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Source publication
Leptospirosis is an acute generalized infectious disease, caused by spirochaetes, Leptospira interrogans. The severity of the disease ranges from an asymptomatic subclinical course to a fatal outcome. Pulmonary involvement is common but often mild and of little clinical significance. However, over the last two decades an increasing number of cases...
Citations
... In recent years, cases of human and animal leptospirosis have been reported in numerous countries in the Middle East through direct and/or indirect diagnostic techniques. Human cases commonly involve farmers, rice field workers [28][29][30][31][32][33][34][35][36], travelers [37], and plumbers [38]. Leptospirosis cases in children and/or adults in contact with infected livestock or contaminated water have also been reported [28,[39][40][41]. ...
Leptospirosis is a major zoonotic disease that has emerged worldwide, and numerous studies performed in affected countries have provided epidemiological knowledge of the disease. However, currently, there is inadequate knowledge of leptospirosis in the Middle East. Therefore, we grouped publications from various Middle Eastern countries to acquire a general knowledge of the epidemiological situation of leptospirosis and provide an initial description of the leptospiral relative risk and circulating serogroups. We conducted a detailed literature search of existing studies describing Leptospira prevalence and seroprevalence in Middle Eastern countries. The search was performed using online PubMed and ScienceDirect databases. One hundred and one articles were included in this review. Some countries, including Iran, Turkey, and Egypt, reported more publications compared to others, such as Lebanon, Kuwait, and Saudi Arabia. Frequently, the seroprevalence of leptospirosis varied considerably between and within countries. The prevalence of leptospirosis was comparable in most Middle Eastern countries; however, it varied between some countries. The methods of detection also varied among studies, with the microscopic agglutination test used most commonly. Some hosts were more recurrent compared with others. This review summarizes the epidemiological situation of Leptospira infection in the Middle East, reporting predominant serogroups—Sejroe, Grippotyphosa, Icterohaemorrhagiae, Autumnalis, and Pomona—that were identified in the most commonly tested hosts. Our findings emphasize the need to develop a deeper understanding of the epidemiology of Leptospira spp. and prioritize the disease as a public health problem in this region. To achieve this goal, increased awareness is critical, and more publications related to the topic and following a standardized approach are needed.
... 13,14 Given the wide spectrum of clinical presentations, the incidence of leptospirosis in Saudi Arabia is likely to be underestimated. 15 Vector-borne infectious diseases have gained prominence in recent years as a result of recurring outbreaks, especially in the tropics and subtropics. 16,17 The climate of Saudi Arabia favors breeding of Anopheles and Aedes mosquitoes, the arthropod vectors responsible for the transmission of protozoan parasite Plasmodium species, and dengue (DENV) and chikungunya (CHIKV) viruses. ...
Objectives
Little is known about the prevalence of febrile illness in the Arabian region as clinical, laboratory and immunological profiling remains largely uncharacterised.
Methods
A total of 2018 febrile patients from Jazan, Saudi Arabia, were recruited between 2014 and 2017. Patients were screened for dengue and chikungunya virus, Plasmodium, Brucella, Neisseria meningitidis, group A streptococcus and Leptospira. Clinical history and biochemical parameters from blood tests were collected. Patient sera of selected disease‐confirmed infections were quantified for immune mediators by multiplex microbead‐based immunoassays.
Results
Approximately 20% of febrile patients were tested positive for one of the pathogens, and they presented overlapping clinical and laboratory parameters. Nonetheless, eight disease‐specific immune mediators were identified as potential biomarkers for dengue (MIP‐1α, MCP‐1), malaria (TNF‐α), streptococcal and meningococcal (eotaxin, GRO‐α, RANTES, SDF‐1α and PIGF‐1) infections, with high specificity and sensitivity profiles. Notably, based on the conditional inference model, six of these mediators (MIP‐1α, TNF‐α, GRO‐α, RANTES, SDF‐1α and PIGF‐1) were revealed to be 68.4% accurate in diagnosing different febrile infections, including those of unknown diseases.
Conclusions
This study is the first extensive characterisation of the clinical analysis and immune biomarkers of several clinically important febrile infections in Saudi Arabia. Importantly, an immune signature with robust accuracy, specificity and sensitivity in differentiating several febrile infections was identified, providing useful insights into patient disease management in the Arabian Peninsula.
