Leptospirosis in the Tropics: When Prevention Doesn’t Easily Sell as a Ton of Cure

Abstract

Problem statement: Human leptospirosis --the most widespread zoonotic disease --thrives in tropical and subtropical climates. It is seldom addressed ex ante or prior to an outbreak or expected outbreak by governments of high-risk countries. Whether common, post-exposure treatment with antimicrobial drugs is more cost-efficient than reducing animal reservoir populations was the overarching question that guided this study. A related question in this study was how to establish comparability of pertinent price or cost estimates. Approach: Annualized price samples of government-approved, antimicrobial therapies and proposed rat and other rodent chemical agents (rodenticides) were gathered from three leptospirosis-endemic countries: Brazil, the Philippines and Sri Lanka. Certain price data were adjusted for present value based on a linear cost accounting function. Two-tailed hypothesis-testing (α = 0.05) was performed to determine any statistically significant differences in pricing antimicrobial therapies and rodenticides in each country under investigation. Results: Shared socio-demographic characteristics of infected populations appear to support the need for ex ante containment of rat/rodent reservoir populations in tropical and subtropical countries. In each surveyed country, we found t crit >t obs >-t crit . Therefore, the null hypothesis, µ antimicrobial = µ rodenticides = µ antimicrobial -µ rodenticides = 0, could not be rejected in favor of the alternative, µ antimicrobial ≠ µ rodenticides = µ antimicrobial -µ rodenticides ≠ 0. Conclusion: Applications of Price Estimation (PE) methods in financial economics, such as present value, help optimize health decisions concerning zoonotic diseases. Leptospira transmission in Brazil, the Philippines and Sri Lanka illuminate the need for broad and cohesive policies that take into account zoocentric measures. These may be critical in high-risk, tropical and subtropical countries that periodically experience flooding, standing water and increased rainfall.

Rodent Abundance Dynamics and Leptospirosis Carriage in an Area of Hyper-Endemicity in New Caledonia

“…Should the impact of climate and meteorological variability be confirmed, the best rodent management strategy to minimize leptospirosis burden in New Caledonia would probably be the use of rodenticides before the start of a hot rainy period, a situation similar to rodent control for agricultural crops [38] , therefore at times of low rodent density and low leptospirosis incidence, also corresponding to periods of low political and public awareness. Nevertheless, because economical modeling tends to demonstrate a similar cost-benefit effect of rodent control measures compared to post-exposure treatments [48] , a better control of rodent populations should be increasingly considered as a possible approach for leptospirosis management in endemic areas.…”

Prescribing Pattern of Intravenous Antibiotics for Hospitalized Patient in Hospital Jerantut

“…There is a tremendous increase in the number of reported cases and frequency of outbreaks has been reported in Southeast Asia especially Thailand, Indonesia and Malaysia (Victoriano et al, rd 2009). In Malaysia, Pahang was listed as the 3 highest number of Leptospirosis incident with total amount of 184 out of 1418 cases in 2009 (Mendoza, 2010). This may be caused by the existence of large forest and establishment of felda area that lead to the contract of the disease.…”

Gamification, a Successful Method to Foster Leptospirosis Knowledge among University Students: A Pilot Study

“…Leptospirosis is a zoonotic disease that was designated as a notifiable disease in 2010 in Malaysia [1]. It has raised concerns owing to the increasing number of cases reported every year, with a mortality rate > 10%, particularly in Southeast Asia and America [2,3]. The National Notifiable Disease Surveillance System estimated 1.03 million cases of infections and 58,900 human deaths every year worldwide, with an annual average of 0.55 notified cases/100,000 individuals; moreover, tropical countries are hotspots, accounting for more than half of the global estimated cases [4].…”