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标题：Leptospirosis in Northeastern Malaysia: Misdiagnosed or Coinfection?
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作者：Leptospirosis in Northeastern Malaysia: Misdiagnosed or Coinfection?AA Noor Rafizah ; BD Aziah ; YN Azwany 等
期刊名称：International Journal of Collaborative Research on Internal Medicine & Public Health
电子版ISSN：1840-4529
出版年度：2012
卷号：4
期号：7
出版社：DRUNPP Sarajevo
摘要：Background: For the past decade leptospirosis has been re-emerging as an important disease and can be a serious public health issue in a humid tropical and subtropical country such as Malaysia. Leptospirosis also known as “the Great Mimicker” and may be overlooked and under diagnosed due to its varied clinical presentations. Objective: Since leptospirosis is a significant cause of undifferentiated fever and frequently not recognized, this study was conducted to determine the prevalence of this disease among febrile patients in northeastern Malaysia hospitals. Design: A hospital-based cross sectional study was conducted among 999 of febrile patients admitted in 10 hospitals in northeastern Malaysia. Materials and methods: An interviewer-guided proforma sheet on sociodemographic and final hospital diagnosis data was distributed to all adult patients with fever on admission. Serum sample for leptospirosis was screened by IgM Enzyme-linked Immunosorbent Assay test (IgM ELISA) and confirmed by Microscopic Agglutination Test (MAT). The cut-off point for positive MAT was ≥1:400 titre in single acute specimen. Results: The seroprevalence of leptospirosis was 8.4% (95% CI: 6.8, 10.3) (n=84) by MAT. In our study, only 31.0% of the confirmed leptospirosis cases by MAT in northeastern Malaysia hospitals were diagnosed as leptospirosis for the final diagnosis on discharge. About 38.1%, 14.3% and 7.1% of the confirmed leptospirosis cases by MAT were diagnosed as dengue fever or dengue hemorrhagic fever, pneumonia and typhoid fever respectively.
关键词：leptospirosis; IgM Enzyme-linked Immunosorbent Assay; Microscopic;Agglutination Test