{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:46:16Z","timestamp":1785905176561,"version":"3.56.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leptospirosis is a major cause of febrile illness in tropical regions, but early diagnosis is challenging due to overlapping clinical features and delayed serological confirmation. We developed a simple bedside decision model using readily available clinical variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis used archived data from a randomized controlled trial of adults with undifferentiated febrile illness (October 2020\u2013February 2021) of 5\u201315 days\u2019 duration. Independent predictors of IgM-ELISA positive leptospirosis were identified using multivariable logistic regression. A simplified score assigning one point per predictor was derived. Discrimination was assessed using ROC analysis, and post-test probabilities were modelled for clinical combinations and simulated rapid diagnostic testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 190 patients, 48 (25.3%) were serologically positive for leptospirosis. Conjunctival suffusion, icterus and acute kidney injury were independent predictors. The score (0\u20133) showed good discrimination (AUC 0.801), with sensitivity 68.8% and specificity 82.4% at \u22652. An exploratory proteinuria-based model demonstrated moderate discrimination (AUC 0.741). Probability increased from 25% at baseline to 91% when all three predictors were present and to 97%\u201399% when combined with a positive rapid test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A simple bedside score substantially increases the probability of diagnosing leptospirosis in patients with undifferentiated febrile illness of 5\u201315 days' duration, particularly when integrated with rapid testing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/trstmh\/trag046","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:57:49Z","timestamp":1775044669000},"page":"873-878","source":"Crossref","is-referenced-by-count":0,"title":["Simple clinical decision model for predicting leptospirosis: a secondary analysis of a randomized controlled trial"],"prefix":"10.1093","volume":"120","author":[{"given":"Nitin","family":"Gupta","sequence":"first","affiliation":[{"name":"Kasturba Medical College, Manipal Academy of Higher Education Department of Infectious Diseases, , Manipal 576104 ,","place":["India"]},{"name":"Institute of Tropical Medicine Department of Clinical Sciences, , Antwerp 2000,","place":["Belgium"]},{"name":"University of Antwerp Department of Clinical Sciences, , Antwerp 2000,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tirlangi Praveen","family":"Kumar","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Manipal Academy of Higher Education Department of Infectious Diseases, , Manipal 576104 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Van Den Broucke","sequence":"additional","affiliation":[{"name":"Institute of Tropical Medicine Department of Clinical Sciences, , Antwerp 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