In our study out of 91 children 14 were diagnosed as leptospirosis using IgM ELISA, 23 and 39 were diagnosed as leptospirosis using Faines and modified Faines criteria respectively. A score of 26 or more in Part A or in Part A + Part B, or 25 or more as the total of three parts may suggest a with fever were taken up for the study from April 2002 to March 2003. Faine had evolved a criteria for diagnosis of leptospirosis on the basis of clinical, epidemiological and laboratory data (A+B+C).2 The modifications in the Faines criteria has been made by us in the epidemiological and laboratory criteria (Table 1). All authors: No reported disclosures. The high negative predictive value may help to screen patients with acute febrile illness for leptospirosis during the early phase of the disease. The Faine's criteria (standard) is utilized for the diagnosis of leptospirosis & consists of 3 criteria - A) Clinical data ; B) Epidemiological factors C) Laboratory findings. Bhattacharya PK(Ed); Medicine update- APICON, Assam, 2003;7:6. Applying the WHO modified Faine's criteria for diagnosing leptospirosis revealed a sensitivity of 3.03%, specificity of 80%, and positive predictive value of 66%. Prospective observational study held over 1 year. The high titres of past infection persist for a long time (1-5years) and therefore interfere with the diagnosis of current leptospirosis. Methods. Conclusion. Aims: Restructuring and validating modified Faine's criteria for leptospirosis to better suit health scenario of south Gujarat. The standard Faines criteria had a sensitivity of 41.9%, specificity of 84.9% and a positive predictive value of 41.9%. 15 However, there is paucity of data in literature regarding the usefulness of Faines criteria in pediatrics. Out of 71 cases, the male-to-female ratio was 1.5:1 and mean age 36.8 15.6 years. Only those patients who were serologically positive were used for analysis utilizing modified Faine's criteria [clinical (A) + epidemiological (B) + laboratory findings (C). Our case was diagnosed to be a presumptive case of leptospirosis based on the Modified Faines criteria (score >25).13 Though PCR is a highly sensitive molecular detection method for diagnosing leptospirosis, its performance is affected by factors such as late presentation to the hospital for investigations, prior antibiotic treatment and the type of PCR which could lead to a false negative 1, 2, 14 Faines criteria has been recommended by the world health organization as a useful clinical tool in the diagnosis of Leptospirosis. Hence the clinical and epidemiological criteria (A+B) only have been compared between standard and modified Faines criteria (Table 2). All these patients had both standard and modified Faines criteria positive (A+B+C 25). It manifests with various symptoms, ranging from fever and muscle pain to a severe syndrome characterized by jaundice, renal failure and pulmonary hemorrhage. Leptospirosis is a worldwide bacterial zoonosis which is mainly transmitted through contact with water contaminated by rodents urine. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Laboratory criteria Presumptive diagnosis: y A positive result of a rapid screening test such as IgM ELISA, latex agglutination test, lateral flow, dipstick etc. Confirmatory diagnosis: y Isolation from blood or other clinical materials through culture of pathogenic leptospires. J Assoc Phys India 2002;50:394-6. BMC Infect Dis. Superhydrophobic self-similar nonwoven-titanate nanostructured materials. Guidelines for the control of leptospirosis / edited by S. Faine. Co-infections present in our patients were enteric fever in 2 cases, malaria in 6 cases, dengue fever in 6 cases, and viral hepatitis in 3. By Faines criteria, 44 out of 118 patients were diagnosed to have leptospirosis. J Assoc Phys India 2003;51:329-30. It was observed that the positive features (A+B 26) were more in seronegative leptospirosis compared to seropositive leptospirosis. The standard Faines criteria had a sensitivity of 41.9%, specificity of 84.9% and a positive predictive value of 41.9%. Applying the WHO modified Faine's criteria for diagnosing leptospirosis revealed a sensitivity of 3.03%, specificity of 80%, and positive predictive value of 66%. World Health Organization (WHO) has introduced Faines criteria for diagnosis of leptospirosis, based on clinical history (Part A) and epidemiological history (Part B) supported by laboratory parameters (Part C) . Context: Clinical and epidemiological variables in the modified Faine's criteria offered low validity in our study setting. As leptospirosis tests become positive only after the fifth day, the diagnosis of leptospirosis has to be done only by clinical and epidemiological criteria during this period. The original Faines criteria (WHO guidelines) have been designated as Standard Faines criteria in this study. If clinical and epidemiological criteria (A+B) alone were utilized, only 18 cases were diagnosed by modified Faines criteria (sensitivity - 58%), but if lab criteria was incorporated 31 cases were diagnosed (A+B+C). It is observed that 38% (22/57) of the patients with fever had leptospirosis during monsoon when compared to 9% in the non-monsoon season (9/93). Leptospirosis is a re-emerging zoonosis of global importance and unique environmental and social correlations. This value can be increased by modification of Faines criteria (Part B). Evaluation of clinical criteria for diagnosis of leptospirosis. No modifications have been made in the clinical aspects of leptospirosis (Part A). Faines criteria were first developed based on clinical data (Part A), epidemiological factors (Part B), and bacteriological and laboratory findings based on only MAT titre (Part C). Thirty one of 150 patients (20.7%) were diagnosed to have leptospirosis. In contrast, modified Faines criteria had a sensitivity of 58%, Specificity of 97.4% and positive predictive value (PPV) of 85.7%. World Health Organization (WHO) has introduced Faines criteria for diagnosis of leptospirosis, based on clinical history (Part A) and epidemiological history (Part B) supported by laboratory parameters (Part C) [ 9 ]. Hence, a study to assess They have been included with appropriate scores (Part C). Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Oxford University Press is a department of the University of Oxford. References 20 Appendices Appendix A. Humans most commonly become infected through occupational, recreational, or domestic contact with the urine of carrier animals, either directly or via contaminated water or soil. beneficial in studies. An important observation in the study has been the importance of laboratory tests. Therefore factors such as rainfall and contact with contaminated environment have been incorporated with appropriate scores. 17,18 Faines score was obtained for each patient using clinical (Part A), epidemiological (Part B) and laboratory and bacteriological data (Part C). A score of 26 or more when using PART A, PART A+B or 25 or more using PART A+B+C can be considered as current leptospirosis. After modification of Faine's criteria it become very easy to diagnose leptospirosis as it includes IgM ELISA. Background. developing countries. Microscopic agglutination tests (MAT) is the Gold Standard test, but it is complicated and less sensitive compared to ELISA and SAT. AIM OF THE STUDY: Aim of the study was to evaluate Faines, modified Faines criteria and IgM Elisa in the diagnosis of leptospirosis. Results. A repeat sample is necessary, if the first sample is negative. Your comment will be reviewed and published at the journal's discretion. Faines criteria or WHO score and modified version in 2004 and 2012, were developed as diagnostic guide for clinicians to make presumptive diagnosis of leptospirosis [2124]. Malaria, enteric fever, UTI, pneumonia and TB was excluded by appropriate tests. Fifty-one percent of our cases had contact with flood/stagnant water and 48% with livestock and stray animals. Although the WHO modified Faine's criteria have good specificity and a moderate positive predictive value in diagnosing human leptospirosis, the presence of other tropical infections with similar clinical features resulted in a much lower sensitivity. SOFA scores were calculated and in 38 patients ranged from 2 to 7, in 22 patients from 8 to 11, and in 4 cases was greater than 11. Modified Faines Criteria Part A : Clinical Data Part B: Epidemiologic Factors : Rainfall, contact with contaminated environment, animal contact ( specific scores for each) Part C: Bacteriologic Factors and Lab findings WHO Criteria for the Diagnosis of Leptospirosis

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