Chronic Post-leptospirosis Manifestations in Reunion (LEPTONIC)

Centre Hospitalier Universitaire de la Réunion

Status: Enrolling

Conditions: Leptospirosis

Treatments: Other: Biological sampling and collection

Study type: Interventional

Funder types: Other

Identifiers

NCT05436756

2022/CHU/16

Details and patient eligibility

About

Leptospirosis is a zoonosis caused by spirochetes, pathogenic bacteria of the genus Leptospira. It is transmitted to humans through mucocutaneous lesions by contact with water or soil contaminated by the urine of animal reservoirs (rats, dogs, pigs, cattle, etc.). Exposure to fresh water, contact with water or soil contaminated with animal waste are the main risk factors.

This disease is an important public health problem in humans and animals. The annual global incidence is estimated at nearly one million cases with a mortality of 5 to 10% for all cases combined and up to 50% in the event of multi-organ failure. The number of cases is growing and the disease is probably more widespread because it is underdiagnosed. The incidence could increase further in the coming decades due to climate change and rapid urbanization.

In the Overseas Departments and Regions (DROM), it is an endemic condition and its incidence is 10 to 100 times higher than that of mainland France, mainly for climatic reasons. In Réunion, the disease is notifiable with a number of notified cases ranging from 70 to more than 100 cases per year in recent years. Nearly 90% of confirmed cases were hospitalized and more than a third of patients stayed in intensive care.

Recently, a multicenter cohort of patients hospitalized with leptospirosis in La Réunion (COLEPT) was funded by Inserm to identify the severity factors of the disease in patients hospitalized in one of the 4 hospitals on the island. A community of hospital practitioners active on this theme has been identified and constitutes the core of this project. The main objective of the study, the inclusions of which began in January 2020, is to identify the severity factors of leptospirosis in Reunion. Patient follow-up is planned for up to 1 year with 2 medical visits at 1 month and 1 year and 2 telephone interviews on quality of life.

The disease is generally perceived as a purely acute condition with a rapid ad integrum recovery. Nevertheless, the evolution at a distance has been little evaluated. A few publications report complications and elements of chronicity in the medium/long term (>1 year) which would require monitoring these patients over a longer period. Regarding these potential chronic manifestations, they may be chronic fatigue, uveitis, renal failure, chronic renal carriage with urinary excretion of leptospires, myalgia and muscle weakness, headaches, malaise but also cardiac or neurological manifestations. A Dutch study conducted on subjects with confirmed diagnosis reported 30% of patients with chronic post-leptospirosis symptoms which persisted in 21% of subjects more than 24 months after infection, but very few data are available on the chronic forms.

The objective will be to study the future of patients beyond 1 year of infection in clinical and serological terms, but also in terms of quality of life, use of alternative medicines and complementary and health literacy profiles.

Enrollment: 198 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult or child subjects having been included in the COLEPT cohort with confirmed leptospirosis Where
• Adult subjects or children hospitalized for leptospirosis confirmed within 12-18 months before LEPTONIC inclusion;
• Be resident in Reunion
• Ability to answer a telephone questionnaire
• Benefit from a social security scheme

Exclusion criteria

• Refusal of participation by the patient or his entourage if the patient is physically unable to give his opinion (coma, resuscitation, etc.).
• Exclusion or premature termination of participation in the COLEPT cohort
• Patient under judicial safeguard, guardianship or curatorship, under activated future protection mandate and family authorization

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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198 participants in 1 patient group

sampling and clinical data collection

Other group

Description:

Biological sampling and collection: whole blood: 1 dry tube for IgG and IgM anti-leptospirosis serology (volume depending on the patient's weight) urine: 1 bottle of 30ml Freezing of serum after centrifugation Storage at Biological Ressources Center Collection of clinico-biological data on a dedicated eCRF

Treatment:

Other: Biological sampling and collection