Research and Reports in Tropical Medicine最新文献

{"title":"Intestinal parasites in public transport buses from the city of Diamantina, Minas Gerais, Brazil.","authors":"Sabrina S Andrade,&nbsp;Layane M Teodoro,&nbsp;Daniel Js Viana,&nbsp;Egleise M Canuto-Sales,&nbsp;Gustavo H Bahia-de-Oliveira,&nbsp;Suedali Villas Bôas,&nbsp;Ricardo A Barata","doi":"10.2147/RRTM.S122046","DOIUrl":"https://doi.org/10.2147/RRTM.S122046","url":null,"abstract":"<p><strong>Background: </strong>Intestinal parasites' eggs, larvae, or cysts can be carried in public transport buses, and contribute to the increased incidence of diseases. This study aimed to detect biological forms of intestinal parasites in samples from public buses in the town of Diamantina, Minas Gerais, in order to know the local situation and propose interventions to improve public health.</p><p><strong>Materials and methods: </strong>In November 2014, six samples were obtained in buses of the two stations by using Graham method, in duplicate, by affixing a 6×5 cm clear tape, six times on each collection site of the bus, in an area of ~30 cm². Then, each tape was positioned longitudinally on a slide microscope, and the identification of the biological forms of the parasites was performed with the aid of a 40× objective optical microscope.</p><p><strong>Results: </strong>A total of 216 slides were analyzed, of which 86 (39.8%) were positive for at least one intestinal parasite. Cysts of <i>Entamoeba coli</i> were the most frequently found in this study (52.1%), followed by <i>Endolimax nana</i> cysts (30.7%), <i>Iodamoeba butschlii</i> (6.5%), helminth larvae (4.7%), <i>Giardia lamblia</i> cysts (3.6%), <i>Hymenolepis nana</i> eggs (1.2%), <i>Enterobius vermicularis</i> eggs (0.6%), and <i>Entamoeba histolytica</i> cysts (0.6%). Top right handrails and right stanchions had the highest occurrence of biological forms, with 18.3% and 14.8%, respectively.</p><p><strong>Conclusion: </strong>The results indicated the need for better cleaning of the buses and better personal hygiene by users, since pathogenic and non-pathogenic intestinal parasites were found, suggesting fecal contamination of these sites, representing a risk to public health.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"59-63"},"PeriodicalIF":3.1,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S122046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential for sublethal insecticide exposure to impact vector competence of <i>Aedes albopictus</i> (Diptera: Culicidae) for dengue and Zika viruses.","authors":"Stephanie L Richards,&nbsp;Avian V White,&nbsp;Jo Anne G Balanay","doi":"10.2147/RRTM.S133411","DOIUrl":"https://doi.org/10.2147/RRTM.S133411","url":null,"abstract":"<p><p>Chikungunya, dengue, and Zika viruses (CHIKV, family <i>Togaviridae</i>, genus <i>Alphavirus</i>; DENV and ZIKV, family <i>Flaviviridae</i>, genus <i>Flavivirus</i>) are arboviruses that cause human epidemics. Due to the lack of vaccines for many mosquito-borne diseases, there is a need for mosquito control. In the US and other regions, residual barrier insecticide sprays are applied to foliage where female mosquitoes rest and/or sugar feed between blood meals. Residual sprays are an important control method for anthropogenic day-active sylvan mosquitoes such as <i>Aedes albopictus</i> (vector of CHIKV, DENV, and ZIKV) that are difficult to control using ultralow-volume sprays applied only at dusk or dawn when these mosquitoes are not active. In this exploratory study, we analyzed the extent to which ingestion of a sublethal dose of the active ingredient bifenthrin affected vector competence (i.e., infection, dissemination, and transmission) of <i>Ae. albopictus</i> for DENV and ZIKV. Two incubation periods (IPs; 7 and 14 d) were tested at 28°C for insecticide-fed and sugar-fed mosquitoes. We show that mosquitoes that were fed bifenthrin (0.128 µg/mL) mixed with sucrose solution exhibited significantly lower DENV infection rates and body titers after a 14-d IP. During the 7-d IP, one mosquito (sugar group) transmitted ZIKV. During the 14-d IP, 100% of mosquitoes showed body and leg ZIKV infections, and one mosquito (sugar+bifenthrin group) transmitted ZIKV. This is a preliminary communication, and more studies will be required to further investigate these findings. We expect the findings of this small-scale study to spur larger-scale investigations of the impacts of insecticides on mechanisms regulating vector competence, and exposure to other active ingredients, and aid in development of new insecticides.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"53-57"},"PeriodicalIF":3.1,"publicationDate":"2017-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S133411","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first report of two cases of cystic echinococcosis in the lung by <i>Echinococcus ortleppi</i> infection, in Vietnam.","authors":"Nguyen Van De,&nbsp;Duyet Le Van","doi":"10.2147/RRTM.S122014","DOIUrl":"https://doi.org/10.2147/RRTM.S122014","url":null,"abstract":"<p><p>In 2013, two cases of infection by <i>Echinococcus</i> that caused cystic echinococcosis in the lungs were reported. In the first case, there was a cyst of 6 × 7 cm in diameter, and in the second case, there were four cysts of 5 × 6 cm, 4 × 4 cm, 3.5 × 3 cm and 2.5 × 2 cm in diameter, respectively. In both cases, <i>Echinococcus</i> larvae were collected from the cysts. The larvae were identified as <i>Echinococcus ortleppi</i> by morphology and a molecular method (using reduced nicotinamide adenine dinucleotide hydrogenase [NADH] with 99%-100% homology compared with <i>E. ortleppi</i> in GenBank). This is the first time that this species has been found in humans in Vietnam.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"45-51"},"PeriodicalIF":3.1,"publicationDate":"2017-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S122014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to typhoid fever vaccine access in endemic countries.","authors":"M Imran Khan,&nbsp;Carlos Franco-Paredes,&nbsp;Sushant Sahastrabuddhe,&nbsp;R Leon Ochiai,&nbsp;Vittal Mogasale,&nbsp;Bradford D Gessner","doi":"10.2147/RRTM.S97309","DOIUrl":"https://doi.org/10.2147/RRTM.S97309","url":null,"abstract":"<p><p>Typhoid vaccines have been available as a means of disease control and prevention since 1896; however, their use as a routine tool for disease prevention in endemic settings has been hampered because of: 1) insufficient data on disease burden particularly regarding the lack of health care access in the poorest communities affected by typhoid; 2) limitations of the typhoid vaccine, such as shorter duration of protection, moderate efficacy in young children, and no efficacy for infants; 3) inadequate evidence on potential economic benefits when used for a larger population; 4) neglect in favor of alternative interventions that require massive infrastructure; 5) no financial support or commitment regarding vaccine delivery cost; 6) ambivalence about whether to invest in water and sanitation hygiene versus the vaccine; and 7) clarity on global policy for country adoption. If current typhoid-protein conjugate vaccines live up to their promise of higher efficacy, longer duration of protection, and efficacy in young children, typhoid vaccine use will be a critical component of short- and medium-term disease control strategies. Typhoid control could be accelerated if the global framework includes plans for accelerated introduction of the conjugate typhoid vaccine in developing countries.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"37-44"},"PeriodicalIF":3.1,"publicationDate":"2017-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S97309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anemia in young children living in the Surinamese interior: the influence of age, nutritional status and ethnicity.","authors":"Cwr Zijlmans,&nbsp;A Stuursma,&nbsp;A J Roelofs,&nbsp;B C Jubitana,&nbsp;M S MacDonald-Ottevanger","doi":"10.2147/RRTM.S125125","DOIUrl":"https://doi.org/10.2147/RRTM.S125125","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the prevalence of anemia in young children living in the interior of Suriname and the influence of the associated factors age, nutritional status and ethnicity.</p><p><strong>Results: </strong>In this cross-sectional observational study, 606 children aged 1-5 years from three different regions of Suriname's interior were included, and hemoglobin levels and anthropometric measurements were collected. Logistic regression models were computed to examine independent associations between anemic and nonanemic groups and to measure the influence of age, nutritional status and ethnicity.</p><p><strong>Results: </strong>A total of 606 children were included, of whom 330 (55%) were aged 1-3 years and 276 were aged 4-5 years. The overall prevalence of anemia was 63%. Younger age was associated with anemia (odds ratio [OR]=1.78; 95% confidence interval [CI]: 1.27-2.51). Anemia was less prevalent in Amerindian than in Maroon children (OR=0.51; 95% CI: 0.34-0.76). Hemoglobin level was not influenced by nutritional status nor by sex.</p><p><strong>Conclusion: </strong>The prevalence of anemia in children aged 1-5 years living in Suriname's interior is high (63%) compared to that in similar aged children in Latin America and the Caribbean (4-45%). Children aged 1-3 years were more affected than those aged 4-5 years as were Maroon children compared to Amerindian children. Nutritional status and sex were not of influence.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"21-24"},"PeriodicalIF":3.1,"publicationDate":"2017-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S125125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation and genetic characterization of <i>Lysinibacillus sphaericus</i> strains found in mosquito larvae (Diptera: Culicidae).","authors":"Clara de Fátima Gomes Cavados,&nbsp;Eder Soares Pires,&nbsp;Jeane Quintanilha Chaves,&nbsp;Danielle Nunes Alvarez,&nbsp;Helio Benites Gil,&nbsp;Iris Braz Ribeiro de Oliveira,&nbsp;Andrea de Barros Pinto Viviani Cunha,&nbsp;Carlos José Pereira da Cunha de Araújo-Coutinho","doi":"10.2147/RRTM.S124066","DOIUrl":"https://doi.org/10.2147/RRTM.S124066","url":null,"abstract":"<p><strong>Introduction: </strong><i>Lysinibacillus sphaericus</i> is a highly effective and specific bioinsecticide used for the control of Culicidae larvae.</p><p><strong>Objective: </strong>This study aimed to identify and characterize <i>L. sphaericus</i> strains isolated from <i>Culex quinquefasciatus</i> larvae in Brazil.</p><p><strong>Methods: </strong><i>C. quinquefasciatus</i> larvae were collected from streams in the urban area of São Paulo state. <i>L. sphaericus</i> strains were identified through cytomorphology, biochemical, and physiological analyses. Qualitative bioassays were performed to evaluate the toxicity of the strains against <i>C. quinquefasciatus</i>. The crystal compound protein pattern of <i>L. sphaericus</i> strains was analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Five reference strains were used as standards in all tests performed. Repetitive extragenic palindromic elements-polymerase chain reaction (REP-PCR) was utilized in an attempt to differentiate pathogenic and nonpathogenic isolates.</p><p><strong>Results: </strong>Twenty-one strains were isolated. Only one presented toxic activity against <i>C. quinquefasciatus</i>. REP-PCR results identified 23 patterns among the 26 strains used in the study, and the fragment analysis showed low similarity (16%) between <i>L. sphaericus</i> isolates and the five reference strains.</p><p><strong>Conclusion: </strong>Comparison of strains isolated in this study using REP-PCR showed a low similarity to other strains, demonstrating the high intraspecific variability for <i>L. sphaericus</i>.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"17-20"},"PeriodicalIF":3.1,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S124066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing likely invasion sites of Zika virus-infected mosquitoes in civilian and naval maritime ports in Florida.","authors":"Thomas M Kollars","doi":"10.2147/RRTM.S123456","DOIUrl":"https://doi.org/10.2147/RRTM.S123456","url":null,"abstract":"<p><p>Several mosquito species are capable of invading new geographic regions and exploiting niches that are similar to their natural home ranges where they may introduce, or reintroduce, pathogens. In addition to initial invasion, introduction of new genotypes into established populations may also occur. Zika virus is spreading throughout the world, posing significant health risks to human populations, particularly pregnant women and their infants. The first locally acquired case of Zika virus in the US occurred in July 2016 in Miami, Florida on the Atlantic coast; the first locally acquired case in another US county occurred in the Tampa, Florida area. Three port cities in Florida were chosen to assess the risk of import and spread of Zika virus: Mayport Naval Station, Miami, and Tampa. The bioagent transport and enviromental modeling system TIGER model and ArcGIS were used to analyze abiotic and biotic factors influencing potentially Zika-infected <i>Aedes</i> species, should they enter through these ports. The model was tested by overlaying documented and suspected concurrent Zika cases and comparing published high-risk areas for Zika virus. In addition to Zika hot zones being identified, output indicates surveillance and integrated mosquito management should expect larger zones. Surveillance sites at ports should be identified and prioritized for pathogen and vector control to reduce the import of mosquitoes infected with Zika virus. Low resolution maps often provide valuable suitability of the geographic expansion of organisms. Providing a higher resolution predictive map, identifying probable routes of invasion, and providing areas at high risk for initial invasion and control zones, will aid in controlling and perhaps eliminating the spread of arboviruses through mosquito vectors.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"1-6"},"PeriodicalIF":3.1,"publicationDate":"2017-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S123456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Chikungunya fever outbreak in Western Jamaica during July-December 2014.","authors":"Phuong N Pham,&nbsp;LaQueena T Williams,&nbsp;Uduak Obot,&nbsp;Luz A Padilla,&nbsp;Maung Aung,&nbsp;Tomi F Akinyemiju,&nbsp;April P Carson,&nbsp;Pauline E Jolly","doi":"10.2147/rrtm.s122032","DOIUrl":"https://doi.org/10.2147/rrtm.s122032","url":null,"abstract":"<p><strong>Objective: </strong>Our study describes the 2014 Chikungunya outbreak in Western Jamaica in terms of geographic distribution and trend of the outbreak over time, and evaluates clinical symptoms of the disease based on pre-existing conditions.</p><p><strong>Methods: </strong>We conducted a retrospective, cross-sectional study of 609 clinically defined Chikungunya virus (CHIKV) fever cases that occurred in the four parishes of the Western Regional Health Authority of Jamaica from July 2014 to December 2014. Cases were not confirmed by laboratory tests but met clinical and epidemiological criteria of CHIKV fever.</p><p><strong>Results: </strong>Our results show a propagated spread of CHIKV fever during the outbreak period with the peak at the end of October. Main urban cities, such as Montego Bay and Lucea, were identified as places that had high numbers of cases. Fever and arthralgia were the two most common clinical symptoms in CHIKV patients. Although a majority (80%) of infants aged <2 years had up to four symptoms (80%), the percentage of infants with higher numbers of symptoms (9-10) was higher than in older age groups. However, back pain was found to occur significantly more in older patients. Those with arthritis as a pre-existing condition were more likely to experience headache, asthenia, back pain, and periarticular edema.</p><p><strong>Conclusion: </strong>These findings can help public health officials develop more effective programs to prevent the spread of CHIKV outbreaks by focusing on crowded urban cities. The findings indicate that those who are likely to develop a higher number of symptoms, such as young infants and people with pre-existing conditions, such as arthritis, should be more closely monitored to better manage the disease outcome.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"7-16"},"PeriodicalIF":3.1,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/rrtm.s122032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35771400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Mortality within Prison and after Release among Persons Living with HIV in Indonesia.","authors":"Gabriel J Culbert,&nbsp;Forrest W Crawford,&nbsp;Astia Murni,&nbsp;Agung Waluyo,&nbsp;Alexander R Bazazi,&nbsp;Junaiti Sahar,&nbsp;Frederick L Altice","doi":"10.2147/RRTM.S126131","DOIUrl":"https://doi.org/10.2147/RRTM.S126131","url":null,"abstract":"<p><strong>Objectives: </strong>HIV-related mortality is increasing in Indonesia, where prisons house many people living with HIV and addiction. We examined all-cause mortality in HIV-infected Indonesian prisoners within prison and up to 24 months post-release.</p><p><strong>Materials and methods: </strong>Randomly selected HIV-infected male prisoners (n=102) from two prisons in Jakarta, Indonesia completed surveys in prison and were followed up for 2 years (until study completion) or until they died or were lost to follow-up. Death dates were determined from medical records and interviews with immediate family members. Kaplan-Meier and Cox proportional hazards regression models were analyzed to identify mortality predictors.</p><p><strong>Results: </strong>During 103 person-years (PYs) of follow-up, 15 deaths occurred, including ten in prison. The crude mortality rate within prison (125.2 deaths per 1,000 PYs) was surpassed by the crude mortality rate in released prisoners (215.7 deaths per 1,000 PYs). HIV-associated opportunistic infections were the most common probable cause of death. Predictors of within-prison and overall mortality were similar. Shorter survival overall was associated with being incarcerated within a specialized \"narcotic\" prison for drug offenders (hazard ratio [HR] 9.2, 95% confidence interval [CI] 1.1-76.5; <i>P</i>=0.03), longer incarceration (HR 1.06, 95% CI 1.01-1.1; <i>P</i>=0.01), and advanced HIV infection (CD4⁺ T-cell count<200cells/μL; HR 4.8, 95% CI 1.2-18.2; <i>P</i>=0.02). Addiction treatment was associated with longer survival (HR 0.1, 95% CI 0.01-0.9; <i>P</i>=0.03), although treatment with antiretroviral therapy (ART) or methadone was not.</p><p><strong>Conclusions: </strong>Mortality in HIV-infected prisoners is extremely high in Indonesia, despite limited provision of ART in prisons. Interventions to restore immune function with ART and provide prophylaxis for opportunistic infections during incarceration and after release would likely reduce mortality. Narcotics prisons may be especially high-risk environments for mortality, emphasizing the need for universal access to evidence-based HIV treatments.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"8 ","pages":"25-35"},"PeriodicalIF":3.1,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S126131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35654317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leptospirosis: risk factors and management challenges in developing countries.","authors":"Cyrille Goarant","doi":"10.2147/RRTM.S102543","DOIUrl":"https://doi.org/10.2147/RRTM.S102543","url":null,"abstract":"<p><p>Leptospirosis is a widespread bacterial zoonosis with highest burden in low-income populations living in tropical and subtropical regions, both in urban and in rural environments. Rodents are known as the main reservoir animals, but other mammals may also significantly contribute to human infections in some settings. Clinical presentation of leptospirosis is nonspecific and variable, and most of the early signs and symptoms point to the so-called \"acute fever of unknown origin\", a major diagnostic challenge in tropical and subtropical areas. However, leptospirosis can rapidly evolve to life-threatening complications, especially if left untreated. There is a need for good awareness of leptospirosis and rapid antibiotic treatment based on clinical and epidemiological suspicion. Severe leptospirosis cases include renal and/or respiratory failure and shock, necessitating intensive care, also seldom available or with limited capacity. Confirmation of leptospirosis relies on biological diagnosis, which unfortunately uses tricky methods seldom available. This biological confirmation, however, is essential for surveillance and public health purpose. A good knowledge of leptospirosis epidemiology (eg, the reservoir animals involved, the <i>Leptospira</i> strains circulating, the seasonal and geographical patterns, and specific populations at risk) can be achieved through adequate surveillance and diagnosis. This can pave the way to prevention and intervention strategies and in turn alleviate the toll leptospirosis takes on affected populations. Over the past few years, leptospirosis has been increasingly recognized, as the need for multidisciplinary approaches in a One-Health perspective has been acknowledged, raising hope to successfully tackle the challenges of this zoonosis.</p>","PeriodicalId":21138,"journal":{"name":"Research and Reports in Tropical Medicine","volume":"7 ","pages":"49-62"},"PeriodicalIF":3.1,"publicationDate":"2016-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/RRTM.S102543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36348693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}