, accuracy and reproducibility of a rapid real time-PCR based method (TruenatTM) for early diagnosis of leptospirosis, and its usage in low resource settings. Methods: The Truenat™ test was performed using plasma sample collected from confirmed patients and controls. DNA was extracted from plasma samples and the reaction was performed as per the manufacturer's instructions. Leptospiral isolates were also used to assess the performance using different serovars. Results: Evaluation of the Truenat™ test with RT-PCR as the gold standard showed that Truenat™ had a sensitivity of 97.4 per cent and a specificity of 98.6 per cent. The overall agreement with RT-PCR was 98.2 per cent. Interpretation & conclusions: Our results showed that the test would be a useful tool for early diagnosis of leptospirosis in settings with minimal facilities and the test results could be obtained within an hour. This indicates that a specific therapy can be instituted during the early phase of the disease even at peripheral healthcare facilities as well during the outbreaks.

Anopheles sundaicus Mosquitoes as Vector for Plasmodium knowlesi, Andaman and Nicobar Islands, India.

Using PCR and sequencing, we found Plasmodium knowlesi in the malaria vector Anopheles sundaicus mosquito collected from Katchal Island in the Andaman and Nicobar Islands, India. We cannot rule out natural transmission of this parasite to humans through this mosquito species. An in-depth investigation is needed to prevent disease outbreaks.

B1c genetic subtype of coxsackievirus A16 associated with hand, foot and mouth disease in Andaman Islands, India.

BACKGROUND: An outbreak of hand, foot and mouth disease (HFMD) occurred in the Andaman Islands in 2013. Therefore, we aimed to identify the aetiological agent and to explore its genetic characteristics. METHODS: Clinical specimens were subjected to virus isolation, further confirmed by sequencing the partial VP1/2A region of enterovirus, and analysed using MEGA 6 software with intra-serotype reference sequences. RESULTS: Coxsackievirus A16 (CV A16) was found to be the causative agent, closely grouped with B1c genetic clusters of CV A16. However, it has significant genetic distance (K2P=0.059%) with B1c sub-clusters. CONCLUSION: Extended research work should be carried out to better understand the emerging nature of CV A16 associated with HFMD in these islands.GenBank accession numbers: KU523376-KU523387.