Investigator(s)
| Submitter |
Thinley Dorji Central Regional Referral Hospital Thinley Dorji 
|
| Principal Investigator |
Thinley Dorji Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan Thinley Dorji
|
| Co-Investigator(s) |
Mathieu Picardeau Department of Microbiology, Instituet Pasteur, Paris, France Mathieu Picardeau
|
| Co-Investigator(s) |
Ivo Elliott Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom Ivo Elliott
|
| Co-Investigator(s) |
Karchung Tshering Royal Centers for Disease Control, Thimphu, Bhutan Karchung Tshering
|
| Co-Investigator(s) |
Tshering Dorji Royal Centers for Disease Control, Thimphu, Bhutan Tshering Dorji
|
| Co-Investigator(s) |
Lungten Lungten National Centre for Animal Health, Ministry of Agriculture and Livestock, Thimphu, Bhutan Lungten Lungten
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| Co-Investigator(s) |
Rixin Jamtsho Medical Education Centre for Research, Innovation and Training, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan Rixin Jamtsho
|
| Co-Investigator(s) |
Mimi Lhamu Mynak National Medical Services, Ministry of Health, Thimphu, Bhutan Mimi Lhamu Mynak
|
| Co-Investigator(s) |
Paul N Newton Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom Paul N Newton
|
Title(s) and abstract
| Scientific title | Improving clinical care of leptospirosis in Bhutan through molecular diagnostics and knowledge assessment |
| Public title | Bhutan Leptospirosis Project |
| Background | Leptospirosis has high incidences in the population of many countries in the tropics but remains neglected due to lack of awareness and lack of access to testing facilities. Leptospirosis may constitute up to one-fifth of patients with acute febrile illness in South Asia. In Bhutan, testing for leptospirosis is available only for surveillance purposes, reflecting a major gap in the understanding of the burden and clinical implications. |
| Objectives | This study has two research components. Part A of the project is to describe the incidence, genotype and clinical course in inpatients with leptospirosis. Part B will assess the knowledge, attitude and practice of health workers regarding leptospirosis. |
| Study Methods | For Part A, a convenience sampling method will be used to perform PCR tests for Leptospire LipL32 in whole blood for those with fever onset < 10 days and in urine if fever onset is < 21 days. PCR testing will be established through this project in all the five selected hospitals with oversight monitoring and quality assurance from Royal Centers for Disease Control (RCDC), Bhutan and Institut Pasteur, France. The test reports of PCR will be available in real time through the Electronic Patient Information System to help clinical decision making. We expect approximately 10% patients to be LipL32 PCR positive and the samples from the positive patients will be sent to RCDC for Leptospire lfb1 PCR testing and leptospiral whole genome sequencing. For Part B, a simple random sampling will be done to obtain a proportionate sample of doctors, health assistants and nurses to assess their knowledge, attitude and practice regarding leptospirosis. |
| Expected outcomes and use of results | Through Part A of the project, we will establish Leptospira spp. PCR protocol for Bhutan, train PCR technicians at five hospitals and the RCDC, establish quality assessment for Leptospira spp. PCR testing, and establish genotype information to identify dominant serovars and develop country/region-specific serology assays. Part B of the project will provide baseline information on the knowledge, attitude and practices on leptospirosis and provide guidance on the need for continuing medical education on leptospirosis for doctors, Health Assistants, and nurses. Part A and Part B research will inform a third Part C to use the new information to inform Ministry of Health on leptospirosis diagnosis and management guidelines. |
| Keywords | Leptospira; LipL32 protein; Neglected Tropical Disease; Spirochaeta; Weil’s Disease |
Research Details
| Student research | No |
| Start Date | 01-Oct-2025 |
| End Date | 30-Nov-2026 |
| Key Implementing Institution | Central Regional Referral Hospital |
| Multi-country research | No |
| Nationwide research | Yes, with randomly selected geographical areas |
| Bhutan, Bhutan, Bhutan, Bhutan, Bhutan | |
| Research Domain(s) | Communicable Disease Research |
| Research field(s) | Other (Leptospirosis) |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Under Review |