Risk factors for leptospirosis during a flood disaster in Kelantan, Malaysia

Abstract

Leptospirosis is a zoonotic disease caused by the Leptospira spirochete. These microorganisms are transmitted through stagnant water or soil via urine of wild and domestic animals which act as reservoir hosts. During flooding incidents, Leptospira spirochetes are dispersed in flood waters and may infect humans who come in contact with the water. The aim of this study is to assess the risk factors for leptospirosis during a major flood disaster in Kelantan at the end of December 2014 until early January 2015. A hospital-based case-control study was conducted from 12 - 30 January 2015 in the state of Kelantan, Malaysia. Leptospirosis cases were confirmed by microscopic agglutination test (MAT) or polymerase chain reaction (PCR). A standardized questionnaire was used to collect demographic and exposure information from both cases and controls. We recruited 54 confirmed leptospirosis cases and 119 controls. Multivariable logistic regression showed staying in flood relief centres (AOR: 4.23; 95% CI: 1.02, 17.53) and history of walking in floodwaters (6.16; 1.40, 27.21) were significantly associated with leptospirosis. Our findings suggest that risk of leptospirosis infection during major floods may be reduced by avoiding walking in floodwaters and ensuring high standards of hygiene and cleanliness in flood relief centers.