DIAGNOSIS OF LEPTOSPIROSIS UTILIZING MODIFIED FAINES CRITERIA (2012)

IN RURAL HOSPITAL OF INDONESIA

Yosefin Ratnaningtyas1, Maela Rustiana Dewi2
1,2*
Ajibarang Hospital, Banyumas Regency, Indonesia;

Background Leptospirosis is a zoonotic disease that is still being overlooked and underreported. Diagnostic tests for
leptospirosis are expensive and also may have limited availability, especially in rural areas. Clinicians need a clear and
locally appropriate diagnostic criteria for diagnosing leptospirosis. The objective of this study was to evaluate the use
of the Modified Faines Criteria (2012) for leptospirosis patients in a rural hospital of Indonesia.

Methods All patients with Acute Undifferentiated Fever were screened from August 2016 to July 2017. Inclusion
criteria: All cases presenting with symptoms of part A of the WHO Modified Faine's Criteria. Leptospirosis diagnosis
was established after laboratory tests using lateral flow assay (Uji Leptospira IgM, Indonesia). Results were analyzed
according to Modified Faines Criteria (2012). Seropositive results with a score of 26 or more when using Part A or
Part A+B of Modified Faine's Criteria were considered true positive infections.

Results There were 38 cases (25.85%) of leptospirosis in this study out of 147 patients with Acute Undifferentiated
Fever, with a male-to-female ratio of 1.7:1 and mean age 52 15.2 years. A total of 22 cases (57,89 %) were
designated as severe leptospirosis. Modified Faines Criteria (2012) had a sensitivity of 18.43%, specificity of 94.5%,
positive predictive value (PPV) of 53.85% and negative predictive value (NPV) of 76.87%.

Conclusions The use of leptospirosis diagnosis Modified Faines Criteria (2012) makes it easier for clinicians to
diagnose leptospirosis especially in rural areas, based on clinical features, history of exposure, and laboratory
outcomes.

Keywords leptospirosis, rural areas, Modified Faines Criteria

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