Pratt Nicola, Rajeev Sreekumari
Department of Biomedical Sciences, Ross University School of Veterinary Medicine, PO Box 334, Basseterre, Saint. Kitts, West Indies.
Acta Trop. 2018 Jun;182:34-42. doi: 10.1016/j.actatropica.2018.02.011. Epub 2018 Feb 16.
This systematic review summarises the data published on the Leptospira seroprevalence, serovar diversity and distribution among animal species in the Caribbean region. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and checklist, relevant articles were identified and data were extracted and recorded. The review provided Leptospira seroprevalence data from 16 Caribbean islands (Barbados, Trinidad, Grenada, Puerto Rico, Saint Croix, St. Kitts and Nevis, Jamaica, Antigua, Carriacou, Dominica, Guadalupe, Martinique, Monserrat, St. Lucia, St. Maarten, and St. Vincent) in a variety of animal species. Reviewing the literature highlighted the limited amount of data available from limited number of islands. Many of the studies conducted have recorded seroprevalences based on variable and small samples sizes. Besides, serovar panels used for MAT were not consistent between studies. The review indicates that the Leptospira exposure in a given geographic location may change with time and climatic and environmental conditions, and highlights the need to conduct continual surveillance in tropical countries where the climate supports the survival of Leptospira in the environment. Specific attention must be given to standardization of MAT panels and protocols and providing training across laboratories involved in testing. Further, animal and environment testing to isolate and identify circulating Leptospira spp. in a geographic region must actively be pursued. This knowledge is important to implement geographically specific control programs, as risk factors of Leptospira transmission is favoured by various factors such as change in climatic conditions, urbanization, encroachment of wildlife inhabitation, import/export of animals, increase in adventure travel, and water related recreational activities.
本系统综述总结了加勒比地区动物物种中钩端螺旋体血清流行率、血清型多样性及分布情况的已发表数据。按照系统综述与Meta分析的首选报告项目(PRISMA)指南及清单,识别了相关文章并提取和记录了数据。该综述提供了来自16个加勒比岛屿(巴巴多斯、特立尼达、格林纳达、波多黎各、圣克罗伊、圣基茨和尼维斯、牙买加、安提瓜、卡里亚库、多米尼克、瓜德罗普、马提尼克、蒙特塞拉特、圣卢西亚、圣马丁和圣文森特)多种动物物种的钩端螺旋体血清流行率数据。回顾文献发现,来自有限岛屿的可用数据量有限。许多已开展的研究基于可变且较小的样本量记录血清流行率。此外,各研究中用于显微镜凝集试验(MAT)的血清型组合不一致。该综述表明,特定地理位置的钩端螺旋体暴露情况可能随时间以及气候和环境条件而变化,并强调在气候有利于钩端螺旋体在环境中存活的热带国家进行持续监测的必要性。必须特别关注MAT组合和方案的标准化,并为参与检测的各实验室提供培训。此外,必须积极开展动物和环境检测,以分离和鉴定某一地理区域内传播的钩端螺旋体菌株。这些知识对于实施因地制宜的防控计划很重要,因为钩端螺旋体传播的风险因素受到多种因素的青睐,如气候条件变化、城市化、野生动物栖息地的侵占、动物进出口、探险旅行增加以及与水相关的娱乐活动。