Investigator(s)
| Submitter |
Monu Tamang 1. Central Regional Referral Hospital, Gelephu, Bhutan 2. International University of Health and Welfare, Japan Monu Tamang 
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| Principal Investigator |
Monu Tamang 1. Department of Physiotherapy, Central Regional Referral Hospital, Gelephu, Bhutan 2. Department of Global Health and Infectious Diseases, Graduate School of Public Health, International University of Health and Welfare, Narita, Japan Monu Tamang
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| Co-Investigator(s) |
Thinley Dorji Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan Thinley Dorji
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| Co-Investigator(s) |
Kinley Choki Department of Pharmacy, Central Regional Referral Hospital, Gelephu, Bhutan Kinley Choki
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| Co-Investigator(s) |
Tshokey Tshokey 1. Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan 2. Department of Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan Tshokey Tshokey
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| Co-Investigator(s) |
Chenga Dawa Department of Laboratory Medicine, Central Regional Referral Hospital, Gelephu, Bhutan Chenga Dawa
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| Co-Investigator(s) |
Choki Dolkar Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan Choki Dolkar
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| Co-Investigator(s) |
Kesang Wangchuk Royal Centre for Disease Control, Thimphu, Bhutan Kesang Wangchuk
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| Co-Investigator(s) |
Dorji Tshering Royal Centre for Disease Control, Thimphu, Bhutan Dorji Tshering
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| Co-Investigator(s) |
Sangay Tenzin Department of Clinical Nursing, Central Regional Referral Hospital, Gelephu, Bhutan Sangay Tenzin
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| Co-Investigator(s) |
Naoko Yamamoto Department of Global Health and Infectious Diseases, Graduate School of Public Health, International University of Health and Welfare, Narita, Japan Naoko Yamamoto
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| Co-Investigator(s) |
Rie Takeuchi Department of Global Health and Infectious Diseases, Graduate School of Public Health, International University of Health and Welfare, Narita, Japan Rie Takeuchi
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Title(s) and abstract
| Scientific title | Sero-epidemiology of leptospirosis in selected communities of a supposedly high-risk district in southern Bhutan: a cross-sectional study |
| Public title | Sero-epidemiology of leptospirosis in selected communities of a supposedly high-risk district in southern Bhutan: a cross-sectional study |
| Background | Leptospirosis is a non-specific febrile syndrome that has significant morbidity and mortality worldwide. The diagnosis of leptospirosis is difficult due to involvement of multiple organs and lack of both human and infrastructural resources. The previous studies about leptospirosis in Bhutan shows that the disease burden is significantly high. However, the epidemiological studies about leptospirosis in supposedly high-risk area (Sarpang district) in Bhutan is not conducted. Therefore, this study aims to assess the seroprevalences of leptospirosis in select communities in Sarpang as well as establish the geospatial mapping for the prevalence of leptospirosis in the district. As such, a total of 466 households will be recruited to be part of this study. The blood samples will be collected and centrifuged at Central Regional Referral Hospital in Gelephu and transport the serum to Royal Centre for Disease Control in Thimphu for ELISA and MAT test. The result of the study will be submitted to the Ministry of Health, Royal Centre for Disease Control and International University of Health and Welfare in Japan as fulfilment of master’s thesis of principal investigators and publish it in a peer-reviewed journal. |
| Objectives | Among residents of selected rural communities in Sarpang district, Bhutan in 2024, to describe the: 1. Estimate the seroprevalence of leptospirosis 2. Describe the serovar distribution of Leptospira; 3. Assess the environmental and epidemiological risk factors associated with seropositivity for Leptospira. 4. Map a geospatial distribution of Leptospira seropositive cases in selected area. |
| Study Methods | This is a descriptive cross-sectional study. This study will recruit 20 trained professionals (phlebotomists, laboratory officers/technicians, and nurses) and give one-day data and blood sample collection training. The training aims to equip the data collectors to collect correct information, appropriate blood sample collection and ensure patient safety. The training schedule is provided in Annexure 5. The trained professionals will be given the randomly selected households. During the field visit to selected households, one individual aged ≥18 years from each selected household will be selected based on the lottery system and invited to participate in the study. If the individuals from selected households deny to give written consent, nearest household in the vicinity (not included in the list) will be considered. About 10 millilitres of venous blood will be collected by the trained professionals, in red and purple cap clot activator vial, and store in the cold chain box. The specimen in red vial will be centrifuged at the Department of Laboratory Medicine in Central Regional Referral Hospital, Gelephu. The serum will be extracted by centrifugation at 3500rpm for three minutes and stored at 4°C and transport the serum to Royal Centre for Disease Control after triple packaging. Each blood sample will have a unique identification code (Annexure 5). The specimen in purple vial will be store at – 80°C at Department of Laboratory Medicine in Central Regional Referral Hospital as back-up specimen, and destroyed after the final data analysis. |
| Expected outcomes and use of results | 1. Though the sample size and area covered is small, the data generated by this study will be pivotal in implementing public health measures in Gelephu Mindfulness City. Currently, test kits for dengue, scrub typhus, malaria and leishmaniasis are available in hospitals, only rapid test kits for leptospirosis are available in JDWNRH in Thimphu. This study aims to make test kits available at least in high-risk areas including Sarpang district as well as enhance the laboratory infrastructure and human resources to conduct tests for Leptospira. 2. This will be the first epidemiological study on leptospirosis to be conducted in Sarpang district. Therefore, the data generated will be able to provide comprehensive data about the prevalence, burden and risk factors for leptospirosis, not only in Sarpang but also in the country. Additionally, as data collection is scheduled during the rainy season, this study will provide robust information on the prevalence of leptospirosis because laboratory tests will be able to detect high titer of antibodies. |
| Keywords | Leptospirosis, Neglected tropical diseases, Epidemiology |
Research Details
| Student research | Yes |
| Institution: Department of Global Health and Infectious Diseases, Graduate School of Public Health, International University of Health and Welfare, Narita, Japan | |
| Academic degree: Master | |
| Supervisor of the student(s) | |
| Full Name and title: Prof. Rie Takeuchi | |
| Email: rtakeuchi@iuhw.ac.jp | |
| Start Date | 06-Apr-2024 |
| End Date | 30-Apr-2025 |
| Key Implementing Institution | Ministry of Health |
| Multi-country research | Yes |
| Bhutan | |
| Nationwide research | No |
| Bhutan | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Infectious Disease |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |