Pathogenic Leptospira contamination in the environment: a systematic review

Figures & data

Figure 1. Flowchart of the article selection process based on PRISMA.

Table 1. Characteristics of articles.

Variable	Number of Articles			Total
	urban	rural	urban & rural
Geographical Region of research origin
West Africa	1	-	-	1
South America	3	3	2	8
United States of America	-	2		2
Central America	2	-	-	2
West Indies	-	1		1
South Asia	-	1	2	3
Southeast Asia	5	8	2	15
East Asia		1	-	1
Western Europe	2	2	-	4
Southern Europe	1	-	-	1
Total	14	18	6	38
Publication Year
2006	-	-	1	1
2008	1	-	-	1
2010	-	1	-	1
2011	-	2	-	2
2012	-	-	1	1
2013	1	1	-	2
2014	1	3	-	4
2015	1	1	-	2
2016	-	-	3	3
2017	3	2	-	5
2018	2	3	1	6
2019	2	2	-	4
2020	2	2	-	4
2021	1	1	-	2
Total	14	18	6	38
Research design
Case Study	2	-	-	2
Cross-Sectional	9	14	4	27
Experimental	3	2	1	6
Prospective Study	-	1	1	2
Retrospective Study	-	1	-	1
Total	14	18	6	38

Table 2. Presence of leptospira in water samples.

Geographical Region	Main Author	Sample Source	Urban					Rural					References
			Number of Samples	Positive Leptospira Pathogens			%	Number of Samples	Positive Leptospira Pathogens		%
South America	Arnau Casanovas-Massana, 2017	Sewage Water	335	121			36.0	-	-		-		[49]
		Standing Water	250	115			46.0	-	-		-
	Miller et al., 2021	River	-	-			-	112	4		3.6		[19]
	Mason et al., 2016	Source of animal drinking water	2	0			0	83	14		17.0		[45]
		Puddles (pool)	120	31			25.8	128	53		41.4
		Source of human drinking water	38	3			8.0	57	11		19.3
		Water flow	27	2			7.4	107	11		10.3
		Water in the reservoir	53	4			7.5	141	24		17.0
	Muñoz-zanzi et al., 2014	Puddles (ponds/rainwater containers)	-	-			-	186	36		19.3		[37]
		Canal/river	-	-			-	103	4		3.9
		Containers (water in buckets, cans, old tires)	-	-			-	141	16		11.3
		Animal drinking water	-	-			-	83	12		14.5
		Human drinking water sources (wells, springs, tap water)	-	-			-	57	9		15.8
	Ganoza et al., 2006	Puddles, sewers in the market	78	53			68.0	-	-		-		[46]
		Puddles, sewers, rainwater reservoirs, rivers, well in housing	114	38			33.3	-	-		-
		Freshwater wells, fish farming, slow river flow	-	-			-	236	60		25.4
	Calderón, Alfoso et al., 2013	Animal drinking water	-	-			-	18	1		5,6%		[32]
		Well	-	-			-	18	0		0%
		Livestock wastewater	-	-			-	18	1		5,6%
USA	Viau et al., 2011	River on the coast	-	-			-	42	4		9.5		[38]
	Verma et al., 2019	Open water (moats, ponds, puddles, rivers, springs)	-	-			-	89	2		2.2		[39]
Central America	Allwood et al., 2014	Household water storage drum	224	9			4.0	-	-		-		[24]
	Flores et al., 2020	Water storage in the house	29	1			3.4	-	-		-		[25]
		Puddle	3	0			0	-	-		-
		Well	11	1			9.0	-	-		-
		River	35	2			5.7	-	-		-
South Asia	Lall et al., 2018	Puddle of rice field	-	-			-	69	8		11.6		[40]
		Field puddles	-	-			-	84	13		15.5
		Puddles in settlements	-	-			-	32	2		6.3
		Puddles in the forest	-	-			-	41	2		5.0
Geographical Region	Main Author	Sample Source	Urban					Rural					References
			Number of Samples		Positive Leptospira Pathogens	%		Number of Samples	PositiveLeptospira Pathogens		%
	Vinod et al.,2016	Rice field water	-		-	-		24	8		33.3		[47]
		Water on rice leaves	-		-	-		18	5		27.2
		Household sewer	30		8	26.6		23	3		13.0
		Main drain	20		7	35.0		12	2		16.6
		Rainwater storage	6		0	0		9	1		11.1
	Zala et al., 2018	Sewage	30		2	6.7		-	-		-		[48]
		Household drainage	20		4	20.0		-	-		-
		Market drainage	30		1	3.3		-	-		-
		Public toilet drainage	10		0	0		-	-		-
		Industrial drainage	10		0	0		-	-		-
		River	1		0	0		-	-		-
		Rice field water	-		-	-		40	5		12.5
		Stream	-		-	-		10	0		0
		Household drainage	-		-	-		30	2		6.7
		Cowshed drainage	-		-	-		30	4		13.3
		Pool	-		-	-		1	0		0
		Forest land	-		-	-		3	0		0
		River	-		-	-		1	0		0
Southeast Asia	Nugroho et al., 2017	Rice field water, puddle water, sewage water	60		5	8.3		-	-		-		[26]
	Widiastuti et al., 2015	Household water storage (washing, bathing, defecating)	-		-	-		15	7		46.7		[42]
	Azali et al., 2016	Market						36	7		19.4		[41]
		Recreation areas						36	0		0
	Benacer et al., 2013	Lake (recreational area)	121		2	1.7		-	-		-		[27]
	Mohd Ali et al., 2018	Puddle	-		-	-		21	0		0		[43]
	Neela et al., 2019	River water around the military training ground	-		-	-		18	6		33.3		[44]
	Pui et al., 2017	Wastewater, rivers, lakes, puddles near people’s houses	324		6	1.9		-	-		-		[28]
	Ridzlan et al., 2010	Ponds, streams, drainage, puddles	-		-	-		145	3		2.1		[35]
	Zaki et al., 2020	Water flows and stagnates	-		-	-		198	26		13.3		[33]
	Tabo et al., 2019	The puddle at the slaughterhouse	6		0	0		-	-		-		[29]
		Channel	6		1	16.7		-	-		-
		River	6		0	0		-	-		-
		Flood water	18		0	0		-	-		-
Geographical Region	Main Author	Sample Source	Urban					Rural					References
			Number of Samples		Positive Leptospira Pathogens	%		Number of Samples		PositiveLeptospira Pathogens		%
	Tantengco et al., 2017	Home yard, irrigation, canal near market, paddy field, dry canal, river	97		0	0		-		-		-	[30]
	Chaiwattanarungrueng-paisan et al., 2018	Waterfall	-		-	-		17		6		35.3	[36]
	Kurilung et al., 2017	Source of groundwater & rice field water	14		3	21.4		-		-		-	[22]
East Asia	Saito et al., 2012	Water from markets or roadsides, open drainage, canals, and rivers	16		10	62.5		-		-		-	[31]
West Indies	Rawlins et al., 2014	Pool	-		-	-		15		0		0	[34]
		stream	-		-	-		3		0		0
		Puddle	-		-	-		13		1		8
		Dam	-		-	-		8		5		62.5
		Springs (mountains)	-		-	-		5		2		40.0
West Africa	Houéménou, Honoré et al., 2021	Air tanah	61		1	1,6%		-		-		-	[21]
		Kolam sementara	29		5	17,2%		-		-		-
		Kolam permanen	17		0	0%		-		-		-
		Air kran	83		0	0%		-		-		-
		Danau	3		0	0%		-		-		-
Southern Europe	Luchini et al., 2008	Air toilet	3		2	66,7%		-		-		-	[23]
		Air kran	1		0	0%		-		-		-
		Total	2.341		437	18,7%		2.576		380		14,7%

Table 3. Presence of pathogenic leptospira in soil samples.

Geographical Region	Main Author	Sample Source	urban			rural			References
			Number of Samples	Positive Leptospira Pathogens	%	Number of Samples	Positive Leptospira Pathogens	%
South America	Miller et al., 2021	river land	-	-	-	64	14	22%	[19]
		beach land	-	-	-	25	10	40%
	Schneider, et al., 2018	The land near the rat tracks, and the ditch	70	22	31.4%	-	-	-	[50]
South Asia	Zala et al., 2018	industrial area	15	1	6.7%	-	-	-
		Market area	10	0	0%	-	-	-
		Land near the stables	-	-	-	15	2	13.3%
		forest area	-	-	-	10	0	0%
		Rice fields	-	-	-	10	1	10%
Southeast Asia	Azali et al., 2016	Market	-	-	-	36	22	61%	[41]
		Recreation areas	-	-	-	36	4	11%
	Mohd Ali et al., 2018	The wet soil in the patient’s house	-	-	-	21	7	33.3%
	Neela et al., 2019	The land at the military training ground	-	-	-	18	8	44.4%
	Pui et al., 2017	Around houses, landfills, open fields, around lakes	292	34	11.6%	-	-	-
	Zaki et al., 2020	Recreation area (topsoil)	-	-	-	198	26	13%
East Asia	Saito et al., 2012	Around Kyusu campus	12	3	25%	-	-	-	[31]
Western Europe	Thibeaux, et al., 2017	Recreational areas (where the patient is exposed)	-	-	-	52	30	58%	[16]
Central America	Flores et al., 2020	Rain puddle land	20	1	5%	-	-	-	[25]
		River	22	2	9%	-	-	-
Southeast Asia	Saito et al., 2014	Wetlands on the coast	-	-	-	23	11	47.8%	[51]
	Tatengco et al., 2017	Around the trash	38	3	8%	-	-	-	[30]
Southern Erope	Luchini et al., 2008	Around the pool	2	2	100%	-	-	-	[23]
East Asia	Fuh, Ying Bin, et al., 2011	Cow and chicken farm	-	-	-	108	7	6.5	[52]
		Total	481	68	14%	508	142	28%

Table 4. Leptospira survival in the environmental samples.

Main Author	Microorganism	Environmental condition	Findings	References
Saito et al.. (2012)	All variant	Moisture content of soil samples between 3,4% − 42,8%,	Leptospira survive in the soil (67%) with moisture content of > 20%.	[31]
		pH value of soil samples between 6,2–7,2	pH value higher than 6,2 had no influence to the distribution and survival of Leptospira in the soil
Saito et al. (2014)	Pathogenic Leptospira	Artificial seawater (sodium chloride)	Leptospira were killed within several hours	[51]
		Seawater	Leptospira survive approximately 3 days
		Isolate mix with soil	Leptospira survive in seawater for 4 days
			These results suggest that leptospires living in soil are more resistant to seawater
Cassanovas-Massana et al. (2018)	L. interrogansCopenhageni	Laboratory microcosms	The findings suggest that the environment is not a multiplication reservoir but a temporary carrier of L. interrogans Copenhageni, although the observed prolonged persistence at low concentrations may still enable the transmission of Leptospirosis	[49]
Andre-Fontaine (2015)	Leptospira spp.	Water samples that were stored for 20 months at 4°C, 20°C or 30°C. The survival and preservation of virulence of Leptospira spp. was estimated by subculturing these stored samples.	The finding of this experiment was showed Leptospira spp. that despite unfavourable storage conditions such as cold, nutrient-poor acidic waters, the survival and virulence of pathogenic Leptospira spp. was fully preserved over at least 20 months.	[53]
Nau et al. (2020)	L. kirschneri	50-meter-long hose system simulating a water stream	From this experiment results concluded that once excreted via animal urine, the leptospires immediately need moisture or a water body to survive and stay infectious.	[54]
Bierque et al.. (2020)	Leptospira interrogans	water microcosms were designed to evaluate the survival and virulence of Leptospira spp. for 2 years using four commercial bottled drinking waters and a non-ionized water, all previously filter-sterilized.	The results confirmed that pathogenic Leptospira able to survive for more than a year in water. In addition, showed the ability of L. interrogans in nutrient-deprived conditions to directly cause systemic infection in susceptible animals.	[55]

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