A systematic review and meta-analysis of the epidemiology of Leptospirosis in HIV uninfected and in people living with HIV from the Southern African Development Community

BackgroundLeptospirosis is an occupational, neglected febrile disease of bacterial origin transmitted between humans and animals. In this manuscript we summarize available data onLeptospirainfection in HIV uninfected and in people living with HIV from the Southern African Development Community (SADC) countries, identifying gaps in knowledge and recommend future research priorities.MethodologyArticles published between 1990 and 2021 were accessed by an online search of Google Scholar and Medline/PubMed performed between February 2020 and July 2022. The STATA program was used for the Meta-analysis. Pooled prevalence values with 95% confidence intervals and heterogeneity were determined.ResultsThirty studies from eight SADC countries, reporting the prevalence onLeptospirawere reviewed. A pooled prevalence of 19% (CI: 13–25%), a heterogeneity level of 96% and index score ranging from 2 to 9 was determined. Only four (4) studies reported HIV co-infection status. Three species ofLeptospira(Leptospira interrogans(4),L.kirschneri(3),Leptospira borgpetersenii(1) and 23 serogroups were identified. The most frequently reported serogroups were Icterohaemorrhagiae (13), Grippotyphosa and Australis (10) followed by Sejroe (8).ConclusionStudies on human leptospirosis in the SADC region are scarce, especially in people living with HIV. Additional studies aimed at determining the prevalence and the role of the pathogen in people living with HIV, including detailed clinical, molecular and demographic data are recommended.