Leptospirosis in Si Sa Ket, Thailand: Incidence and Factors of Death during 2010-2019

Abstract

Leptospirosis is an emerging public health problem in Thailand especially Si Sa Ket. The aims of this study were to determine the leptospirosis incidence and factors of death among leptospirosis patients in Si Sa Ket. This study was performed during 2010-2019 from the 506-surveillance report of leptospirosis to the Sisaket Provincial Public Health Office and the National Disease Surveillance System, Bureau of Epidemiology, Ministry of Public Health, Thailand. The data was using the definition of leptospirosis patient for disease surveillance. Multiple logistic regression analysis was performed to evaluate factors of death. A total of 3,988 cases were reported from 22 districts, mainly in rural settings. The incidence rate for leptospirosis was 27.15 per 100,000 population. The dramatic phenomenal of epidemiological characteristics of leptospirosis in Si Sa Ket include a peak incidence in August and October in association with the rainy season. Seventy-four point eight percent of subjects were male, 24.5% were aged 45-54 years and 78.3% were agricultural workers. A total number of 86 deaths were registered in 19 districts. Mortality was higher in males (80.2%). The fatality rate was 2.16%. Significant factors of death found on multiple logistic regression analysis were agricultural workers (Adjusted OR=2.51, 95% CI: 1.15-5.49) and the duration of seeking for medical care >3 days after onset (Adjusted OR=2.45, 95% CI: 1.30-4.61). To reduce the burden disease, the promotion of preventive health behavior, early recognition and treatment of patients have been shown to reduce the severity of illness and death.