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Nazir A, Oduoye MO, Nazir A, Uzoamaka CB, Ali Muzammil M, Sakr SM, Scott GY, Khan suheb M. Unraveling the leptospirosis epidemic: tales from the Philippine outbreak - a short communication. Ann Med Surg (Lond) 2024; 86:1238-1242. [PMID: 38333303 PMCID: PMC10849348 DOI: 10.1097/ms9.0000000000001535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 11/13/2023] [Indexed: 02/10/2024] Open
Abstract
Leptospirosis, also known as Weil's disease, is an emerging zoonotic infection that occurs worldwide but is particularly common in the tropics. There has been an increasing trend of leptospirosis in the Philippines since the outbreak occurred in 2020. The number of reported cases was 182 in 2020, 1661 in 2021, and 2794 in 2022. This present article aimed to access previously published studies on the prevalence, implications, and efforts to combat leptospirosis worldwide, with a particular focus on the Philippines from 2001 to 2023. In writing this article, we conducted a thorough search of databases such as PubMed, Researchgate, Web of Science, Scopus, and Google Scholar within 20 years. This present article found that more than 810 cases were reported from 1 January to 4 March 2023. The Cagayan Valley Region has 103 cases, the Zamboanga Peninsula has 77 cases, and the Western Visayas Region has 176 cases, making them the worst-hit areas. The increase in leptospirosis cases in the Philippines is primarily attributed to several factors. Firstly, the country is prone to natural disasters such as typhoons, floods, and landslides, which increase the risk of water sources and the environment being contaminated with Leptospira bacteria. To address the menace of leptospirosis in the Philippines, we urge the Philippine government to focus on improving healthcare infrastructure, providing swift, reliable, and effective treatments, implementing safety regulations, supplying personal protective equipment to medical authorities, and taking strict actions to improve water sanitation.
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Affiliation(s)
- Abubakar Nazir
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine, King Edward Medical University
| | - Malik Olatunde Oduoye
- Department of Medicine, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Awais Nazir
- Department of Medicine, King Edward Medical University
| | | | | | | | - Godfred Y. Scott
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Ghana
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Baharom M, Ahmad N, Hod R, Ja’afar MH, Arsad FS, Tangang F, Ismail R, Mohamed N, Mohd Radi MF, Osman Y. Environmental and Occupational Factors Associated with Leptospirosis: A Systematic Review. Heliyon 2024; 10:e23473. [PMID: 38173528 PMCID: PMC10761560 DOI: 10.1016/j.heliyon.2023.e23473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Background 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. Objective This review aimed to summarize the potential environmental and occupational risk factors associated with leptospirosis infection. Methods 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. Results 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. Conclusion 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.
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Affiliation(s)
- Mazni Baharom
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Mohd Hasni Ja’afar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Fadly Syah Arsad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
| | - Fredolin Tangang
- Department of Earth Sciences and Environment, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, 43600, Selangor, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Malaysia
| | - Norlen Mohamed
- Environmental Health Unit, Disease Control Division, Ministry of Health Malaysia, Malaysia
| | | | - Yelmizaitun Osman
- Kelantan State Health Department, Ministry of Health Malaysia, Malaysia
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Gizamba JM, Mugisha L. Leptospirosis in humans and selected animals in Sub-Saharan Africa, 2014-2022: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:649. [PMID: 37784071 PMCID: PMC10546638 DOI: 10.1186/s12879-023-08574-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/29/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Jacob Mugoya Gizamba
- 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.
| | - Lawrence Mugisha
- Department of Wildlife and Aquatic Animal Resources, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, Kampala, Uganda.
- Ecohealth Research Group, Conservation &Ecosystem Health Alliance, Kampala, Uganda.
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Nardoni Marteli A, Guasselli LA, Diament D, Wink GO, Vasconcelos VV. Spatio-temporal analysis of leptospirosis in Brazil and its relationship with flooding. GEOSPATIAL HEALTH 2022; 17. [PMID: 36468592 DOI: 10.4081/gh.2022.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/17/2022] [Indexed: 06/17/2023]
Abstract
Leptospirosis is a serious public health problem in Brazil, which can be observed after flooding events. Using an exploratory mixed clustering method, this ecological study analyzes whether spatial-temporal clustering patterns of leptospirosis occur in Brazil. Data from the Brazilian Unified Health System (SUS) were used to calculate the prevalence of leptospirosis between 2007 and 2017 in all counties of the country. Clustering techniques, including spatial association indicators, were used for analysis and evaluation of disease yearly spatial distribution. Based on Local Indicators of Spatial Association (LISA) with Empirical Bayesian rates detected spatial patterns of leptospirosis ranging from 0.137 (p = 0.001 in 2009) to 0.293 (p = 0.001 in 2008). Over the whole period, the rate was 0.388 (p = 0.001). The main pattern showed permanence of leptospirosis clusters in the South and emergence and permanence of such clusters in northern Brazil. The municipalities with leptospirosis cases and at least one flood occurrence registered in the Brazilian Integrated Disaster Information System were incorporated into the LISA cluster map with Empirical Bayesian rates. These counties were expected to exhibit clustering, not all did. The results of the cluster analysis suggest allocation of health resources in areas with leptospirosis clustering.
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Affiliation(s)
- Alice Nardoni Marteli
- Federal University of Rio Grande do Sul (UFRGS), Postgraduate Program in Remote Sensing (PPGSR), Porto Alegre (RS).
| | - Laurindo Antonio Guasselli
- Federal University of Rio Grande do Sul (UFRGS), Postgraduate Program in Remote Sensing (PPGSR), Porto Alegre (RS).
| | - Décio Diament
- Emilio Ribas Institute of Infectious Diseases (IIER), São Paulo (SP).
| | - Gabriele Ozório Wink
- Federal University of Rio Grande do Sul (UFRGS), Geosciences Institute (IGEO), Porto Alegre (RS).
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Sykes JE, Haake DA, Gamage CD, Mills WZ, Nally JE. A global one health perspective on leptospirosis in humans and animals. J Am Vet Med Assoc 2022; 260:1589-1596. [PMID: 35895801 DOI: 10.2460/javma.22.06.0258] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Leptospirosis is a quintessential one health disease of humans and animals caused by pathogenic spirochetes of the genus Leptospira. Intra- and interspecies transmission is dependent on 1) reservoir host animals in which organisms replicate and are shed in urine over long periods of time, 2) the persistence of spirochetes in the environment, and 3) subsequent human-animal-environmental interactions. The combination of increased flooding events due to climate change, changes in human-animal-environmental interactions as a result of the pandemic that favor a rise in the incidence of leptospirosis, and under-recognition of leptospirosis because of nonspecific clinical signs and severe signs that resemble COVID-19 represents a "perfect storm" for resurgence of leptospirosis in people and domestic animals. Although often considered a disease that occurs in warm, humid climates with high annual rainfall, pathogenic Leptospira spp have recently been associated with disease in animals and humans that reside in semiarid regions like the southwestern US and have impacted humans that have a wide spectrum of socioeconomic backgrounds. Therefore, it is critical that physicians, veterinarians, and public health experts maintain a high index of suspicion for the disease regardless of geographic and socioeconomic circumstances and work together to understand outbreaks and implement appropriate control measures. Over the last decade, major strides have been made in our understanding of the disease because of improvements in diagnostic tests, molecular epidemiologic tools, educational efforts on preventive measures, and vaccines. These novel approaches are highlighted in the companion Currents in One Health by Sykes et al, AJVR, September 2022.
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Affiliation(s)
- Jane E Sykes
- 1Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA
| | - David A Haake
- 2VA Greater Los Angeles Healthcare System, Los Angeles, CA.,3David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA
| | - Chandika D Gamage
- 4Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Jarlath E Nally
- 6National Animal Disease Center, Agriculture Research Service, USDA, Ames, IA
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Phosri A. Effects of rainfall on human leptospirosis in Thailand: evidence of multi-province study using distributed lag non-linear model. STOCHASTIC ENVIRONMENTAL RESEARCH AND RISK ASSESSMENT : RESEARCH JOURNAL 2022; 36:4119-4132. [PMID: 35692716 PMCID: PMC9167037 DOI: 10.1007/s00477-022-02250-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Leptospirosis is a zoonotic bacterial disease that remains an important public health problem, especially in tropical developing countries. Many previous studies in Thailand have revealed the outbreak of human leptospirosis after heavy rainfall, but research determining its quantitative risks associated with rainfall, especially at the national level, remains limited. This study aims to examine the association between rainfall and human leptospirosis across 60 provinces of Thailand. A quasi-Poisson regression framework combined with the distributed lag non-linear model was used to estimate province-specific association between rainfall and human leptospirosis, adjusting for potential confounders. Province-specific estimates were then pooled to derive regional and national estimates using random-effect meta-analysis. The highest risk of leptospirosis associated with rainfall at national level was observed at the same month (lag 0). Using 0 cm/month of rainfall as a reference, the relative risks of leptospirosis associated with heavy (90th percentile), very heavy (95th percentile), and extremely heavy (99th percentile) rainfall at the national level were 1.0994 (95% CI 0.9747, 1.2401), 1.1428 (95% CI 1.0154, 1.2862), and 1.1848 (95% CI 1.0494, 1.3378), respectively. The highest risk of human leptospirosis associated with rainfall was observed in the northern and north-eastern regions. Specifically, the relative risks of leptospirosis associated with extremely heavy rainfall in northern and north-eastern regions were 1.2362 (95% CI 0.9110, 1.6775) and 1.2046 (95% CI 0.9728, 1.4918), respectively. Increasing rainfall was associated with increased risks of leptospirosis, especially in the northern and northeastern regions of Thailand. This finding could be used for precautionary warnings against heavy rainfall. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s00477-022-02250-x.
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Affiliation(s)
- Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, 10400 Thailand
- Center of Excellence on Environmental Health and Toxicology (EHT), OPS, Ministry of Higher Education, Science, Research and Innovation, Bangkok, Thailand
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Saito N, Solante RM, Guzman FD, Telan EO, Umipig DV, Calayo JP, Frayco CH, Lazaro JC, Ribo MR, Dimapilis AQ, Dimapilis VO, Villanueva AM, Mauhay JL, Suzuki M, Yasunami M, Koizumi N, Kitashoji E, Sakashita K, Yasuda I, Nishiyama A, Smith C, Ariyoshi K, Parry CM. A prospective observational study of community-acquired bacterial bloodstream infections in Metro Manila, the Philippines. PLoS Negl Trop Dis 2022; 16:e0010414. [PMID: 35613181 PMCID: PMC9173634 DOI: 10.1371/journal.pntd.0010414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/07/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Community-acquired bacterial bloodstream infections are caused by diverse pathogens with changing antimicrobial-resistance patterns. In low-middle income countries in Southeast Asia, where dengue fever is endemic and a leading cause of fever, limited information is available about bacterial bloodstream infections due to challenges of implementing a blood culture service. This study describes bacterial bloodstream pathogens and antimicrobial-resistance patterns in Metro Manila, the Philippines. We aimed to identify the proportion of patients with a positive blood culture, the bacteria isolated and their antimicrobial resistance patterns, and the clinical characteristics of these patients, in this dengue endemic area. We conducted a prospective observational study in a single hospital enrolling febrile patients clinically suspected of having a community-acquired bacterial bloodstream infection between 1st July 2015 and 30th June 2019. Each patient had a blood culture and additional diagnostic tests according to their clinical presentation. We enrolled 1315 patients and a significant positive blood culture was found in 77 (5.9%) including Staphylococcus aureus (n = 20), Salmonella enterica Typhi (n = 18), Escherichia coli (n = 16), Streptococcus pneumoniae (n = 3) and Burkholderia pseudomallei (n = 2). Thirty-four patients had meningococcal disease diagnosed by culture (n = 8) or blood PCR (n = 26). Additional confirmed diagnoses included leptospirosis (n = 177), dengue virus infection (n = 159) and respiratory diphtheria (n = 50). There were 79 (6.0%, 95%CI 4.8%−7.4%) patients who died within 28 days of enrollment. Patients with a positive blood culture were significantly more likely to die than patients with negative culture (15.2% vs 4.4%, P<0.01). Among S. aureus isolates, 11/20 (55%) were methicillin-resistant (MRSA) and ST30: USA1100 was dominant sequence type (88.9%). Antimicrobial-susceptibility was well preserved in S. enterica Typhi. Among hospitalized patients with clinically suspected community-acquired bacterial bloodstream infection in Metro Manila, the Philippines, 5.9% had a blood culture confirmed infection of whom 15.6% died. S. aureus, including a significant number of MRSA (USA1100 clones), S. enterica Typhi, E.coli and Neisseria meningitidis were frequently identified pathogens.
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Affiliation(s)
- Nobuo Saito
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Microbiology, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | | | | | | | | | | | | | | | | | | | | | - Annavi M. Villanueva
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- San Lazaro Hospital, Manila, the Philippines
| | - Jaira L. Mauhay
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Motoi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Michio Yasunami
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Emi Kitashoji
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Kentaro Sakashita
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ikkoh Yasuda
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Akira Nishiyama
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Koya Ariyoshi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- * E-mail: (KA); (CMP)
| | - Christopher M. Parry
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail: (KA); (CMP)
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Cunha M, Costa F, Ribeiro GS, Carvalho MS, Reis RB, Nery Jr N, Pischel L, Gouveia EL, Santos AC, Queiroz A, Wunder Jr. EA, Reis MG, Diggle PJ, Ko AI. Rainfall and other meteorological factors as drivers of urban transmission of leptospirosis. PLoS Negl Trop Dis 2022; 16:e0007507. [PMID: 35404948 PMCID: PMC9022820 DOI: 10.1371/journal.pntd.0007507] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 04/21/2022] [Accepted: 03/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Leptospirosis is an important public health problem affecting vulnerable urban slum populations in developing country settings. However, the complex interaction of meteorological factors driving the temporal trends of leptospirosis remain incompletely understood. METHODS AND FINDINGS From March 1996-March 2010, we investigated the association between the weekly incidence of leptospirosis and meteorological anomalies in the city of Salvador, Brazil by using a dynamic generalized linear model that accounted for time lags, overall trend, and seasonal variation. Our model showed an increase of leptospirosis cases associated with higher than expected rainfall, lower than expected temperature and higher than expected humidity. There was a lag of one-to-two weeks between weekly values for significant meteorological variables and leptospirosis incidence. Independent of the season, a weekly cumulative rainfall anomaly of 20 mm increased the risk of leptospirosis by 12% compared to a week following the expected seasonal pattern. Finally, over the 14-year study period, the annual incidence of leptospirosis decreased significantly by a factor of 2.7 (8.3 versus 3.0 per 100,000 people), independently of variations in climate. CONCLUSIONS Strategies to control leptospirosis should focus on avoiding contact with contaminated sources of Leptospira as well as on increasing awareness in the population and health professionals within the short time window after low-level or extreme high-level rainfall events. Increased leptospirosis incidence was restricted to one-to-two weeks after those events suggesting that infectious Leptospira survival may be limited to short time intervals.
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Affiliation(s)
- Marcelo Cunha
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Federico Costa
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Guilherme S. Ribeiro
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Marilia S. Carvalho
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Ministério da Saúde, Rio de Janeiro, Brazil
| | - Renato B. Reis
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Nivison Nery Jr
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Lauren Pischel
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Edilane L. Gouveia
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Andreia C. Santos
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Adriano Queiroz
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Elsio A. Wunder Jr.
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Mitermayer G. Reis
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Peter J Diggle
- Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
| | - Albert I. Ko
- Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Heaven, Connecticut, United States of America
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Abstract
Leptospirosis is a zoonotic disease caused by infection with pathogenic leptospires. Consistent with recent studies by other groups, leptospires were isolated from 89 out of 110 (80.9%) soil or water samples from varied locations in the Philippines in our surveillance study, indicating that leptospires might have a life cycle that does not involve animal hosts. However, despite previous work, it has not been confirmed whether leptospires multiply in the soil environment under various experimental conditions. Given the fact that the case number of leptospirosis is increased after flood, we hypothesized that waterlogged soil, which mimics the postflooding environment, could be a suitable condition for growing leptospires. To verify this hypothesis, pathogenic and saprophytic leptospires were seeded in the bottles containing 2.5 times as much water as soil, and bacterial counts in the bottles were measured over time. Pathogenic and saprophytic leptospires were found to increase their number in waterlogged soil but not in water or soil alone. In addition, leptospires were reisolated from soil in closed tubes for as long as 379 days. These results indicate that leptospires are in a resting state in the soil and are able to proliferate with increased water content in the environment. This notion is strongly supported by observations that the case number of leptospirosis is significantly higher in rainy seasons and increased after flood. Therefore, we reached the following conclusion: environmental soil is a potential reservoir of leptospires. IMPORTANCE Since research on Leptospira has focused on pathogenic leptospires, which are supposed to multiply only in animal hosts, the life cycle of saprophytic leptospires has long been a mystery. This study demonstrates that both pathogenic and saprophytic leptospires multiply in the waterlogged soil, which mimics the postflooding environment. The present results potentially explain why leptospirosis frequently occurs after floods. Therefore, environmental soil is a potential reservoir of leptospires and leptospirosis is considered an environment-borne as well as a zoonotic disease. This is a significant report to reveal that leptospires multiply under environmental conditions, and this finding leads us to reconsider the ecology of leptospires.
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Md-Lasim A, Mohd-Taib FS, Abdul-Halim M, Mohd-Ngesom AM, Nathan S, Md-Nor S. Leptospirosis and Coinfection: Should We Be Concerned? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179411. [PMID: 34502012 PMCID: PMC8431591 DOI: 10.3390/ijerph18179411] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/05/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
Pathogenic Leptospira is the causative agent of leptospirosis, an emerging zoonotic disease affecting animals and humans worldwide. The risk of host infection following interaction with environmental sources depends on the ability of Leptospira to persist, survive, and infect the new host to continue the transmission chain. Leptospira may coexist with other pathogens, thus providing a suitable condition for the development of other pathogens, resulting in multi-pathogen infection in humans. Therefore, it is important to better understand the dynamics of transmission by these pathogens. We conducted Boolean searches of several databases, including Google Scholar, PubMed, SciELO, and ScienceDirect, to identify relevant published data on Leptospira and coinfection with other pathogenic bacteria. We review the role of the host-microbiota in determining the synanthropic interaction of Leptospira sp. with other bacteria, thus creating a suitable condition for the leptospira to survive and persist successfully. We also discuss the biotic and abiotic factors that amplify the viability of Leptospira in the environment. The coinfection of leptospira with pathogenic bacteria has rarely been reported, potentially contributing to a lack of awareness. Therefore, the occurrence of leptospirosis coinfection may complicate diagnosis, long-lasting examination, and mistreatment that could lead to mortality. Identifying the presence of leptospirosis with other bacteria through metagenomic analysis could reveal possible coinfection. In conclusion, the occurrence of leptospirosis with other diseases should be of concern and may depend on the success of the transmission and severity of individual infections. Medical practitioners may misdiagnose the presence of multiple infections and should be made aware of and receive adequate training on appropriate treatment for leptospirosis patients. Physicians could undertake a more targeted approach for leptospirosis diagnosis by considering other symptoms caused by the coinfected bacteria; thus, more specific treatment could be given.
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Affiliation(s)
- Asmalia Md-Lasim
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
- Herbal Medicine Research Centre (HMRC), Institute for Medical Research (IMR), National Institue of Health (NIH), Ministry of Health, Shah Alam 40170, Selangor, Malaysia
| | - Farah Shafawati Mohd-Taib
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
- Correspondence: ; Tel.: +60-12-3807701
| | - Mardani Abdul-Halim
- Biotechnology Research Institute, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia;
| | - Ahmad Mohiddin Mohd-Ngesom
- Center for Toxicology and Health Risk, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Federal Territory of Kuala Lumpur, Malaysia;
| | - Sheila Nathan
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
| | - Shukor Md-Nor
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, Bangi 43600, Selangor, Malaysia; (A.M.-L.); (S.N.); (S.M.-N.)
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11
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Gutierrez JD. Effects of meteorological factors on human leptospirosis in Colombia. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:257-263. [PMID: 33037904 DOI: 10.1007/s00484-020-02028-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 08/29/2020] [Accepted: 09/27/2020] [Indexed: 06/11/2023]
Abstract
Leptospirosis is a disease usually acquired by humans through water contaminated with the urine of rodents that comes into direct contact with the cutaneous lesions, eyes, or mucous membranes. The disease has an important environmental component associated with climatic conditions and natural disasters, such as floods. We analyzed the relationship between rainfall and temperature and the incidence of leptospirosis in the top 30 municipalities with the highest numbers of cases of the disease in the period of 2007 to 2016. It was an ecological study of the time series of cases of leptospirosis, rainfall, and temperature with lags of 0, 1, 2, 3, and 4 weeks. A multilevel negative binomial regression model was implemented to evaluate the relationship between leptospirosis and both meteorological factors. In the 30 evaluated municipalities during the study period, a total of 5136 cases of leptospirosis were reported. According to the implemented statistical model, there was a positive association between the incidence of leptospirosis and rainfall with a lag of 1 week and a negative association with temperature with a lag of 4 weeks. Our results show the importance of short-term lags in rainfall and temperature for the occurrence of new cases of leptospirosis in Colombia.
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Affiliation(s)
- J D Gutierrez
- Facultad de Ingeniería, Grupo Ambiental de Investigación Aplicada-GAIA, Universidad de Santander, Bucaramanga, Colombia.
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12
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Predicting the Presence of Leptospires in Rodents from Environmental Indicators Opens Up Opportunities for Environmental Monitoring of Human Leptospirosis. REMOTE SENSING 2021. [DOI: 10.3390/rs13020325] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Leptospirosis, an environmental infectious disease of bacterial origin, is the infectious disease with the highest associated mortality in Seychelles. In small island territories, the occurrence of the disease is spatially heterogeneous and a better understanding of the environmental factors that contribute to the presence of the bacteria would help implement targeted control. The present study aimed at identifying the main environmental parameters correlated with animal reservoirs distribution and Leptospira infection in order to delineate habitats with highest prevalence. We used a previously published dataset produced from a large collection of rodents trapped during the dry and wet seasons in most habitats of Mahé, the main island of Seychelles. A land use/land cover analysis was realized in order to describe the various environments using SPOT-5 images by remote sensing (object-based image analysis). At each sampling site, landscape indices were calculated and combined with other geographical parameters together with rainfall records to be used in a multivariate statistical analysis. Several environmental factors were found to be associated with the carriage of leptospires in Rattus rattus and Rattus norvegicus, namely low elevations, fragmented landscapes, the proximity of urbanized areas, an increased distance from forests and, above all, increased precipitation in the three months preceding trapping. The analysis indicated that Leptospira renal carriage could be predicted using the species identification and a description of landscape fragmentation and rainfall, with infection prevalence being positively correlated with these two environmental variables. This model may help decision makers in implementing policies affecting urban landscapes and/or in balancing conservation efforts when designing pest control strategies that should also aim at reducing human contact with Leptospira-laden rats while limiting their impact on the autochthonous fauna.
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Munoz-Zanzi C, Groene E, Morawski BM, Bonner K, Costa F, Bertherat E, Schneider MC. A systematic literature review of leptospirosis outbreaks worldwide, 1970-2012. Rev Panam Salud Publica 2020; 44:e78. [PMID: 32684917 PMCID: PMC7363284 DOI: 10.26633/rpsp.2020.78] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 04/17/2020] [Indexed: 12/13/2022] Open
Abstract
Objective. This review describes the geographic and temporal distribution of, detection methods for, and other epidemiological features of published leptospirosis outbreaks, with the aim of informing efforts to standardize outbreak-reporting practices. Methods. We conducted a systematic review of leptospirosis outbreaks reported in the scientific literature and ProMED during 1970–2012. Predefined criteria were used to identify and classify outbreaks and a standard form was used to extract information. Results. During 1970–2012, we identified 318 outbreaks (average: 7 outbreaks/year; range: 1–19). Most outbreaks were reported in the Latin America and the Caribbean region (36%), followed by Southern Asia (13%), and North America (11%). Most outbreaks were located in tropical and subtropical ecoregions (55%). Quality classification showed that there was clear description of laboratory-confirmed cases in 40% of outbreaks. Among those, the average outbreak size was 82 cases overall (range: 2–2 259) but reached 253 cases in tropical/subtropical ecoregions. Common risk factors included outdoor work activities (25%), exposure to floodwaters (23%), and recreational exposure to water (22%). Epidemiologic investigation was conducted in 80% of outbreaks, mainly as case interviews. Case fatality was 5% overall (range: 0%–60%). Conclusions. Outbreak reporting increased over the study period with outbreaks covering tropical and non-tropical regions. Outbreaks varied by size, setting, and risk factors; however, data reviewed often had limited information regarding diagnosis and epidemiology. Guidelines are recommended to develop standardized procedures for diagnostic and epidemiological investigations during an outbreak and for reporting.
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Affiliation(s)
- Claudia Munoz-Zanzi
- University of Minnesota Minneapolis MN United States of America University of Minnesota, Minneapolis MN, United States of America
| | - Emily Groene
- University of Minnesota Minneapolis MN United States of America University of Minnesota, Minneapolis MN, United States of America
| | - Bozena M Morawski
- University of Minnesota Minneapolis MN United States of America University of Minnesota, Minneapolis MN, United States of America
| | - Kimberly Bonner
- University of Minnesota Minneapolis MN United States of America University of Minnesota, Minneapolis MN, United States of America
| | - Federico Costa
- Universidade Federal da Bahia Salvador BA Brazil Universidade Federal da Bahia, Salvador BA, Brazil
| | - Eric Bertherat
- World Health Organization Geneva Switzerland World Health Organization, Geneva, Switzerland
| | - Maria Cristina Schneider
- Pan American Health Organization Washington DC United States of America Pan American Health Organization, Washington DC, United States of America
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Sanchez Fernandez P, Kodjo A, Medkour H, Laidoudi Y, Dubourg G, Eldin C, Parola P, Davoust B, Lagier JC. Autochthonous human and animal leptospirosis, Marseille, France. IDCases 2020; 21:e00899. [PMID: 32670795 PMCID: PMC7341346 DOI: 10.1016/j.idcr.2020.e00899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/29/2020] [Accepted: 06/29/2020] [Indexed: 01/11/2023] Open
Abstract
Autochtonous leptospirosis is an emerging zoonotic disease in Europe, particularly in France. We report a case of leptospirosis in a 36 year-old man, who is a recently arrived migrant from Tunisia and lives in a squat. He suffered from pulmonary and neurological involvement as well as hepatitis. Seven rats (Rattus norvegicus) were trapped in the squat where the patient lived. Leptospira spp. DNA was detected in the kidney of one rat, highlighting the most likely source of contamination. In addition to the classic recreational or professional exposure to fresh water and practice of outdoor sports as a source of leptospirosis contamination, unhealthy living conditions (homeless or squatting) and therefore frequent exposure to rats, are another risk factor for leptospirosis in Europe.
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Affiliation(s)
| | - Angeli Kodjo
- Leptospirosis Laboratory, VetAgro Sup, Veterinary Campus of Lyon, Marcy l’Etoile, France
| | - Hacène Medkour
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Younes Laidoudi
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Grègory Dubourg
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
- IHU Méditerranée Infection, Marseille, France
| | - Carole Eldin
- IHU Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Philippe Parola
- IHU Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Bernard Davoust
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
- IHU Méditerranée Infection, Marseille, France
- Corresponding author.
| | - Jean-Christophe Lagier
- Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
- IHU Méditerranée Infection, Marseille, France
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15
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Cucchi K, Liu R, Collender PA, Cheng Q, Li C, Hoover CM, Chang HH, Liang S, Yang C, Remais JV. Hydroclimatic drivers of highly seasonal leptospirosis incidence suggest prominent soil reservoir of pathogenic Leptospira spp. in rural western China. PLoS Negl Trop Dis 2019; 13:e0007968. [PMID: 31877134 PMCID: PMC6948824 DOI: 10.1371/journal.pntd.0007968] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 01/08/2020] [Accepted: 12/03/2019] [Indexed: 12/15/2022] Open
Abstract
Climate exerts complex influences on leptospirosis transmission, affecting human behavior, zoonotic host population dynamics, and survival of the pathogen in the environment. Here, we describe the spatiotemporal distribution of leptospirosis incidence reported to China’s National Infectious Disease Surveillance System from 2004–2014 in an endemic region in western China, and employ distributed lag models at annual and sub-annual scales to analyze its association with hydroclimatic risk factors and explore evidence for the potential role of a soil reservoir in the transmission of Leptospira spp. More than 97% of the 2,934 reported leptospirosis cases occurred during the harvest season between August and October, and most commonly affected farmers (83%). Using a distributed lag Poisson regression framework, we characterized incidence rate ratios (IRRs) associated with interquartile range increases in precipitation of 3.45 (95% confidence interval 2.57–4.64) over 0-1-year lags, and 1.90 (1.18–3.06) over 0-15-week lags. Adjusting for soil moisture decreased IRRs for precipitation at both timescales (yearly adjusted IRR: 1.05, 0.74–1.49; weekly adjusted IRR: 1.36, 0.72–2.57), suggesting precipitation effects may be mediated through soil moisture. Increased soil moisture was positively associated with leptospirosis at both timescales, suggesting that the survival of pathogenic Leptospira spp. in moist soils may be a critical control on harvest-associated leptospirosis transmission in the study region. These results support the hypothesis that soils may serve as an environmental reservoir and may play a significant yet underrecognized role in leptospirosis transmission. Leptospirosis is among the leading causes of morbidity from zoonotic infections worldwide, affecting populations that are exposed to contaminated water. The disease is caused by Leptospira spp. bacteria, which are transmitted to humans either through direct contact with infected animals, or indirectly through the environment. Climatic conditions can influence transmission by altering human exposure, animal host population dynamics, and environmental conditions that allow Leptospira spp. to persist in the environment (e.g., moist environments, warm temperatures). Here, we investigated the spatiotemporal distribution of leptospirosis cases in a rural setting in western China and estimated the association between hydroclimatic conditions and leptospirosis incidence. We found that incidence of leptospirosis—especially high amongst farmers—may be associated with rice harvest, and modulated by prior bacterial accumulation within the soil under moist conditions. These results corroborate previous findings that soils may be underrecognized environmental reservoirs of pathogenic Leptospira spp., and that their role in explaining leptospirosis incidence should be considered when developing prevention programs.
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Affiliation(s)
- Karina Cucchi
- University of California, Berkeley, Berkeley, California, United States of America
| | - Runyou Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Philip A. Collender
- University of California, Berkeley, Berkeley, California, United States of America
| | - Qu Cheng
- University of California, Berkeley, Berkeley, California, United States of America
| | - Charles Li
- University of California, Berkeley, Berkeley, California, United States of America
| | | | - Howard H. Chang
- Emory University, Atlanta, Georgia, United States of America
| | - Song Liang
- University of Florida, Gainesville, Florida, United States of America
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Justin V. Remais
- University of California, Berkeley, Berkeley, California, United States of America
- * E-mail:
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16
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Mohammadinia A, Saeidian B, Pradhan B, Ghaemi Z. Prediction mapping of human leptospirosis using ANN, GWR, SVM and GLM approaches. BMC Infect Dis 2019; 19:971. [PMID: 31722676 PMCID: PMC6854714 DOI: 10.1186/s12879-019-4580-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 10/21/2019] [Indexed: 02/07/2023] Open
Abstract
Background Recent reports of the National Ministry of Health and Treatment of Iran (NMHT) show that Gilan has a higher annual incidence rate of leptospirosis than other provinces across the country. Despite several efforts of the government and NMHT to eradicate leptospirosis, it remains a public health problem in this province. Modelling and Prediction of this disease may play an important role in reduction of the prevalence. Methods This study aims to model and predict the spatial distribution of leptospirosis utilizing Geographically Weighted Regression (GWR), Generalized Linear Model (GLM), Support Vector Machine (SVM) and Artificial Neural Network (ANN) as capable approaches. Five environmental parameters of precipitation, temperature, humidity, elevation and vegetation are used for modelling and predicting of the disease. Data of 2009 and 2010 are used for training, and 2011 for testing and evaluating the models. Results Results indicate that utilized approaches in this study can model and predict leptospirosis with high significance level. To evaluate the efficiency of the approaches, MSE (GWR = 0.050, SVM = 0.137, GLM = 0.118 and ANN = 0.137), MAE (0.012, 0.063, 0.052 and 0.063), MRE (0.011, 0.018, 0.017 and 0.018) and R2 (0.85, 0.80, 0.78 and 0.75) are used. Conclusion Results indicate the practical usefulness of approaches for spatial modelling and predicting leptospirosis. The efficiency of models is as follow: GWR > SVM > GLM > ANN. In addition, temperature and humidity are investigated as the most influential parameters. Moreover, the suitable habitat of leptospirosis is mostly within the central rural districts of the province.
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Affiliation(s)
- Ali Mohammadinia
- GIS Division, Faculty of Geodesy and Geomatics, K. N. Toosi University of Technology, Tehran, Iran
| | - Bahram Saeidian
- GIS Division, Faculty of Geodesy and Geomatics, K. N. Toosi University of Technology, Tehran, Iran
| | - Biswajeet Pradhan
- The Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), Faculty of Engineering and IT, University of Technology Sydney, Sydney, NSW, 2007, Australia. .,Department of Energy and Mineral Resources Engineering, Sejong University, Choongmu-gwan, 209 Neungdong-ro, Gwangjin-gu, Seoul, 05006, Republic of Korea.
| | - Zeinab Ghaemi
- GIS Division, Faculty of Geodesy and Geomatics, K. N. Toosi University of Technology, Tehran, Iran
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Ehelepola NDB, Ariyaratne K, Dissanayake WP. The correlation between local weather and leptospirosis incidence in Kandy district, Sri Lanka from 2006 to 2015. Glob Health Action 2019; 12:1553283. [PMID: 31154987 PMCID: PMC6327921 DOI: 10.1080/16549716.2018.1553283] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Leptospirosis is an important public health problem in Sri Lanka. Most people become infected by contact with leptospires in soil and in surface water. Survival of leptospires in the environment depends upon the moisture in soil, humidity, temperature and surface water. Leptospires are spread by flood water and waterways. Therefore, the weather of an area influences the leptospirosis incidence of that area. Objectives: To find out the correlations between the leptospirosis incidence in the district of Kandy, Sri Lanka, and local weather variables and then to explore the utility of the findings. Methods: We gathered data on reported leptospirosis cases in the Kandy district and mid-year population data and calculated weekly incidences for 2006 to 2015. Daily weather data from Katugastota weather station was obtained and converted into weekly data. We plotted time series graphs and observed the correlation between six aggregated weather parameters and leptospirosis incidence. Those weather parameters were rainfall, the count of wet days per week, days with rainfall >100 mm per week, minimum temperature, average temperature and average humidity. Then we looked for correlations between leptospirosis incidence and those weather parameters by performing the wavelet analysis. Results: Our wavelet analysis results show peaks of wet days per week, days with rainfall >100 mm per week, minimum temperature, average temperature and average humidity respectively after 2, 3, 13, 20 and 1 week lags were followed by peaks of leptospirosis incidence. Nadirs (troughs) of rainfall after a week were followed by nadirs of leptospirosis incidence. Conclusions: All weather parameters studied are correlated with local leptospirosis incidence and the climate in Kandy is conducive for leptospirosis transmission. Leptospirosis incidence in the Kandy district is high compared to the national and global incidence. Therefore, leptospirosis preventive work in Kandy deserves more attention, especially during months with favorable weather for leptospirosis transmission. Video abstract Read the transcript Watch the video on Vimeo.
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Affiliation(s)
- N D B Ehelepola
- a Department of Medicine , Teaching (General) Hospital - Kandy , Kandy , Sri Lanka
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18
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Ding G, Li X, Li X, Zhang B, Jiang B, Li D, Xing W, Liu Q, Liu X, Hou H. A time-trend ecological study for identifying flood-sensitive infectious diseases in Guangxi, China from 2005 to 2012. ENVIRONMENTAL RESEARCH 2019; 176:108577. [PMID: 31306984 PMCID: PMC7094502 DOI: 10.1016/j.envres.2019.108577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/15/2019] [Accepted: 07/04/2019] [Indexed: 05/13/2023]
Abstract
BACKGROUND Flood-related damage can be very severe and include health effects. Among those health impacts, infectious diseases still represent a significant public health problem in China. However, there have been few studies on the identification of the spectrum of infectious diseases associated with floods in one area. This study aimed to quantitatively identify sensitive infectious diseases associated with floods in Guangxi, China. METHODS A time-trend ecological design was conducted. A descriptive analysis was first performed to exclude infectious diseases with low incidence from 2005 to 2012 in ten study sites of Guangxi. The Wilcoxon rank-sum test was applied to examine the difference in the ten-day attack rate of infectious diseases between the exposure and control periods with different lagged effects. Negative binomial, zero-inflated Poisson and zero-inflated negative binomial models were used to examine the relationship and odd ratios (ORs) of the risk of floods on infectious diseases of preliminary screening. RESULTS A total of 417,271 infectious diseases were notified. There were 11 infectious diseases associated with floods in the preliminary screening process for flood-sensitive infectious diseases. The strongest effect was shown with a 0-9 ten-day lag in different infectious diseases. Multivariate analysis showed that floods were significantly associated with an increased the risk of bacillary dysentery (odds ratio (OR) = 1.268, 95% confidence interval (CI): 1.072-1.500), acute haemorrhagic conjunctivitis (AHC, OR = 3.230, 95% CI: 1.976-5.280), influenza A (H1N1) (OR = 1.808, 95% CI: 1.721-1.901), tuberculosis (OR = 1.200, 95% CI: 1.036-1.391), influenza (OR = 2.614, 95% CI: 1.476-4.629), Japanese encephalitis (OR = 2.334, 95% CI: 1.119-4.865), and leptospirosis (OR = 1.138, 95% CI: 1.075-1.205), respectively. CONCLUSION The spectrum of infectious diseases which are associated with floods are bacillary dysentery, AHC, influenza A (H1N1), tuberculosis, influenza, Japanese encephalitis and leptospirosis in Guangxi. Floods can result in differently increased risk of these diseases, and public health action should be taken to control a potential risk of these diseases after floods.
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Affiliation(s)
- Guoyong Ding
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian, Shandong Province, PR China
| | - Xiaomei Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian, Shandong Province, PR China
| | - Xuewen Li
- School of Public Health, Shandong University, 250012, Jinan, Shandong Province, PR China
| | - Baofang Zhang
- Jinan Second Maternal and Child Health Hospital, 271199, Jinan, Shandong Province, PR China
| | - Baofa Jiang
- School of Public Health, Shandong University, 250012, Jinan, Shandong Province, PR China
| | - Dong Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian, Shandong Province, PR China
| | - Weijia Xing
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian, Shandong Province, PR China
| | - Qiyong Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, China CDC, 102206, Beijing, PR China
| | - Xuena Liu
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian, Shandong Province, PR China.
| | - Haifeng Hou
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Taian, Shandong Province, PR China.
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Dhewantara PW, Hu W, Zhang W, Yin WW, Ding F, Mamun AA, Soares Magalhães RJ. Climate variability, satellite-derived physical environmental data and human leptospirosis: A retrospective ecological study in China. ENVIRONMENTAL RESEARCH 2019; 176:108523. [PMID: 31203048 DOI: 10.1016/j.envres.2019.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/28/2019] [Accepted: 06/03/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND In the past three decades, the incidence rate of notified leptospirosis cases in China have steeply declined and are now circumscribed to discrete areas in the country. Previous research showed that climate and environmental variation may play an important role in leptospirosis transmission. However, quantitative associations between climate, environmental factors and leptospirosis in the high-risk areas in China, is still poorly understood. OBJECTIVE To quantify the temporal effects of climate and remotely-sensed physical environmental factors on human leptospirosis in the high-risk counties in China. METHODS Time series seasonal decomposition was performed to explore the seasonality pattern of leptospirosis incidence in Mengla County, Yunnan and Yilong County, Sichuan for the period 2006-2016. Time series cross-correlation analysis was carried out to examine lagged effects of rainfall, relative humidity, normalized difference vegetation index (NDVI), modified normalized difference water index (MNDWI) and land surface temperature (LST) on leptospirosis. The associations of climatic and physical environment factors with leptospirosis in each county were assessed by using a generalized linear regression model with negative binomial link, adjusted by seasonal components. RESULTS Leptospirosis incidence in both counties showed strong and unique annual seasonality. Our results show that in Mengla County leptospirosis notifications exhibits a bi-modal temporal pattern while in Yilong County it follows a typical single epidemic curve. After adjusting for seasonality, the final best-fitting model for Mengla County indicated that leptospirosis notifications were significantly associated with present LST values (incidence rate ratio, IRR = 0.857, 95% confidence interval (CI):0.729-0.929) and rainfall at a lag of 6-months (IRR = 0.989; 95% CI: 0.985-0.993). The incidence of leptospirosis in Yilong was associated with rainfall at 1-month lag (IRR = 1.013, 95% CI: 1.003-1.023), LST (3-months lag) (IRR = 1.193, 95% CI: 1.095-1.301), and MNDWI (5-months lag) (IRR = 7.960, 95% CI: 1.241-47.66). CONCLUSIONS Our study identified lagged effects between leptospirosis incidence and climate and remotely-sensed environmental factors in the two most endemic counties in China. Rainfall in combination with satellite derived physical environment factors provided better insight of the local epidemiology as well as good predictors for leptospirosis outbreak in both counties. This would also be an avenue for the development of leptospirosis early warning systems to support leptospirosis control in China.
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Affiliation(s)
- Pandji Wibawa Dhewantara
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia; Pangandaran Unit of Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, West Java, 46396, Indonesia.
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia.
| | - Wenyi Zhang
- Center for Disease Control and Prevention of PLA, Beijing, 100071, People's Republic of China.
| | - Wen-Wu Yin
- Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.
| | - Fan Ding
- Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.
| | - Abdullah Al Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, 4068, Australia.
| | - Ricardo J Soares Magalhães
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, 4343, Australia; Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, 4101, Australia.
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Naing C, Reid SA, Aye SN, Htet NH, Ambu S. Risk factors for human leptospirosis following flooding: A meta-analysis of observational studies. PLoS One 2019; 14:e0217643. [PMID: 31141558 PMCID: PMC6541304 DOI: 10.1371/journal.pone.0217643] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/15/2019] [Indexed: 01/05/2023] Open
Abstract
Leptospirosis is probably the most widespread zoonotic disease in the world especially in tropical countries. There has been an increase in individual studies, which assessed the frequency of leptospirosis in flood conditions. Some studies showed contact with floods was significantly associated with the occurrence of leptospirosis while other studies reported differently. The objective of this meta-analysis was to synthesize the evidence on the risk factors which are associated with human leptospirosis following flooding. We set up the inclusion criteria and searched for the original studies, addressing leptospirosis in human with related to flood in health-related electronic databases including PubMed, Embase, Ovid Medline, google scholar and Scopus sources. We used the terms ‘leptospirosis’, ‘flood’, ‘risk factor’ and terms from the categories were connected with “OR” within each category and by “AND” between categories. The initial search yielded 557 citations. After the title and abstract screening, 49 full-text papers were reviewed and a final of 18 observational studies met the pre-specified inclusion criteria. Overall, the pooled estimates of 14 studies showed that the contact with flooding was a significant factor for the occurrence of leptospirosis (pooled OR: 2.19, 95%CI: 1.48–3.24, I2:86%). On stratification, the strength of association was greater in the case-control studies (pooled OR: 4.01, 95%CI: 1.26–12.72, I2:82%) than other designs (pooled OR:1.77,95%CI:1.18–2.65, I2:87%). Three factors such as ‘being male’(pooled OR:2.06, 95%CI:1.29–2.83), the exposure to livestock animals (pooled OR: 1.95, 95%CI:1.26–2.64), the lacerated wound (pooled OR:4.35, 95%CI:3.07–5.64) were the risk factors significantly associated with the incidence of leptospirosis following flooding in the absence of within-study heterogeneity (I2: 0%). We acknowledge study limitations such as publication bias and type 2 statistical errors. We recommended flood control and other environmental modifications that are expected to reduce the risk of leptospiral infection, and a multi-sectoral effort to this aspect would have long-term benefits.
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Affiliation(s)
- Cho Naing
- International Medical University, Kuala Lumpur, Malaysia
- Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
- * E-mail:
| | - Simon A. Reid
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Saint Nway Aye
- International Medical University, Kuala Lumpur, Malaysia
| | | | - Stephen Ambu
- International Medical University, Kuala Lumpur, Malaysia
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21
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Dhewantara PW, Lau CL, Allan KJ, Hu W, Zhang W, Mamun AA, Soares Magalhães RJ. Spatial epidemiological approaches to inform leptospirosis surveillance and control: A systematic review and critical appraisal of methods. Zoonoses Public Health 2018; 66:185-206. [PMID: 30593736 DOI: 10.1111/zph.12549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/19/2018] [Indexed: 12/17/2022]
Abstract
Leptospirosis is a global zoonotic disease that the transmission is driven by complex geographical and temporal variation in demographics, animal hosts and socioecological factors. This results in complex challenges for the identification of high-risk areas. Spatial and temporal epidemiological tools could be used to support leptospirosis control programs, but the adequacy of its application has not been evaluated. We searched literature in six databases including PubMed, Web of Science, EMBASE, Scopus, SciELO and Zoological Record to systematically review and critically assess the use of spatial and temporal analytical tools for leptospirosis and to provide general framework for its application in future studies. We reviewed 115 articles published between 1930 and October 2018 from 41 different countries. Of these, 65 (56.52%) articles were on human leptospirosis, 39 (33.91%) on animal leptospirosis and 11 (9.5%) used data from both human and animal leptospirosis. Spatial analytical (n = 106) tools were used to describe the distribution of incidence/prevalence at various geographical scales (96.5%) and to explored spatial patterns to detect clustering and hot spots (33%). A total of 51 studies modelled the relationships of various variables on the risk of human (n = 31), animal (n = 17) and both human and animal infection (n = 3). Among those modelling studies, few studies had generated spatially structured models and predictive maps of human (n = 2/31) and animal leptospirosis (n = 1/17). In addition, nine studies applied time-series analytical tools to predict leptospirosis incidence. Spatial and temporal analytical tools have been greatly utilized to improve our understanding on leptospirosis epidemiology. Yet the quality of the epidemiological data, the selection of covariates and spatial analytical techniques should be carefully considered in future studies to improve usefulness of evidence as tools to support leptospirosis control. A general framework for the application of spatial analytical tools for leptospirosis was proposed.
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Affiliation(s)
- Pandji W Dhewantara
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.,Pangandaran Unit for Health Research and Development, National Health Research and Development, Ministry of Health of Indonesia, Pangandaran, West Java, Indonesia
| | - Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn J Allan
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Wenyi Zhang
- Center for Disease Surveillance and Research, Institute of Disease Control and Prevention of PLA, Beijing, China
| | - Abdullah A Mamun
- Faculty of Humanities and Social Sciences, Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Ricardo J Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.,Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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