Data from: Has Madagascar lost its exceptional leptospirosis free-like status?

Background: Leptospirosis is a widespread but underreported cause of morbidity and mortality. It has rarely been reported in either humans or animals in Madagascar. Methods: We conducted a cross-sectional survey of the inhabitants in Moramanga, Madagascar, in June 2011, to estimate the prevalence of human infection using the microscopic agglutination test (MAT). This activity was carried out as part of a workshop implemented by the Pasteur Institute of Madagascar, focusing on surveillance with a one week field study and targeting the health staff of the district level. Results: In total, we sampled 678 inhabitants from 263 households. The sex ratio (M/F) was 0.65 and the mean age 26.7 years. We obtained a value of 2.9% for the first recorded seroprevalence of this disease in the human community of Moramanga. Questionnaire responses revealed frequent contacts between humans and rodents in Moramanga. However, activities involving cattle were identified as a risk factor significantly associated with seropositivity (OR=3). Conclusion: Leptospirosis remains a neglected disease in Madagascar. This study highlights the need to quantify the public health impact of this neglected disease in a more large scale, in all the country and to establish point-of-care laboratories in remote areas.

背景：钩端螺旋体病（Leptospirosis）是一种广泛流行却报告不足的致死致残性疾病，此前在马达加斯加鲜有人类及动物相关病例报告。
方法：本研究于2011年6月在马达加斯加莫拉曼加地区开展横断面调查，采用显微镜凝集试验（microscopic agglutination test, MAT）评估人类感染的血清流行率（seroprevalence）。本次工作为马达加斯加巴斯德研究所实施的讲习班内容之一，聚焦疾病监测工作，包含为期一周的现场研究，研究对象为该地区的医疗卫生人员。
结果：本研究共纳入263户家庭的678名居民作为研究对象。研究对象性别比（男/女）为0.65，平均年龄26.7岁。本研究测得的血清流行率为2.9%，这是莫拉曼加地区人类社区中该疾病的首项血清流行率记录。问卷调查结果显示，该地区人类与啮齿动物接触频繁；但与牛只相关的活动被确定为与血清学阳性显著相关的危险因素（比值比（OR）=3）。
结论：钩端螺旋体病仍是马达加斯加的一种被忽视疾病。本研究强调，有必要在全国范围内开展更大规模的研究，量化此种被忽视疾病的公共卫生影响，并在偏远地区建立即时检测（point-of-care）实验室。