Estimating the burden of leptospirosis: global lessons from Sri Lanka

Warnasekara, Janith; Srimantha, Shalka; Agampodi, Suneth

doi:10.1136/bmjgh-2021-006946

Cited by 8 publications

(9 citation statements)

References 14 publications

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“…Only when the battery of MAT has local isolates, its sensitivity can be improved. Several outstanding studies have come out from Sri Lanka which will be useful globally [45 ▪▪ –47 ▪▪ ].…”

Section: Current Trend-epidemiologymentioning

confidence: 99%

Ocular leptospirosis: lack of awareness among ophthalmologists and challenges in diagnosis

Sivakumar¹

2022

Current Opinion in Ophthalmology

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Purpose of reviewSystemic leptospirosis exists worldwide. But leptospiral uveitis, an important late complication is not identified by ophthalmologists in several countries.Recent findingsIn the last 18 months numerous publications, especially on epidemiology, surveillances, and novel rapid diagnostic kits to test at the point of care site on leptospirosis have been published from all over the world. However, publications from ophthalmologists are very scarce. Remarkably ophthalmologists should know the global burden of leptospirosis, prevalence of the disease in their country, demographic factors associated, risk factors, and systemic signs to elicit relevant history and travel history. They should be aware of recent advances in investigations to confirm their clinical diagnosis.SummaryIt is quite evident from this work that leptospirosis is prevalent worldwide. Ophthalmologists’ awareness has to improve to identify the etiological diagnosis. They should have access to simple, less expensive, and less cumbersome laboratory tests.

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Section: Current Trend-epidemiologymentioning

confidence: 99%

Ocular leptospirosis: lack of awareness among ophthalmologists and challenges in diagnosis

Sivakumar¹

2022

Current Opinion in Ophthalmology

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“…The reported cases of leptospirosis are considered a gross underestimation and could have been described as part of the COVID-19 pandemic based on previously published causes of underestimations [ 6 ]. First, underreporting in public, private, and traditional health sectors has been identified as a major reason for underestimation even without the pandemic [ 7 ].…”

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confidence: 99%

“…The fear, lockdowns, and changes in focus that accompanied the pandemic could have exacerbated this underestimation. Second, the lack of early diagnostics during the acute phase of the disease often causes misdiagnoses of leptospirosis, since many other diseases, such as hantavirus infections, mimic leptospirosis [ 6 ]. In response to the COVID-19 pandemic, the diagnostic focus and the resources were primarily directed towards COVID-19, for which reason there were even more missing cases due to a lack of appropriate diagnostics.…”

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confidence: 99%

“…In response to the COVID-19 pandemic, the diagnostic focus and the resources were primarily directed towards COVID-19, for which reason there were even more missing cases due to a lack of appropriate diagnostics. Third, the available diagnostics are neither perfect nor effective for diagnosing leptospirosis [ 6 ]. The few places engaged in molecular diagnosis, which is now considered as the standard diagnostic procedure for leptospirosis, were also transformed into facilities for COVID-19 diagnosis.…”

mentioning

confidence: 99%

“…The few places engaged in molecular diagnosis, which is now considered as the standard diagnostic procedure for leptospirosis, were also transformed into facilities for COVID-19 diagnosis. Finally, diverse species of Leptospira causing different clinical and biochemical manifestations often misdirect the diagnosis of leptospirosis [ 6 ]. Some of its symptoms resemble those of influenza, and many mild cases of leptospirosis could have been missed during the COVID-19 pandemic due to this reason.…”

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confidence: 99%

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Neglecting the neglected during the COVID-19 pandemic: the case of leptospirosis in Sri Lanka

Warnasekara

Agampodi

2022

Epidemiol Health

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The coronavirus disease 2019 (COVID-19) pandemic has disrupted global health systems and affected the transmission dynamics as well as the surveillance of other infectious diseases. This study described the probable effect of the COVID-19 pandemic on the surveillance and control of leptospirosis in Sri Lanka. With 8,579 reported cases and more than 800 estimated deaths, the Sri Lankan public health surveillance system documented the largest outbreak of leptospirosis in Sri Lankan history in 2020. This was the worst infectious disease outbreak Sri Lanka experienced in 2020, but it was neglected, primarily due to the COVID-19 pandemic.

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Global, regional, and country-level cost of leptospirosis due to loss of productivity in humans

Agampodi

Gunarathna

Lee

et al. 2023

Preprint

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Background Leptospirosis, a prevalent zoonotic disease with One Health priority and a disease of poverty, lacks global economic burden estimates. This study aims to determine the global, regional, and country-level cost of leptospirosis due to loss of productivity. Methodology/Principal Findings The cost of leptospirosis due to loss of productivity (referred to as productivity cost hereafter) was estimated by converting the disability-adjusted life years (DALYs) lost due to leptospirosis to a monetary value using the per capita gross domestic product (GDP). The country-specific DALYs lost were obtained from the global burden of leptospirosis study published previously. For the cost conversion of DALYs, non-health GDP per capita (GDP- per capita health expenditure) was used. Country-specific GDP and health expenditure data were obtained from the World Bank data repositories. Estimates were done using both nominal and international dollars. The estimated global productivity cost of leptospirosis in 2019 was Int$ 29.3 billion, with low and high estimates ranging from Int$ 11.6 billion to 52.3 billion. China (Int$ 4.8 billion), India (Int$ 4.6 billion), Indonesia (Int$ 2.8 billion), Sri Lanka (Int$ 2.1 billion), and the United States (Int$ 1.3 billion) had the highest productivity cost due to leptospirosis. Eight out of 10 countries with the highest burden were in the Asia-Pacific region. In addition, lower middle-income countries had an annual productivity cost of Int$ 13.8 billion, indicating that the disease is poverty-related. Conclusions Although significant, the cost estimate due to loss of productivity is merely a fraction of the overall economic burden of this disease, which also includes other direct, indirect, and intangible costs. The existing partial estimates of the different components of economic cost suggest a profound economic burden that demands the inclusion of leptospirosis in the global health agenda for comprehensive disease control and prevention efforts, including vaccine development.

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Estimating the burden of leptospirosis: global lessons from Sri Lanka

Abstract: Provenance and peer review Not commissioned; externally peer reviewed.Data availability statement There are no data in this work.

Cited by 8 publications

References 14 publications

Ocular leptospirosis: lack of awareness among ophthalmologists and challenges in diagnosis

Ocular leptospirosis: lack of awareness among ophthalmologists and challenges in diagnosis

Neglecting the neglected during the COVID-19 pandemic: the case of leptospirosis in Sri Lanka

Global, regional, and country-level cost of leptospirosis due to loss of productivity in humans

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