Environmental and Behavioral Risk Factors for Severe Leptospirosis in Thailand

Soawapak Hinjoy, Somkid Kongyu, Pawinee Doung-Ngern, Galayanee Doungchawee, Soledad D. Colombe, Royce Tsukayama, Duangjai Suwancharoen

Research output: Contribution to journalArticlepeer-review


A nationwide prevention and control campaign for leptospirosis in Thailand has led to a decreased incidence rate, but the mortality and case fatality rates have remained stable. Regarding the limited knowledge of risk factors, a case-control study of the association between environmental and behavioral exposure with severe leptospirosis was implemented to identify the risk factors among adults in Thailand. The study was conducted in 12 hospital-based sites. Hospitalized patients with suspected clinical symptoms of leptospirosis were tested for leptospirosis by culture, loop mediated isothermal amplification (LAMP), real-time PCR, and the microscopic agglutination test (MAT). All participants answered a standardized questionnaire about potential risk factors. Risk factors were identified by univariable and multivariable logistic regression. Of the 44 confirmed cases, 33 (75.0 presented with severe illness, as determined by clinical criteria, and were categorized as severe cases. Non-severe cases were defined as patients with non-severe symptoms of leptospirosis. Living nearby a rubber tree plantation (adjusted OR 11.65, 95.08-125.53) and bathing in natural bodies of water (adjusted OR 10.45, 95.17-93.35) were both significantly associated with an increased risk of severe leptospirosis. We recommend designating rubber plantations in Thailand as high-risk zones and closely monitoring hospitalized patients in those areas.
Original languageEnglish
JournalTropical Medicine and Infectious Disease
Issue number2
Pages (from-to)79
Number of pages1
Publication statusPublished - 1-May-2019


  • adult
  • behavior
  • case-control study
  • environment
  • leptospirosis


Dive into the research topics of 'Environmental and Behavioral Risk Factors for Severe Leptospirosis in Thailand'. Together they form a unique fingerprint.

Cite this