부산대학교 도서관

Background: Leptospirosis is an occupational, neglected febrile disease of bacterial origin transmitted between humans and animals. In this manuscript we summarize available data on Leptospira infection in HIV uninfected and in people living with HIV from the Southern African Development Community (SADC) countries, identifying gaps in knowledge and recommend future research priorities. Methodology: Articles published between 1990 and 2021 were accessed by an online search of Google Scholar and Medline/PubMed performed between February 2020 and July 2022. The STATA program was used for the Meta-analysis. Pooled prevalence values with 95% confidence intervals and heterogeneity were determined. Results: Thirty studies from eight SADC countries, reporting the prevalence on Leptospira were reviewed. A pooled prevalence of 19% (CI: 13–25%), a heterogeneity level of 96% and index score ranging from 2 to 9 was determined. Only four (4) studies reported HIV co-infection status. Three species of Leptospira (Leptospira interrogans (4), L. kirschneri (3), Leptospira borgpetersenii (1) and 23 serogroups were identified. The most frequently reported serogroups were Icterohaemorrhagiae (13), Grippotyphosa and Australis (10) followed by Sejroe (8). Conclusion: Studies on human leptospirosis in the SADC region are scarce, especially in people living with HIV. Additional studies aimed at determining the prevalence and the role of the pathogen in people living with HIV, including detailed clinical, molecular and demographic data are recommended. Author summary: The SADC region is severely affected by infections such as HIV, tuberculosis and malaria, which divert attention from several other diseases with major public health impacts. These critically neglected tropical diseases, include leptospirosis, cysticercosis, onchocerciasis, lymphatic filariasis, intestinal parasites and schistosomiasis among others. Leptospirosis is often misdiagnosed as one of several other febrile diseases including malaria, brucellosis and rickettsiosis because of similarities in symptoms. It is also likely underdiagnosed because of the complexity of laboratory diagnostic methodologies. Our review found that there is a scarcity of studies on leptospirosis, and lack of standardization tools for data collection, especially in the framework of leptospirosis in people living with HIV. In this review we summarize the pooled prevalence of leptospirosis in the SADC countries and the reported circulating serovars and species of Leptospira and uncover gaps in knowledge about the epidemiology of the pathogen. Misconceptions about the prevalence of leptospirosis among the scientific community, health care providers and policy makers coupled with complexity of clinical and laboratory diagnosis have resulted in a systematic underestimation of the public health impact of this important neglected pathogen. [ABSTRACT FROM AUTHOR]