Leptospirosis Study Update from the Field

January 30, 2019

By Jane Fieldhouse, MSc and Diego Gálan

Leptospirosis study team at Sibu Clinical Research Centre (left-to-right Ms. Jakie Ting, Ms. Kamilah Dahian, Dr. Wendy Lee, Ms. Tiing Tiing Chua, Diego Gálan, Dr. Teck-Hock Toh, and Dr. Gregory Gray)

The Duke One Health team is working with collaborators across several hospitals in Sarawak, a state along the northwest coast of the island of Borneo, to improve early diagnosis of leptospirosis. Leptospirosis is a zoonotic disease with symptoms similar to those of other tropical infectious diseases such as malaria. Leptospirosis most commonly presents as an acute febrile illness, though severe and potentially fatal manifestations can occur.

The study will enroll patients at Sibu and Kapit Hospitals, where clinicians currently rely on rapid diagnostic tests as their only means of diagnosing leptospirosis. However, physicians in hospitals have become aware of the poor sensitivity and specificity of these tests. In order to obtain a reliable diagnosis, physicians in Sarawak must send patient samples to Kuala Lumpur, where a MAT analysis is performed. However, results from external testing take approximately 2-4 weeks to which often is not useful to individual patients.

Diego Gálan, a third-year medical student at Duke University, is conducting the leptospirosis study with Malaysian collaborators

The study aims to enroll 150 patients with clinical symptoms consistent with leptospirosis infection. Consenting patients will be asked to complete a survey capturing demographic information that will help us better understand the risk factors associated with this infection. Furthermore, blood and urine samples from the enrolled patients will be analyzed using a common rapid diagnostic test, a commercial ELISA assay, and a newer molecular assay. The US and Malaysian investigators will compare the sensitivity and specificity of the different tests and analyze the feasibility of implementing the new diagnostic tests in the hospitals in Sarawak. This project will hopefully improve the diagnostic power of the hospitals in Sarawak resulting in improved patient care. A better understanding of molecular and serologic epidemiology of leptospirosis, as well as understanding of alternative etiologies in acutely febrile patients, is important for determining health protection decisions and better-defining risks for exposure.


Support for this work comes from US Navy Medical Research Center – Asia.