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      A cross sectional study of leptospirosis and fetal death in Yucatan, Mexico Translated title: Estudio transversal de leptospirosis y muerte fetal en Yucatán, México

      research-article
      1 , , 1 , 1 , 1 , 2
      Colombia Médica : CM
      Universidad del Valle
      Leptospirosis, abortion spontaneous, Leptospira

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          Abstract

          Introduction:

          Leptospirosis is a zoonotic disease affecting mainly to low income human population. Acute leptospiral infection during pregnancy has been associated with spontaneous abortion and fetal death during the first trimester and the abortion may occur as consequence of systemic failure.

          Objective:

          To estimate the frequency of Leptospira interrogans infection in women with spontaneous abortion in the state of Yucatan, Mexico.

          Methods:

          A cross sectional study on women with spontaneous abortion was conducted. Serum samples were tested for Leptospirosis by the microaglutination test, to estimate the frequency of the infecting serovar. The indirect ELISA IgM was used to detect recent infection by L. interrogans. DNA was extracted from paraffin-embedded tissue of placenta for PCR detection of L. interrogans.

          Results:

          Overall frequency of infection with L. interrogans in the 81 women with abortion was 13.6%. Five of the 12 serovars evaluated were found and included. Two of the 11 women with abortion and positive to microaglutination test were also positive to the ELISA IgM test. None samples were positive for PCR Leptospira diagnosis.

          Conclusion:

          two women could be associated with spontaneous abortion due to leptospirosis, because they showed antibodies against L. interrogans in the microaglutination test and ELISA IgM assays. Differences between regions were found with respect to the prevalences of lesptospirosis.

          Translated abstract

          Introducción:

          Leptospirosis es una enfermedad zoonótica que afecta principalmente la población humana de bajos recursos. Infección aguda por leptospirosis durante el embarazo se ha asociado con aborto espontáneo y muerte fetal durante el primer trimestre del embarazo.

          Objetivo:

          Estimar la frecuencia de infección por Leptospira interrogans en mujeres con aborto espontáneo en el estado de Yucatán, México.

          Métodos:

          Se efectuó un estudio transversal en 81 mujeres con aborto espontáneo. La prueba de referencia para Leptospirosis, prueba de microaglutinación, se utilizó para estimar la frecuencia de la serovar infectante. El ELISA IgM indirecto se utilizó para detectar infección reciente por L. interrogans. Se extrajo ADN a partir de tejido embebido en parafina de placenta para la detección de L. interrogans por PCR.

          Resultados:

          La frecuencia global de la infección con L. interrogans en 81 mujeres con aborto, fue del 13.6%. Se encontró cinco de 12 serovares de Leptospira. Dos de las 11 mujeres con aborto espontáneo y positivo a microaglutinación también fueron positivas a la prueba ELISA IgM. Ninguna muestra fue positiva hacia el diagnóstico PCR de Leptospira.

          Conclusion:

          Dos mujeres podrían estar asociados con el aborto espontáneo debido a la leptospirosis, porque mostraron anticuerpos contra L. interrogans en la microaglutinación y ensayos de ELISA IgM. Diferencias entre regiones fueron encontradas con respecto a las prevalencias de leptospirosis.

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          Most cited references18

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          Toxoplasma gondii presence in women with spontaneous abortion in Yucatan, Mexico.

          The objective of this study was to estimate the seroprevalence of anti- Toxoplasma gondii antibodies and DNA of women with spontaneous abortions in 2 hospitals located in Yucatan, Mexico. Between June 2008 and May 2009, blood samples were taken from 100 women with spontaneous abortion attending the Ticul City Communitarian Hospital and the Merida Mother-Kid Hospital. The sera were tested for anti- T. gondii IgG and IgM antibodies. Blood samples (5 ml with anticlotting agent) were also used for polymerase chain reaction (PCR) assay, to detect T. gondii DNA. Forty-two of the 100 samples were negative. Of the positive samples (n = 58), 32 were positive to IgG, 2 to IgM, 5 to IgG and IgM, 6 to IgG and PCR, 1 to IgM and PCR, and 12 to IgG, IgM, and PCR. Accordingly, 55% of the women were seropositive to at least IgG, 20% to at least IgM, and 19% via PCR. Differences between hospitals were significant (P < 0.05) only for IgM. The risk of infection (IgM positive) was 2.85 (odds ratio [OR] 95%, confidence interval [CI]; 1.03-7.87) times greater in women patients at the Merida Mother-Kid Hospital, than those at the Ticul Communitarian Hospital. More studies are needed to evaluate the impact of this disease and to establish strategies to follow in order to reduce congenital toxoplasmosis in the populations at risk.
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            Leptospirosis in pregnancy and its effect on the fetus: case report and review.

            We report the case of a pregnant woman with leptospirosis who gave birth to a healthy baby. We also review 15 previously reported cases of leptospirosis in pregnancy. Of these 15 cases, eight women had abortions, two delivered healthy babies, and four delivered babies who had signs of active leptospirosis; in one case, the fate of the fetus was not stated. It appears that women are more likely to spontaneously abort if leptospirosis occurs in the early months of pregnancy. Since congenital infection is rare, leptospirosis should not necessarily be considered an indication to terminate pregnancy. Increased awareness of the possibility of leptospirosis for pregnant women who live in areas where the disease is endemic is of utmost importance for early detection and treatment of the disease and, thus, for the safety of the fetus.
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              • Article: not found

              Clinical-epidemiological study of leptospirosis in humans and reservoirs in Yucatán, México.

              A leptospirosis clinical-epidemiological study was made in humans and reservoirs in the state of Yucatán, México. Interviews and serological analyses were made on 400 persons from an open population, 439 probable cases of leptospirosis and 1060 animal reservoirs (cows, pigs, dogs, rats and opossums). IgM Leptospira Dipstick and Microscopic Agglutination Test (MAT) was used to detect human antibodies to leptospiras and serovar respectively. Leptospirosis incidence in humans was 2.2/100,000 inhab. in 1998, 0.7/100,000 in 1999 and 0.9/100,000 in 2000. Overall seroprevalence was 14.2%, relatively unchanged from seroprevalences observed 20 years ago. Highest seropositivity was found in people over 56 years of age, predominating males over females. Predominant serovars in the open population were tarassovi, hardjo, pomona and panama. Leptospirosis cases were most frequent in rural areas, and the anicteric course predominated over the icteric. The panama, icterohaemorrhagiae and pomona serovars predominated in both anicteric and icteric courses. Dogs, pigs and rodents had the highest seropositivity among the reservoirs. Contact with rodents and natural water sources were significant factors (p < or = 0.05). Human cases (74%) occurred during the rainy season. It is concluded that leptospirosis is still a serious illness with important clinical and epidemiological implications in the state of Yucatán, Mexico.
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                Author and article information

                Journal
                Colomb Med (Cali)
                Colombia Médica : CM
                Universidad del Valle
                0120-8322
                1657-9534
                30 March 2016
                Jan-Mar 2016
                : 47
                : 1
                : 11-14
                Affiliations
                [1 ] Laboratorio de Enfermedades Infecciosas y Parasitarias II. Facultad de Medicina de la Universidad Autónoma de Yucatán. Merida, Yucatán México
                [2 ] Campus Ciencias Biológicas y Agropecuarias. Universidad Autónoma de Yucatán, Merida Yucatán, México
                Author notes
                María Fidelia Cárdenas Marrufo. Laboratorio de Enfermedades Infecciosas y Parasitarias II. Facultad de Medicina de la Universidad Autónoma de Yucatán, México. Avenida Itzáes, No 498 entre 59 y 59-A. Centro. Mérida, Yucatán, México. Phone +52 9999 240554 ext 1162. Email: cmarrufo@ 123456correo.uady.mx

                Conflict of interest: Authors declare no conflict of interest in the preparation and presentation of this article

                Article
                4867511
                27226658
                e7645d73-74a2-40d5-aec0-c330c9d5415a

                © 2016. Universidad del Valle. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 26 May 2015
                : 13 January 2016
                : 04 February 2016
                Page count
                Tables: 2, References: 19, Pages: 4
                Categories
                Original Article

                leptospirosis,abortion spontaneous,leptospira
                leptospirosis, abortion spontaneous, leptospira

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