Leptospirosis in Perak state for the year 2024: Hospitalisation rate and its associated factors.

INTRODUCTION: Leptospirosis remains a public health concern in Malaysia, particularly in high-burden states like Perak. Understanding the hospitalisation rate and its associated factors is important for informing early intervention strategies and optimising disease management; however, local data on these aspects remain scarce. This study seeks to address this gap by determining the hospitalisation rate and identifying the risk factors associated with hospitalisation among probable and confirmed leptospirosis cases in Perak. MATERIALS AND METHODS: This is a retrospective cohort study using secondary data from two data sources obtained from the e-Notifikasi system database and laboratory reports of all registered leptospirosis cases in Perak from January to December 2024. The outcome variable, which was hospitalisation status, was determined by the treating team based on clinical manifestation and disease severity. Multiple logistic regression was applied to identify factors associated with hospitalisation cases. Data was analysed using SPSS version 29. RESULTS: A total of 764 registered leptospirosis cases were included in the study, with 75.5% (n=577) required hospital admission (95% CI: 72%,79%). The average age of patients was 32 years (SD: 20.5), with two-thirds (67.8%) being male. Kinta district reported the highest proportion of cases (30.4%). Factors significantly associated with hospitalisation included: presence of complications (aOR: 8.06, 95% CI: 1.57,41.48), vomiting (aOR: 11.00, 95% CI: 6.63,18.25), headache (aOR: 4.44, 95% CI: 2.70,7.32), onsetto- diagnosis (aOR: 1.37, 95% CI: 1.23,1.52), histories of recreational activity exposure (aOR: 3.41, 95% CI: 2.07,5.62), soil exposure (aOR: 2.60, 95% CI: 1.11,6.07) and types of occupation; student (aOR: 2.79, 95% CI: 1.58,4.93), agriculture (aOR: 5.06, 95% CI: 2.20,11.63), military personnel (aOR: 4.87, 95% CI: 1.08,21.92) and pensioners (aOR: 5.96, 95% CI: 3.31,10.74). CONCLUSION: This study adds to the existing knowledge on the hospitalisation rate and its associated factors among registered leptospirosis cases in Perak. These findings highlight the importance of targeted health education, enhanced clinical vigilance and risk-based interventions tailored to local exposure patterns. While the study's strengths include comprehensive case capture and validated data, limitations include the absence of meteorological, socioeconomic status and health literacy data. These limitations emphasise the need for future longitudinal and behavioural studies.