High incidence of leptospirosis in an observational study of hospital outpatients in Vanuatu highlights the need for improved awareness and diagnostic capacities

摘要

Author summary Leptospirosis is thought to impose its highest burden to tropical island populations, especially in the Pacific region of Oceania. Yet, very few information has ever been reported from some of the Pacific Island Countries and Territories, including Vanuatu. In this study, we aimed at evidencing leptospirosis in a convenience sample of outpatients visiting Port Vila Central Hospital, the major hospital of this archipelago country in the South Pacific. Using reference laboratory techniques, our study confirms a significant number of acute leptospirosis cases, as well as a high level of previous exposure in outpatients visiting this hospital. Risk factor analysis point to livestock and lifestyle as important factors exposing to leptospirosis in this developing country. Furthermore, there is evidence that the disease probably has a higher incidence in remote islands outside of the capital of Efate in this very wide archipelago. Taken together, our results point to a need of increased awareness, notably in peripheral health centers and of better access to laboratory confirmation for surveillance.