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Skin infections cause significant health burden and affect underserved communities such as the indigenous Negrito communities disproportionately. There is only one study that has addressed skin infections among the Negrito communities, which is the smallest and most isolated indigenous tribe in Peninsular Malaysia, with approximately 6,500 individuals remaining in northern and central Peninsular Malaysia. This study, which aims to update the infection patterns of scabies and tinea among the Negrito communities, recruited 361 participants from eight villages representing all six Negrito subtribes. The results revealed an overall skin infection prevalence of 35.6%, with scabies (11.7%), tinea versicolor (11.3%), and tinea imbricata (7.5%) as major infections, with no co-infection. Notably, infection rates were significantly higher in resettled villages (55.2%) compared to inland villages (24.8%). Scabies and tinea versicolor were more prevalent in resettled villages (21.2% and 23.6%, respectively) than inland villages (6.4% and 4.7%, respectively), while tinea imbricata was more common in inland villages (9.4% vs 3.9%). Furthermore, there exist predisposition of scabies among Kensiu. High prevalence of tinea imbricata was observed among the inland Bateq while prevalence of tinea versicolor was high among the resettled Bateq. Risk analysis revealed specific associations: scabies with Kensiu subtribe (P = 0.002), high income (P = 0.001) and underweight individuals (P = 0.009); tinea versicolor with Bateq subtribe (P = 0.003), resettled villagers (P < 0.001), males (p = 0.040), and overweight/obese individuals (P = 0.015); and tinea imbricata with Bateq (P = 0.011) and smokers (P = 0.004). These findings highlight a complex interplay between environment and lifestyle in skin infection prevalence. Addressing these infections requires targeted interventions, including regular medical care in inland villages and socio-economic support for resettled communities, considering the distinct predispositions in different village types. Author summary: Skin infections (tinea and scabies) are significant health concerns among the indigenous Negrito communities in Peninsular Malaysia. Given that there was only one documented study among Negrito communities previously, the present study enrolled 361 participants from eight Negrito categorised into resettled or inland villages in Peninsular Malaysia to update the epidemiological status and risk factors. We found a high overall skin infection prevalence of 35.6%. Scabies, tinea versicolor, and tinea imbricata accounted for 11.7%, 11.3%, and 7.5%, respectively with no co-infection. Higher prevalence was observed among resettled villages (55.2%) compared to inland villages (24.8%). Risk factor analysis among these Negrito communities identified different predictors associated with each type of infection, generally linked to the type of village category. We highlighted that scabies and tinea versicolor were more common in resettled communities. However, rare infection like tinea imbricata, which require high treatment compliance, was more localized in inland villages. Village-specific measures including regular medical interventions in inland villages and socio-economic aid to resettled communities to address urban/semi-urban poverty are essential, considering the existing predisposition of skin infections in different types of villages. [ABSTRACT FROM AUTHOR]

BACKGROUND:Leptospirosis, commonly known as rat-urine disease, is a global but endemic zoonotic disease in the tropics. Despite the historical report of leptospirosis in Malaysia, the information on human-infecting species is limited. Determining the circulating species is important to understand its epidemiology, thereby to strategize appropriate control measures through public health interventions, diagnostics, therapeutics and vaccine development. METHODOLOGY/PRINCIPLE FINDINGS:We investigated the human-infecting Leptospira species in blood and serum samples collected from clinically suspected leptospirosis patients admitted to three tertiary care hospitals in Malaysia. From a total of 165 patients, 92 (56%) were confirmed cases of leptospirosis through Microscopic Agglutination Test (MAT) (n = 43; 47%), Polymerase Chain Reaction (PCR) (n = 63; 68%) or both MAT and PCR (n = 14; 15%). The infecting Leptospira spp., determined by partial 16S rDNA (rrs) gene sequencing revealed two pathogenic species namely Leptospira interrogans (n = 44, 70%) and Leptospira kirschneri (n = 17, 27%) and one intermediate species Leptospira wolffii (n = 2, 3%). Multilocus sequence typing (MLST) identified an isolate of L. interrogans as a novel sequence type (ST 265), suggesting that this human-infecting strain has a unique genetic profile different from similar species isolated from rodents so far. CONCLUSIONS/SIGNIFICANCE:Leptospira interrogans and Leptospira kirschneri were identified as the dominant Leptospira species causing human leptospirosis in Central Malaysia. The existence of novel clinically important ST 265 (infecting human), that is different from rodent L. interrogans strains cautions reservoir(s) of these Leptospira lineages are yet to be identified.