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Estimating the duration of antibody positivity and likely time of Leptospira infection using data from a cross-sectional serological study in Fiji

Authors: Eleanor M. Rees; Colleen L. Lau; Mike Kama; Simon Reid; Rachel Lowe; Adam J. Kucharski;

Estimating the duration of antibody positivity and likely time of Leptospira infection using data from a cross-sectional serological study in Fiji

Abstract

BackgroundLeptospirosis is a zoonotic disease prevalent throughout the world, but with particularly high burden in Oceania (including the Pacific Island Countries and Territories). Leptospirosis is endemic in Fiji, with outbreaks often occurring following heavy rainfall and flooding. As a result of non-specific clinical manifestation and diagnostic challenges, cases are often misdiagnosed or under-ascertained. Furthermore, little is known about the duration of persistence of antibodies to leptospirosis, which has important clinical and epidemiological implications.Methodology and principal findingsUsing the results from a serosurvey conducted in Fiji in 2013, we fitted serocatalytic models to estimate the duration of antibody positivity and the force of infection (FOI, the rate at which susceptible individuals acquire infection or seroconversion), whilst accounting for seroreversion. Additionally, we estimated the most likely timing of infection.Using the reverse catalytic model, we estimated the duration of antibody persistence to be 8.33 years (4.76–12.50; assuming constant FOI) and 7.25 years (3.36–11.36; assuming time-varying FOI), which is longer than previous estimates. Using population age-structured seroprevalence data alone, we were not able to distinguish between these two models. However, by bringing in additional longitudinal data on antibody kinetics we were able to estimate the most likely time of infection, lending support to the time-varying FOI model. We found that most individuals who were antibody-positive in the 2013 serosurvey were likely to have been infected within the previous two years, and this finding is consistent with surveillance data showing high numbers of cases reported in 2012 and 2013.ConclusionsThis is the first study to use serocatalytic models to estimate the FOI and seroreversion rate forLeptospirainfection. As well as providing an estimate for the duration of antibody positivity, we also present a novel method to estimate the most likely time of infection from seroprevalence data. These approaches can allow for richer, longitudinal information to be inferred from cross-sectional studies, and could be applied to other endemic diseases where antibody waning occurs.

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Spain
Keywords

Àrees temàtiques de la UPC::Ciències de la salut::Medicina::Medicina comunitària i salut pública, RC955-962, Oceania, 1117 Public Health and Health Services, Tropical medicine, Seroepidemiologic Studies, Arctic medicine. Tropical medicine, Simulació per ordinador, Zoonoses, Animals, Fiji, Humans, Leptospirosis, 11 Medical and Health Sciences, Leptospira, Public Health, Environmental and Occupational Health, Outbreaks, Infectious Diseases, Cross-Sectional Studies, :Ciències de la salut::Medicina::Medicina comunitària i salut pública [Àrees temàtiques de la UPC], Public aspects of medicine, RA1-1270, Research Article

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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