A systematic review and meta-analysis of the epidemiology of Leptospirosis in HIV uninfected and in people living with HIV from the Southern African Development Community.
A systematic review and meta-analysis of the epidemiology of Leptospirosis in HIV uninfected and in people living with HIV from the Southern African Development Community.
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DOI：
10.1371/journal.pntd.0010823
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发表时间：
2022-12
影响因子：
3.8
通讯作者：
中科院分区：
文献类型：
--
作者：
钩端螺旋体病是一种被忽视的职业性发热性疾病，由细菌引起，在人与动物之间传播。在这篇手稿中，我们总结了南部非洲发展共同体（SADC）国家未感染艾滋病毒和艾滋病毒感染者中钩端螺旋体感染的现有数据，找出了知识差距并建议了未来的研究重点。通过 2020 年 2 月至 2022 年 7 月期间进行的 Google Scholar 和 Medline/PubMed 在线搜索访问了 1990 年至 2021 年期间发表的文章。Meta 分析使用了 STATA 程序。确定了具有 95% 置信区间和异质性的汇总患病率值。对来自 8 个南部非洲发展共同体国家的 30 项报告钩端螺旋体流行情况的研究进行了审查。确定合并患病率为 19%（CI：13-25%），异质性水平为 96%，指数评分范围为 2 至 9。只有四 (4) 项研究报告了 HIV 合并感染状况。鉴定出三种钩端螺旋体（问号钩端螺旋体 (4)、克氏钩端螺旋体 (3)、博格彼得森尼钩端螺旋体 (1) 和 23 个血清群。最常报告的血清群是黄疸出血菌 (13)、Grippotyphosa 和 Australis (10)，其次是 Sejroe (8)。南部非洲发展共同体 地区稀缺，尤其是艾滋病毒感染者。建议开展其他旨在确定艾滋病毒感染者中病原体的流行率和作用的研究，包括详细的临床、分子和人口统计数据。南部非洲发展共同体地区受到艾滋病毒、结核病和疟疾等感染的严重影响，这些疾病转移了人们对其他几种对公共卫生产生重大影响的疾病的注意力。这些被严重忽视的热带疾病包括 钩端螺旋体病、囊尾蚴病、盘尾丝虫病、淋巴丝虫病、肠道寄生虫病和血吸虫病等。由于症状相似，钩端螺旋体病经常被误诊为其他几种发热性疾病之一，包括疟疾、布鲁氏菌病和立克次体病。由于实验室诊断方法的复杂性，也可能导致诊断不足。我们的审查发现 缺乏关于钩端螺旋体病的研究，并且缺乏数据收集的标准化工具，特别是在艾滋病毒感染者的钩端螺旋体病框架内。在这篇综述中，我们总结了南部非洲发展共同体国家钩端螺旋体病的流行情况以及报告的钩端螺旋体流行血清型和种类，并揭示了有关病原体流行病学的知识差距。对流行病的误解 科学界、卫生保健提供者和政策制定者对钩端螺旋体病的认识，加上临床和实验室诊断的复杂性，导致系统性地低估了这种被忽视的重要病原体对公共卫生的影响。
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. 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. 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). 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. 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.
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使用基于医院的监测和坦桑尼亚的基于人群的医疗保健利用调查来估计钩端螺旋体病的发病率。
影响因子：
3.8
作者：
Biggs HM;Hertz JT;Munishi OM;Galloway RL;Marks F;Saganda W;Maro VP;Crump JA
通讯作者：
Crump JA
DOI：
10.4269/ajtmh.1999.61.731
发表时间：
1999-11-01
影响因子：
3.3
作者：
Cumberland, P;Everard, COR;Levett, PN
通讯作者：
Levett, PN
影响因子：
1
作者：
Chilongola JO;Sabuni EJ;Kapyolo EP
通讯作者：
Kapyolo EP
影响因子：
3.8
作者：
Allan KJ;Halliday JEB;Moseley M;Carter RW;Ahmed A;Goris MGA;Hartskeerl RA;Keyyu J;Kibona T;Maro VP;Maze MJ;Mmbaga BT;Tarimo R;Crump JA;Cleaveland S
通讯作者：
Cleaveland S
DOI：
10.1099/00207713-48-1-207
发表时间：
1998-01-01
期刊：
INTERNATIONAL JOURNAL OF SYSTEMATIC BACTERIOLOGY
影响因子：
--
作者：
Feresu, SB;Bolin, CA;Korver, H
通讯作者：
Korver, H