Baharom Mazni, Ahmad Norfazilah, Hod Rozita, Ja'afar Mohd Hasni, Arsad Fadly Syah, Tangang Fredolin, Ismail Rohaida, Mohamed Norlen, Mohd Radi Mohd Firdaus, Osman Yelmizaitun
Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia.
Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, 43600, Selangor, Malaysia.
Heliyon. 2023 Dec 10;10(1):e23473. doi: 10.1016/j.heliyon.2023.e23473. eCollection 2024 Jan 15.
Leptospirosis is a neglected emerging zoonotic disease with a profound public health impact worldwide with higher burden of disease in resource-poor countries. The environmental and occupational exposures contribute to human and animal transmission, but the interaction was less explored. A deeper understanding of the critical environmental and occupational drivers in different contexts will provide useful information for disease control and prevention measures.
This review aimed to summarize the potential environmental and occupational risk factors associated with leptospirosis infection.
Four databases (Scopus, Web of Science, Ovid MEDLINE, EBSCOhost) were searched for articles published from 2012 to 2021. Eligible articles were assessed using a checklist for assessing the quality of the studies. The quality of the articles was assessed based on the laboratory diagnosis approach and statistical analysis method.
A total of 32 studies were included in this systematic review. Water-related risk factors such as natural water as the primary water source (AOR 1.8-18.28), water-related recreational activities (AOR 2.36-10.45), flood exposure (AOR 1.54-6.04), contact with mud (AOR 1.57-4.58) and stagnant water (AOR 2.79-6.42) were associated with increased risk of leptospirosis. Infrastructural deficiencies such as un-plastered house walls and thatched houses presented a higher risk (AOR 2.71-5.17). Living in low-lying areas (AOR 1.58-3.74), on clay loam soil (OR 2.72), agricultural land (OR 2.09), and near rubber tree plantations (AOR 11.65) is associated with higher risk of leptospirosis. Contact with rats (AOR 1.4-3.5), livestock (AOR 1.3-10.4), and pigs (AOR 1.54-7.9) is associated with an increased risk of leptospirosis. Outdoor workers (AOR 1.95-3.95) and slaughterhouse workers (AOR 5.1-7.5) have higher risk of leptospirosis.
The environmental and occupational components related to water, infrastructure, landscape, agriculture, and exposed animals play an essential role in leptospirosis transmission. The magnitude of those risk factors differs with geographical region, climate factor, urbanization and population growth, and the country's socioeconomic status.
钩端螺旋体病是一种被忽视的新发人畜共患病，对全球公共卫生有深远影响，在资源匮乏国家疾病负担更高。环境和职业暴露会导致人与动物之间的传播，但这种相互作用较少被研究。更深入了解不同背景下关键的环境和职业驱动因素将为疾病控制和预防措施提供有用信息。
本综述旨在总结与钩端螺旋体病感染相关的潜在环境和职业风险因素。
检索了四个数据库（Scopus、科学网、Ovid MEDLINE、EBSCOhost）中2012年至2021年发表的文章。使用研究质量评估清单对符合条件的文章进行评估。根据实验室诊断方法和统计分析方法评估文章质量。
本系统综述共纳入32项研究。与水相关的风险因素，如以天然水作为主要水源（调整后比值比1.8 - 18.28）、与水相关的娱乐活动（调整后比值比2.36 - 10.45）、洪水暴露（调整后比值比1.54 - 6.04）、接触泥浆（调整后比值比1.57 - 4.58）和死水（调整后比值比2.79 - 6.42）与钩端螺旋体病风险增加相关。基础设施缺陷，如未抹灰的房屋墙壁和茅草屋，呈现出更高的风险（调整后比值比2.71 - 5.17）。生活在低洼地区（调整后比值比1.58 - 3.74）、粘壤土上（比值比2.72）、农田（比值比2.09）以及橡胶种植园附近（调整后比值比11.65）与钩端螺旋体病风险较高相关。接触大鼠（调整后比值比1.4 - 3.5）、家畜（调整后比值比1.3 - 10.4）和猪（调整后比值比1.54 - 7.9）与钩端螺旋体病风险增加相关。户外工作者（调整后比值比1.95 - 3.95）和屠宰场工人（调整后比值比5.1 - 7.5）感染钩端螺旋体病的风险更高。
与水、基础设施、地形、农业和接触动物相关的环境和职业因素在钩端螺旋体病传播中起重要作用。这些风险因素的程度因地理区域、气候因素、城市化和人口增长以及国家的社会经济状况而异。
