Leptospirosis Incidence at Four Sites in Sub-Saharan Africa and South East Asia: An International Multi-Site Hybrid Surveillance Study

Crump, JA; Picardeau, M; Ajanovic, SA; Bradley, J; Bramugy, JM; Chimenya, M; Green, EW; Lal, S; Mabey, DCW; Mayxay, M; Newton, PN; Olaru, ID; Hopkins, H; Bottomley, C; Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) Consortium

COVID-19 Collection

Journal article

Leptospirosis Incidence at Four Sites in Sub-Saharan Africa and South East Asia: An International Multi-Site Hybrid Surveillance Study

Abstract:: Background: There are few leptospirosis incidence studies despite such estimates being central to accurate burden of disease estimation. We used data from the multicenter Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study to make leptospirosis incidence estimates from new sites. Methods: Febrile patients aged ≥2 months in Laos, Malawi, Mozambique, and Zimbabwe were enrolled and underwent standardized clinical and exposure assessment. Acute and convalescent sera were tested by Leptospira microscopic agglutination test and acute plasma by lfb1 polymerase chain reaction (PCR). Participants with ≥4-fold rise in antibody titer between acute and convalescent sample, or Leptospira PCR positive for the lfb1, had confirmed leptospirosis. Leptospirosis incidence was estimated after adjusting for incomplete enrollment of febrile patients, availability of paired sera, and use of study healthcare facilities by febrile patients based on healthcare utilization data from community controls. Results: Leptospirosis incidence (95% CI) per 100 000 population per year was 1302 (1011, 1677) in Laos, 1337 (874, 2044) in Malawi, 187 (85, 409) in Mozambique, and could not be calculated for Zimbabwe. Sensitivity analysis restricted to pre-COVID years of 2018 and 2019 produced similar estimates of incidence to that of the whole study period. Conclusions: Leptospirosis incidence was high at the Laos, Malawi, and Mozambique sites and at the upper end of published incidence estimates from the Asia and Africa regions. We recommend more leptospirosis incidence studies be done in areas lacking data to strengthen leptospirosis global burden of disease estimates and to stimulate progress on diagnosis, management, and control.

Publication status:: Published

Peer review status:: Peer reviewed

Actions

Email

Email this record

Send the bibliographic details of this record to your email address.

Your Email
Please enter the email address that the record information will be sent to.

-
Your message (optional)
Please add any additional information to be included within the email.
Share
Cite

Cite this record

APA Style

Crump, J. A., Picardeau, M., Ajanovic, S. A., Bradley, J., Bramugy, J. M., Chimenya, M., Green, E. W., Lal, S., Mabey, D. C. W., Mayxay, M., Newton, P. N., Olaru, I. D., Hopkins, H., Bottomley, C., & Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) Consortium . (2026). Leptospirosis Incidence at Four Sites in Sub-Saharan Africa and South East Asia: An International Multi-Site Hybrid Surveillance Study. Open Forum Infectious Diseases, 13(3).

MLA Style

Crump, JA, et al. “Leptospirosis Incidence at Four Sites in Sub-Saharan Africa and South East Asia: An International Multi-Site Hybrid Surveillance Study.” Open Forum Infectious Diseases, vol. 13, no. 3, 2026.

Chicago Style

Crump, JA, M Picardeau, SA Ajanovic, et al. 2026. “Leptospirosis Incidence at Four Sites in Sub-Saharan Africa and South East Asia: An International Multi-Site Hybrid Surveillance Study.” Open Forum Infectious Diseases 13 (3).
Print