Hypocalcemia, hypochloremia, and eosinopenia as clinical predictors of leptospirosis: A retrospective study.

BACKGROUND: Underestimation of leptospirosis cases is happening in many countries. The most common factor of underreporting is misdiagnosis. Considering the limitations of direct detection of pathogen and serological diagnosis for leptospirosis, clinical features and blood tests though non-specific are usually referred in making presumptive diagnosis to decide disease management. METHODS: In this single-centre retrospective study, comparative analysis on clinical presentations and laboratory findings was performed between confirmed leptospirosis versus non-leptospirosis cases. RESULTS: In multivariate logistic regression evidenced by a Hosmer-Lemeshow significance value of 0.979 and Nagelkerke R square of 0.426, the predictors of a leptospirosis case are hypocalcemia (calcium <2.10mmol/L), hypochloremia (chloride <98mmol/L), and eosinopenia (absolute eosinophil count <0.040×109/L). The proposed diagnostic scoring model has a discriminatory power with area under the curve (AUC) 0.761 (p<0.001). A score value of 6 reflected a sensitivity of 0.762, specificity of 0.655, a positive predictive value of 0.38, negative predictive value of 0.91, a positive likelihood ratios of 2.21, and a negative likelihood ratios of 0.36. CONCLUSION: With further validation in clinical settings, implementation of this diagnostic scoring model is helpful to manage presumed leptospirosis especially in the absence of leptospirosis confirmatory tests.

DEPRESSION, ANXIETY, STRESS, AND THEIR ASSOCIATED FACTORS AMONG CORPS MEMBERS SERVING IN KEBBI STATE.

BACKGROUND: Depression, anxiety and stress, are not only health problems by themselves, but also associated with other negative health consequences. The national youth service is usually characterized by a number of new challenges and experiences which may require life style adjustments by the corps member. However, no previous study on psychological factors has been conducted among corps members. OBJECTIVE: This study was conducted to determine the prevalence of depression, anxiety and, stress and their associated factors among corps members serving in Kebbi state. METHODS: A cross-sectional study was conducted among 264 corps members from four local government areas of the state. Selection of the local government areas and the individual participants was by simple random sampling. Data was collected from May to June 2014 using a self-administered questionnaire. Data analysis used chi-square test to identify the relationship between categorical variables and multivariate logistic regression to identify the independent factors for depression, anxiety and stress each. RESULTS: The response rate was 97%. Most of the respondents were males (63.6%), single (85.5%), and above 20 years of age (71.6%). The overall prevalences of depression, anxiety and stress among the respondents were 36.4%, 54.5% and 18.2% respectively. The independent factors for depression were; being from the North central (OR = 5.99; 95% CI: 2.194-16.354) or South-south; and the perception of earning enough income (OR = 2.987; 95% CI: 1.062-8.400). For anxiety, male gender (OR = 0.411; 95% CI: 0.169-0.999); and being from the North central were significant risk factors (OR = 3.731; 95% CI: 1.450-9.599). Being above 26 years of age was an independent risk factor for stress (OR = 0.083; 95% CI: 0.018-0.381). Also, those who had ever schooled outside their towns of residence were less likely to be stressed compared to those who had never (OR = 0.30; 95% CI: 0.110-0.855). All other factors did not show any significant association with any of the outcome variables in multivariate analysis. CONCLUSION: In conclusion, the prevalences of depression, anxiety and stress are high among corps members serving in Kebbi state. There is need to expand the scope of this study to a national level so as to get a bigger picture of the problem.