Leptospirosis in Ecuador: Current Status and Future Prospects

Area of Science:

• * Tropical Medicine
• * Infectious Diseases
• * Veterinary Epidemiology

Background:

• * Ecuador's equatorial location facilitates *Leptospira* multiplication and dispersal.
• * Leptospirosis is a significant public health concern in Ecuador, yet its epidemiology is not fully understood.
• * Studies predominantly focus on the Pacific Coast, with limited data from other regions.

Purpose of the Study:

• * To update knowledge on the epidemiology and geographical distribution of *Leptospira* species and leptospirosis in Ecuador.
• * To identify gaps in research and inform the development of a national control strategy.
• * To synthesize existing data on human, animal, and environmental *Leptospira* infections.

Main Methods:

• * Retrospective literature search of 5 databases (1919-2022).
• * Analysis of 47 publications covering human, animal, and environmental *Leptospira* and leptospirosis.
• * Inclusion of studies from all Ecuadorian ecoregions, with no language or publication date restrictions.

Main Results:

• * Leptospirosis is endemic with active transmission in all four geoclimatic regions, including the Galápagos Islands.
• * *Leptospira* (pathogenic, intermediate, saprophytic) identified in humans, animals, and environments; 9 species and 29 serovars recorded.
• * Animal infections pose a significant risk to humans; males are more commonly affected. No human cases reported in Galápagos.

Conclusions:

• * Leptospirosis remains a prevalent endemic disease in Ecuador, necessitating comprehensive control strategies.
• * Animal infections are a critical reservoir and transmission source for human leptospirosis.
• * Further nationwide epidemiological surveys, research on risk factors, genotyping, and enhanced laboratory capacity are crucial for effective intervention using One Health approaches.