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Seroprevalence of Leptospirosis and Risk Factor Analysis in Flood-prone Rural Areas in Lao PDR

A cross-sectional seroprevalence study on leptospirosis, using microscopic agglutination test (MAT), was conducted in rural villages in Khammouane Province, Lao People’s Democratic Republic, in December 2006. The overall prevalence of leptospiral infection among 406 subjects was 23.9% (95% confidence interval [CI] 19.7–28.0%). Independent risk factors for the infection, identified by multivariate logistic regression, were male sex (odds ratio [OR], 1.92; 95% CI: 1.24–2.98), recent flooding on one’s own property (OR, 2.12; 95% CI: 1.25–3.58), and collecting wood in the forest (OR, 1.90; 95% CI: 1.17–3.09). Age, occupation, and animal ownership were not associated with seropositivity. Flooding was associated with the risk of infection particularly for women, whose behaviors or activities involving contact with floodwater were presumed to play an important role. This study showed that leptospirosis is endemic in Khammouane Province and that local flooding plays an important role in the transmission of the disease.

Received January 17, 2008. Accepted for publication March 20, 2008.

Acknowledgments: The authors thank Bounfeng Phoummalaysith of the Cabinet of the Ministry of Health, Lao PDR, for helping coordinate the field work and for providing thoughtful advice; Paul Newton of Wellcome Trust–Mahosot Hospital–Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR, and Nobuyuki Hamajima and Hiroshi Yatsuya of Nagoya University School of Medicine for providing critical comments; and the residents of Khammouane Province who generously participated in this study and the officials and staff members of Khammouane Provincial Health Office for cooperation in the field work.

Financial support: This study was supported in part by the International Cooperation Research Grant from Ministry of Health, Labour, and Welfare, Japan, and by the Research Grant from Gushin-Kai Foundation, Japan.

^* Address correspondence to Leo Kawaguchi, Department of International Health, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. E-mail: leo-k{at}med.nagoya-u.ac.jp

Authors’ addresses: Leo Kawaguchi, Hidechika Akashi, and Atsuko Aoyama, Department of International Health, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan, Tel: 81-52-744-2109, Fax: 81-52-744-2114. Bounthanom Sengkeopraseuth and Phengta Vongphrachanh, National Center for Laboratory and Epidemiology, Ministry of Health, Vientiane, Lao People’s Democratic Republic, km 3, Thadeua Road, Vientiane, Lao People’s Democratic Republic, Tel: 856-21-312351, Fax: 856-21-350209. Reiko Tsuyuoka, World Health Organization Office in the Lao People’s Democratic Republic, Ban Phonxay, That Luang Road, Vientiane, Lao People’s Democratic Republic, Tel: 856-21-413431, Fax: 856-21-413432. Nobuo Koizumi and Haruo Watanabe, Department of Bacteriology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan, Tel: 81-3-5285-1111 ext. 2224, Fax: 81-3-5285-1163.

Reprint requests: Leo Kawaguchi, Department of International Health, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan, E-mail: leo-k{at}med.nagoya-u.ac.jp.