Alejandro Riefkohl1, Oriana Ramírez-Rubio1,2, Rebecca L Laws3, Michael D McClean3, Daniel E Weiner4, James S Kaufman5, Renee L Galloway6, Sean V Shadomy6, Marta Guerra6, Juan José Amador1, José Marcel Sánchez1, Damaris López-Pilarte1, Chirag R Parikh7,8, Jessica H Leibler3, Daniel R Brooks1. 1. a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA. 2. b Preventive Medicine and Public Health Department , Universidad Autónoma de Madrid , Madrid , Spain. 3. c Department of Environmental Health , Boston University School of Public Health , Boston , MA , USA. 4. d Division of Nephrology, Department of Medicine , Tufts Medical Center and Tufts University School of Medicine , Boston , MA , USA. 5. e Research Service, VA New York Harbor Healthcare System and New York University School of Medicine , New York , NY , USA. 6. f Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens & Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA. 7. g Section of Nephrology, Department of Medicine , Yale University , New Haven , CT , USA. 8. h Program of Applied Translational Research, Department of Medicine , Yale University , New Haven , CT , USA.
Abstract
BACKGROUND: Leptospirosis is postulated as a possible cause of Mesoamerican Nephropathy (MeN) in Central American workers. OBJECTIVES: Investigate job-specific Leptospira seroprevalence and its association with kidney disease biomarkers. METHODS: In 282 sugarcane workers, 47 sugarcane applicants and 160 workers in other industries, we measured anti-leptospiral antibodies, serum creatinine, and urinary injury biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and N-acetyl-D-glucosaminidase (NAG). RESULTS: Leptospira seroprevalence differed among job categories and was highest among sugarcane cutters (59%). Seropositive sugarcane workers had higher NGAL concentrations (relative mean: 1.28; 95% CI: 0.94-1.75) compared to those who were seronegative, with similar findings among field and non-field workers. CONCLUSIONS: Leptospira seroprevalence varied by job category. There was some indication that seropositivity was associated with elevated biomarker levels, but results were inconsistent. Additional studies may help establish whether Leptospira infection plays any role in MeN among Central American workers.
BACKGROUND: Leptospirosis is postulated as a possible cause of Mesoamerican Nephropathy (MeN) in Central American workers. OBJECTIVES: Investigate job-specific Leptospira seroprevalence and its association with kidney disease biomarkers. METHODS: In 282 sugarcane workers, 47 sugarcane applicants and 160 workers in other industries, we measured anti-leptospiral antibodies, serum creatinine, and urinary injury biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and N-acetyl-D-glucosaminidase (NAG). RESULTS: Leptospira seroprevalence differed among job categories and was highest among sugarcane cutters (59%). Seropositive sugarcane workers had higher NGAL concentrations (relative mean: 1.28; 95% CI: 0.94-1.75) compared to those who were seronegative, with similar findings among field and non-field workers. CONCLUSIONS: Leptospira seroprevalence varied by job category. There was some indication that seropositivity was associated with elevated biomarker levels, but results were inconsistent. Additional studies may help establish whether Leptospira infection plays any role in MeN among Central American workers.
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