Abstract
<title>Abstract</title> <p> <bold>Background:</bold> Leptospirosis is a neglected zoonotic disease caused by <italic>leptospira</italic> bacteria, primarily transmitted through contact with contaminated water or soil. While endemic in several parts of India, its presence in Rajasthan, an arid region, remains underreported. This study investigates the risk factors for leptospirosis in Sawai Madhopur, a district in Rajasthan that has recently reported an increase in cases. <bold>Methods:</bold> A hospital-based case-control study was conducted from January to September 2023. Cases were defined as individuals suspected and tested positive for leptospirosis via IgM ELISA, while controls were age-matched inpatients from surgical wards. A structured questionnaire was used to assess sociodemographic and environmental risk factors. Data were analyzed using univariate and multivariate logistic regression. <bold>Results:</bold> A total of 42 cases and 80 controls were included. The median age was 26.5 years. Females were 60%. Fever was seen in 96% of cases. Risk factors included exposure to heavy rainfall or flooding (AOR 4.2, CI 1.1-15.6) and contact with sewage or dirty water (AOR 5.8, CI 1.6-20.3). Contact with animals was seen as significant in univariate analysis (OR 3, CI 2-7.3) but not in multiple regression. Rural housing was protective in multivariate analysis (AOR 0.3, CI 0.1-0.9). Housing types were not significantly associated with infection. <bold>Conclusions:</bold> Sewage, dirty water contact and flooding were significant risk factors and housing type was not, rural residence was protective. Enhanced surveillance, improved sanitation, and healthcare provider training are essential for early detection and control. Public awareness initiatives should target high-risk populations, particularly women, to prevent further outbreaks. </p>