Seroepidemiology of human leptospirosis in the Dominican Republic: A multistage cluster survey, 2021
Little is known about the epidemiology of leptospirosis in the Dominican Republic, the second most populous country in the Caribbean. We report on findings from a multi-stage household survey across two regions in the country that reveals a previously under-estimated burden of human Leptospira infection. Our findings, based on the reference-standard microscopic agglutination test, indicate a complex picture of serogroup diversity, spatial heterogeneity in infection and risk, and a marked discrepancy between reported cases and serologically estimated infections. Given an overall seroprevalence of 11.3% (95% CI: 10.8-13.0%) and a lower estimated force of infection (0.30% per year [0.27%-0.35%]) the number of infections may exceed national reported case data by 145-fold or more. Icterohaemorrhagiae, associated with severe Weil's disease, was the most commonly identified serogroup with a serogroup-specific prevalence of 4.4%. Consistent with other settings, risk factors including age, male sex, and rat exposure were associated with higher seroprevalence. Our study highlights the need for targeted public health interventions informed by serogroup-specific dynamics, detailed spatial analyses, knowledge of local animal reservoirs, and strengthened laboratory surveillance to effectively control this pathogen.
Authors
- Eleanor M. Rees (ORCID: https://orcid.org/0000-0002-4993-2795)
- Cecilia Then Paulino
- Gideon Loevinsohn (ORCID: https://orcid.org/0000-0002-4487-3087)
- William Duke
- Gabriela Abdalla
- Salomé Garnier (ORCID: https://orcid.org/0000-0003-3802-115X)
- Benn Sartorius (ORCID: https://orcid.org/0000-0001-6761-2325)
- Devan Dumas (ORCID: https://orcid.org/0000-0002-2355-3586)
- Emily Zielinski Gutiérrez
- Beatris Mário Martin (ORCID: https://orcid.org/0000-0002-8264-0153)
- Lucia de la Cruz
- Renee L. Galloway (ORCID: https://orcid.org/0000-0003-4627-0906)
- Helen J. Mayfield (ORCID: https://orcid.org/0000-0003-3462-4324)
- Colleen L. Lau (ORCID: https://orcid.org/0000-0001-8288-4169)
- Farah Peña (ORCID: https://orcid.org/0000-0001-7308-6552)
- Michael de St. Aubin (ORCID: https://orcid.org/0000-0003-4833-6200)
- Margaret Baldwin (ORCID: https://orcid.org/0000-0002-3594-4330)
- Bernarda Henríquez
- Eric James Nilles (ORCID: https://orcid.org/0000-0001-7044-5257)
- Angela Cadavid Restrepo (ORCID: https://orcid.org/0000-0003-0359-9410)
- Kara Durski
- Adam J. Kucharski (ORCID: https://orcid.org/0000-0001-8814-9421)
- Beatriz López (ORCID: https://orcid.org/0000-0003-1353-9948)
- Marie Caroline Etienne
- Naomi Iihoshi
- Ronald Skewes-Ramm (ORCID: https://orcid.org/0000-0003-0039-7768)
Institutions
- Brigham and Women's Hospital (US)
- Centers for Disease Control and Prevention (US)
- Harvard University (US)
- The University of Queensland (AU)
- Massachusetts General Hospital (US)
- London School of Hygiene & Tropical Medicine (GB)
- Universidad Nacional Pedro Henríquez Ureña (DO)
- Dana-Farber/Harvard Cancer Center (US)
- University of Glasgow (GB)
Publication Details
- Journal
- PLoS neglected tropical diseases
- Published
- 2024-12-23
- DOI
- https://doi.org/10.1371/journal.pntd.0012463
- Citations
- 6
- Primary Topic
- Leptospirosis research and findings
- Type
- article
- Field-Weighted Citation Impact
- 3.09
Funders
- Wellcome Trust
- Centers for Disease Control and Prevention