Policy Options for Prevention of Leptospirosis Epidemics: A Scoping Review
Abstract
Background: Leptospirosis is a widespread zoonotic disease causing over one million cases and 60,000 deaths annually. This review aimed to identify and assess policy options for leptospirosis prevention using the One Health approach and One Health Governance Index (OHGI) framework.
Methods: PubMed, Web of Science, Scopus, and Cochrane Library were searched for full-text academic articles, along with Google Scholar and reference lists from Jan 2008 to Dec 2023. A scoping review was conducted following Arksey and O’Malley’s framework and PRISMA-ScR guidelines. Articles were retrieved from major databases using defined keywords. Eligible studies focused on community-based policies for human leptospirosis prevention. Two reviewers independently assessed quality, and data were categorized by One Health domains and analyzed using the OHGI framework.
Results: Forty-two studies were included. Common policy strategies involved sanitation education, medical training, surveillance of humans, animals, and environments, legal controls on exposure sources, infrastructure upgrades, and vaccination. Tools like GIS and climate data supported preparedness. Policy options most addressed rule of law, effectiveness, and equity.
Conclusion: Preventing leptospirosis epidemics demands coordinated, context-specific One Health policies that address implementation gaps and promote equity across vulnerable settings.
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2. Costa F, Hagan JE, Calcagno J, et al (2015). Global morbidity and mortality of leptospirosis: A systematic review. PLoS Negl Trop Dis, 9(9): e0003898.
3. Le Turnier P, Epelboin L (2019). Update on leptospirosis. Rev Med Interne, 40(5): 306–312.
4. Ranieri TM, Viegas da Silva E, Vallandro MJ, et al (2025). Leptospirosis cases during the 2024 catastrophic flood in Rio Grande do Sul, Brazil. Pathogens, 14(4):393.
5. Centers for Disease Control and Prevention (CDC) (2025). Epidemic definition. CDC Glossary.
6. World Health Organization EMRO (2024). Health promotion and disease prevention. WHO EMRO.
7. AbdulRaheem Y (2023). Unveiling the significance and challenges of integrating prevention levels in healthcare practice. J Prim Care Community Health, 14: 21501319231186500.
8. Viroj J, Claude J, Lajaunie C, et al (2021). Agro-environmental determinants of leptospirosis: A retrospective spatiotemporal analysis (2004–2014) in Mahasarakham Province, Thailand. Trop Med Infect Dis, 6(3):115.
9. Arksey H, O'Malley L (2005). Scoping studies: Towards a methodological framework. Int J Soc Res Methodol, 8(1): 19–32.
10. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med, 169(7): 467–473.
11. Hong QN, Pluye P, Fàbregues S, et al (2018). Mixed Methods Appraisal Tool (MMAT) version 2018 - User guide. Canadian Intellectual Property Office.
12. Baethge C, Goldbeck-Wood S, Mertens S (2019). SANRA – a scale for the quality assessment of narrative review articles. Res Integr Peer Rev, 4:5.
13. McArthur A, Klugarova J, Yan H, Florescu S (2015). Innovations in the systematic review of text and opinion. Int J Evid Based Healthc, 13(3): 188–195.
14. Critical Appraisal Skills Programme (CASP) (2024). CASP checklist for economic evaluation.
15. World Health Organization (2024). One Health.
16. Li OY, Wang X, Yang K, et al (2023). The approaching pilot for One Health governance index. Infect Dis Poverty, 12(1): 16.
17. Azfar ZM, Nazri SM, Rusli AM, et al (2018). Knowledge, attitude and practice about leptospirosis prevention among town service workers in northeastern Malaysia: A cross-sectional study. J Prev Med Hyg, 59(1): E92–E98.
18. Viroj J, Lajaunie C, Claude J, Morand S (2019). Knowledge and practices of leptospirosis patients and communities regarding leptospirosis prevention and control in Maha Sarakham province, Thailand. Southeast Asian J Trop Med Public Health, 50(4): 760–769.
19. Allwood P, Muñoz-Zanzi C, Chang M, Brown PD (2014). Knowledge, perceptions, and environmental risk factors among Jamaican households with a history of leptospirosis. J Infect Public Health, 7(4): 314–322.
20. Liverpool J, Francis S, Liverpool CE, et al (2008). Leptospirosis: Case reports of an outbreak in Guyana. Ann Trop Med Parasitol, 102(3): 239–245.
21. Sethi S, Sharma N, Kakkar N, et al (2010). Increasing trends of leptospirosis in northern India: A clinico-epidemiological study. PLoS Negl Trop Dis, 4(1): e579.
22. Chiu CH, Wang YC, Yang YS, Chang FY (2009). Leptospirosis after typhoon in Taiwan. J Med Sci, 29(3): 131–134.
23. Bhardwaj P, Kosambiya JK, Desai VK (2008). A case-control study to explore the risk factors for acquisition of leptospirosis in Surat city after flood. Indian J Med Sci, 62(11): 431–438.
24. Mgode GF, Mhamphi GG, Massawe AW, Machang'u RS (2021). Leptospira seropositivity in humans, livestock and wild animals in a semi-arid area of Tanzania. Pathogens, 10(6):696.
25. Biscornet L, de Comarmond J, Bibi J, et al (2020). An observational study of human leptospirosis in Seychelles. Am J Trop Med Hyg, 103(3): 999–1008.
26. Desai KT, Patel F, Patel PB, et al (2016). A case-control study of epidemiological factors associated with leptospirosis in South Gujarat region. J Postgrad Med, 62(4): 223–227.
27. Bracho G, Varela E, Fernández R, et al (2010). Large-scale application of highly diluted bacteria for leptospirosis epidemic control. Homeopathy, 99(3): 156–166.
28. Jacobs J (2018). Homeopathic prevention and management of epidemic diseases. Homeopathy, 107(3): 157–160.
29. Brockmann S, Piechotowski I, Bock-Hensley O, et al (2010). Outbreak of leptospirosis among triathlon participants in Germany, 2006. BMC Infect Dis, 10(1):91.
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31. Chusri S, Sritrairatchai S, Hortiwahul T, et al (2012). Leptospirosis among river water rafters in southern Thailand. J Med Assoc Thai, 95(7): 874–877.
32. Fischer RSB, Flores Somarriba B (2017). Challenges to diagnosing leptospirosis in endemic regions require urgent attention. Curr Trop Med Rep, 4(2): 57–61.
33. Ratsitorahina M, Rahelinirina S, Michault A, et al (2015). Has Madagascar lost its exceptional leptospirosis free-like status? PLoS One, 10(4): e0122683.
34. Ludwig B, Zotzmann V, Bode C, et al (2017). Lethal pulmonary hemorrhage syndrome due to Leptospira infection transmitted by pet rat. IDCases, 8: 84–86.
35. Suárez Conejero AM, Otero Morales JM, Cruillas Miranda S, Otero Suárez M (2015). Prevention of human leptospirosis in the community. Rev Cubana Med Militar, 44(1): 86–95.
36. Owers KA, Odetunde J, de Matos RB, et al (2018). Fine-scale GPS tracking to quantify human movement patterns and exposure to leptospires in the urban slum environment. PLoS Negl Trop Dis, 12(8): e0006752.
37. Jobbins SE, Sanderson CE, Alexander KA (2014). Leptospira interrogans at the human–wildlife interface in northern Botswana: A newly identified public health threat. Zoonoses Public Health, 61(2): 113–123.
38. Davoust B, Marié JL, Boni M (2008). Prevention of zoonoses: Creation of a unit for early detection of animal infections. Bull Acad Natl Med, 192(3): 541–552.
39. Day MJ (2016). The CALLISTO project: A summary. J Comp Pathol, 155(1 Suppl 1):S1-7.
40. Diaz JH (2014). Recognition and management of rodent-borne infectious disease outbreaks after heavy rainfall and flooding. J La State Med Soc, 166(5): 186–192.
41. Koizumi N, Morita M, Pheng V, et al (2022). Rat trade and leptospirosis: Molecular epidemiology of Leptospira species in rats exported from Cambodia to Vietnam. Transbound Emerg Dis, 69(3): 1641–1648.
42. Richardson JL, Silveira G, Medrano IS, et al (2019). Significant genetic impacts accompany an urban rat control campaign in Salvador, Brazil. Front Ecol Evol, 7:115.
43. Rao AM (2020). Rodent control as a tool for prevention of leptospirosis: A success story from Gujarat State. J Commun Dis, 52(3): 38–42.
44. Pertile AC, Lustosa R, Carvalho-Pereira T, et al (2022). Evaluation of the impact of chemical control on the ecology of Rattus norvegicus in an urban community in Salvador, Brazil. PLoS One, 17(7): e0270568.
45. Okosun KO, Mukamuri M, Makinde DO (2016). Global stability analysis and control of leptospirosis. Open Math, 14(1): 567–585.
46. Benacer D, Woh PY, Mohd Zain SN, et al (2013). Pathogenic and saprophytic Leptospira species in water and soils from selected urban sites in peninsular Malaysia. Microbes Environ, 28(1): 135–140.
47. Suwannin P, Jangpatarapongsa K, Polpanich D, et al (2024). Enhancing leptospirosis control with nanosensing technology: A critical analysis. Comp Immunol Microbiol Infect Dis, 104: 102092.
48. Briskin EA, Casanovas-Massana A, Ryff KR, et al (2019). Seroprevalence, risk factors, and rodent reservoirs of leptospirosis in an urban community of Puerto Rico, 2015. J Infect Dis, 220(9): 1489–1497.
49. Buffon EAM (2018). Socio-environmental vulnerability to human leptospirosis in metropolitan Curitiba, Brazil: Methodological proposal from the multicriteria analysis and maps algebra. Saude Soc, 27(2): 588–604.
50. Cardwell JM, Van Winden S, Beauvais W, et al (2016). Assessing the impact of tailored biosecurity advice on farmer behaviour and pathogen presence in beef herds in England and Wales. Prev Vet Med, 135: 9–16.
51. Casanovas-Massana A, Costa F, Riediger IN, et al (2018). Spatial and temporal dynamics of pathogenic Leptospira in surface waters from the urban slum environment. Water Res, 130: 176–184.
52. Cucchi K, Liu R, Collender PA, et al (2019). Hydroclimatic drivers of seasonal leptospirosis incidence suggest soil reservoirs in rural western China. PLoS Negl Trop Dis, 13(12): e0007968.
53. Djati RRAP, Kusnoputranto H, Utomo SW, et al (2020). Leptospirosis control based on eco-social factors in Central Java, Indonesia. Biodiversitas, 21(12): 5818–5828.
54. Edre MA, Hayati KS, Salmiah MS, Sharifah Nor Khadijah SI (2018). Spatial distribution of knowledge, attitude and practice on leptospirosis prevention in a flood-prone area of Malaysia. Asian J Agric Biol, 6: 103–107.
55. Shojaee J, Hosseini A, Abedi G, et al (2015). Spatial pattern and distribution of leptospirosis in Mazandaran Province using geographic information system. J Mazandaran Univ Med Sci, 25(131): 151–154.
56. Emmanuel EL (2020). Factors contributing to leptospirosis occurrence and public health impact in Saint Lucia (2008–2019). Texila Int J Public Health, 8(4).
57. Feuer B, Domash-Martinez T (2011). Report of case: Leptospirosis after exposure to alligator carcass. Osteopath Fam Physician, 3(1): 23–26.
58. Nursitasari HA (2019). Residents’ behavior, rat-proofing conditions and leptospirosis incidence in Ponorogo Regency. J Kesehatan Lingkungan, 11(3): 198–207.
59. Chapman M, Barnes AN (2023). Waterborne and water-related disease in Florida (1999–2022): A scoping review. Rev Environ Health, 39(3): 585–601.
60. McPherson A, Hill PS, Kama M, Reid S (2018). Governance for One Health collaboration for leptospirosis prevention and control in Fiji: Stakeholder perceptions, evidence, and processes. Int J Health Plann Manage, 10.1002/hpm.2521.
61. Shannon PD, Swanston CW, Janowiak MK, et al (2019). Adaptation strategies and approaches for forested watersheds. Clim Serv, 13: 51–64.
62. Madon S, Malecela MN, Mashoto K, et al (2018). Community participation for sustainable neglected tropical disease and WASH programs in Tanzania. Soc Sci Med, 202: 28–37.
63. Costa F, Ribeiro GS, Felzemburgh RD, et al (2014). Influence of household rat infestation on leptospira transmission in the urban slum environment. PLoS Negl Trop Dis, 8 (12): e3338.
64. Teixeira AF, Fernandes LGV, Cavenague MF, et al (2019). Adjuvanted leptospiral vaccines: Challenges and future development of new leptospirosis vaccines. Vaccine, 37 (30): 3961–73.
65. Grassmann AA, Souza JD, McBride AJ (2017). A universal vaccine against leptospirosis: Are we going in the right direction? Front Immunol, 8: 256.
66. Liu B, Zhang X, Ding X, Wang Y, Zhu G (2021). Regulatory mechanisms of sub-inhibitory levels antibiotics agent in bacterial virulence. Appl Microbiol Biotechnol, 105 (9): 3495–505.
67. Nogueira T, David PHC, Pothier J (2019). Antibiotics as both friends and foes of the human gut microbiome: The microbial community approach. Drug Dev Res, 80 (1): 86–97.
68. Schneider MC, Velasco-Hernandez J, Min KD, et al (2017). The use of chemoprophylaxis after floods to reduce the occurrence and impact of leptospirosis outbreaks. Int J Environ Res Public Health, 14(6):594.
69. Reiserer RS, Schuett GW, Greene HW (2018). Seed ingestion and germination in rattlesnakes: Overlooked agents of rescue and secondary dispersal. Proc Biol Sci, 285(1872):20172755.
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71. Barazzone GC, Teixeira AF, Azevedo BOP, et al (2022). Revisiting the development of vaccines against pathogenic Leptospira: Innovative approaches, present challenges, and future perspectives. Front Immunol, 12: 760291.
72. Rodríguez S, Sanz AM, Llano G, et al (2020). Acceptability and usability of a mobile application for management and surveillance of vector-borne diseases in Colombia: An implementation study. PLoS One, 15 (5): e0233269.
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2. Costa F, Hagan JE, Calcagno J, et al (2015). Global morbidity and mortality of leptospirosis: A systematic review. PLoS Negl Trop Dis, 9(9): e0003898.
3. Le Turnier P, Epelboin L (2019). Update on leptospirosis. Rev Med Interne, 40(5): 306–312.
4. Ranieri TM, Viegas da Silva E, Vallandro MJ, et al (2025). Leptospirosis cases during the 2024 catastrophic flood in Rio Grande do Sul, Brazil. Pathogens, 14(4):393.
5. Centers for Disease Control and Prevention (CDC) (2025). Epidemic definition. CDC Glossary.
6. World Health Organization EMRO (2024). Health promotion and disease prevention. WHO EMRO.
7. AbdulRaheem Y (2023). Unveiling the significance and challenges of integrating prevention levels in healthcare practice. J Prim Care Community Health, 14: 21501319231186500.
8. Viroj J, Claude J, Lajaunie C, et al (2021). Agro-environmental determinants of leptospirosis: A retrospective spatiotemporal analysis (2004–2014) in Mahasarakham Province, Thailand. Trop Med Infect Dis, 6(3):115.
9. Arksey H, O'Malley L (2005). Scoping studies: Towards a methodological framework. Int J Soc Res Methodol, 8(1): 19–32.
10. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med, 169(7): 467–473.
11. Hong QN, Pluye P, Fàbregues S, et al (2018). Mixed Methods Appraisal Tool (MMAT) version 2018 - User guide. Canadian Intellectual Property Office.
12. Baethge C, Goldbeck-Wood S, Mertens S (2019). SANRA – a scale for the quality assessment of narrative review articles. Res Integr Peer Rev, 4:5.
13. McArthur A, Klugarova J, Yan H, Florescu S (2015). Innovations in the systematic review of text and opinion. Int J Evid Based Healthc, 13(3): 188–195.
14. Critical Appraisal Skills Programme (CASP) (2024). CASP checklist for economic evaluation.
15. World Health Organization (2024). One Health.
16. Li OY, Wang X, Yang K, et al (2023). The approaching pilot for One Health governance index. Infect Dis Poverty, 12(1): 16.
17. Azfar ZM, Nazri SM, Rusli AM, et al (2018). Knowledge, attitude and practice about leptospirosis prevention among town service workers in northeastern Malaysia: A cross-sectional study. J Prev Med Hyg, 59(1): E92–E98.
18. Viroj J, Lajaunie C, Claude J, Morand S (2019). Knowledge and practices of leptospirosis patients and communities regarding leptospirosis prevention and control in Maha Sarakham province, Thailand. Southeast Asian J Trop Med Public Health, 50(4): 760–769.
19. Allwood P, Muñoz-Zanzi C, Chang M, Brown PD (2014). Knowledge, perceptions, and environmental risk factors among Jamaican households with a history of leptospirosis. J Infect Public Health, 7(4): 314–322.
20. Liverpool J, Francis S, Liverpool CE, et al (2008). Leptospirosis: Case reports of an outbreak in Guyana. Ann Trop Med Parasitol, 102(3): 239–245.
21. Sethi S, Sharma N, Kakkar N, et al (2010). Increasing trends of leptospirosis in northern India: A clinico-epidemiological study. PLoS Negl Trop Dis, 4(1): e579.
22. Chiu CH, Wang YC, Yang YS, Chang FY (2009). Leptospirosis after typhoon in Taiwan. J Med Sci, 29(3): 131–134.
23. Bhardwaj P, Kosambiya JK, Desai VK (2008). A case-control study to explore the risk factors for acquisition of leptospirosis in Surat city after flood. Indian J Med Sci, 62(11): 431–438.
24. Mgode GF, Mhamphi GG, Massawe AW, Machang'u RS (2021). Leptospira seropositivity in humans, livestock and wild animals in a semi-arid area of Tanzania. Pathogens, 10(6):696.
25. Biscornet L, de Comarmond J, Bibi J, et al (2020). An observational study of human leptospirosis in Seychelles. Am J Trop Med Hyg, 103(3): 999–1008.
26. Desai KT, Patel F, Patel PB, et al (2016). A case-control study of epidemiological factors associated with leptospirosis in South Gujarat region. J Postgrad Med, 62(4): 223–227.
27. Bracho G, Varela E, Fernández R, et al (2010). Large-scale application of highly diluted bacteria for leptospirosis epidemic control. Homeopathy, 99(3): 156–166.
28. Jacobs J (2018). Homeopathic prevention and management of epidemic diseases. Homeopathy, 107(3): 157–160.
29. Brockmann S, Piechotowski I, Bock-Hensley O, et al (2010). Outbreak of leptospirosis among triathlon participants in Germany, 2006. BMC Infect Dis, 10(1):91.
30. Chadsuthi S, Chalvet-Monfray K, Geawduanglek S, et al (2022). Spatial-temporal patterns and risk factors for human leptospirosis in Thailand, 2012–2018. Sci Rep, 12(1): 5066.
31. Chusri S, Sritrairatchai S, Hortiwahul T, et al (2012). Leptospirosis among river water rafters in southern Thailand. J Med Assoc Thai, 95(7): 874–877.
32. Fischer RSB, Flores Somarriba B (2017). Challenges to diagnosing leptospirosis in endemic regions require urgent attention. Curr Trop Med Rep, 4(2): 57–61.
33. Ratsitorahina M, Rahelinirina S, Michault A, et al (2015). Has Madagascar lost its exceptional leptospirosis free-like status? PLoS One, 10(4): e0122683.
34. Ludwig B, Zotzmann V, Bode C, et al (2017). Lethal pulmonary hemorrhage syndrome due to Leptospira infection transmitted by pet rat. IDCases, 8: 84–86.
35. Suárez Conejero AM, Otero Morales JM, Cruillas Miranda S, Otero Suárez M (2015). Prevention of human leptospirosis in the community. Rev Cubana Med Militar, 44(1): 86–95.
36. Owers KA, Odetunde J, de Matos RB, et al (2018). Fine-scale GPS tracking to quantify human movement patterns and exposure to leptospires in the urban slum environment. PLoS Negl Trop Dis, 12(8): e0006752.
37. Jobbins SE, Sanderson CE, Alexander KA (2014). Leptospira interrogans at the human–wildlife interface in northern Botswana: A newly identified public health threat. Zoonoses Public Health, 61(2): 113–123.
38. Davoust B, Marié JL, Boni M (2008). Prevention of zoonoses: Creation of a unit for early detection of animal infections. Bull Acad Natl Med, 192(3): 541–552.
39. Day MJ (2016). The CALLISTO project: A summary. J Comp Pathol, 155(1 Suppl 1):S1-7.
40. Diaz JH (2014). Recognition and management of rodent-borne infectious disease outbreaks after heavy rainfall and flooding. J La State Med Soc, 166(5): 186–192.
41. Koizumi N, Morita M, Pheng V, et al (2022). Rat trade and leptospirosis: Molecular epidemiology of Leptospira species in rats exported from Cambodia to Vietnam. Transbound Emerg Dis, 69(3): 1641–1648.
42. Richardson JL, Silveira G, Medrano IS, et al (2019). Significant genetic impacts accompany an urban rat control campaign in Salvador, Brazil. Front Ecol Evol, 7:115.
43. Rao AM (2020). Rodent control as a tool for prevention of leptospirosis: A success story from Gujarat State. J Commun Dis, 52(3): 38–42.
44. Pertile AC, Lustosa R, Carvalho-Pereira T, et al (2022). Evaluation of the impact of chemical control on the ecology of Rattus norvegicus in an urban community in Salvador, Brazil. PLoS One, 17(7): e0270568.
45. Okosun KO, Mukamuri M, Makinde DO (2016). Global stability analysis and control of leptospirosis. Open Math, 14(1): 567–585.
46. Benacer D, Woh PY, Mohd Zain SN, et al (2013). Pathogenic and saprophytic Leptospira species in water and soils from selected urban sites in peninsular Malaysia. Microbes Environ, 28(1): 135–140.
47. Suwannin P, Jangpatarapongsa K, Polpanich D, et al (2024). Enhancing leptospirosis control with nanosensing technology: A critical analysis. Comp Immunol Microbiol Infect Dis, 104: 102092.
48. Briskin EA, Casanovas-Massana A, Ryff KR, et al (2019). Seroprevalence, risk factors, and rodent reservoirs of leptospirosis in an urban community of Puerto Rico, 2015. J Infect Dis, 220(9): 1489–1497.
49. Buffon EAM (2018). Socio-environmental vulnerability to human leptospirosis in metropolitan Curitiba, Brazil: Methodological proposal from the multicriteria analysis and maps algebra. Saude Soc, 27(2): 588–604.
50. Cardwell JM, Van Winden S, Beauvais W, et al (2016). Assessing the impact of tailored biosecurity advice on farmer behaviour and pathogen presence in beef herds in England and Wales. Prev Vet Med, 135: 9–16.
51. Casanovas-Massana A, Costa F, Riediger IN, et al (2018). Spatial and temporal dynamics of pathogenic Leptospira in surface waters from the urban slum environment. Water Res, 130: 176–184.
52. Cucchi K, Liu R, Collender PA, et al (2019). Hydroclimatic drivers of seasonal leptospirosis incidence suggest soil reservoirs in rural western China. PLoS Negl Trop Dis, 13(12): e0007968.
53. Djati RRAP, Kusnoputranto H, Utomo SW, et al (2020). Leptospirosis control based on eco-social factors in Central Java, Indonesia. Biodiversitas, 21(12): 5818–5828.
54. Edre MA, Hayati KS, Salmiah MS, Sharifah Nor Khadijah SI (2018). Spatial distribution of knowledge, attitude and practice on leptospirosis prevention in a flood-prone area of Malaysia. Asian J Agric Biol, 6: 103–107.
55. Shojaee J, Hosseini A, Abedi G, et al (2015). Spatial pattern and distribution of leptospirosis in Mazandaran Province using geographic information system. J Mazandaran Univ Med Sci, 25(131): 151–154.
56. Emmanuel EL (2020). Factors contributing to leptospirosis occurrence and public health impact in Saint Lucia (2008–2019). Texila Int J Public Health, 8(4).
57. Feuer B, Domash-Martinez T (2011). Report of case: Leptospirosis after exposure to alligator carcass. Osteopath Fam Physician, 3(1): 23–26.
58. Nursitasari HA (2019). Residents’ behavior, rat-proofing conditions and leptospirosis incidence in Ponorogo Regency. J Kesehatan Lingkungan, 11(3): 198–207.
59. Chapman M, Barnes AN (2023). Waterborne and water-related disease in Florida (1999–2022): A scoping review. Rev Environ Health, 39(3): 585–601.
60. McPherson A, Hill PS, Kama M, Reid S (2018). Governance for One Health collaboration for leptospirosis prevention and control in Fiji: Stakeholder perceptions, evidence, and processes. Int J Health Plann Manage, 10.1002/hpm.2521.
61. Shannon PD, Swanston CW, Janowiak MK, et al (2019). Adaptation strategies and approaches for forested watersheds. Clim Serv, 13: 51–64.
62. Madon S, Malecela MN, Mashoto K, et al (2018). Community participation for sustainable neglected tropical disease and WASH programs in Tanzania. Soc Sci Med, 202: 28–37.
63. Costa F, Ribeiro GS, Felzemburgh RD, et al (2014). Influence of household rat infestation on leptospira transmission in the urban slum environment. PLoS Negl Trop Dis, 8 (12): e3338.
64. Teixeira AF, Fernandes LGV, Cavenague MF, et al (2019). Adjuvanted leptospiral vaccines: Challenges and future development of new leptospirosis vaccines. Vaccine, 37 (30): 3961–73.
65. Grassmann AA, Souza JD, McBride AJ (2017). A universal vaccine against leptospirosis: Are we going in the right direction? Front Immunol, 8: 256.
66. Liu B, Zhang X, Ding X, Wang Y, Zhu G (2021). Regulatory mechanisms of sub-inhibitory levels antibiotics agent in bacterial virulence. Appl Microbiol Biotechnol, 105 (9): 3495–505.
67. Nogueira T, David PHC, Pothier J (2019). Antibiotics as both friends and foes of the human gut microbiome: The microbial community approach. Drug Dev Res, 80 (1): 86–97.
68. Schneider MC, Velasco-Hernandez J, Min KD, et al (2017). The use of chemoprophylaxis after floods to reduce the occurrence and impact of leptospirosis outbreaks. Int J Environ Res Public Health, 14(6):594.
69. Reiserer RS, Schuett GW, Greene HW (2018). Seed ingestion and germination in rattlesnakes: Overlooked agents of rescue and secondary dispersal. Proc Biol Sci, 285(1872):20172755.
70. Das N, G S S, Teja KSS, et al (2024). Integrated pest management: Success stories and key takeaways. Uttar Pradesh J Zool, 45 (16): 229–44.
71. Barazzone GC, Teixeira AF, Azevedo BOP, et al (2022). Revisiting the development of vaccines against pathogenic Leptospira: Innovative approaches, present challenges, and future perspectives. Front Immunol, 12: 760291.
72. Rodríguez S, Sanz AM, Llano G, et al (2020). Acceptability and usability of a mobile application for management and surveillance of vector-borne diseases in Colombia: An implementation study. PLoS One, 15 (5): e0233269.
73. Sykes JE, Reagan KL, Nally JE, et al (2022). Role of diagnostics in epidemiology, management, surveillance, and control of leptospirosis. Pathogens, 11(4):395.
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| Files | ||
| Issue | Vol 54 No 12 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Public health Education Sanitation One health Early diagnosis Environmental monitoring | ||
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How to Cite
1.
Pourasghari H, Rezaei MA. Policy Options for Prevention of Leptospirosis Epidemics: A Scoping Review. Iran J Public Health. 2025;54(12):2647-2659.
