Environmental and Travel Factors Related to Lepto-
spirosis in Thailand
WARALUK TANGKANAKUL, M.D., MPH.*,
THOMAS POOL, DVM, MPH***,
SUPAMITR CHUNSUTTIWAT, M.D., MPH.*
POJAMAN SIRIARA Y APORN, M.D., Dr PH.**,
KUMNUAN UNGCHUSAK, M.D., MPH.**,
Affiliation : * Department of Communicable Disease Control,
** Division of Epidemiology, Ministry of Public Health, Nonthaburi 11000, Thailand.
***Headquarters, U.S. Army Veterinary Command, San Antonio, Texas, USA.
AbstractTo identify potential environmental and travel factors related to leptospirosis, we conducted
an unmatched case controlled study and household assessment of cases and controls in Nakhon
Ratchasima province (north-eastern, Thailand) from August to December, 1998. Fifty-six cases
and 145 controls were included in the study. Cases were hospitalized patients who had been diag-
nosed with leptospirosis and tested positive for anti-leptospiral IgM antibody using the Panbio
ELISA (Panbio Inc, Brisbane, Australia). Controls were the neighbors of cases who had tested nega-
tive. Standardized questionnaires and household assessments were used to collect information on
demographics, number of animals kept, evidence of rats in the home, presence of rat food inside
the home, road characteristics, awareness of leptospirosis disease, environment, and travel history.
Multivariant, unconditional logistic regression demonstrated that travel on potholed roads was
independently associated with leptospirosis infection (OR 5.0; 95%CI 1.2-20.2) and traveling by
car was a protective factor (OR 0.2; 95%CI 0.06-0.9).
Keywords : Leptospirosis, Travel, Risks Factor, Thailand, Environment
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