Leptospirosis in Ruminants in Yogyakarta, Indonesia: A Serological Survey with Mixed Methods to Identify Risk Factors

One Health approach and zoonotic diseases in Indonesia: Urgency of implementation and challenges

The urgency of implementing the One Health approach to overcome zoonotic diseases cannot be overstated. By recognizing the interconnectedness of human health, animal health, and the environment, we can effectively prevent and respond to emerging infectious disease threats. This review article provides information on the importance of generating research on zoonotic diseases, especially in Indonesia, where research is still relatively scarce. The Indonesian government has taken steps to implement the One Health by establishing the One Health Coordinating Unit and the National Zoonosis Committee; however, implementation has not been optimal. The urgency and challenges are focused on critical implementation aspects in the community. The urgency of implementing One Health includes that Indonesia has experienced several outbreaks of zoonotic diseases; high environmental degradation; and the antimicrobial resistance issue in Indonesia has increased. The challenges faced in implementing One Health are overcoming fragmentation due to incohesive communication between important sectors, securing funding and resource investment, aligning policies to eliminate regulation barriers, capacity building to increase awareness and professionals, and addressing critical socioeconomic factors. By prioritizing implementing the One Health approach and addressing existing challenges, Indonesia can build a more resilient and integrated system to protect the well-being of all species, protect ecosystems, and prevent the devastating effects of zoonotic diseases on global health. In this review, we present the urgency of One Health implementation and its challenges comprehensively.

An investigation of geographical clusters of leptospirosis during the outbreak in Pangandaran, West Java, Indonesia

Leptospirosis is neglected in many tropical developing countries, including Indonesia. Our research on this zoonotic disease aimed to investigate epidemiological features and spatial clustering of recent leptospirosis outbreaks in Pangandaran, West Java. The study analysed data on leptospirosis notifications between September 2022 and May 2023. Global Moran I and local indicator for spatial association (LISA) were applied. Comparative analysis was performed to characterise the identified hotspots of leptospirosis relative to its neighbourhoods. A total of 172 reported leptospirosis in 40 villages from 9 sub-districts in Pangandaran District were analysed. Of these, 132 cases (76.7%) were male. The median age was 49 years (interquartile range [IQR]: 34-59 years). Severe outcomes including renal failure, lung failure, and hepatic necrosis were reported in up to 5% of the cases. A total of 30 patients died, resulting in the case fatality rate (CFR) of 17.4%. Moran's I analysis showed significant spatial autocorrelation (I=0.293; p=0.002) and LISA results identified 7 High-High clusters (hotspots) in the Southwest, with the total population at risk at 26,184 people. The hotspots had more cases among older individuals (median age: 51, IQR: 36-61 years; p<0.001), more farmers (79%, p=0.001) and more evidence of the presence of rats (p=0.02). A comprehensive One Health intervention should be targeted towards these high-risk areas to control the transmission of leptospirosis. More empirical evidence is needed to understand the role of climate, animals and sociodemographic characteristics on the transmission of leptospirosis in the area studied.

The Effect of Temperature on the Distribution of Zoonotic Pathogens in Livestock and Wildlife Populations: A Systematic Review

Background

Evidence for the impact of climate change on the distribution of zoonoses has largely focussed on the burden in humans and is lacking information on the effect of temperature on nonvectorborne zoonoses that are transmitted indirectly through contaminated environments. We present a systematic literature review on the impact of temperature on the distribution of zoonotic pathogens in mammalian livestock and wildlife populations, with a focus on nonvectorborne zoonoses that can be spread through air, water, food, and soil.

Methods

We systematically searched PubMed, Scopus, and Web of Science, as well as grey literature, and screened titles, abstracts, and full text. English, peer-reviewed, and full text studies were included if they: focused on temperature; considered incursion, distributional burden or risk; and focused on a zoonotic pathogen in livestock and/or wildlife populations of mammalian vertebrates that can be transmitted through indirect pathways without a nonmammalian and nonvertebrate intermediate host.

Results

Temperature was an important determinant of zoonoses distribution across all 17 studies included in the final review, with 11 studies finding a positive association. The majority of studies focused on parasites (7) and bacteria (9) and were conducted in the northern hemisphere. Two studies provided future climate projections that identified areas of increasing prevalence and expanded risk for pathogens that were already established. However, no studies specifically investigated the risk of zoonotic incursion with increasing temperature. Few studies explored how local variations in temperature and urbanisation interact with distal changes like Arctic warming to affect the distribution and spread of nonvectorborne pathogens through food, water, and soil.

Conclusions

The review's findings point to the value of a One Health approach to biosecurity that builds on the interconnected relationship between human, animal, plant, and environmental health. Such research is urgently needed to inform the prioritisation and risk assessment of zoonoses more comprehensively in a rapidly changing climate.

A case-control study of agricultural and behavioral factors associated with leptospirosis in Vietnam

Introduction

Leptospirosis is a neglected disease in Vietnam. Until now, there has been limited knowledge about risk factors of this disease in Vietnam. The study was carried out to identify agricultural and behavioral factors associated with the transmission of leptospirosis in Vietnam.

Methods

This matched retrospective hospital-community-based case–control study was conducted from 1 October 2018 to 31 October 2019. We recruited cases from 11 selected government hospitals in three provinces of Vietnam, while controls were selected from the same communes of cases and matched by age (± 2 years) and sex. Microscopic agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA) were applied to determine confirmed cases, while only MAT was used to identify controls with a single high MAT titer < 1:100.

Results

504 participants (252 cases and 252 controls) were identified. Cultivating (OR 2.83, CI 1.38–5.79), animal farming (OR 8.26, CI 2.24–30.52), pig owners (OR 10.48, CI 5.05–21.73), cat owners (OR 2.62, CI 1.49–4.61) and drinking unboiled water (OR 1.72, CI 1.14 –2.59, p = 0.010) were significantly associated with human leptospirosis in Vietnam. Hand washing after farming/ gardening (OR 0.57, CI 0.38–0.86, p = 0.007) and bathing after farming, gardening, contact with cattle and poultry (OR 0.33, CI 0.19–0.58, p = 0.000) were determined as protective factors for this disease.

Conclusions

In short, the case–control study has revealed the risks in agricultural and animal practices and protective behavioral factors related to human leptospirosis in Vietnam. The findings suggested promotion of communication and health education programs targeting health behaviors in daily life and agricultural practices. Using personal protective equipment such as gowns, gloves, and boots during agricultural practices, especially cultivating and animal farming, is most recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07561-6.

Leptospirosis in rats and livestock in Bantul and Gunungkidul district, Yogyakarta, Indonesia

Background and Aim:

The animal reservoir of leptospirosis is comprised of both domestic and wild mammals, with rats known as the most important in the spread of the disease. The occurrence of this reservoir in residential areas increases the potential for leptospirosis transmission. This study aimed to investigate the type of reservoirs and estimate the prevalence of leptospirosis in rats and livestock animals in Bantul and Gunungkidul districts, Special Region of Yogyakarta Province, Indonesia.

Materials and Methods:

This research utilized a cross-sectional study design. Rat trapping and livestock (cattle, goat, and sheep) blood surveys were conducted at four locations in each district. Samples of rat renal and livestock blood serum were examined using the polymerase chain reaction technique to determine the presence of Leptospira bacteria. The data were analyzed descriptively by describing the species of rats trapped, the types of cattle, and the prevalence of Leptospira in the sample.

Results:

The rat species infected with Leptospira in Bantul district consisted of Rattus tanezumi 4.8% (3/63); Rattus norvegicus 12.5% (2/16); Bandicota indica 28.6% (2/7); and Bandicota bengalensis 50.0% (1/2). No rats were found to be positive for Leptospira in Gunungkidul district. The prevalence of Leptospira in cattle was 63.64% (7/11) in Bantul district and 50.00% (8/16) in Gunungkidul district. In goats and sheep, the prevalence of Leptospira was 22.22% (2/9) in Bantul district and 45.16% (14/31) in Gunungkidul district.

Conclusion:

The potential exists for transmission of leptospirosis from rats and cattle in Bantul and Gunungkidul Districts. It is necessary to increase leptospirosis awareness. Community education, especially for livestock farmers, needs to be improved to prevent the transmission of leptospirosis from livestock.

Going Micro in Leptospirosis Kidney Disease

Leptospirosis is a zoonotic and waterborne disease worldwide. It is a neglected infectious disease caused by Leptospira spp., as well as a reemerging disease and global public health problem with respect to morbidity and mortality both in humans and animals. Leptospirosis emerges as a leading cause of acute febrile illness along with hepatorenal injury in many countries, including Thailand. While most affected persons are symptomatic in acute disease, which is always difficult to differentiate from other tropical diseases, there is growing evidence of subtle manifestations that cause unrecognized chronic symptoms. The kidney is one of the common organs affected by Leptospires. Although acute kidney injury in the spectrum of interstitial nephritis is a well-described characteristic in severe leptospirosis, chronic kidney disease from leptospirosis is widely discussed. Early recognition of severe leptospirosis leads to reduce morbidity and mortality. Thus, in this review, we highlight the spectrum of characteristics involved in leptospirosis kidney disease and the use of serologic and molecular methods, as well as the treatments of severe leptospirosis.