A Systematic Review of the geographic distribution of pathogenic Leptospira serovars in the Americas, 1930-2017.

Leptospirosis is an important public health problem caused by Leptospira. The objective is to characterize the geographic distribution of pathogenic leptospira serovars in the Americas through a systematic review of the literature between 1930-2017. Searches were conducted in six scientific databases (PubMed, Web of Science, Embase, Lilacs, Scopus and Cochrane). We included studies conducted unambiguously in the Americas, that investigated infection of Leptospira in humans and animals in their natural environments with serovar identification. 283 articles were included, of which 69 were studies in humans, 86 in wild animals, and 182 in domestic animals. Most of them conducted in Brazil (104, 36.7%) and in rural environments (158, 55.8%). Bovines, equines and dogs where the most frequently studied domestic species. However, a large diversity including 80 species of wild animals were studied. Icterohaemorrhgiae, Canicola, Pomona and Grippotyphosa were the most common serovars, described in 46 (16.2%), 38 (13.3%), 32 (11.3%) and 26 (9%) of the articles, respectively. The Results indicate a large concentration of studies in Latin America, with emphasis on Brazil, in wild mammals and three main domestic animal groups. Our results emphasize the need for studies that delve into the relationships of the epidemiological cycle, environment, and health.