Antoniolli Andrea, Guis Hélène, Picardeau Mathieu, Goarant Cyrille, Flamand Claude
Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia.
Université Paris-Cité, Paris, France.
Open Forum Infect Dis. 2024 Dec 30;12(1):ofae757. doi: 10.1093/ofid/ofae757. eCollection 2025 Jan.
Leptospirosis is a neglected zoonosis transmitted through urine of infected hosts or contaminated environments. The transmission of bacteria between humans, animals, and the environment underscores the necessity of a One Health approach.
We conducted a systematic review to identify significant findings and challenges in One Health research on leptospirosis, focusing on studies involving sampling in ≥2 of the 3 compartments: human, animal, and environment. We searched in PubMed, Web of Science, Medline, Scopus, and ScienceDirect from 1 January 1918 to 31 December 2022. We assessed risk of bias in studies using Joanna Briggs Institute tools and performed a meta-analysis to identify links between One Health compartments.
Of 1082 leptospirosis studies with sampling, 102 multicompartmental studies conducted between 1972 and 2022 were included: 70 human-Animal, 18 animal-environment, 4 human-environment, and 10 across all compartments. Various methodological weaknesses were identified, from study design to statistical analysis. Meta-regressions identified positive associations between human and animal seroprevalences, particularly with livestock and with wild nonrodent animals, and a link between the environmental positivity rate and domestic animal seroprevalence. Our analysis was constrained by the limited number of studies included and by the quality of protocols.
This 50-year overview of One Health field approach to leptospirosis highlights the critical need for more robust, well-supported One Health research to clarify the transmission dynamics and identify risk factors of zoonoses.
钩端螺旋体病是一种被忽视的人畜共患病，通过受感染宿主的尿液或受污染的环境传播。细菌在人类、动物和环境之间的传播凸显了采取“同一健康”方法的必要性。
我们进行了一项系统综述，以确定钩端螺旋体病“同一健康”研究中的重要发现和挑战，重点关注涉及在人类、动物和环境这三个部分中至少两个部分进行采样的研究。我们在1918年1月1日至2022年12月31日期间在PubMed、科学网、医学在线、Scopus和ScienceDirect上进行了检索。我们使用乔安娜·布里格斯研究所的工具评估研究中的偏倚风险，并进行荟萃分析以确定“同一健康”各部分之间的联系。
在1082项有采样的钩端螺旋体病研究中，纳入了1972年至2022年期间进行的102项多部分研究：70项人类 - 动物研究、18项动物 - 环境研究、4项人类 - 环境研究以及10项涵盖所有部分的研究。从研究设计到统计分析，发现了各种方法学上的弱点。荟萃回归确定了人类和动物血清阳性率之间的正相关，特别是与家畜和野生非啮齿动物的血清阳性率之间的正相关，以及环境阳性率与家畜血清阳性率之间的联系。我们的分析受到纳入研究数量有限和方案质量的限制。
对钩端螺旋体病“同一健康”领域方法的这一50年概述突出表明，迫切需要开展更有力、有充分支持的“同一健康”研究，以阐明传播动态并确定人畜共患病的风险因素。
