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Regional Prevalence of Intermediate Leptospira spp. in Humans: A Meta-Analysis
Aina Nadheera Abd Rahman1, Nurul Husna Hasnul Hadi1, Zhong Sun1
1Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia.
Abstract:
Leptospirosis is one of the most widespread bacterial diseases caused by pathogenic Leptospira. There are broad clinical manifestations due to varied pathogenicity of Leptospira spp., which can be classified into three clusters such as pathogenic, intermediate, and saprophytic. Intermediate Leptospira spp. can either be pathogenic or non-pathogenic and they have been reported to cause mild to severe forms of leptospirosis in several studies, contributing to the disease burden. Hence, this study aimed to estimate the global prevalence of intermediate Leptospira spp. in humans using meta-analysis with region-wise stratification. The articles were searched from three databases which include PubMed, Scopus, and ScienceDirect. Seven studies were included consisting of two regions based on United Nations geo-scheme regions, among 469 records identified. Statistical analysis was performed using RevMan software. The overall prevalence estimate of intermediate Leptospira spp. in humans was 86% and the pooled prevalences were 96% and 17% for the American and Asia regions, respectively. The data also revealed that Leptospira wolffii was the most predominantly found compared to the other intermediate species identified from the included studies, which were Leptospira inadai and Leptospira broomii. The estimated prevalence data from this study could be used to develop better control and intervention strategies in combating human leptospirosis.
Insights
Intermediate Leptospira species, a significant cause of leptospirosis, show a global human prevalence of 86%. This meta-analysis highlights regional variations, with 96% in the Americas and 17% in Asia, informing control strategies.
Area of Science:
- Bacteriology
- Epidemiology
- Public Health
Background:
- Leptospirosis, a widespread bacterial disease caused by pathogenic Leptospira, presents diverse clinical manifestations.
- Leptospira species are categorized into pathogenic, intermediate, and saprophytic clusters.
- Intermediate Leptospira spp. can cause mild to severe leptospirosis, contributing to the global disease burden.
Purpose of the Study:
- To estimate the global human prevalence of intermediate Leptospira species.
- To stratify prevalence data by geographic region.
- To identify predominant intermediate Leptospira species in human infections.
Main Methods:
- A systematic literature search was conducted across PubMed, Scopus, and ScienceDirect databases.
- A meta-analysis was performed on seven selected studies, encompassing two UN geo-scheme regions.
- Statistical analysis was executed using RevMan software.
Main Results:
- The overall estimated prevalence of intermediate Leptospira spp. in humans was 86%.
- Pooled prevalence estimates were 96% for the American region and 17% for the Asian region.
- Leptospira wolffii was the most frequently identified intermediate species, followed by Leptospira inadai and Leptospira broomii.
Conclusions:
- Intermediate Leptospira species exhibit a high global prevalence in humans.
- Significant regional disparities in prevalence exist, particularly between the Americas and Asia.
- Findings provide crucial data for developing targeted control and intervention strategies against human leptospirosis.
