Petersen Kyle, Maranich Ashley
Department of Preventive Medicine, Uniformed Services University of the Health Sciences Bethesda, Bethesda, MD 20814, USA.
Department of Pediatrics, Uniformed Services University of the Health Sciences Bethesda, Bethesda, MD 20814, USA.
Trop Med Infect Dis. 2024 Jul 2;9(7):148. doi: 10.3390/tropicalmed9070148.
Leptospirosis is a neglected tropical disease that remains potentially life threatening and hard to diagnose. Climate change combined with overlapping reservoir and human habitats will likely lead to increasing incidence, outbreaks, and mortality in the future. Preventative vaccines are either of limited scope and availability, or under development. Antibiotic chemoprophylaxis for prevention has been the subject of numerous clinical trials. However, despite 40 years of effort, clinical trials to better define protective efficacy, dosing, and the preferred medication are of poor quality and offer limited evidence. We reviewed the literature and offer critiques of the existing trials as well as potential areas for future exploration that may better define the epidemiology and yield a better evidence base for both travel medicine and public health efforts.
钩端螺旋体病是一种被忽视的热带疾病，仍然具有潜在的生命威胁且难以诊断。气候变化加上重叠的宿主和人类栖息地，未来可能会导致发病率、疫情和死亡率上升。预防性疫苗的范围和可及性有限，或者仍在研发中。用于预防的抗生素化学预防一直是众多临床试验的主题。然而，尽管经过40年的努力，旨在更好地确定保护效力、剂量和首选药物的临床试验质量很差，提供的证据有限。我们回顾了文献，并对现有试验提出批评，以及未来可能更好地界定流行病学并为旅行医学和公共卫生工作提供更好证据基础的探索领域。
