2 research outputs found
Animal Reservoirs for Leptospira spp. in South-East Asia: A Meta-Analysis
No full textBackground and Aim: Leptospirosis is a zoonotic disease responsible for high morbidity worldwide. This review is intended to identify other possible animal reservoirs of Leptospira spp. within human surroundings, which may improve the prevention and control of the disease. Methods: A systematic search was performed for the relevant titles, abstracts and keywords in PubMed, Scopus and Google Scholar in March 2018 based on the PICO strategy; which returned 1226 studies. Screening of abstracts had shortlisted 71 studies and data extraction was conducted for 15 studies which had been accepted after review of the full text. Only studies done in South-East Asia were considered. Meta-analysis of the accepted studies was done to compute the composite prevalence of each animal group using random effects model. Results: The articles were analysed from the viewpoint of the study settings and the prevalence of Leptospira spp. in types of animal with the animals being grouped into five major groups, based on taxonomy and likelihood of human contact. It was found that all animal groups have statistically significant value of pooled prevalence, with a range between 8.17% (95% CI: 4.80% - 12.39%) for sheep and goats, to as high as 27.28% (95% CI: 1.24% - 69.69%) for carnivores. The prevalence for other animal groups are 17.95% (95% CI: 7.77% - 31.18%) for rodents, 19.24% (95% CI: 10.65% - 29.65%) for pigs, and 24.90% (95% CI: 15.45% - 35.71%) for ruminants. Conclusion: Meta-analysis showed that other groups of animals, particularly carnivores, pigs, and large ruminants are just as culpable as rodents in being the reservoir for Leptospira spp. These other groups of animals may also play a vital role in the transmission and overall dynamics of human leptospirosis
Effectiveness of Antibiotic Prophylaxis for Leptospirosis among Adults: A Systematic Review
No full textLeptospirosis is one of the most widespread re-emerging zoonoses in the world. Malaysia is known to be an endemic country for human leptospirosis, with a case fatality rate of 2.11%, and an average annual incidence rate of 7.80 cases per 100,000 individuals. This systematic review is conducted to determine the effectiveness of antibiotic prophylaxis for leptospirosis among the adult populations who are highly at risk of getting infected. A systematic search was performed for the relevant titles, abstracts and keywords on PubMed, Scopus, Cochrane and Google Scholar from inception to November 2017 based on the PICO strategy; which returned 126 studies. Screening of abstracts had shortlisted 19 studies and data extraction was conducted for 8 studies which had been accepted after review of the full text. For the evaluation of antibiotics prophylaxis effectiveness against leptospirosis, only trials and cohort studies with risk ratio (RR) were selected. The articles were analyzed from the viewpoint of the dosage, adverse effects, study settings and effectiveness of the antibiotic prophylaxis. Using fixed effects model, pooled RR showed protective association between antibiotic prophylaxis use against the incidence of leptospirosis (RR = 0.31; 95% CI: 0.20, 0.48). Antibiotic prophylaxis for leptospirosis had been shown to be effective in preventing the incidence of the disease among high-risk populations and carries minimal adverse effects. It is recommended that the practice of antibiotic prophylaxis for leptospirosis is included in the standard protocol for leptospirosis prevention among people at high-risk, including disaster response teams and patrons of eco-sports tourism activities; with the drug of choice being doxycycline, either as a single 200 mg dose or weekly dose of 200 mg for the duration of exposure, based on the setting, duration of event and resources available
