{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:28Z","timestamp":1772168908472,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.26202.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000}}],"reference-count":14,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T00:00:00Z","timestamp":1620604800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U19AI115658"],"award-info":[{"award-number":["U19AI115658"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background:<\/ns3:bold>\n                    In Sri Lanka, the disease burden of leptospirosis is estimated based on a routine notification system, which is predominated by patients ill enough to be hospitalized. The notification system does not function well with ambulatory patients in outpatient departments (OPDs). The objective of this study was to determine the proportion of leptospirosis in an OPD setting in a regional public hospital in Sri Lanka to provide further estimation of disease burden.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods:<\/ns3:bold>\n                    This study was conducted in the OPD of the Rathnapura Provincial General Hospital from August to September 2017. Suspected leptospirosis patients were recruited based on standardized criteria and tested using the microscopic agglutination test and quantitative polymerase chain reaction. The number of OPD patients was compared with the reported patient numbers with leptospirosis from the hospital during the same period as the denominator, and the 95% confidence interval was calculated for the proportions using Poisson distribution.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results:<\/ns3:bold>\n                    During the study period, of 2,960 fever patients presenting to the OPD, 33 (1.1%) were suspected to have leptospirosis; 8\/33 suspected (22.3%) cases were confirmed as being due to leptospirosis. There were 82 notifications of leptospirosis cases from hospital inpatients during the same period, none from the OPD. The total missing proportion from the surveillance system was 28.6% (95% CI, 19.4-40.4%). Among OPD patients, 12 (36.4%) had been given antibiotics from a primary care center prior to the OPD visit. No OPD patient was admitted to the hospital for inward care.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    More than 25% of cases of leptospirosis were not identified because they were not sick enough to be admitted nor subjected to routine leptospirosis diagnostic testing.These data have public health implications if the sources of leptospirosis transmission are to be controlled.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.26202.2","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T09:25:23Z","timestamp":1620638723000},"page":"1129","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving the leptospirosis disease burden assessment by including ambulatory patients from outpatient departments: a cross-sectional study"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6554-6851","authenticated-orcid":false,"given":"Janith","family":"Warnasekara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parami","family":"Aberathna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetha","family":"Nanayakkara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Vinetz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7810-1774","authenticated-orcid":false,"given":"Suneth","family":"Agampodi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"key":"ref-1","article-title":"Quarterly Epidemiological 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Lankan researchers.","volume":"2","author":"S Agampodi","year":"2012","journal-title":"Sri Lankan J Infect Dis."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"e027850","DOI":"10.1136\/bmjopen-2018-027850","article-title":"Study protocol: characterising the clinical, epidemiological and aetiological aspects of leptospirosis in Sri Lanka: a hospital based clinico-epidemiological study.","volume":"9","author":"S Agampodi","year":"2019","journal-title":"BMJ Open."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"197-198","DOI":"10.4038\/cmj.v61i4.8393","article-title":"Real time surveillance of dengue fever \u2013 a preliminary study.","volume":"61","author":"Y Warnasekara","year":"2016","journal-title":"Ceylon Med J."},{"key":"ref-14","article-title":"OPD Lepto Data base - Clinical check List","author":"J Warnasekara","year":"2020","journal-title":"Zenodo."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T10:10:20Z","timestamp":1621851020000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,10]]},"references-count":14,"URL":"https:\/\/doi.org\/10.12688\/f1000research.26202.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.56435.r85002","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.56435.r85002","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,10]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.28916.r74988, Georgies F Mgode, Pest Management Centre, Sokoine University of Agriculture, Morogoro, Tanzania, 10 Feb 2021, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/9-1129\/v1#referee-response-74988","order":0,"name":"referee-response-74988","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Janith Warnasekara<\/b>; \n<i>Posted: 10 Feb 2021<\/i>; Thank you very much for the response. I agree with the comments made by the reviewer. I would like to do the following changes in the manuscript.  Change the plane into plain in methodology &nbsp; Add a supplementary file of full MAT protocol&nbsp;   Thank you very much","URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2#referee-comment-6348","order":1,"name":"referee-comment-6348","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.56435.r85002, Chinthika P. Gunasekara, Department of Microbiology, University of Sri Jayewardenepura, Nugegoda, Sri Lanka, 24 May 2021, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/9-1129\/v2#referee-response-85002","order":2,"name":"referee-response-85002","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was partially funded by National Institute of Allergy and Infectious Diseases [U19AI115658]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}