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An outbreak of Leptospirosis cases occurred in Oct 2009 following typhoon Ketsana in Sept 26, 2009. Many areas
of Manila were flooded. This is a prospective observational study with the following objectives: describe the clinical profile of
Leptospirosis patients that needed dialysis, determine their outcome and risk factors for dialysis and mortality.
Algorithmic approach to diagnosis (WHO Faine?s criteria and positive culture/MAT) and treatment of Leptospirosis
were followed. Patients were classified as needing dialysis or not based on initial clinical evaluation. Descriptive statistics and
univariate and multivariate analyses were used to analyze data.
Of the 154 cases, majority were males (n=130, 84.4%), with mean age of 26. 128 (83.12%) had ARF, 94 (73.4%) of them
necessitated dialysis: 76 (81%) hemodialysis and 18 (19%) peritoneal dialysis. Confirmed cases were 113 (73.37%) by MAT &
4 (3%) by positive blood culture. Overall mortality was 20 (15.6%), half of them were dialyzed and majority died of pulmonary
hemorrhage. The predictors for dialysis were: animal carcass exposure, RR 2.08 (1.13-3.84, .02); headache/meningismus, RR 1.97
(1.079-3.61, .03); oliguria, RR 2.34 (1.44-2.65, .02) and Crea>7.1mg/dL, RR 1.10 (1.01-1.21, 0.03). The predictors for mortality
were: jaundice, RR 2.67 (1.13 ? 6.3, .03); hypotension, RR 1.52 (1.13-3.22, .03); flood exposure >4hrs, RR 1.13 (1.03-1.24, .01),
pulmonary hemorrhage, RR 2.32 (1.76 -4.33, .02) and platelet count <100,000mm3, RR 2.33 (1.17-4.6, .02).
Majority of leptospirosis cases seen at NKTI were severe, 64% dialyzed. The predictors for dialysis are animal carcass
exposure, headache/menigismus, oliguria & Crea>7.1mg/dL while predictors for mortality are jaundice, hypotension, flood
exposure >4hrs, pulmonary hemorrhage and platelet count <100,000mm
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