Leptospiral infection in domestic cats: Systematic review with meta-analysis

The role of domestic cats in the transmission of Leptospira is controversial, being considered either as a protective factor or a potential source of infection for humans. The aims of this study were to obtain an integrated estimate of the prevalence of leptospiral infection in domestic cats, and to characterize those individuals most susceptible to infection. For this systematic review and meta-analysis, five electronic databases, as well as the reference lists of eligible reports were screened for observational studies published during 1979-2022. The overall prevalence of leptospiral antibodies and of pathogenic Leptospira in kidney/urine was estimated using three-level meta-analysis models. To investigate potential sources of heterogeneity, moderator analyses was performed using the sampling year, health status, living environment, and origin of the cats. The odds-ratio (OR) of potential risk factors was estimated using random-effects meta-analysis models for binary outcomes. The literature search identified 61 eligible publications, containing 114 effect estimates. The overall seroprevalence was 11.7 % (95 % CI: 9.3-14.6 %), the prevalence of leptospires in urine was 3.7 % (95 % CI: 1.7-8.1 %), and the prevalence of leptospires in kidney tissue was 12.8 % (95 % CI: 3.2-39.9 %). There were no significant differences in the estimated prevalence after removing articles with medium risk of bias. Seroprevalence was higher in Europe when compared to Latin America and the Caribbean (P = 0.047) and showed a mild decrease over time (P = 0.023). Outdoor cats had almost three times greater probabilities of infection with Leptospira (OR: 2.74, 95 % CI: 1.10-6.84). No other significant effect was detected among the tested moderators or potential risk factors (P > 0.05). Results suggest that feline leptospirosis should receive particular attention in veterinary care, as exposure to leptospires can occur in approximately 1 in every 10 cats, and more frequently in cats with street access. Domestic cats should be considered as potential Leptospira carriers when designing public health strategies for the control and prevention of leptospirosis. Further investigation is required to improve knowledge of the role of these animals in the environmental transmission cycle.