Diagnostic specificity of Leptospirosis with well's syndrome using Leptoscore compared with Leptotiter (IgG-Ab,IgM-Ab).
Keywords:
Leptospirosis, diagnostic specificity, diagnostic accuracyAbstract
This study aimed to compare the diagnostic performance of Leptoscore—a clinical scoring system integrating clinical manifestations and urinalysis results—with Leptotiter (IgM ELISA) and Leptospira IgG/IgM antibody testing in confirming leptospirosis cases. A retrospective study was conducted among 128 patients diagnosed with leptospirosis between 2021 and 2025. Data on clinical presentations, urinalysis (UA), and Leptospira IgG/IgM serology (ELISA) were analyzed. Statistical analyses included descriptive statistics (frequency, percentage, mean, standard deviation, minimum, and maximum) and inferential statistics using the Chi-square test. Associations were examined using Odds Ratios (OR) and 95% confidence intervals (CI), with statistical significance set at p < 0.05. Diagnostic performance was assessed in terms of sensitivity, specificity, and overall accuracy.
Results: Leptoscore demonstrated the highest sensitivity (92.7%), specificity (86.2%), and accuracy (88.3%), indicating strong performance as a rapid screening tool for early detection of leptospirosis. In contrast, Leptotiter showed slightly lower sensitivity (85.4%) but higher specificity (90.8%) with an accuracy of 88.0%. The IgG/IgM antibody tests revealed low sensitivity (0–12.2%) but high specificity (86.2–98.9%), particularly in post-infection stages, reflecting their limited value for early diagnosis but potential utility for follow-up or immunity monitoring. Among urinalysis variables, three showed statistically significant associations with confirmed leptospirosis: urine turbidity (OR = 3.337; p = 0.004), urine bilirubin (OR = 4.355; p = 0.005), and urine blood/hemoglobin (OR = 3.051; p = 0.004).
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