Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/11922
Title: Global morbidity and mortality of leptospirosis: a systematic review
Authors: Costa, Federico
Hagan, José E
Calcagno, Juan
Kane, Michael
Torgerson, Paul
Martinez-Silveira, Martha Silvia
Stein, Claudia
Abela-Ridder, Bernadette
Ko, Albert Icksang
Affilliation: Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, Bahia, Brasil. Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, Bahia, Brasil. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, Estados Unidos.
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, Bahia, Brasil. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, Estados Unidos.
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, Bahia, Brasil.
Yale School of Public Health. Center for Analytical Sciences. New Haven, Connecticut, Estados Unidos
University of Zürich. Vetsuisse Faculty. Section of Epidemiology. Zurich, Suiça
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, Bahia, Brasil.
World Health Organization, Regional Office for Europe. Division of Information, Evidence, Research and Innovation. Copenhagen, Dinamarca
World Health Organization. Department for the Control of Neglected Tropical Diseases. Geneve. Suiza
Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, Bahia, Brasil. Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, Connecticut, Estados Unidos.
Abstract: Background Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrome, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status. Methodology/Principal Findings We conducted a systematic review of published morbidity and mortality studies and databases to extract information on disease incidence and case fatality ratios. Linear regression and Monte Carlo modelling were used to obtain age and gender-adjusted estimates of disease morbidity for countries and Global Burden of Disease (GBD) and WHO regions. We estimated mortality using models that incorporated age and gender-adjusted disease morbidity and case fatality ratios. The review identified 80 studies on disease incidence from 34 countries that met quality criteria. In certain regions, such as Africa, few quality assured studies were identified. The regression model, which incorporated country-specific variables of population structure, life expectancy at birth, distance from the equator, tropical island, and urbanization, accounted for a significant proportion (R2 = 0.60) of the variation in observed disease incidence. We estimate that there were annually 1.03 million cases (95% CI 434,000–1,750,000) and 58,900 deaths (95% CI 23,800–95,900) due to leptospirosis worldwide. A large proportion of cases (48%, 95% CI 40–61%) and deaths (42%, 95% CI 34–53%) were estimated to occur in adult males with age of 20–49 years. Highest estimates of disease morbidity and mortality were observed in GBD regions of South and Southeast Asia, Oceania, Caribbean, Andean, Central, and Tropical Latin America, and East Sub-Saharan Africa. Conclusions/Significance Leptospirosis is among the leading zoonotic causes of morbidity worldwide and accounts for numbers of deaths, which approach or exceed those for other causes of haemorrhagic fever. Highest morbidity and mortality were estimated to occur in resource-poor countries, which include regions where the burden of leptospirosis has been underappreciated
Keywords: Leptospirosis
Morbidity
Mortality
Epidemiology
keywords: Leptospirose
Mortalidade
Morbidade
Epidemiologia
DeCS: Leptospirose
Vigilância da População
Issue Date: 2015
Publisher: Public Library of Science
Citation: COSTA, F. et al. Global morbidity and mortality of leptospirosis: a systematic review. PLoS Neglected Tropical Diseases, v. 9, n. 9, p. 1-19, 2015.
DOI: 10.1371/journal.pntd.0003898
ISSN: 1935-2735
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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