Existence of Similar Leptospira Serovars among Dog Keepers and Their Respective Dogs in Mwanza, Tanzania, the Need for a One Health Approach to Control Measures

One Health Field Approach Applied to Leptospirosis: A Systematic Review and Meta-Analysis Across Humans, Animals and the Environment

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Serological Survey of Leptospira spp. in Livestock and Rodents from Different Settlements in the Kilombero Wetland, Tanzania

BACKGROUND

The circulation of Leptospira has been linked to various occupational activities globally. This study investigated the seroprevalence of Leptospira spp. in rodents and livestock (cattle and goats) in three settlements/villages involved in agriculture, livestock keeping, and mixed agriculture and livestock in the Kilombero district, Tanzania.

METHODS

Data were collected during the wet and dry seasons. A total of 179 rodents were live-captured from selected habitats. Livestock samples were collected from 80 cattle in a livestock settlement and 120 goats from both livestock and mixed agricultural-livestock settlements. The microscopic agglutination test was utilized to identify Leptospira serovars.

RESULTS

The seroprevalence of Leptospira spp. was 17.3% in rodents (21.7% in Mastomys natalensis and 3.9% in Rattus rattus) and 8.3% in livestock (13.5% in cattle and 12.6% in goats). The prevalence among rodents and livestock differed between settlements (p = 0.01). A higher prevalence was observed among rodents in the agricultural settlement relative to the other settlements. A higher prevalence of antibodies in livestock was observed in the livestock settlement compared with the mixed agricultural-livestock settlement. The Leptospira serovars Sokoine (serogroup Icterohaemorrhagiae) and Hebdomadis (serogroup Hebdomadis) were detected in both rodents and livestock. The serovars Hardjo (serogroup Sejroe) and Gripothyphosa (serogroup Gripothyphosa) were found exclusively in cattle, whereas the serovars Pomona (serogroup Pomona) and Lora (serogroup Australis) were identified in rodents. Leptospira antibodies were found to be elevated during the rainy season compared with the dry season (p = 0.05) in all settlements, with the exception of rodents in the mixed agricultural-livestock settlement.

CONCLUSIONS

This study demonstrates the presence of anti-Leptospira antibodies in rodents and livestock related to occupational activities in human settlements. It further demonstrates that wild animals (rodents) and livestock are reservoirs of Leptospira and are important in the epidemiology of leptospirosis. Management and control strategies should target both rodents and livestock.

Landscape, Socioeconomic, and Meteorological Risk Factors for Canine Leptospirosis in Urban Sydney (2017-2023): A Spatial and Temporal Study

Leptospirosis is a potentially fatal zoonotic disease caused by infection with pathogenic Leptospira spp. We described reported clinical cases of canine leptospirosis in the council areas of the Inner West and the City of Sydney, Australia, from December 2017 to January 2023 and tested the association with urban spatial (landscape and socioeconomic factors, community seroprevalence, and urban heat island effect) and temporal (precipitation and minimum and maximum temperature) factors and the cases using log-transformed Poisson models, spatially stratified population-adjusted conditional logistic models, General Additive Models (GAMs), and Autoregressive Integrated Moving Average (ARIMA) models. The results suggested that canine leptospirosis is now endemic in the study area. A longer distance to the nearest veterinary hospital (RR 0.118, 95% CI -4.205--0.065, p < 0.05) and a mildly compromised Index of Economic Resources (IER) (RR 0.202, 95% CI -3.124--0.079, p < 0.05) were significant protective factors against leptospirosis. In areas proximal to the clinical cases and seropositive samples, the presence of tree cover was a strong risk factor for higher odds of canine leptospirosis (OR 5.80, 95% CI 1.12-30.11, p < 0.05). As the first study exploring risk factors associated with canine leptospirosis in urban Sydney, our findings indicate a potential transmission from urban green spaces and the possibility of higher exposure to Leptospira-or increased case detection and reporting-in areas adjacent to veterinary hospitals.

Leptospirosis in humans and selected animals in Sub-Saharan Africa, 2014-2022: a systematic review and meta-analysis

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.

Seropositivity of Leptospira spp. Antibodies among Febrile Patients Attending Outpatient Clinics in Mwanza, Tanzania: Should It Be Included in Routine Diagnosis?

Leptospirosis is a zoonotic neglected tropical disease with a worldwide distribution caused by the pathogenic spirochetes of the genus Leptospira. Despite being a widespread disease in tropical regions, it has never been considered in the routine diagnostic panel for febrile patients. This study determined seropositivity and factors associated with Leptospira antibodies among febrile adult patients in Mwanza, Tanzania. The cross-sectional study involving 296 febrile patients attending different outpatient clinics in Mwanza region was conducted between May and July 2019. Detection of Leptospira serovars antibodies was done using a microscopic agglutination test (MAT). Descriptive analysis was done using STATA version 13. The median age of the febrile patients was 32 (IQR: 24–45 years). Out of 296 patients, 36 (12.16%, 95%CI: 8–15) were seropositive for Leptospira antibodies. Common circulating serovars were Sokoine 28 (9.45%), followed by Lora 12 (4.05%) and Grippotyphosa 2 (0.67%). In the multivariable logistic regression analysis, the odds of being Leptospira seropositive were significantly higher with increased age (aOR: 1.03, 95%CI 1.00–1.07, p = 0.03). About one tenth of febrile patients in Mwanza were seropositive for Leptospira antibodies and this was significantly associated with age. With the decline of malaria fever in endemic areas, other causes of febrile illness like Leptospiral spp. should be considered in the routine diagnostic panel for febrile patients.