Department of Wildlife and Aquatic Animal Resources, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, Kampala, Uganda.
Spatial Science Institute, University of Southern California, Los Angeles, USA.
BMC Infect Dis. 2023 Oct 3;23(1):649. doi: 10.1186/s12879-023-08574-5.
Leptospirosis is an emerging neglected tropical zoonotic disease of public health importance causing substantial morbidities and mortalities among humans. The infection is maintained within the population through interactions between humans, animals, and the environment. Understanding the burden of disease in both humans and animals is necessary for effective prevention and control in Sub-Saharan Africa (SSA). Therefore, we aimed to determine the seroprevalence of leptospirosis in humans, selected domestic animals, and rodents in SSA.
A comprehensive search was done in six databases: Scopus, PubMed, Google Scholar, CINAHL, Web of Science, and African Journals Online databases for articles published between 01 January 2014 and 30 August 2022. Thirty-seven articles distributed across 14 out of 46 countries in SSA were included. The random effects meta-analysis model was used to pool the extracted seroprevalence data.
The overall pooled seroprevalence of leptospirosis among humans was 12.7% (95% CI: 7.5,20.8), 15.1% (95% CI: 9.4,23.5), and 4.5% (95% CI: 0.4, 35.6) based on results obtained using ELISA, MAT, and PCR diagnostic methods respectively. The pooled seroprevalence estimates among cattle were 29.2%, 30.1%, and 9.7% based on ELISA, MAT, and PCR respectively. Further, the pooled seroprevalence in goats was 30.0% for studies that used MAT, and among rodents, the pooled seroprevalence estimates were 21.0% for MAT and 9.6% for PCR diagnostic criteria. The seroprevalence of leptospirosis varied extensively between studies, across SSA regions and study setting (rural or urban).
Leptospirosis is widespread in SSA in both humans and animals based on the current results of the pooled seroprevalence in the limited studies available. The burden is high in animals and humans and underestimated due to limited studies and challenges with limited diagnostic capacity in most healthcare settings in SSA. Hence, we recommend that leptospirosis should be listed as a disease of concern and be included on the list of routine diagnostics among patients presenting with febrile illness in healthcare settings. Further, we recommend the enhancement of surveillance of leptospirosis in all countries in SSA and the development of strategies with a One Health perspective to effectively prevent and control leptospirosis.
钩端螺旋体病是一种新兴的被忽视的热带人畜共患传染病，对人类健康造成了重大的发病率和死亡率。该感染通过人类、动物和环境之间的相互作用在人群中得以维持。了解撒哈拉以南非洲（SSA）地区人类和动物的疾病负担对于有效预防和控制该病至关重要。因此，我们旨在确定 SSA 地区人类、选定的家畜和啮齿动物的钩端螺旋体病血清流行率。
我们在六个数据库中进行了全面检索：Scopus、PubMed、Google Scholar、CINAHL、Web of Science 和 African Journals Online 数据库，检索时间为 2014 年 1 月 1 日至 2022 年 8 月 30 日期间发表的文章。共纳入了来自 SSA 地区 14 个国家的 37 篇文章。我们使用随机效应荟萃分析模型来汇总提取的血清流行率数据。
基于 ELISA、MAT 和 PCR 诊断方法获得的结果，人类钩端螺旋体病的总血清流行率分别为 12.7%（95%CI：7.5，20.8）、15.1%（95%CI：9.4，23.5）和 4.5%（95%CI：0.4，35.6）。基于 ELISA、MAT 和 PCR 诊断方法，牛的血清流行率估计值分别为 29.2%、30.1%和 9.7%。此外，MAT 检测的山羊血清流行率为 30.0%，而啮齿动物的 MAT 和 PCR 检测的血清流行率估计值分别为 21.0%和 9.6%。基于现有的有限研究结果，SSA 地区的钩端螺旋体病血清流行率在各研究之间、各地区和研究环境（农村或城市）之间存在广泛差异。
根据目前有限研究中汇总的血清流行率结果，SSA 地区的人类和动物中广泛存在钩端螺旋体病。动物和人类的负担很高，但由于大多数卫生保健环境中诊断能力有限且研究有限，因此被低估。因此，我们建议将钩端螺旋体病列为关注疾病，并将其列入卫生保健机构中出现发热性疾病患者的常规诊断项目中。此外，我们建议加强对 SSA 所有国家的钩端螺旋体病监测，并制定具有“同一健康”视角的策略，以有效预防和控制钩端螺旋体病。
