{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:21:25Z","timestamp":1767176485779,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009670","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000}}],"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"japan international cooperation agency","award":["scholarship for the Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases"],"award-info":[{"award-number":["scholarship for the Program for Nurturing Global Leaders in Tropical and Emerging Communicable Diseases"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Fever with jaundice is a common symptom of some infectious diseases. In public health surveillance within the Democratic Republic of the Congo (DRC), yellow fever is the only recognized cause of fever with jaundice. However, only 5% of the surveillance cases are positive for yellow fever and thus indicate the involvement of other pathogens.\n                      <jats:italic>Leptospira<\/jats:italic>\n                      spp. are the causative agents of leptospirosis, a widespread bacterial zoonosis, a known cause of fever with jaundice. This study aimed to determine the seropositivity of anti-\n                      <jats:italic>Leptospira<\/jats:italic>\n                      antibodies among suspected yellow fever cases and map the geographical distribution of possible leptospirosis in the DRC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective study using 1,300 samples from yellow fever surveillance in the DRC from January 2017 to December 2018. Serum samples were screened for the presence of IgM against\n                      <jats:italic>Leptospira<\/jats:italic>\n                      spp. by a whole cell-based IgM ELISA (Patoc-IgM ELISA) at the Institut National de Recherche Biomedicale in Kinshasa (INRB) according to World Health Organization (WHO) guidance. Exploratory univariable and multivariable logistic regression analyses were undertaken to assess associations between socio-demographic factors and the presence of\n                      <jats:italic>Leptospira<\/jats:italic>\n                      IgM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 1,300 serum samples screened, 88 (7%) showed evidence of IgM against\n                      <jats:italic>Leptospira<\/jats:italic>\n                      spp. Most positive cases (34%) were young adult males in the 20\u201329-year group. There were statistically significant associations between having\n                      <jats:italic>Leptospira<\/jats:italic>\n                      IgM antibodies, age, sex, and living area. Observed positive cases were mostly located in urban settings, and the majority lived in the province of Kinshasa. There was a statistically significant association between seasonality and IgM\n                      <jats:italic>Leptospira<\/jats:italic>\n                      spp. positivity amongst those living in Kinshasa, where most of the positive cases occurred during the rainy season.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study showed that leptospirosis is likely an overlooked cause of unexplained cases of fever with jaundice in the DRC and highlights the need to consider leptospirosis in the differential diagnosis of fever with jaundice, particularly in young adult males. Further studies are needed to identify animal reservoirs, associated risk factors, and the burden of human leptospirosis in the DRC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009670","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T14:31:39Z","timestamp":1629210699000},"page":"e0009670","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Leptospirosis as a cause of fever associated with jaundice in the Democratic Republic of the Congo"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9312-9345","authenticated-orcid":true,"given":"Patrick","family":"Mukadi Kakoni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8303-318X","authenticated-orcid":true,"given":"Yannick","family":"Munyeku Bazitama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-5888","authenticated-orcid":true,"given":"Jean Raphael","family":"Nepomuceno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Pukuta-Simbu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francois","family":"Kawhata Mawika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gracia","family":"Kashitu Mujinga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6944-1750","authenticated-orcid":true,"given":"Luigi","family":"Palla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Ahuka-Mundeke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Jacques","family":"Muyembe Tamfum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5733-535X","authenticated-orcid":true,"given":"Nobuo","family":"Koizumi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinao","family":"Kubo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koya","family":"Ariyoshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-3202","authenticated-orcid":true,"given":"Chris","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"issue":"1","key":"pntd.0009670.ref001","doi-asserted-by":"crossref","first-page":"e2534","DOI":"10.1371\/journal.pntd.0002534","article-title":"A 21-Year-Old Student with Fever and Profound Jaundice.","volume":"8","author":"SE Isa","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0009670.ref002","first-page":"1","article-title":"Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: A retrospective assessment, 2008\u20132010","volume":"17","author":"CLB Gadia","year":"2017","journal-title":"BMC Infect Dis"},{"issue":"2","key":"pntd.0009670.ref003","article-title":"Fever, Jaundice and Hepatitis: It is not always a Viral Infection","author":"Le\u00f3n Lina","year":"2015","journal-title":"Rev colomb gastroenterol"},{"key":"pntd.0009670.ref004","unstructured":"World Health Organization Emerging and other Communicable Diseases, Surveillance and Control [Internet]. 1996 [cited 2019 Apr 14]. 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