Incidence and distribution of human leptospirosis in the Western Cape Province, South Africa, (2010-2019): A retrospective study.

Background Leptospirosis is an emerging zoonosis of global importance. In South Africa, the infection is an underreported public health concern, with limited information on its incidence and distribution. This study aimed to determine the incidence of human leptospirosis from 2010 to 2019 in Western Cape Province (WPC), and to compare the incidence based on seasonal and demographic factors. Methods A retrospective study was conducted with data on leptospirosis diagnoses by sex, age, season, and year in WCP obtained from the National Health Laboratory Services. With the provincial population sizes as the denominator, the incidence of leptospirosis was estimated and expressed as cases per 100,000 population. Negative binomial regression was used to estimate the effect of sex, season, and year on the incidence of leptospirosis. Results A total of 254 cases of leptospirosis were reported between 2010 and 2019, with the highest number of cases being in 2015. The annual incidence ranged between 0.15 and 0.66/100,000 population with a 10-year average incidence of 0.40/100,000 population. The incidence was higher among males than in females (0.55 vs. 0.25/ 100,000 population; incidence rate ratio (IRR) 2.2, 95% CI: 1.66,3.03). The 18-44 age cohort and had the highest average incidence (0.56/100,000 population), while the less or equal to 17 age cohort had the lowest incidence (0.07/100,000 population). The 18-44 (IRR 8.0, 95% CI: 4.65,15.15) and the greater or equal to 45 (IRR 7.4, 95% CI: 4.17,14.17) age cohorts were more at risk of infection compared to the less or equal to 17 age cohort. The average incidence of the infection was similar among seasons and there was no significant association between season and incidence of leptospirosis. Conclusions The results highlight that leptospirosis is an important zoonosis within the province disproportionately affecting males and the productive age demographic groups. These findings should enhance targeted prevention and provoke further investigation on the importance of environmental and socioeconomic factors on leptospirosis burden.

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Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend

Epidemiology and Infection ◽

10.1017/s0950268818002649 ◽

2018 ◽

Vol 146 (16) ◽

pp. 2107-2115 ◽

Cited By ~ 1

Author(s):

T. N. Mann ◽

H. S. Schaaf ◽

R. N. Dunn ◽

S. Dix-Peek ◽

K. du Preez ◽

...

Keyword(s):

South Africa ◽

Spinal Tuberculosis ◽

Health Concern ◽

Western Cape ◽

Demographic Information ◽

Spinal Disease ◽

Western Cape Province ◽

Clear Trend ◽

Tertiary Hospitals ◽

Clinical Records

AbstractThe aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6–4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.

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