SEROPREVALENCE OF LEPTOSPIROSIS AMONG TOWN SERVICE WORKERS IN KELANTAN, MALAYSIA

Leptospirosis is presumed to be the most widespread re-emerging zoonotic disease of global distribution affecting humans in tropical, subtropical and temperate zones. Humans can be exposed to leptospirosis as a result of variety of occupations, such as town service worker, paddy planter, army and health care worker due to the presence of environmental determinants for human leptospirosis. This study determined seroprevalence of leptospirosis among 321 town service workers in Kelantan, a northeastern state of Malaysia, involving a cross sectional study in four districts, namely, Kota Bharu, Gua Musang, Kuala Krai, and Tanah Merah in Kelantan. Sociodemographic data were collected and sera samples screened for the presence of anti-leptospiral antibodies using IgM enzyme-linked immunosorbent assay (IgM ELISA) and confirmed by microscopic agglutination test (MAT) using a panel of 20 live leptospires obtained from Institute of Medical Research (IMR) Kuala Lumpur, Malaysia. Serovars used were australis, autumnalis, bataviae, canicola, celledoni, copenhageni, djasiman, grippotyposa, hardjobovis, hardjoprajitno, icterohaemorrhagiae, javanica, lai, melaka, pomona, pyrogenes, patoc, sarawak, tarassov, and terengganu. A MAT titer of ≥100 was used as cut-off for positive samples. All participants were of Malay race, with mean age (± SD) of 40 (± 10) years and mean duration of employment of 12 (± 10) years. Ninety-eight samples were positive or indeterminate by IgM ELISA, and MAT revealed an overall seroprevalence of leptospirosis of 25.5% (95% CI : 20.6-30.5). Garbage collectors had the highest seroprevalence (35%; 95% CI : 8.1-14.9), followed by town cleaners (30%; 95% CI : 43.6-54.8), lorry drivers/ mechanics (20%; 95% CI : 17.8-27.4), and landscapers (14%; 95% CI : 13.1-21.8). The most common serovar was against a strain of Leptospira spp isolated from Sarawak (60%) and none positive for serovars bataviae, djasiman, hardjoprajitno, melaka, pyrogenes, pomona and terengganu. The present study highlights the high risk of leptospiral infection among town service workers in Kelantan, Malaysia.