TAMBAHAN

Beberapa penelitian membuktikan bahwa petani berisiko tinggi terkena leptospirosis

dibanding pekerjaan lainnya. Di Punjab, Pakistan, 2017, dari 250 subjek, persentase seroposivity
leptospirosis pada petani padi sebanyak 83.2% sedangkan pada pekerjaan lain sebanyak 42%1.
Dalam penelitian yang dilakukan Gayatri (2016), 23,8% petani padi yang datang ke rumah sakit
dengan keluhan demam diketahui menderita leptospirosis melalui uji serologis2. Pada penelitian
yang dilakukan di Iran tahun 2014, dari 65 sampel darah yang positif terdapat antibody IgM
anti-leptospira, 52 (36,1%) sampel berasal dari petani dan 14 (9,7%) dari kalangan non-petani.3

Tingginya angka leptospirosis pada petani bisa disebabkan oleh beberapa faktor. Pertama,
petani biasanya berada di genangan air selama berjam-jam lamanya. Paparan pada genangan air
yang dicurigai terkontaminasi oleh urin tikus yang terinfeksi leptospirosis dalam waktu yang
lama merupakan faktor risiko kuat seseorang dapat terkena leptospirosis.1

Faktor lainnya bisa disebabkan oleh penggunaan pupuk secara berlebihan yang menyebabkan
derajat pH air dan tanah menjadi basa. Hal ini menyebabkan Leptospira untuk bertahan hidup
lebih lama dan mampu menunjang penyebarannya2

1. Khan, Muhammad Athar , et all. Risk Factors of Leptospirosis in Rice Cultivators as

Compared to non-Rice Cultivators in Punjab, Pakistan. Annals of King Edward
Medical University. Oct-Dec 2017 | Volume 23 | Issue 4 | Page 3
The dissemination of the organisms to human beings is also considered from the
Rice field water mixed with the infected urine of rat. The organism penetrates the human
host from the broken mucosa or skin and may lead to bacteremia/ septicemia.
The workers of rice cultivation are exposed to water in the rice field which may
be infected with the urine of rat. Due to this exposure these workers are at higher risk of
disease development as compared to non-cultivators of rice
The cultivators or the workers of rice field paddy water usually stand for many
hours in water for the implantation of rice in the mud field. This exposure of several
hours is a strong risk factor among the exposed individuals for the development of
disease
 A total of 250 subjects were included in the study. Out of these, 125 subjects were
exposed to the rice paddy water where as 125 were not exposed to rice paddy water.
These study subjects were selected from five different rice cultivating districts of Punjab.
The cumulative seropositivity among the exposed is (83.2%) as compared to (42%)
among the non exposed to rice paddy field water.
These results are consistent with the finding of another study conducted by Syed
Muhammad Ali in South West Iran which concluded that the farmers of rice cultivation
are more significantly infected with Leptospirosis as compared to other residents of the
rural areas
It is recommended that rice cultivators should protect their body parts with gloves
or boots as prevention is the most appropriate way to control any disease

2. Gayatri et al. Prevalence of Leptospirosis among paddy field workers in Pune, Western
India. Int J Cur Res Rev | Vol 9 • Issue 5 • March 2017
This was a cross-sectional prospective study conducted at B J Govt Medical
College Pune. A total of 160 paddy field workers were included in the study. Blood
samples were collected from these 160 paddy field workers attending Rural Hospital,
Pawana Nagar, Pune, during year 2013 to2014.
Percentage is taken into consideration in common presenting clinical features, age
wise distribution of patients among ELISA positive patients, sex-wise distribution, and
for results of ELISA and MAT test.
The common clinical presentations amongst the paddy farmers were Myalgia and
headache in association with fever. Majority of the study group were patients in the age
group 30-50 years (Table 2). 55.2% males and 44.7% females were affected (Table 3).
Evidence of recent infection by leptospires could be found in Leptospirosis was found in
23.8% of the patients. Only 9.4 % of the infections could be confirmed by MAT. The
commonest serovars to which antibodies were detected was Grippotyphosa (Table 4).
60.52% of patients with laboratory confirmed leptospirosis gave evidence of leptospirosis
by Faine’s Criteria.
In the present study 23.8% of paddy field workers reporting to hospital with a
febrile illness had serological evidence of leptospirosis
 Serological evidence in present study is definitely higher than the previous report
of urban studies in western Maharashtra. Total of 18.6% cases were seropositive in cases
of Pyrexia of unknown origin(15). The reason for high prevalence of leptospirosis in this
area may also be due to the overuse of fertilizers commonly used for agriculture, which
makes the pH of the water and soil alkaline, thereby allowing Leptospira to survive for a
longer time and thus facilitating its transmission. The prevalence of leptospirosis is
higher in rural as compared to the urban population, mainly due to greater exposure to
livestock.
Adequate foot covers in the form of closed shoes and rubber gloves must be
advised for farmers working in the paddy fields to prevent infection.

3. Alavi, Seyed Mohammad et al Seroprevalence Study of Leptospirosis Among Rice

Farmers in Khuzestan Province, South West Iran, 2012. Jundishapur J Microbiol.
2014 July; 7(7): e11536.
Participants were placed in two groups: Rice farmers as the case group, and the
other people not engaged in farming as the control group. Three hundred and twenty six
subjects were enrolled. Thirty eight subjects declined due to fear of phlebotomy and were
excluded. Blood samples were tested from the remaining subjects. Only the 288 subjects
with blood test results were included in the final analysis. Of the 288 tested samples, 65
were positive for IgM anti-leptospira antibodies, indicating recent leptospiral infection
(22.5%). Among the positive samples, 52 (36.1%) were from the case (rice farmer) and
14 (9.7%) from the control groups

4. Wongbutdee, Jaruwan, et. al. Perceptions and risky behaviors associated with
Leptospirosis in an endemic area in a village of Ubon Ratchathani Province, Thailand
African Health Sciences Vol 16 Issue 1, March 2016
The Bureau of Epidemiology, Department of Disease Control (Bureau of Epidemiology,
MOPH) presented data from 1 January 2013 to 19 October 2013, 2012, and 2011. From 1
January 2013 to 19 October 2013, 2,230 patients suffered from leptospirosis resulting in
19 deaths. Of these, 56.0% were farmers, 22.4% were hired employees, and 9.5% were
students. In 2012, 3,093 patients suffered from leptospirosis. Of these, 56.26% were
farmers, 22.18% were hired employees, and 9.60% were students. In 2011, 4,237
leptospirosis patients were high in farmers (59.07%), hired employees (19.78%), and
students (10.05%)