School of Public Health, The University of Adelaide, Adelaide, Australia.
Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
Epidemiol Infect. 2024 Oct 8;152:e118. doi: 10.1017/S0950268824001250.
Leptospirosis is a bacterial zoonosis that poses an increasing global public health risk. Pacific Island communities are highly vulnerable to leptospirosis outbreaks, yet the local drivers of infection remain poorly understood. We conducted a systematic review to identify the drivers of human infection in the Pacific Islands. There were 42 included studies from which findings were synthesized descriptively. In tropical Pacific Islands, infections were a product of sociodemographic factors such as male gender/sex, age 20 to 60 years, Indigenous ethnicity, and poverty; lifestyle factors such as swimming, gardening, and open skin wounds; and environmental factors, including seasonality, heavy rainfall, and exposure to rodents, cattle, and pigs. Possible mitigation strategies in these islands include strengthening disease reporting standards at a regional level; improving water security, rodent control, and piggery management at a community level; and information campaigns to target individual-level drivers of infection. By contrast, in New Zealand, exposures were predominantly occupational, with infections occurring in meat and farm workers. Accordingly, interventions could include adjustments to occupational practices and promoting the uptake of animal vaccinations. Given the complexity of disease transmission and future challenges posed by climate change, further action is required for leptospirosis control in the Pacific Islands.
钩端螺旋体病是一种人畜共患的细菌性疾病，对全球公共卫生构成的威胁日益增加。太平洋岛屿社区极易受到钩端螺旋体病的爆发的影响，但感染的本地驱动因素仍知之甚少。我们进行了一项系统综述，以确定太平洋岛屿上人类感染的驱动因素。有 42 项纳入的研究提供了描述性综合结果。在热带太平洋岛屿上，感染是社会人口因素（如男性/性别、20 至 60 岁、土著民族和贫困）、生活方式因素（如游泳、园艺和开放性皮肤伤口）以及环境因素（如季节性、强降雨和接触啮齿动物、牛和猪）的产物。这些岛屿上可能的缓解策略包括加强区域一级的疾病报告标准；在社区一级改善水安全、控制啮齿动物和管理养猪业；并开展针对感染个体驱动因素的宣传运动。相比之下，在新西兰，感染主要是职业性的，发生在肉类和农场工人中。因此，可以采取调整职业做法和促进动物疫苗接种的措施。鉴于疾病传播的复杂性以及气候变化带来的未来挑战，需要采取进一步行动来控制太平洋岛屿上的钩端螺旋体病。
