ArticlePLoS neglected tropical diseases2022
Diagnostic method-based underestimation of leptospirosis in clinical and research settings; an experience from a large prospective study in a high endemic setting.
Article in PLoS neglected tropical diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Review of the aetiologies of central nervous system infections in Vietnam.Frontiers in public health · 2024Pooled it
- A Label-Free Graphene Quantum Dot-Based Fluorescent Aptasensor for Rapid and Sensitive Detection of Leptospira interrogans.Journal of fluorescence · 2026Article
- Multi-omics analysis of human patient samples identifies key immune factors inMicrobiology spectrum · 2026Article
- Subclinical Leptospiral Infections and Antibody Waning During Pregnancy: A Population-Based Cohort Study from Rural Sri Lanka.The American journal of tropical medicine and hygiene · 2026Article
- Molecular detection and genetic characterisation of a large flood-borne outbreak of human leptospirosis in Jakarta, Indonesia: A retrospective analysis of surveillance data.PLoS neglected tropical diseases · 2026Article
- Clinical presentation and laboratory findings: key indicators for early diagnosis and severity prediction of leptospirosis in Sri Lanka.BMC infectious diseases · 2026Article
- Genomic analysis of human-infecting Leptospira borgpetersenii isolates in Sri Lanka: Expanded PF07598 gene family repertoire and less genome reduction than bovine isolates.PLoS neglected tropical diseases · 2026Article
- Leptospirosis Incidence at Four Sites in Sub-Saharan Africa and South East Asia: An International Multi-Site Hybrid Surveillance Study.Open forum infectious diseases · 2026Article
- Evaluating the diagnostic accuracy of clinical judgement and rapid tests for leptospirosis in the Philippines: implications for public health management.Infectious diseases of poverty · 2026Article
- Leptospirosis in Southeast Asia: Investigating Seroprevalence, Transmission Patterns, and Diagnostic Challenges.Tropical medicine and infectious disease · 2026Review
- Urine PCR testing as an effective method for early diagnosis of leptospirosis.Microbiology spectrum · 2025Article
- Evolution of human leptospirosis in French Guiana, 2016-2022.PLoS neglected tropical diseases · 2025Article
- Into the spotlight: A spatial study of potentially underreported leptospirosis among dengue-negative patients in São Paulo city, Brazil.PLoS neglected tropical diseases · 2025Article
- Enhancing leptospirosis screening using a deep convolutional neural network with microscopic agglutination test images.Biology methods & protocols · 2025Article
- Diagnosis and Clinical Description of Leptospirosis Cases Identified Through Hospital-Based Active Surveillance in Puerto Rico, 2019-2021.Journal of tropical medicine · 2025Article
- Investigation of Viral, Bacterial and Parasitic Zoonotic Diseases in Rodents in Turkey.Veterinary medicine and science · 2024Article
- Serologically Confirmed Human Leptospirosis in Colombia, 2015-2020.The American journal of tropical medicine and hygiene · 2024Article
- Clinical presentation of human leptospirosis in febrile patients: Urabá, Colombia.PLoS neglected tropical diseases · 2024Observational
- Prevalence and risk factors for human leptospirosis at a hospital serving a pastoralist community, Endulen, Tanzania.PLoS neglected tropical diseases · 2023Article
- Global, regional, and country-level cost of leptospirosis due to loss of productivity in humans.PLoS neglected tropical diseases · 2023Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundLeptospirosis has globally significant human mortality and morbidity, yet estimating the clinical and public health burden of leptospirosis is challenging because timely diagnosis remains limited. The goal of the present study was to evaluate leptospirosis undercounting by current standard methods in both clinical and epidemiological study settings. METHODOLOGY/PRINCIPAL
findingsA prospective hospital-based study was conducted in multiple hospitals in Sri Lanka from 2016 to 2019. Culture, whole blood, and urine samples were collected from clinically suspected leptospirosis cases and patients with undifferentiated fever. Analysis of biological samples from 1,734 subjects confirmed 591 (34.1%) cases as leptospirosis and 297 (17.1%) were classified as "probable" leptospirosis cases. Whole blood quantitative PCR (qPCR) did identify the most cases (322/540(60%)) but missed 40%. Cases missed by each method include; urine qPCR, 70% (153/220); acute sample microscopic agglutination test (MAT), 80% (409/510); paired serum sample MAT, 58% (98/170); and surveillance clinical case definition, 53% (265/496). qPCR of negative culture samples after six months of observation was of diagnostic value retrospectively with but missed 58% of positives (109/353).
conclusionLeptospirosis disease burden estimates should consider the limitations of standard diagnostic tests. qPCR of multiple sample types should be used as a leading standard test for diagnosing acute leptospirosis.
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