@article{fdi:010079074,
  title = {{I}dentifying factors associated with treatment delay in leptospirosis : a retrospective study of patients admitted to hospital in {R}eunion ({I}ndian {O}cean) between 2014 and 2015},
  author = {{L}ebeau-{D}esmoulin, {L}. and {B}runeau, {L}. and {C}ommins, {J}{\'e}r{\'e}my and {H}erbreteau, {V}incent and {R}affray, {L}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. - {L}eptospirosis is a life-threatening zoonotic disease for which delayed treatment onset has been associated to poor prognosis. {T}he purpose of the study was to identify the determinants of therapeutic delay in hospitalized leptospirosis cases. {P}atients and methods. - {W}e carried out a retrospective multicenter study in the 4 public hospitals of {R}eunion {I}sland, {S}outh {W}estern {I}ndian {O}cean. {M}edical records of confirmed leptospirosis cases occurring in 2014-2015 were reviewed for socio-economic, demographic, geographic and medical data. {T}he primary outcome measure was the therapeutic delay, defined as the time elapsed between the onset of symptoms and initiation of antibiotics. {R}esults. - {O}f the 117 patients included, 107 were men, with an average age of 44.9 +/- 15 years. {T}he median therapeutic delay was 4 days (interquartile: 2-5 days) and this delay was not found to be associated with severity. {T}he following were found to be at increased risk of having a longer therapeutic delay: cases occurring outside the epidemic period, or rainy season ({OR} 2.8 [1.08-7.3], {P} = 0.04) and cases with first medical evaluation in primary health care ({OR} 4.63 [1.43-14.93]; {P} = 0.01) instead of emergency unit. {N}osocio-economic or geographic characteristics were found to be linked to a longer therapeutic delay. {C}onclusion. - {A}lthough delayed treatment was not associated to disease severity, our results indicate that leptospirosis awareness is needed all year in the subtropical area of {R}eunion {I}sland and particularly in primary care.},
  keywords = {{D}elay ; {L}eptospirosis ; {R}eunion ; {S}everity ; {OCEAN} {INDIEN} ; {REUNION}},
  booktitle = {},
  journal = {{M}edecine et {M}aladies {I}nfectieuses},
  volume = {50},
  numero = {4},
  pages = {352--360},
  ISSN = {0399-077{X}},
  year = {2020},
  DOI = {10.1016/j.medmal.2019.09.008},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079074},
}