Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil.
Leptospirosis and dengue share similar unspecific symptoms, complicating differential diagnosis in endemic regions. This overlap is further exacerbated by the often-underrecognized nature of leptospirosis, resulting in low clinical suspicion among healthcare providers. Understanding the scale of und...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2025-03-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0012888 |
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| author | Stephanie Bergmann Esteves Luciano Marcondes de Oliveira Aline Gil Alves Guilloux Adriana Cortez Eduardo de Masi Isabelle Martins Ribeiro Ferreira Evelyn Moura de Lima Gabriele Yumi Ramalho Priscila de Castilho Luna Jose Soares Ferreira Neto Marcos Bryan Heinemann Bruno Alonso Miotto |
| author_facet | Stephanie Bergmann Esteves Luciano Marcondes de Oliveira Aline Gil Alves Guilloux Adriana Cortez Eduardo de Masi Isabelle Martins Ribeiro Ferreira Evelyn Moura de Lima Gabriele Yumi Ramalho Priscila de Castilho Luna Jose Soares Ferreira Neto Marcos Bryan Heinemann Bruno Alonso Miotto |
| author_sort | Stephanie Bergmann Esteves |
| collection | DOAJ |
| description | Leptospirosis and dengue share similar unspecific symptoms, complicating differential diagnosis in endemic regions. This overlap is further exacerbated by the often-underrecognized nature of leptospirosis, resulting in low clinical suspicion among healthcare providers. Understanding the scale of underdiagnosed leptospirosis cases, particularly among dengue-negative patients, is critical for improving public health responses. This cross-sectional study analyzed data from 6,936 febrile patients who tested negative for dengue at public health services across São Paulo city. Serum samples from these patients were subsequently tested for anti-Leptospira IgM antibodies. Spatial analysis was conducted to identify areas at increased risk of underdiagnosed leptospirosis, and these findings were compared to cases reported in the Brazilian's Information System for Notifiable Diseases from 2009 to 2019. Our results revealed that, from the 6,936 patients tested, 786 (11.3%) were seroreactive for leptospirosis, with a higher prevalence among women (55.7%; p=0.003). Spatial analysis identified 18 high-risk clusters for potentially unrecognized leptospirosis, predominantly in peripheral regions with socioeconomic vulnerabilities. Notably, two significant high-risk areas were located in the North (RR=2.13) and South (RR=2.69) regions of the city. These findings underscore the urgent need for targeted public health interventions to improve disease surveillance and diagnostic capacity, particularly in the high-risk areas identified. Addressing underrecognition of leptospirosis is essential for reducing morbidity and mortality associated with the disease. Future research should expand on this work by integrating broader temporal, environmental, and socioeconomic data. |
| format | Article |
| id | doaj-art-eebfba322f3d43c3881297ba2d4abaaf |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-eebfba322f3d43c3881297ba2d4abaaf2025-08-20T03:52:47ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-03-01193e001288810.1371/journal.pntd.0012888Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil.Stephanie Bergmann EstevesLuciano Marcondes de OliveiraAline Gil Alves GuillouxAdriana CortezEduardo de MasiIsabelle Martins Ribeiro FerreiraEvelyn Moura de LimaGabriele Yumi RamalhoPriscila de Castilho LunaJose Soares Ferreira NetoMarcos Bryan HeinemannBruno Alonso MiottoLeptospirosis and dengue share similar unspecific symptoms, complicating differential diagnosis in endemic regions. This overlap is further exacerbated by the often-underrecognized nature of leptospirosis, resulting in low clinical suspicion among healthcare providers. Understanding the scale of underdiagnosed leptospirosis cases, particularly among dengue-negative patients, is critical for improving public health responses. This cross-sectional study analyzed data from 6,936 febrile patients who tested negative for dengue at public health services across São Paulo city. Serum samples from these patients were subsequently tested for anti-Leptospira IgM antibodies. Spatial analysis was conducted to identify areas at increased risk of underdiagnosed leptospirosis, and these findings were compared to cases reported in the Brazilian's Information System for Notifiable Diseases from 2009 to 2019. Our results revealed that, from the 6,936 patients tested, 786 (11.3%) were seroreactive for leptospirosis, with a higher prevalence among women (55.7%; p=0.003). Spatial analysis identified 18 high-risk clusters for potentially unrecognized leptospirosis, predominantly in peripheral regions with socioeconomic vulnerabilities. Notably, two significant high-risk areas were located in the North (RR=2.13) and South (RR=2.69) regions of the city. These findings underscore the urgent need for targeted public health interventions to improve disease surveillance and diagnostic capacity, particularly in the high-risk areas identified. Addressing underrecognition of leptospirosis is essential for reducing morbidity and mortality associated with the disease. Future research should expand on this work by integrating broader temporal, environmental, and socioeconomic data.https://doi.org/10.1371/journal.pntd.0012888 |
| spellingShingle | Stephanie Bergmann Esteves Luciano Marcondes de Oliveira Aline Gil Alves Guilloux Adriana Cortez Eduardo de Masi Isabelle Martins Ribeiro Ferreira Evelyn Moura de Lima Gabriele Yumi Ramalho Priscila de Castilho Luna Jose Soares Ferreira Neto Marcos Bryan Heinemann Bruno Alonso Miotto Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil. PLoS Neglected Tropical Diseases |
| title | Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil. |
| title_full | Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil. |
| title_fullStr | Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil. |
| title_full_unstemmed | Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil. |
| title_short | Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil. |
| title_sort | into the spotlight a spatial study of potentially underreported leptospirosis among dengue negative patients in sao paulo city brazil |
| url | https://doi.org/10.1371/journal.pntd.0012888 |
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