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Original Article
- Spatial patterns of laboratory-confirmed leptospirosis in north-eastern Peninsular Malaysia, 2016-2023
- Hazlienor Mohd Hatta, Kamarul Imran Musa, Nik Mohd Hafiz Mohd Fuzi, Paula Moraga
- Epidemiol Health. 2025;47:e2025030. Published online May 29, 2025
- DOI: https://doi.org/10.4178/epih.e2025030
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AbstractOBJECTIVES
Leptospirosis presents significant public health challenges in endemic regions such as north-eastern Peninsular Malaysia. Spatial analysis is essential for visualising disease incidence and distribution, assessing vulnerability based on geographical and socioeconomic factors, and ultimately informing targeted interventions, optimising resource allocation, and enhancing surveillance strategies. This study aimed to determine the incidence and characterise the spatial distribution of leptospirosis in Kelantan, Malaysia.METHODSAll laboratory-confirmed leptospirosis cases reported in Kelantan between 2016 and 2023 were extracted from the Communicable Disease Control Information System e-Notifikasi online database. Spatial analyses were performed using the spatstat, spdep, and ggplot2 packages within the RStudio integrated development environment.RESULTSThe analysis encompassed 1,534 laboratory-confirmed leptospirosis cases. The average crude annual incidence of leptospirosis cases per 1,000 population from 2016 to 2023 was 0.101 (95% confidence interval, 0.038 to 0.164). Incidence varied considerably across districts and subdistricts, initially higher in the north but declining over time, while consistently high and increasing incidence was observed in the southern region. Significant clustering of leptospirosis cases occurred throughout the studied years, except during the coronavirus disease 2019 pandemic. Hotspots were initially prevalent in northern areas but later emerged in south-eastern and southern regions. Significant spatial autocorrelation evolved from high-low to high-high clusters, particularly evident in central and southern regions.CONCLUSIONSThis study provides valuable local epidemiological and spatial insights into the endemicity of leptospirosis. The findings highlight the need for targeted interventions and continued surveillance to effectively mitigate the leptospirosis burden in endemic areas. -
SummaryKey Message
• This study examined leptospirosis patterns in Kelantan, Malaysia, from 2016 to 2023, highlighting distinct regional varia- tions in disease incidence. • Case densities were high in the northern region, whereas incidence demonstrated higher risk in the central and southern regions. • The study underscores the importance of considering both geographic location and population dynamics when planning interventions and allocating resources for disease control. • The evident spatial clustering highlights the need for targeted public health interventions.COVID-19: Perspective- Neglecting the neglected during the COVID-19 pandemic: the case of leptospirosis in Sri Lanka
- Janith Warnasekara, Suneth Agampodi
- Epidemiol Health. 2022;44:e2022015. Published online January 10, 2022
- DOI: https://doi.org/10.4178/epih.e2022015
- 30,206 View
- 634 Download
- 14 Web of Science
- 18 Crossref
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Abstract
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AbstractThe 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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SummaryKey Message
The largest reported outbreak of leptospirosis in Sri Lankan history was not given proper attention; probably due to COVID pandemic.Citations
Citations to this article as recorded by
- The impact of floods on the Leptospirosis outbreak in the Irkutsk Region
S. E. Budaeva, N. V. Breneva, E. Yu. Kiseleva, M. B. Sharakshanov, A. F. Timoshenko, D. M. Rudakov
Acta Biomedica Scientifica.2026; 11(1): 248. CrossRef - Genomic analysis of human-infecting Leptospira borgpetersenii isolates in Sri Lanka: Expanded PF07598 gene family repertoire and less genome reduction than bovine isolates
Indika Senavirathna, Dinesha Jayasundara, Janith Warnasekara, Suneth Agampodi, Ellie J. Putz, Jarlath E. Nally, Darrell O. Bayles, Reetika Chaurasia, Joseph M. Vinetz, Ana LTO Nascimento
PLOS Neglected Tropical Diseases.2026; 20(3): e0012540. CrossRef - Spatiotemporal dynamics and environmental trends of reported human leptospirosis in Sri Lanka, 2007–2024
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Balkan Medical Journal.2025; 42(3): 254. CrossRef - Improving leptospirosis treatment through increased suspicion—“Leptospirosis calendar for general practitioners in Sri Lanka”
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BMC Infectious Diseases.2025;[Epub] CrossRef - Unraveling the drivers of leptospirosis risk in Thailand using machine learning
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PLOS Neglected Tropical Diseases.2025; 19(10): e0013618. CrossRef - Detection of P1 and P2 Subclades of Leptospira carriage in swine in Sri Lanka
Nipun Rathnayake, Devinda Muthusinghe, Rydhnieya Vijeyakumaran, Pavani Senarathne, Videesha Bandara, Yomani Sarathkumara, Ruwanpathiranage Nalinda, Kanae Shiokawa, Kumiko Yoshimatsu, Sanath Rajapakse, Nobuo Koizumi, Chandika Gamage
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International Journal of Environmental Research and Public Health.2024; 21(9): 1238. CrossRef - Analysis of the Epizootic and Epidemiological Situation on Leptospirosis in 2023 and Forecast for 2024 in the Russian Federation
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The European Physical Journal Plus.2024;[Epub] CrossRef - Molecular Diagnosis as an Alternative for Public Health Surveillance of Leptospirosis in Colombia
Margarita Arboleda, Mariana Mejía-Torres, Maritza Posada, Nicaela Restrepo, Paola Ríos-Tapias, Luis Alberto Rivera-Pedroza, David Calle, Miryan M. Sánchez-Jiménez, Katerine Marín, Piedad Agudelo-Flórez
Microorganisms.2023; 11(11): 2759. CrossRef - Coinfection of leptospirosis and coronavirus disease 2019: A retrospective case series from a coastal region in South India
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Journal of Medical Virology.2022; 94(9): 4508. CrossRef - A global one health perspective on leptospirosis in humans and animals
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Rathinam R. Sivakumar
Current Opinion in Ophthalmology.2022; 33(6): 532. CrossRef - SARIMA and ARDL models for predicting leptospirosis in Anuradhapura district Sri Lanka
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PLOS ONE.2022; 17(10): e0275447. CrossRef
- An Epidemiologic Study on the Leptospiral Infection in the Period of an Anticipated Epidemic
- Bo Youl Choi, Dae Eun Chung, Soo Jin Lee, Hung-Bae Park, Jeoung Bae Park, Kyung Hee Lee, Jeong Soon Kim
- Korean J Epidemiol. 1992;14(1):91-101. Published online June 30, 1992
- 9,421 View
- 11 Download
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AbstractA large epidemic of leptospirosis was anticipated in September 1990 because flood has resulted the heavy rain for 4 consecutive days from the 8th of September, 1990, in the Yang-pyeung Gun (Country), a farm area of Central Korea. Actually, patients were already appearing sporadically soon after the flood. Soldiers of ROK Army units stationed in this area were under the higher risk since many of them participated in field works (such as tieing rice plant fallen by the flood) as a part of Civil Aid Plan. The objectives of this study were 1) to detect infected ones at early stage 2) to estimate the attack rates of infection and apparent infection through serologic examinations, 3) to estimate pathogenecity and case-fatality rate and 4) to compare the rates of infection by the type of work and the use of protective devices. All of those with febrile episode were interviewed and the leptospiral antibody was examined during the one month period after the field work. Serologic examinations (including the interview) were done twice with 1 week interval (first on 8th to 10th of October, about 4 weeks following the days of field work) for 446 soldiers belong to three companies stationed in the country area. The serologic test (Microscopic agglutination test) were performed with 4 strains. Icterohemorrhagiae lai and Canicola canicola Hond Utrecht IV as standard strains, and 6P-049-1 and YP-35-1 as strains isolated in Korea in 1986, in accordance with WHO guideline. The results are as follows. 1. Among 57 febrile, suspected cases, 37 had serological tests twice and, 20 of them (54.1%) were serologically confirmed to be infected whereas among other 20 subjects who had single serological test, only 2 persons (10.0%) were serologically positive. 2. The dates of onset of fever in confirmed cases were clustered in 10 to 20 days from late September to early October, which coincided well with the duration of exposure (Sep. 13-18). 3. The attack rate of infection and apparent infection were estimated to be 11.2% (95% C. I. ; 8.3-14.1%), 1.8% (95% C. I. ; 0.7-3.1%). Pathogenecity and case-fatality rate were estimated to be 16.0% (95% C. I. ; 6.0-26.0%) and 0%, respectively. 4. The attack rate of infection of persons who worked in rice paddy for 3-6 days, for 1-2 days and participated in other field work were 3.5, 2.7 and 2.1 time high respectively as high as that of persons who did not join in field work (p<0.05). 5. The effectiveness of protective devices shown in this study was rater poor; perhaps the preparation of the protective devices was not sufficient because the mobilization of army is usually a sudden order. For more satisfactory prevention in the future, a complete clothing (including glove and boots) and chemoprophyaxis (with doxycycline) are recommended.
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